AudIT
a project sponsored by
A Presentation of the
Coding Software Tool
and Project Outcomes
AudIT
a project sponsored by
Project BackgroundPHAQ represents 64% of Queensland private hospitals
The PHAQ Health Information Manager Network was re-established in 2004 with 21 active members
The high priority for members was to conduct their own internal clinical coding audits
A clinical coding audit tool had been developed by PHAQ in 1997
Outcome: Re-develop the initial audit tool to meet today’s clinical coding audit requirements
AudIT
a project sponsored by
A Needs Survey showed . . .
A survey of Queensland private hospital HIMs and Health Executives revealed:
o No standard audit methodologies, manual sampling, no linked casemix funding rules to auditing processes
o Access to coding audit expertises varies greatlyo Few suitable tools for audit sampling, audit data entry,
classification of coding errors, analysis and reportingo A strong desire for benchmarking of coding audit results
between private hospitalso Health Executives want to demonstrate to health funds
that regular coding audits are occurring
AudIT
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Creating a Workflow
AudIT operates from a a series of simple workflow steps.
Each workflow is assigned a name.
Each step is shown in red, once completed.
AudIT
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Import Data Extracts
An HCP file format is the initial data extract for AudIT
HCP Plus allows users to quickly import and use additional hospital-specific information:
Future extensions are planned to extend the importing options for State Morbidity Extract Formats
· Unit Record Number · Doctor · Specialty · Ward · Coder
AudIT begins by importing standard pre-defined and user-defined data sets
AudIT
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Selecting Audit Type
Open AudITs display all previous codes and associated information to the Auditor.
Blind AudITs only display the summary episode information
AudIT
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Selecting AudIT Criteria
At the heart of AudIT is a random selection engine for discharge sampling
Many different filters can be applied to alter the profile of records selected.
The Future:AudIT will include the wide-scale expansion of these filters. Common casemix funding rules and references will be included.
AudIT
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Performing the AudIT
Diagnostic and procedural codes can managed separately or displayed together.
Each record selected can be re-examined using (by the Undo Complete Button)
A single data entry screen is maintained for ease of use.
AudIT
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Performing the AudIT
Additional features:Pre and post AudIT DRGs are displayed
An enhancement will soon extend the automatic grouping feature to this screen
Open AudITs:
Each and every change has an associated reason and cause
Errors are tracked code by code
AudIT Continuing Australian Coding Standards
Discrepancy Causes
Coder Error
System Error
Local Coding Policy
Late Information
Unclear Documentation
A data standard for external morbidity coding errors in the AudIT User Network.
Error Statistics derived from agreed definitions.
Discrepancy Reasons
Incorrect PDx Sequencing
Incorrect PDx Coding
Incorrect PDx Selection
Incorrect Additional Dx
Missing Dx Code
Unjustified Additional Dx Code (non-optional)
Incorrect Additional Dx (4th or 5th character)
Incorrect Px Code
Missing Px Code
AudIT
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Grouping the ResultsAudIT has an interface with the 3M Grouper
The user can determine which version of the 3M Grouper to use for each audit
Viewing of the pre and post audit DRGs is flexible as shown on the previous slide
Grouping within AudIT enables reports to be based on DRG changes
AudIT Entering Reports
Accessing the Reporting Suite
Once all data entry is completed the workflow menu is used to generate the reporting suite
AudIT
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Analysis and Reporting
The Suite of Error Summary Reports are generated from a similar set of filters to theSelection Sampling Engine
AudIT
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New TechnologiesAudIT has been built in part using a data-point technology called Perfect Data.
Contact John Dowling (0407 099 071) for further details.
What our Beta Sites said . . . “AudIT is an easy to use, flexible product that enables coding audits to be conducted and managed according to industry best practice with excellent reporting capabilities. AudIT will make our coding audit process more efficient and effective" Sallyanne Wissmann, Manager Clinical Coding Services,Mater Health Services Brisbane.
May 2005
AudIT
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Affordable Pricing
$790 per hospital < 150 beds (annual subscription)
Annual $990 per hospital > 150 beds (annual subscription)
Discounts for State or Group purchases by negotiation
Project-specific (sample size) subscription pricing models
AudIT
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For Hospital ExecutivesThe Reporting Suite clearly shows the revenue impacts of coding quality changes
Reasonably priced, cost-effective
AdvantagesFor Coders
Able to have multiple unfinished audits at one time
Easy sampling, data entry and suited to multi-campus auditing
Workflows designed by HIMs and Clinical Coders
AudIT
a project sponsored by
The FutureRollout throughout PHAQ member hospitals
As an intranet or secure internet product (2006)Expanding the user base (in addition to PHAQ hospitals)
National marketing
User forums and input into internet/intranet design
Including state-based import formats
Refinement and customisation of Report Suites
As a workflow – fully customisable “author” controls
On-line benchmarking
AudIT
a project sponsored by
For more information contact:
Lucy Fisher
Executive Director
PHAQ
(07) 3279 7600