Enhancing the NSW Health Clinical Coding and HIM Workforce

Enhancing the NSW HealthClinical Coding and HIM WorkforceAnita JacobsenNSW Health Education and Training Institute (HETI)30 October 2012HEALTH EDUCATION &TRAINING INSTITUTE

HETI• Legally established on 2 April 2012• Leads, coordinates and advocates for quality educationand training for the NSW public health system• One of 4 Pillars for Health Reform• working with the Clinical Excellence Commission, Agency forClinical Innovation and the Bureau of Health Information• Works closely with the other Pillars to ensure synergiesand close alignment of activities.HEALTH EDUCATION &TRAINING INSTITUTE

HETI’s Vision…“A world class NSW Healthworkforce supporting excellentpatient centred care.”HEALTH EDUCATION &TRAINING INSTITUTE

HETI’s Mission…‘HETI pursues excellence in healtheducation and training and workforcecapability to improve the health of patientsand the working lives of NSW Health staff’HEALTH EDUCATION &TRAINING INSTITUTE

Clinical Coding Workforce Enhancement(CCWE) Project - Background• NSW Health – research and consultation dates back to 2009,project proposal endorsed in 2011• Responding to New Government priorities Health and Hospital Workforce Reforms Introduction of Activity Based Funding (July 2012)• Clinical coding workforce needs Current and projected shortfall (AIHW, 2010) Hospital separations increasing• Challenge of achieving a balance between quality & timelinessin clinical coding• Technological developments (e-health reforms & e-MR) New skill sets required & new opportunities (remote coding)HEALTH EDUCATION &TRAINING INSTITUTE

Clinical Coding Workforce Census• Data collection to guide the implementation of theClinical Coding Workforce Enhancement strategies• 1 July – 30 September 2011 NSW Local Health Districts (LHDs) and 3 specialtyNetworks provided information on:• Clinical coding workforce profiles• Vacancies• Positions above establishmentHEALTH EDUCATION &TRAINING INSTITUTE

Health Information ServicesWorkforce ProfilePositionHealthInformationManagerCodingManagerAdmin/CodersClinicalCodersGrandTotalNSW Health Employee HeadcountF/T P/T Temp Casual Total % FilledFTEFTEVacantFTETotalFTE16 10 1 27 7.8 9.5 2.0 11.513 13 3.8 11.8 4.0 15.819 2 21 6.1 5.3 5.3132 129 3 19 283 82.3 206.4 33.0 239.4180 141 3 20 344 100 233.0 39.0 272.0HEALTH EDUCATION &TRAINING INSTITUTE

Coding QualificationsHEALTH EDUCATION &TRAINING INSTITUTE

Project objective: Enhancing the NSWHealth Clinical Coder & HIM WorkforceHEALTH EDUCATION &TRAINING INSTITUTE

Clinical Coding Workforce EnhancementProject development approachHEALTH EDUCATION &TRAINING INSTITUTE

Clinical Coding Workforce EnhancementProject Governance StructuresHEALTH EDUCATION &TRAINING INSTITUTE

Strategy 1: Recognise and develop theskills of existing clinical coding staffHealth information service staff were invited to enrol inHLT43212 Certificate IV in Health Administrationwhich consists of:• 5 core units of competency; and• 10 elective units of competency, including‣ HLTCC401B Undertake complex clinical coding‣ HLTCC402B Complete highly complex clinical coding (ifappropriate)‣ 8 or 9 other units aligned to the work role.HEALTH EDUCATION &TRAINING INSTITUTE

Strategy 1: Recognise and develop theskills of existing clinical coding staff• Education provider – NSW Health RTO• Partnership with HIMAA – for units ofcompetency aligned to technical functions: Recognition of current competence License to use learning and assessment resources• 3 FTE Trainers with significant experience inHealth Information Management and ClinicalCodingHEALTH EDUCATION &TRAINING INSTITUTE

Enrolments - approximately 130LHD/Network LHD/Network LHD/NetworkAlbury Wodonga 2 Mid North Coast 1 Southern NSW 10Central Coast 5 Nepean BlueMountainsHEALTH EDUCATION &TRAINING INSTITUTE5 St Vincent’s 2Far West 2 Northern NSW 8 South WesternSydneyHunter NewEnglandIllawarraShoalhaven27 Northern Sydney 9 Sydney 76 SydneyChildren’sWestmeadMurrumbidgee 4 South EasternSydney106 Western NSW 79 Western Sydney 8

Training needs of existing workersHEALTH EDUCATION &TRAINING INSTITUTE

Challenges thus far…• Difficult to schedule courses as numbers not knownbefore recognition• Statewide scope reaching out to all equally and fairly different levels and types of clinical coding experience• Resourcing e.g. Trainer recruitment• Staffing difficulties; restrictions in releasing staff toattend training activitiesHEALTH EDUCATION &TRAINING INSTITUTE

Positive observations thus far…• ABF providing opportunities for much-neededpromotion of the profession Shined a light – highlighted issues• Unique opportunity for professional recognition anddevelopment• Free training!• High level of enthusiasm among participants –particularly in relation to the recognition process• Low withdrawal rate – retained with increased flexibility• Ever-increasing interest…HEALTH EDUCATION &TRAINING INSTITUTE

Strategy 2: Recruitment and development tonew entry-level trainee clinical coder positions• Development of consistent state-wide recruitment process Common position description, interview questions & Aptitude test Common recruitment timelines• Most District and Network Chief Executives recently signed offon creation of approximately 30FTE of new 24-month traineepositions across NSW, to commence in February 2013 Some big wins for districts creating positions aboveestablishment Some to participate through recruiting to existing vacancies Some unable to participate due to various pressures, hoping tobe in a position to do so in 2014.HEALTH EDUCATION &TRAINING INSTITUTE

Strategy 2:Next step Recruitment• Districts and networks currently preparing toadvertise new trainee roles• Roles to be advertised from 14-28 November viahttp://www7.health.nsw.gov.au/healthjobs/• Selection process to be completed with preferredapplicants notified before Christmas• New trainee clinical coders to commence employmentand training in February 2013.HEALTH EDUCATION &TRAINING INSTITUTE

Strategy 2: Skills development(Training... and recognition!)HLT32912 Certificate III in Health Administration•BSBMED301B Interpret and apply medical terminologyappropriately•HLTCC301B Produce coded clinical data•Other units of competency – general health perspective•Two year program, generally as follows:‣ Months 1-6: Medical Terminology and general health workfunctions‣ Months 7-12: Introductory Clinical Coding Unit (theory)‣ Months 13-24: Practice clinical coding in the workplace (undersupervision)HEALTH EDUCATION &TRAINING INSTITUTE

Strategy 2: Funding support• NSW Ministry of Health / HETI Funding the education component through the RTO One off contribution towards new trainee salary for allpositions created above the current clinical codingestablishment Locally-based Clinical Coding Coach positions – Funded at 0.2FTE per Trainee FTE, at MRM1 award (Senior Clinical Coder)• To support the trainee and minimise pressure on the workplace• Commonwealth traineeship financial assistance Employer incentives for LHDs/Networks In some cases, funding to the NSW Health RTO Allowances to traineesHEALTH EDUCATION &TRAINING INSTITUTE

Strategy 2: Delivery methods• Program plans currently being developed by NSWHealth RTO Training Team• Combination of delivery methods (face-to-face,distance learning, online) to suit the diverse needs ofparticipants• Will include on-the-job training component – supportedby local coaches• Flexibility required for project success Flexibility: a feature of the VET systemHEALTH EDUCATION &TRAINING INSTITUTE

Strategy 3:Increasing the NSW Health HIM Workforce• Recognised the current absence of an HIM degree in NSW Threat to ongoing NSW HIM workforce viability• Encouraging NSW Health employees to consider a career as aHealth Information Manager• Identified industry needs: Multiple pathways into HIM careers Recruitment difficulties in regional/rural areas Increased visibility of HIM career opportunities Education models – supported delivery via distance education• Potential qualifications for 2013 scholarship program‣ BSc (HIM) – Curtin University‣ Master in HIM – Curtin UniversityHEALTH EDUCATION &TRAINING INSTITUTE

Strategy 3 – Supporting NSW Healthemployees to develop towards HIM rolesHEALTH EDUCATION &TRAINING INSTITUTE

Strategy 3 – Qualifications to supportmultiple entry pointsHEALTH EDUCATION &TRAINING INSTITUTE

Strategy 3 - Meeting industry needsthrough consultation• Process: make the most of the investment through acustomised application and selection process Districts and networks to support applications Selection panel, interview process, references...• Rough timeframes (TBC): Early 2013: Development of process March-May: Application and selection process July: First cohort of scholarship recipients to commence• Scholarships to be administered through establishedHETI and University scholarship processes.HEALTH EDUCATION &TRAINING INSTITUTE

Evaluation and future considerations• Sustainability – continue to support our ClinicalCoding and HIM workforces Project --> Program: planning for sustainability• Evaluation of training & workforce outcomes Overall impact – quality improvement indicators Evaluation of the project process• Training to full qualifications to remain on the NSWHealth RTO’s scope of delivery• Aim: To source ongoing funding to continue to deliveroutcomes for the workforce.HEALTH EDUCATION &TRAINING INSTITUTE

HEALTH EDUCATION &TRAINING INSTITUTE

For more information…Anita JacobsenSenior Program Officer, State-wide Educationajacobsen@heti.nsw.gov.au or 02 9844 6523Maria StephanouClinical Coding Training Coordinator, NSW Health RTOMaria.stephanou@sswahs.nsw.gov.au or 02 8755 3513HEALTH EDUCATION &TRAINING INSTITUTE