Transcript Lucrative Liaisons: Coder -Clinician liaison

Innovation Poster Session
HRT1215 – Innovation Awards
Sydney
11th and 12th Oct 2012
Lucrative Liaisons: CoderClinician Liaison Database
Presenter: James Muller
Royal Brisbane and Womens Hospital
The Health Roundtable
4-4c_HRT1215-Session_MULLER_RoyalBRIS_QLD
1
KEY PROBLEM






Poor communication and liaison between coding and clinical
staff
Inadequate recording and suspected under-reporting of
coder-clinician liaison, and the benefits achieved
No formal mechanism for timely follow-up of unresolved
queries
Reluctance from coding staff to undertake a coder-clinician
query
No ability to collect statistics on specific areas of deficient
documentation for use in clinician education programs
ACHS recommendation
The Health Roundtable
2
AIM OF THIS INNOVATION







Standardise the reporting and capture of CCL queries
Monitor the initiation and completion of CCL queries
Provide a standard template for generating CCL queries
Feedback cost gains obtained through CCLs
Provide information back to individual units / clinicians
regarding their assistance with CCL queries
Collect information on areas producing deficient clinical
documentation
Maximise coding allocation, and thus hospital funding, through
clarification of clinical documentation
The Health Roundtable
3
BASELINE DATA
CCL Queries
60
# of Queries
50
40
30
20
Month
• No consistency from month to month
• Low rate of queries compared with facility size
• Inability to determine exact number of less formal CCL queries
• No indication of revenue through CCL process
The Health Roundtable
4
Mar-11
Feb-11
Jan-11
Dec-10
Nov-10
Oct-10
Sep-10
Aug-10
Jul-10
Jun-10
Apr-10
0
May-10
10
KEY CHANGES IMPLEMENTED

Development and implementation of a CCL Database with
the following features:







An interactive Coder-Clinician Liaison form
Links to data exported from HBCIS (Patient Administration
System) to minimise data entry required by coding staff
Collection of information including break-down of query types,
method of contact, etc.
Ability to print a completed CCL form within the system
Reporting functionality, including number of unresolved queries
per coder / clinical unit, break-down of types of queries, etc.
Ability to easily update CCL details as required
The database went live in April 2011
The Health Roundtable
5
KEY CHANGES IMPLEMENTED
The Health Roundtable
6
$0.00
The Health Roundtable
Aug-12
Jul-12
Jun-12
May-12
Month
7
Aug-12
Jul-12
Jun-12
May-12
Apr-12
Mar-12
Feb-12
Jan-12
Dec-11
Nov-11
Oct-11
Sep-11
Aug-11
Jul-11
Jun-11
140
May-11
Apr-11
Mar-11
Feb-11
Jan-11
Dec-10
Nov-10
Oct-10
Sep-10
# of Queries
160
Apr-12
Mar-12
Feb-12
Aug-10
Jul-10
Jun-10
May-10
Apr-10
0
Jan-12
$
OUTCOMES SO FAR
CCL Queries
200
180
Database Go-Live
120
100
80
60
40
20
Month
CCL Revenue
$700,000.00
$600,000.00
$500,000.00
$400,000.00
$300,000.00
$200,000.00
$100,000.00
LESSONS LEARNT




Coder-clinician liaison is extremely valuable
Standardisation is important
Technology must make the process more efficient and
not be a burden to use
Clinical staff and coding staff like to see the ‘results’ from
their liaison (e.g. how much revenue they have
generated)
Dr T
“Interns would really benefit
from more education on
documentation requirements for
coding.”
The Health Roundtable
Dr L
“This was a $12,000
20 minute
conversation!”
Dr H
“The money made from this
conversation could pay for all
my medical overtime.”
8