Private Hospital Data Collection Review Final Report

4. Recommended implementation plan

Private Hospital Data Collection Review - Final Report

Page last updated: 14 June 2012

      This chapter summarises the implementation plan necessary to deliver the recommendations made in this report.

      4.1   Private hospital data collection streamlining

      This section summarises the milestones and broad timeline required to deliver on the streamlining recommendations made by this Review.

      This is not intended to be a detailed project plan for each recommendation, but is intended to indicate the major steps and likely timing required.

      4.1.1   Transfer of PHEC from ABS to AIHW

      Recommendation:
      That the responsibility for the Private Health Establishments Collection be transferred to the Australian Institute of Health and Welfare.
      Activity or Milestone Key agents Milestone timing
      Establish minimum service standards for transfer to be considered successful. ABS, AIHW, DoHA, PHWG
      Analyse current situation and probability of minimum requirements being met, including prerequisites for achieving success. ABS, AIHW, DoHA, PHWG
      Assess costs of achieving the transfer and ongoing costs of PHEC under AIHW's auspice.
      Agree to funding arrangements and develop budget bids.
      Develop project plan for transfer. ABS, AIHW, PHWG
      Agreed project plan for transfer of PHEC, including timetable for final transfer. February/March 2012
      Implement project plan.
      Likely activities would include: developing service agreements (MoUs or similar for information sharing between ABS and AIHW), developing/adapting forms and procedures, communicating with private hospitals on plans and progress.
      PHEC transfer to AIHW completed. June 2014

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      4.1.2   PHDB, HCP and APC data collection

      Recommendation:
      That CSV file format with field names in the first record be adopted as the standard file format for PHDB and HCP files. This recommendation covers all HCP files, including HCP1, HCP2 and AN-SNAP.
      Activity or Milestone Agents Milestone timing
      Consider timing issues (including whether to wait for updates to HCP specification and PHDB specification). HCPWG, PHWG, DoHA
      Agreed timetable for implementing CSV format for HCP and PHDB. October 2011
      Inform private hospitals and insurers of plans and timetable for changes to HCP and PHDB specifications. DoHA, HCPWG, PHWG
      Inform public hospitals (States and Territories) of intentions to change HCP format specification and timetable. DoHA, HCPWG, PHWG
      Update DoHA procedures for accepting HCP and PHDB data to conform to the new file formats. DoHA, HCPWG, PHWG
      Implement new CSV file formats for HCP and for PHDB.
      At this point, implementation may be partial with some private hospitals continuing to submit data using the current file format. In reality, implementation will need to be phased in over a period of 6 to 12 months. June 2012

      Recommendation:
      That jurisdictions and private hospitals be approached to undertake a pilot test of a process for effecting a common file format for those data fields common to PHDB, HCP and the APC NMDS.
      Activity or Milestone Agents Milestone timing
      Raise proposal with States and Territories, probably through NHISSC. DoHA, NHISSC
      In-principle agreement with at least one jurisdiction(s). December 2011
      Negotiate with interested jurisdiction(s), including scope and objectives of the pilot, governance and funding arrangements. DoHA, Jurisdiction(s)
      Agreed scope and objectives and operating parameters for the pilot with a jurisdiction(s). April 2012
      Identify candidate private hospitals or private hospital operators to invite into the pilot. DoHA, Jurisdictional Partner(s), PHWG
      In-principle agreement for involvement from private hospitals. July 2012
      Negotiate with interested hospitals the operating parameters for their involvement. DoHA, Jurisdictional partner(s), Hospitals
      Agreed operating parameters and governance arrangements with partner hospitals. December 2012
      Develop file specifications, procedures and other operating requirements. DoHA, Jurisdictional partner(s), Hospitals, PHWG, HCPWG
      Implement procedures. DoHA, Jurisdictional partner(s), Hospitals
      Assess results of pilot. DoHA, Jurisdictional partner(s), Hospitals
      Report outcome of pilot test to NHISSC, HCPWG and PHWG. June 2013

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      Recommendation:
      That, subject to the above pilot succeeding, the successful model for common specification of common fields be rolled out to all private hospitals and all jurisdictions.
      Activity or Milestone Agents Milestone timing
      Use learning from pilot to develop the preferred model for the new data transfer process, taking into account any recent changes in APC, PHDB and HCP specifications. DoHA, Partner jurisdiction(s), Partner hospitals
      Use learning from pilot to develop a preferred method for a jurisdiction and its private hospitals to move to the new process. DoHA, Partner jurisdiction(s), Partner hospitals
      Identify pre requisites for successful transition and assess current state for each jurisdictions. DoHA, Partner jurisdiction(s), Partner hospitals
      Use results of above work to identify a preferred order for rolling out the new process to jurisdictions. DoHA, HCPWG, PHWG, NHISSC
      Negotiate with States and Territories to agree to move to the new process. DoHA, HCPWG, PHWG, NHISSC
      Agreed plan to roll out the new process to all jurisdictions and private hospitals. June 2013
      Rollout completed. June 2015

      4.1.3   Governance of national data development activities

      Recommendation:
      That the health insurance industry formally seek membership of NHISSC as an observer. This could be either as a permanent (observer) member or on an occasional basis, when issues specific to health insurers are to be considered.
      Activity or Milestone Agents Milestone timing
      Determine the most suitable form of representation for the industry (e.g., selected HCP member, selected insurer, industry representative body). HCPWG
      Write to Chair of NHISSC. December 2011

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      Recommendation:
      That PHWG and HCPWG meet together at least once per year to discuss data related issues. This meeting should take place in the December quarter, to allow sufficient time for issues requiring implementation in the following financial year to be identified and considered.
      Activity or Milestone Agents Milestone timing
      Consider primary objectives of a joint meeting, need for business rules and timing. PHWG, HCPWG, DoHA
      Agreed format, business rules and timing for annual joint meeting. December 2011
      First joint meeting (items for discussion to include NHISSC private sector impact assessment protocol and protocol for regular communication between HCP and PHWG). February/March 2012

      Recommendation:
      That NHISSC be asked to develop a formal protocol for assessing business and related impacts of proposed changes to APC NMDS data items and associated metadata on the private hospital and health insurance sector.
      Activity or Milestone Agents Milestone timing
      Consider needs of private sector (item for discussion at joint HCPWG/PHWG meeting). PHWG, HCPWG, DoHA
      Draft terms of reference for such a protocol. March 2012
      Put issue onto NHISSC agenda, with draft protocol as basis for discussion. Private hospitals' representative on NHISSC
      NHISSC agrees to final protocol. June 2012

      4.1.4   Making ECLIPSE capable of transmitting HCP data

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      Recommendation:
      That the ECLIPSE record specification be updated to permit transmission of HCP data according to the current HCP specification.
      Activity or Milestone Agents Milestone timing
      DoHA enter into negotiations with Medicare Australia (DHS). DoHA, DHS
      Agreed cost and process for effecting changes.
      It must be noted that budget timetables may affect this timing. December 2011
      Investigate feasibility issues. DoHA, DHS
      Consider timing issues (including whether to wait for updates to HCP specification, ECLIPSE change schedule). DoHA, DHS, HCPWG
      Agreed timetable for update and release of HCP capable ECLIPSE. May 2012
      Inform private hospitals and insurers of plans and timetable for HCP capable ECLIPSE. DoHA, HCPWG, PHWG
      Inform public hospitals (States and Territories) of intentions to change and opportunity available to provide full HCP data if they happen to use ECLIPSE for lodging claims. DoHA
      Software updates according to timetable. DHS
      Release of HCP capable ECLIPSE. June 2012

      Recommendation:
      That the ECLIPSE record specification thereafter be maintained to ensure its capability to transmit HCP data remains current.
      Activity or Milestone Agents Milestone timing
      DoHA enter into negotiations with Medicare Australia (DHS). DoHA, DHS
      Agreed terms of ongoing arrangement. March 2012
      Annual review of HCP requirements within ECLIPSE. DoHA, HCPWG, PHWG
      Annual review of value of HCP capability within ECLIPSE. DoHA, HCPWG, PHWG
      Determination of need for annual update of ECLIPSE or not. September of the relevant year (2013 onwards)

      4.2 Private hospital and public hospital comparability

      This section summarises the milestones and broad timeline required to deliver on the comparability recommendations made by this Review.

      This is not intended to be a detailed project plan for each recommendation, but is intended to indicate the major steps and likely timing required.

      4.2.1   Linkage of APC episodes’ data and insurance claims’ data

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      Recommendation:
      Investigate the feasibility of conducting a data linking exercise between a jurisdictional health department and insurers for improved HCP information.
      Activity or Milestone Agents Milestone timing
      Develop a detailed project plan. This will include developing a data set specification for use in a data linkage process. DoHA, HCPWG December 2011
      Arrange meeting with private health insurer to outline project and obtain participation consent. Provide the data set specification with the identifiers that will be required. Insurer to provide a sample dataset to use in linkage process. DoHA, Insurers February 2012
      Arrange meeting with State and Territory Health Departments. Organise to have data custodians and data linkage representatives from a jurisdictional health department. Specify the identifiers that will be supplied to the jurisdictional health department. DoHA, States February 2012
      Establish governance arrangements and data management protocols. DoHA, Insurer, Jurisdiction
      Commence data exchange, linkage and analysis. Project team May 2012
      Finalise data linkage exercise and prepare report. Identify issues and how process might work on larger scale. July 2012
      Consider pilot results. DoHA, HCPWG, Jurisdiction
      Commence work on expanding beyond pilot to including all insurers that have members attending public hospitals in the jurisdiction. DoHA, HCPWG, Jurisdiction
      Identify data specification for insurers to submit data to pilot jurisdiction health department. HCPWG
      Link all privately insured patient stays in public hospitals within jurisdiction to all of the insurers’ members’ claims for public hospital stays in that jurisdiction. Jurisdiction
      Report and consider expanded pilot results. DoHA, HCPWG, Jurisdiction March 2013
      Commence work of rolling out pilot to other jurisdictions. DoHA, HCPWG, Jurisdictions July 2013

      4.2.2   NHCDC Experimental estimates’ reports

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      Recommendation:
      Undertake increased analysis of NHCDC information and develop a series of “experimental estimates” reports.
      Activity or Milestone Agents Milestone timing
      Determine specific areas to use for first experimentalestimates. DoHA, PHWG
      Develop draft reports for each of the selected areas. DoHA May 2012
      Consider drafts and make decisions regarding release. DoHA, PHWG
      Release report(s) for feedback and comment. DoHA August 2012
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      4.3   The authoritative list of private hospitals

      As discussed in Section 3.3, this term of reference has been overtaken by recent events relating to the national health reforms. Accordingly, although this review considered recommendations relating to this term of reference, the Department has advised that those recommendations are no longer required.

      Given this fact, no timelines nor milestones are included here.

      4.4   The consolidated implementation timetable

      Table 12 summarises the timetables in the preceding sections and provides an overview of the milestones and their timing for each of the recommended areas of streamlining and comparability improvement.

      This consolidated timeline is also summarised in Appendix E. This consolidation makes it clear that there is a significant workload involved in order to implement the full range of recommendations. Much of this workload falls to a few key actors. Principally, these are the Department, the PHWG and the HCPWG.

      The ability to deliver on the recommended timetable is likely to be constrained by availability of adequate resources among these key actors. As such, this timetable may require revision as time progresses. Progress against the timetable should be reviewed regularly and milestones revised as necessary.

      It must also be noted that the arena of hospital data collection and reporting is dynamic and more so at present, with the changes demanded by the recently agreed national health reforms. This fact is underlined by the supersession, by the establishment of the NHPA, of this Review’s term of reference relating to an authoritative list of private hospitals.

      In light of this fluidity of environment, the recommendations of this Review and associated implementation plans should be routinely monitored and modified as circumstances change.

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      Table 12 Implementation plan milestones and their timing.

      Recommendation Milestone Timing
      CSV format for PHDB and HCP Agreed timetable for implementing CSV format for HCP and PHDB. October 2011
      HCP capable ECLIPSE Agreed cost and process for effecting ECLIPSE changes. December 2011
      Health insurers and NHISSC Write to Chair of NHISSC. December 2011
      Joint HCPWG/PHWG meetings Agreed format, business rules and timing for annual PHWG/HCPWG joint meeting. December 2011
      Pilot of new data transfer process In-principle agreement with at least one jurisdiction. December 2011
      HCP data linkage for public hospitals Develop a detailed project plan. This will include developing a data set specification for use in a data linkage process. December 2011
      HCP data linkage for public hospitals Arrange meeting with private health insurer to outline project and obtain participation consent. Provide the data set specification with the identifiers that will be required. Insurer to provide a sample dataset to use in linkage process. February 2012
      HCP data linkage for public hospitals Arrange meeting with State and Territory Health Departments. Organise to have data custodians and data linkage representatives from a jurisdictional department. Specify the identifiers that will be supplied to the jurisdictional department. February 2012
      Joint HCPWG/PHWG meetings First PHWG/HCPWG joint meeting (items for discussion to include NHISSC private sector impact assessment protocol and protocol for regular communication between HCP and PHWG). February/March 2012
      PHEC transfer Agreed project plan for transfer of PHEC, including timetable for final transfer. February/March 2012
      HCP capable ECLIPSE Agreed terms of ongoing arrangement. March 2012
      Private hospital impact assessment protocol Draft terms of reference for a protocol. March 2012
      Pilot of new data transfer process Agreed scope and objectives and operating parameters for the pilot with a jurisdiction(s). April 2012
      NHCDC experimental estimates Develop draft reports for each of the selected areas. May 2012
      HCP capable ECLIPSE Agreed timetable for update and release of HCP capable ECLIPSE. May 2012
      HCP data linkage for public hospitals Commence data exchange, linkage and analysis. May 2012
      CSV format for PHDB and HCP Implement new CSV file formats for HCP and for PHDB. June 2012
      HCP capable ECLIPSE Release of HCP capable ECLIPSE. June 2012
      Private hospital impact assessment protocol NHISSC agrees to final protocol. June 2012
      Pilot of new data transfer process In-principle agreement for involvement from private hospitals. July 2012
      HCP data linkage for public hospitals Finalise data linkage exercise and prepare report. Identify issues and how process might work on larger scale. July 2012
      NHCDC experimental estimates Release report(s) for feedback and comment. August 2012
      Pilot of new data transfer process Agreed operating parameters and governance arrangements with partner hospitals. December 2012
      HCP data linkage for public hospitals Report and consider expanded pilot results. March 2013
      Pilot of new data transfer process Report outcome of pilot test to NHISSC, HCPWG and PHWG. June 2013
      Roll out new data transfer process to all jurisdictions Agreed plan to roll out the new process to all jurisdictions and private hospitals. June 2013
      HCP data linkage for public hospitals Commence work of rolling out pilot to other jurisdictions. July 2013
      HCP capable ECLIPSE Determination of need for annual update of ECLIPSE or not. September of the relevant year (2013 onwards)
      PHEC transfer PHEC transfer to AIHW completed. June 2014
      Roll out new data transfer process to all jurisdictions Rollout completed. June 2015
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