Proposals for revisions to the Victorian Admitted Episodes October 2014
Transcription
Proposals for revisions to the Victorian Admitted Episodes October 2014
Proposals for revisions to the Victorian Admitted Episodes Dataset (VAED) for 1 July 2015 October 2014 Department of Health If you would like to receive this publication in an accessible format, please phone (03) 9096 8595 using the National Relay Service 13 36 77 if required, or email: [email protected] This document is available as a PDF on the internet at: www.health.vic.gov.au/hdss © Copyright, State of Victoria, Department of Health, 2014 This publication is copyright, no part may be reproduced by any process except in accordance with the provisions of the Copyright Act 1968. Authorised and published by Victorian Government, 50 Lonsdale Street, Melbourne. Proposals for revisions to the VAED for 1 July 2015 Page i Contents Executive Summary 1 Introduction 2 Assessment of the impact of proposals 3 Proposal 1 – Amendment to reporting guide for Carer Availability 5 Section 3 Data definitions 5 Carer Availability (amended) 5 Section 4 Business rules (tabular) 8 Age, Care Type and Carer Availability and Separation Mode (removed) 8 Section 8 Editing Validation 8 108 Field(s) missing from sep (amended) 8 390 Incompat Care Type, Carer Avail, Age and Sep Mode (amended) 8 421 Not Separated; Carer Avail Present (amended) 8 599 Carer Availability not required (amended) 8 Proposal 02 – Addition of Advance Care Plan Alert 9 Section 3 Data definitions 10 Advanced Care Plan Alert (new) 10 Section 5 Compilation and transmission 11 New Record required 11 Proposal 3 – Addition of Program Identifier code for ABI rehabilitation service 12 Section3 12 Program Identifier (amended) 12 Section 8 Editing Validation 13 648 Invalid Program Identifier (change to function only) 13 651 Program Identifier, campus not approved for program (change to function only) 13 Proposal 4 – Amendment to Separation Referral code set 14 Section 3 Data definitions 15 Separation Referral (amended) 15 Section 8 Editing Validation 17 329 Geri Respite – Invalid Comb (change in function only) 17 388 Sep Referral - Episode not Separated (change in function only) 17 389 Invalid Sep Referral (change in function only) 17 396 Sep Referral, No Refer Plus Other Ref (change in function only) 17 398 Sep Referral, Duplicates (change in function only) 17 Proposal 5 – Not proceeding to consultation 18 Proposal 6 – Amendment to reporting guide for Duration of Stay in Intensive Care Unit 18 Section 2 Concepts and derived items 18 Intensive Care Unit (amended) 18 3 Data definitions 19 Proposals for revisions to the VAED for 1 July 2015 Page ii Duration of Stay in Intensive Care Unit (amended) 19 Proposal 7 – Restrict reporting of Funding Arrangement code 8 National Bowel Cancer Screening Program to designated providers 20 Funding Arrangement (amended) 20 Section 8 Editing Validation 22 108 Field(s) missing from sep (amended) 22 424 Not Separated: Fund Arr S/Be Spaces (removed) 22 ### Funding Arrangement 8, not NBCSP designated provider (new) 22 Proposal 8 – Removal of notifiable validations 23 Section 8 Editing Validation 23 Introduction (amended) 23 061 Married – age not within range (removed) 25 069 Newborn from overseas (amended) 25 080 Sex Indeterminate Age < 90 Days (amended) 25 187 Adm Weight Low (amended) 25 222 Unqual Newborn; Adm Date not Birth (amended) 26 234 Aboriginal/TS Island but not Aust Born (amended) 26 243 Unqual Newborn but Total Days > 9 (amended) 26 289 Adm Sc T’fer & Onset = Adm Date (amended) 27 290 Stat Adm Sc & Onset = Adm Date (amended) 27 324 Incompat ICU Hrs, A/C Class (amended) 28 325 Incompat MV Hrs, A/C Class (amended) 28 358 Area Code Restraint Rare diagnosis or procedure code (amended) 28 403 Qual Newborn W/Out Justificat (amended) 29 406 Rehab Care Type W/Out Rehab PDx (amended) 29 431 Newborn but not Newborn Accom (removed) 29 445 Dt of Accid Incompat W TAC Claim Nbr – Notifiable (amended) 29 448 ICU Stay but Care Type not Acute (amended) 30 465 Adm Duration < 15 Mins (amended) 30 467 Adm Wt <1000g, LOS <28 Days, Sep Mode ≠ T or D (amended) 31 468 Not NHT, LOS > 365 Days (amended) 31 480 Incompat Adm Source/Age <15 (amended) 31 493 Incompat Sep Mode/Age <15 (amended) 32 513 Indigenous Status/Preferred Language Mismatch (amended) 32 532 Account Class MA: not 4, 5E, 5K, 5G, or U (amended) 32 542 MH Acute Adult Care Type but Age < 14 Years (removed) 32 543 MH Acute Adult Care Type but Age > 65 Years (removed) 32 544 MH APMHS Care Type but Age < 55 Years (removed) 32 545 MH CAMHS Care Type but Age < 5 Years (removed) 32 546 MH CAMHS Care Type but Age > 19 Years (removed) 32 547 MH SECU Care Type but Age < 14 Years (removed) 32 548 MH Specialist Acute Care Type but Age < 14 Years (removed) 32 554 Date of Accident > Adm Date (amended) 33 Proposals for revisions to the VAED for 1 July 2015 Page iii 555 Date of Accident < Date of Birth (amended) 33 556 Given Name Unusual Length (removed) 33 557 Surname Unusual Length (removed) 33 573 Postcode Overseas, Account Public (amended) 33 574 Postcode Overseas, Locality RHCA, Acct not RHCA (amended) 33 582 CCU Duration High (amended) 34 583 NIV Duration High (amended) 34 585 Sex Code Intersex (amended) 34 595 Neoplasm Code Missing 34 633 Delivery Episode, Adm Type not M (amended) 35 642 Unqual Newborn but Sep Mode D (amended) 35 643 Maternity episode but Sep Mode D (amended) 35 654 Mother’s UR does not exist in PRS2 database (amended) 36 660 Care Type ≠ 5x, LOS Same Day, Procedure Code 93341-xx, MHSWPI mismatch (amended) 36 661 Care Type ≠ 5x, Procedure Code 93341-xx, LOS ≠ Same Day MHSWPI mismatch (removed) 36 Proposal 9 – Addition of Year of Arrival 37 Section 3 Data definitions 38 Year of Arrival (new) 38 Proposal 10 – Addition of Trial Protocol Number for patients involved in clinical trials 40 Proposal 11 – Amendment to reporting guide for Leave 42 Section 4 Business rules 42 Leave (amended) 42 Transfer Reporting (amended) 44 Proposal 12 – Removal of Contract/Spoke Identifier codes for lithotripsy services 45 Section 3 Data definitions 46 Contract/Spoke Identifier (amended) 46 Section 8 Editing Validations 47 410 Illegal Comb Fund Arrange & Contract (change to function only) 47 419 Invalid Contract/Spoke Identifier (change to function only) 47 Proposal 13 – Removal of Account Class for geriatric respite care 48 Section 2 Concepts and derived items 48 Geriatric Respite (removed) 48 Section 3 Data definitions 48 Account Class (amended) 48 Section 4 Business rules 48 Geriatric Respite (removed) 48 Account Class: Geriatric Respite (removed) 48 Section 8 Editing Validation 48 329 48 Geri Respite – Invalid Comb (removed) Proposal 14 – Amendment to validation 590 Diag Code Prefix M, not Morph 49 Section 8 Editing Validation 49 590 49 Diag Prefix M/, not Morph Code mismatch (amended) Proposals for revisions to the VAED for 1 July 2015 Page iv Proposal 15 – Addition of free text field Clinical Group 50 Section 3 Data definitions 50 Clinical group (new) 50 Proposals for revisions to the VAED for 1 July 2015 Page v Executive Summary Each year the Department of Health reviews the data items and format of the Victorian Admitted Episodes Dataset (VAED). This review seeks to ensure that the admitted patient collection supports the department’s state and national reporting obligations, assists department planning and policy development, and incorporates appropriate feedback from data providers on improvements. This document has been produced to invite comment and stimulate discussion on the proposals outlined below. If you would like to comment on any of the proposals, please see the introduction section on how to do so. In order to be accepted into the VAED proposals need to demonstrate clear business justification and be fully costed, meaning funding streams will need to be identified and confirmed. Final acceptance of all proposals is dependent on the Deputy Secretary, Health Service Performance and Programs (based upon recommendations by the Annual Changes Governance Committee). For further information on the revisions process and timetable contact the HDSS Help Desk on 9096 8595. The proposed revisions for the Victorian Admitted Episodes Dataset (VAED) for 1 July 2015 are summarised below. They include (but are not limited to): Addition of data items • Advance Care Plan Alert, Year of Arrival and Trial protocol number • Clinical Group – free text data item for health services to record either a clinical/discharging unit, doctor code or any other clinical group Amendments to existing data items • Restrict reporting of Carer Availability to episodes with Separation Mode H • New Program Identifier code for ABI rehabilitation services • Amendment to Separation Referral code set including new code for Health Independence Program (HIP) • Amendment to reporting guide for Duration of Stay in ICU to include HDU activity that occurs in ICU • Amendment to reporting guide for Leave so that when a patient is transferred between campuses, report as a transfer even when it is intended that the patient will return to the first campus • Restrict use of Funding Arrangement code 8 National Bowel Cancer Screening Program to designated providers • Removal of lithotripsy service codes from Contract/Spoke Identifier code set • Removal of Account Class MR Geriatric respite care Amendments to validations Proposals for revisions to the VAED for 1 July 2015 Page 1 Introduction The VAED proposals process The proposal document is being distributed to the HDSS Bulletin mailing list and is also available on the HDSS website. It outlines proposals for changes to the VAED as at the time of its release in October 2014. This should not be regarded as a complete list of changes to be made for 2015–16. Items in this publication are not guaranteed to change or to change in the form suggested here; nor does the absence of an item from this publication indicate it will not change from 1 July 2015. Confirmed changes will be published in the document Final specifications for revisions to the VAED for 1 July 2015 expected to be published in December 2014. It is expected that release of these proposals will stimulate discussion within the health industry. Prompt feedback is sought on these proposals. Hospitals and software suppliers should review this document and assess the feasibility of the proposals. All are invited to provide written feedback to the department by completing the proforma available on the HDSS website, and forwarding it to HDSS as indicated by 5.00pm Wednesday 22 October 2014. HDSS web site located at http://www.health.vic.gov.au/hdss Draft status of document This document is not a complete specification of proposed changes to the VAED. Final specifications will be published at a later date and may contain additions, amendments, and/or removal of information in this document. Although changes to edits, business rules and file structures have been included here, they cannot be considered complete or final. Proposals for revisions to the VAED for 1 July 2015 Page 2 Assessment of the impact of proposals Each proposal is assessed against a set of principles designed to assess the impact that implementation of the proposal is likely to have on services, the department, software vendors and data users. The principles reflect best practice and standard information management principles. Each proposal will be assessed using the measures listed in the table below. The assessment and the feedback from stakeholders will be used to determine whether the proposal is accepted for inclusion in the final specifications for changes for 2015–16. Category Measures Scope • The change should be within the scope of the collection. Collectability • The data should already be collected by the service. • There should be value for the service in collecting the data. • Collection of the data should be aligned with normal business processes in the service. Intended Use • It should be legal for the service to collect the data. • Sufficient business justification must be submitted in the proposal. • The change must be consistent with departmental policy. • There should not be a limited time-period for the use of the data. If there is, other avenues of collection should be investigated to ensure this is the most appropriate. Best Practice • The collection of the data should be compliant with relevant standards and policies. If not, specify where non-compliant. Implementation • The proposal must be clearly specified to enable implementation. • It should be technically possible for services and DH to implement without significant issues. Data Quality • There should be a person, unit or organisation identified to monitor quality. • There should be minimal transformation of data required by services to meet reporting requirements. • Reporting of the data should be mandatory for a specified cohort. Consequential impact • The impact on other data already collected, or proposed to collect must be articulated. • There should not be a negative effect on the reputation or integrity of the collection. • Identify any dependencies with other projects or plans. • The impact on time-series data must be quantified. • The impact on reports, extracts or automated processes must be quantified. Cost and collection burden • The effort required to implement and collect should be commensurate with the frequency of the event triggering collection of reportable data. • All options for the collection of this data should be assessed and the most appropriate method and collection selected. Proposals for revisions to the VAED for 1 July 2015 Page 3 Orientation to this document • • • • • New data items are marked as (new) Changes to existing items are highlighted in green. Redundant values and definitions relating to existing items are struck through. Comments relating only to the proposal document [appear in square brackets and italics.] Page numbers representing cross referencing to another section of the VAED manual are represented by hash #. • Validations that are proposed to change are marked when listed as part of a Data Item or after a Validation Table with a * after the validation number. New proposed validations will be shown with a validation number of ###. • The text is divided into the categories of ‘Specification’ and ‘Administration’ as presented in the th Victorian Admitted Episodes Dataset (VAED 24 edition, July 2014). Specification: details the reporting requirements for the item. Administration: provides additional information including the purpose of the collection of the data item and the source of the code set and definitions. Abbreviations ABS Australian Bureau of Statistics ACAS Aged Care Assessment Service ACHI Australian Classification of Health Interventions AIHW Australian Institute of Health and Welfare AIMS Agency Information Management System AR-DRG Australian Refined Diagnosis Related Group DH Department of Health ERC Expenditure Review Committee FIM Functional Independence Measure HDSS Health Data Standards and Systems HITH Hospital In The Home ICD-10-AM International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification ICU Intensive Care Unit NHDD National Health Data Dictionary NICU Neonatal Intensive Care Unit NIV Non-invasive Ventilation NMDS National Minimum Data Set PRS/2 Patient Reporting System, Version 2 SCN Special Care Nursery VAED Victorian Admitted Episodes Dataset VICC Victorian ICD Coding Committee NWAU National Weighted Activity Unit Proposals for revisions to the VAED for 1 July 2015 Page 4 Proposal 1 – Amendment to reporting guide for Carer Availability It is proposed to Restrict reporting of Carer Availability to episodes where the Separation Mode is H Separation to private residence/accommodation Proposed by Western Health Implementation date 1 July 2015 Reason for proposal Currently Carer Availability is required to be reported by public hospitals for all episodes with Care Types 1, P, 6, 8, 9 and MC. However the only valid reporting option for episodes with a Separation Mode other than H Separated to private residence/accommodation is Carer Availability code 1 Carer not needed/not applicable This proposal limits the requirement to report Carer Availability to episodes with Separation Mode H Separated to private residence/accommodation only. Details of change • Amendment to Carer Availability reporting guide • Amendment to validations Section 3 Data definitions Carer Availability (amended) Specification Definition A record of whether a person, such as a family member, friend or neighbour has been identified as providing regular on-going care or assistance, not linked to a formal service. Data type Numeric Text Form Code Field size 1 Layout N or space Location Episode Record Reported by Public hospitals. Private hospitals: Report a space in this field. Reported for Episodes with a Care Type of 1, P, 6, 8, 9 and or MC and Separation Mode is H Separation to private residence/accommodation. For all other Care Types and Separation Modes, report a space in this field. Reported when A Separation Date is reported in the Episode Record. Proposals for revisions to the VAED for 1 July 2015 Page 5 Code set Reporting Guide Code Descriptor 1 2 3 4 5 6 7 8 Carer not needed/not applicable Lives alone, has a carer Lives alone, has no carer Lives with another, has no carer Lives with another, has a resident carer Lives with another, has a non-resident carer Lives in a mutually dependent situation Missing or not recorded Support provided by a carer excludes (for VAED purposes) formal services such as delivered meals or home help, persons arranged by formal services such as volunteers, and funded group housing or similar services. Availability infers carer willingness and ability to undertake the caring role and can apply when there are several carers. Where a potential carer is not prepared to undertake the role, or when their capacity to carry out necessary tasks is minimal, then the patient must be reported as not having an informal carer. Where there are several carers, a decision should be taken as to which of these is the main or primary carer and report accordingly. 1 Carer not needed/not applicable Person able to self-care and/or their therapeutic regime does not require the input of an informal carer, or reporting in this field is not applicable because this is a statistical separation, or the patient has been transferred to another hospital, left against medical advice or died. Includes: • Those circumstances where it may be inappropriate for a carer at home to undertake a complex medical procedure requiring a high level of nursing skill. • Person who is discharged to supported accommodation or other care facility that will provide the formal care required. Excludes: • Circumstances where a relative or friend is available but is unwilling or unable to undertake a carer role (report 3 or 4). • Children under eight years of age (report 4, 5 or 6), unless the patient has been statistically separated, transferred to another hospital, left against medical advice or died. 2 Lives alone, has a carer Person lives alone and has an informal carer who is able and willing to attend to the person’s recuperative needs on an ongoing basis. 3 Lives alone, has no carer Person lives alone and does not have an informal carer willing and/or able to visit for the purpose of assisting with care on an arranged and regular basis. Proposals for revisions to the VAED for 1 July 2015 Page 6 4 Lives with another, has no carer Person does not live alone but the co-resident/s is/are unable or unwilling to provide the care needed and there is no other external informal carer available. 5 Lives with another, has a resident carer Household where the person lives with another who is willing and able to provide the care required for recuperation. Excludes: Person whose potential co-resident carer is mutually dependent (7). 6 Lives with another, has a non-resident carer Person does not live alone but the co-resident/s is/are unable and/or unwilling to provide the care needed, but there is an external informal carer who is willing and able to provide this care. 7 Lives in a mutually dependent situation Households where the service recipient and another person are mutually dependent. The critical aspect of such households is that if either member becomes unavailable for any reason, the other is either at high risk or unable to remain at home. 8 Missing or not recorded Insufficient information to determine Carer Availability. Edits Validations 108 390 421 491 492 591 599 Related items Section 3: Separation Mode. Field(s) Missing From Sep* Incompat Care Type, Carer Avail, Age and Sep Mode* Not Separated; Carer Avail Present* Incompat Fields for ESAS Incompat Fields for RPI Invalid Carer Availability Carer Availability Not Required* Section 4: Business Rules (tabular) Age, Care Type, Carer Availability and Separation Mode, and Funding Arrangement: Elective Surgery Access Service, and Funding Arrangement: Rural Patients Initiative, and Funding Arrangement: Private Hospital Elective Surgery Initiative. Administration Purpose To enable monitoring of the impact of Carer Availability on separation timing and use of ambulatory services, to support policy development and planning. Principal data users Department of Health Collection start 1999-00 Definition source NHDD Proposals for revisions to the VAED for 1 July 2015 Code set source NHDD (Department of Health modified) Page 7 Section 4 Business rules (tabular) Age, Care Type and Carer Availability and Separation Mode (removed) Section 8 Editing Validation 108 Field(s) missing from sep (amended) Effect REJECTION Problem In the E5 Episode Record, one or more of the Separation fields contain data but one or more mandatory fields are missing. Remedy Check Separation Date, Separation Time, Separation Mode, Account Class on Separation, Accommodation Type on Separation, Mental Health Legal Status, Carer Availability and Funding Arrangement, amend as appropriate and re-transmit the E5. • If episode has ended separated, complete all Separation fields • If episode has not ended not separated, delete data from Separation fields containing data (by sending these fields filled with blanks). 390 Incompat Care Type, Carer Avail, Age and Sep Mode (amended) Effect REJECTION Warning Problem The Public Hospital E5 Episode Record has an invalid combination of Care Type, Carer Availability, Age and Separation Mode. Remedy Check Admission Date, Care Type, Carer Availability, Date of Birth and Separation Mode, amend as appropriate and re-transmit the E5. Refer to: Section 4: Business Rules (tabular) Age, Care Type, Carer Availability and Separation Mode. 421 Not Separated; Carer Avail Present (amended) Effect REJECTION Warning Problem The Public Hospital E5 Episode Record has a Carer Availability, but there is no Separation Date. Remedy Check Carer Availability, Care Type and Separation Date, amend as appropriate and re-transmit the E5. If the episode has ended, complete all separation details. If the episode has not ended, delete the Carer Availability. 599 Carer Availability not required (amended) Effect REJECTION Warning Problem The E5 Episode Record’s Carer Availability is a valid code, but the patient Care Type does not require Carer Availability to be reported Remedy Check Carer Availability and Care Type, amend as appropriate and re-transmit the E5. Proposals for revisions to the VAED for 1 July 2015 Page 8 Proposal 02 – Addition of Advance Care Plan Alert It is proposed to Add a data item to identify the presence of an alert, flag or similar in the medical record or patient management system that indicates an advance care plan and/or substitute decision maker has been recorded. Proposed by Continuing Care, Health Service Programs, Department of Health Implementation date 1 July 2015 Reason for proposal In March 2014 the Victorian Minister for Health launched Advance care planning: have the conversation: A strategy for Victorian health services 20142018 (the Strategy). The strategy outlines how health services are required to demonstrate implementation of the priority action areas over a four year period. This includes measuring the number and percentage of people with an advance care plan (The Strategy, p. 87, priority action 4). The inclusion of an advance care planning alert item in the VAED will support health services to demonstrate an increase in advance care planning activity. A recent survey indicated that many health services are already collecting advance care planning alerts either electronically, paper-based or both. This will further increase as the development of an advance care planning alert is a year 2 requirement for health services (The Strategy, priority action 1, p. 71) Below is a list of further drivers that have resulted in advance care planning being a high priority for health services. The below drivers highlight the importance of advance care plans to the quality provision of care in health services and the expectation that health services ensure that advance care planning is undertaken. As such, it is imperative to be able to measure the extent of implementation of advance care planning. • • • • • • Statement of Priorities (the agreement between the Minister for Health and health services) for two consecutive years: 2013-14 and 2014-15 Endorsement by the Australian Health Ministers Council of the National Framework for Advance Care Directives (2011) Introduction of Activity Based Funding National Health Priorities Framework 2012-2022 – priority to expand models for advanced directives for end-of-life care National Safety and Quality Health Service Standards requiring that services meet advance care planning criteria in order meet accreditation requirements. 2014-15 Policy and funding guidelines – outline advance care planning expectations for the second year Inclusion of the proposed item in the VAED will provide valid, reliable, consistent data on advance care planning that will quantify activity and enable benchmarking across the service system. Details of change • New data item • New record type required Proposals for revisions to the VAED for 1 July 2015 Page 9 Section 3 Data definitions Advanced Care Plan Alert (new) Specification Definition An alert, flag or similar present in the medical record or patient management system that indicates an advance care plan and/or substitute decision maker has been recorded. Field size 1 Location J Record Reported by Public hospitals Reported for All admitted episodes of care Reported when The J Record is reported Code set 1 No advance care plan alert 2 Presence of an advance care plan alert 3 Presence of a substitute decision maker alert 4 Presence of both an advance care plan alert and a substitute decision maker alert Reporting guide Layout N or space An advance care plan alert will be identified by an alert identifying any of the following: • A completed Refusal of Treatment Certificate • A formally documented advance care plan • Other advance care planning documentation (documentation of a person’s future wishes such as a written letter or advance care planning discussion record) * A resuscitation plan, limitation of treatment order or goals of patient care form alone do not meet the requirements for this data item. A substitute decision maker alert will be identified by an alert, flag or similar identifying any of the following: • Enduring power of attorney (medical treatment) • Enduring Power of Guardianship which includes consent to health care. • Guardian appointed by VCAT with powers to consent to health care • Nomination in writing of a person responsible • Identification of the ‘person responsible’ as per the ‘person responsible hierarchy’ Advance care planning: have the conversation: A strategy for Victorian health services 2014-2018 (the Strategy) www.health.vic.gov.au/acp Validations TBA Related items Proposals for revisions to the VAED for 1 July 2015 Page 10 Administration Purpose To provide data on advance care planning that will quantify activity and enable benchmarking across the service system. Principal data users Department of Health Collection start 2015 Definition source DH Value Domain Source DH Section 5 Compilation and transmission New Record required Proposals for revisions to the VAED for 1 July 2015 Page 11 Proposal 3 – Addition of Program Identifier code for ABI rehabilitation service It is proposed to Add a new Program Identifier for Specialist Acquired Brain Injury (ABI) Rehabilitation Service Proposed by Continuing Care, Health Service Programs, Department of Health Implementation date 1 July 2015 Reason for proposal From 2014/15 there will be two centres that provide statewide specialist ABI (Acquired Brain Injury) rehabilitation for Victorians with severe/catastrophic ABI. Due to a new statewide service opening in 2014-15, to assist with statewide service and policy planning the department will need to monitor service utilisation of the two services. Currently health services use the impairment codes for ‘brain dysfunction’ to report patients receiving ABI rehabilitation (specialist and non specialist). Using the ‘brain dysfunction’ impairment codes, it is not possible to separate out those patients being seen by the specialist ABI service as opposed to patients in other non-specialist rehabilitation services. It is proposed to add a program identifier in order to identify those patients being seen in a specialist ABI rehabilitation service. Without the addition of a specific program identifier, it is impossible to determine which separations relate to specialist ABI rehabilitation. Details of change • Amendment to Program Identifier code set • Amendment to validation Section3 Program Identifier (amended) Specification Definition Identifies the specified program, if any, which applies to this episode of care. Data type Alphanumeric Form Code Field size 2 Layout NN or space Location Episode Record Reported by Public and Private Hospitals. Reported for Episodes for patients admitted under a specified Department of Health program. Otherwise, report a space in this field. Reported when An Episode Record is transmitted. Code set Code Descriptor Proposals for revisions to the VAED for 1 July 2015 Page 12 02 04 05 06 07 08 09 Reporting guide 23 Hour Surgery Unit GEM Level 1 Home Birthing Program Competitive Elective Surgery Funding Initiative (CESFI) Program Identifier A Program Identifier B Specialist ABI Rehabilitation Service Report the corresponding code for the program when advised to do so by the Department of Health unit responsible for administration of the program. 02 23 Hour Surgery Unit Patient identified as a 23 Hour Surgery Unit patient. 04 GEM Level 1 Patient identified as a GEM Level 1 patient as approved by DH. Use code 04 only with Care Type 9 05 Home Birthing Program Patient identified as a Home Birthing Program patient as approved by DH. Use code 05 for both mother and baby episodes. 06 Competitive Elective Surgery Funding Initiative (CESFI) Patient identified as a CESFI patient, as approved by DH. Use code 06 only with Care Type 4. 09 Specialist ABI Rehabilitation Service Patient admitted to centre providing statewide specialist Acquired Brain Injury (ABI) rehabilitation for Victorians with severe/catastrophic ABI. Validations 648 649 651 Invalid Program Identifier* Program Identifier Care Type Mismatch Program Identifier, campus not approved for program* Related items Administration Purpose To: • Identify whether a specified program applies to this episode. • Facilitate health services planning and monitoring. Principal data users Multiple internal and external data users. Collection start 2009-10 Definition source Department of Health Code set source Department of Health Section 8 Editing Validation 648 Invalid Program Identifier (change to function only) 651 Program Identifier, campus not approved for program (change to function only) Proposals for revisions to the VAED for 1 July 2015 Page 13 Proposal 4 – Amendment to Separation Referral code set It is proposed to Remove codes P Post Acute Care Program services (PAC) and M Referral to a community rehabilitation centre and replace with new code for Health Independence Program services. Proposed by Continuing Care, Health Services Programs, Department of Health Implementation date 1 July 2015 Reason for proposal The data item ‘Separation Referral’ is intended to capture the clinical care and support services arranged by the hospital to meet the person’s recuperative needs when discharged to private accommodation or home. At present, referrals to Post Acute Care (PAC) and Subacute Ambulatory Care Services (SACS) can be captured through use of codes P and M. It is proposed to remove/end-date these codes and add a new code for ‘Health Independence Program services’. PAC and SACS are now considered as components of the Health Independence Program (HIP). HIP also encompasses the Hospital Admission Risk Programs (HARP) and Residential In Reach programs (RIR). The program objectives of HIP are all aimed at supporting the transition from hospital to home, including facilitation of early discharge and reducing readmission rates. Thus the proposal to replace codes P and M with a new code for HIP is to: • Support the policy direction in transitioning from providing separate programs to provision of a consolidated Health Independence Program • Ensure referrals made to HARP and RIR programs can be captured in addition to SACS and PAC referrals, as all four components are equally important in supporting the transition from hospital to home • Allow VAED episodes that result in a referral to a HIP to be identified for further analysis of HIP efficacy in supporting the transition from hospital to home Details of change Amendment to Separation Referral code set • Remove two codes • Add one new code Amendments to validations Proposals for revisions to the VAED for 1 July 2015 Page 14 Section 3 Data definitions Separation Referral (amended) Specification Definition Clinical care and support services arranged by the hospital to meet the person’s recuperative needs when discharged to private accommodation or home. Data type Field size Alpha 4 Location Episode Record Reported by Public hospitals. Private hospitals – Optional. If the private hospital chooses not to report this data, report spaces in this field. Reported for Episodes where the Separation Mode is H Separation to private residence/accommodation. For all other Separation Modes, report spaces in this field. Reported when A Separation Date is reported in the Episode Record. Code set Select up to four options from list. Do not repeat codes. If more than four referrals have been made, select the first four listed: Form Layout Code AAAA or spaces Left justified, trailing spaces. Code Descriptor F Domiciliary postnatal care, arranged before discharge E Domiciliary postnatal care, referral declined H Health Independence Program services, arranged before discharge P Post Acute Care Program services, arranged before discharge M Referral to a community rehabilitation centre arranged before discharge L Alcohol and drug treatment service, arranged before discharge B Community palliative care support, arranged before discharge U Home nursing support, arranged before discharge C Mental health community services, arranged before discharge S Referral to private psychiatrist, arranged before discharge D Psychiatric disability support services, arranged before discharge G Referral to general practitioner, arranged before discharge A Referral to Aged Care Assessment Service (ACAS), arranged before discharge K Referral to Aboriginal and Torres Strait Islander (ATSI) service, arranged before discharge T Referral to Transition Care home based program, arranged before discharge Proposals for revisions to the VAED for 1 July 2015 Page 15 Reporting guide R Other clinical care and/or support services, arranged before discharge X No referral or support services arranged before discharge In arranging the referral of a patient to these services, the hospital would expect to receive confirmation from the referred provider of their preparedness to accept responsibility for delivering the required services to the patient upon discharge. Unless a specific service has been arranged, or referral to domiciliary postnatal care specifically declined, use code X No referral or support services arranged before discharge. F Domiciliary postnatal care, arranged before discharge Mother discharged, with domiciliary postnatal care arranged before discharge to her own home or home of relative or friend or other private accommodation*. Domiciliary care includes that provided by the hospital and by home nursing services. Code not for use for the baby’s Separation Mode: unless a specific service (with another code) has been arranged for the baby, baby’s code would be X No referral or support services arranged before discharge. Excludes: Referral to domiciliary postnatal care offered, but declined by patient (use code E) E Domiciliary postnatal care, referral declined Mother discharged. Mother offered referral to domiciliary postnatal care before discharge but declined referral. Domiciliary care includes that provided by the hospital, by home nursing services and by community services. Code not for use for the baby’s Separation Mode. H Health Independence Program services, arranged before discharge Referral to a health independence program (HIP) arranged before discharge Includes: Programs previously known as Post Acute Care, Hospital Admission Risk Program, Subacute Ambulatory Care Services and Residential In Reach. P Post Acute Care Program services, arranged before discharge Discharge, with provision of Post Acute Care Program services arranged before discharge to own home or home of relative or friend or other private accommodation*. For more information about Post Acute Program Services refer to Victorian health policy and funding guidelines available at: http://www.health.vic.gov.au/pfg/ M Referral to a community rehabilitation centre arranged before discharge Discharge, with referral to community rehabilitation centre (formerly known as day hospital) arranged before discharge to own home or home of relative or friend or other private accommodation*. Excludes: Discharge, with referral to alcohol and drug treatment service (use code L). [No changes to remainder of item] Proposals for revisions to the VAED for 1 July 2015 Page 16 Section 8 Editing Validation 329 Geri Respite – Invalid Comb (change in function only) 388 Sep Referral - Episode not Separated (change in function only) 389 Invalid Sep Referral (change in function only) 396 Sep Referral, No Refer Plus Other Ref (change in function only) 398 Sep Referral, Duplicates (change in function only) Proposals for revisions to the VAED for 1 July 2015 Page 17 Proposal 5 – Not proceeding to consultation Proposal 6 – Amendment to reporting guide for Duration of Stay in Intensive Care Unit It is proposed to Amend reporting guide for Duration of Stay in Intensive Care Unit to include reporting of HDU activity that occurs within an ICU. Proposed by Health Services Programs, Acute Inpatient & Specialist Clinics Program, Department of Health Implementation date 1 July 2015 Reason for proposal Data quality issue – Currently some health services do not report HDU activity that occurs within an ICU. This change clarifies that HDU activity that is physically and administratively within an ICU must be included in ICU activity. Consistency of reporting – this change will make it possible to compare activity across ICUs in the state. Details of change Amendment to reporting guide for Duration of Stay in Intensive Care Unit Section 2 Concepts and derived items Intensive Care Unit (amended) Definition An intensive care unit (ICU) is a designated ward of a hospital that is specially staffed and equipped to provide observation, care and treatment to patients with actual or potential life-threatening illnesses, injuries or complications, from which recovery is possible. The ICU provides special expertise and facilities for the support of vital functions and utilises the skills of medical, nursing and other staff trained and experienced in the management of these problems. Guide for use There are different types of ICU, listed below: • Adult intensive care • Paediatric intensive care • Neonatal intensive care Beds classified as high dependency unit-type (HDU) within an ICU, administratively and/or physically, are included. ICUs do not include Special Care Nurseries, Coronary Care Units, High Dependency Units, Intensive Nursing Units or Stepdown Units. All types of ICU must substantially conform to appropriate guidelines of the Australian Council on Healthcare Standards (ACHS). Refer to: Section 3: Duration of Stay in ICU and Account Class Proposals for revisions to the VAED for 1 July 2015 Page 18 3 Data definitions Duration of Stay in Intensive Care Unit (amended) Specification Definition Total duration of stay (hours) in an approved Intensive Care Unit (ICU) or Neonatal Intensive Care Unit (NICU), during this episode of care. Data type Numeric Form Quantitative value Field size 4 Layout NNNN or spaces. Right-justified, zero-filled. Location Diagnosis Record Reported by Public and private hospitals with an approved ICU/NICU, and hospitals contracting with a hospital with an approved ICU. Otherwise, report spaces. Reported for Episodes where time is spent in such an ICU/NICU. Otherwise, report spaces. Reported when A Separation Date is reported in the Episode Record. Code set A valid number in the range 0001 to 9999. Reporting guide If patient has more than one period in ICU/NICU during this episode, the total duration of all such periods is reported. Duration is reported in hours, rounded up. Only the time in the ICU/NICU is counted, not time, for example, in an operating theatre. Where a hospital has a combined ICU/CCU, the duration of stay is reported in either the ICU field or the CCU field, not both. However, where a patient receives mechanical ventilation or non-invasive ventilation in a combined ICU/CCU, report the ICU/CCU hours in the ICU field, not the CCU field. A patient admitted to an ICU/NICU in Hospital B during a contracted service episode has the duration of that ICU/NICU stay reported by Hospital B; Hospital A also reports the hours spent in ICU/NICU in Hospital B in addition to any hours spent in ICU/NICU at Hospital A. Where patient is located in an NICU/ICU but does not require the level of care normally provided in a NICU/ICU (for example, due to a lack of beds elsewhere), Duration of Stay in ICU must not be reported. [No change to remainder of item] Proposals for revisions to the VAED for 1 July 2015 Page 19 Proposal 7 – Restrict reporting of Funding Arrangement code 8 National Bowel Cancer Screening Program to designated providers It is proposed to Restrict reporting of Funding Arrangement 8 National Bowel Cancer Screening Program to designated providers Proposed by Screening and Cancer Prevention, Department of Health Implementation date 1 July 2015 Reason for proposal The Victorian Department of Health is responsible for the implementation of the National Bowel Cancer Screening Program in Victoria including timely access to colonoscopies for public patients through the designated provider model, delivering the PFUF, undertaking research, supporting education and training for health professionals involved in the screening pathway, and initiatives to improve community awareness and participation in bowel cancer screening. Designated providers have agreed to: • establish systems to support identification and tracking of NBCSP participants • provide services to NBCSP participants within 30 days of referral • provide high quality patient education & support • provide data, including histopathology data, to the National Register (information for submission of forms including electronic forms is available at http://www.cancerscreening.gov.au ) • participate in initiatives designed to enhance the operation of the NBCSP in Victoria Only the 19 designated providers in Victoria need to be able to report Funding Arrangement 8. Details of change • Amendment to reporting guide for Funding Arrangement • Amendment to validation Funding Arrangement (amended) Specification Definition Identifies the specific funding arrangement, if any, which applies to this episode of care. Data type Alphanumeric Form Code Field size 1 Layout N or space Location Episode Record Reported by • Any Victorian public and private hospital involved in contracted care arrangements with another hospital (purchasers and providers of contracted care). Proposals for revisions to the VAED for 1 July 2015 Page 20 • Any Victorian public and private hospital involved in hub and spoke arrangements with another hospital or satellite site. • Any Victorian public or private hospital treating a patient identified as a Coordinated Care Trial patient. • Any Victorian public hospital involved in the Rural Patients Initiative program. • Any Victorian public hospital involved in the Elective Surgery Access Service program (ESAS). • Any Victorian private hospital involved in the Public/Private Elective Surgery Initiative (PHESI). • Any Victorian public or private hospital involved in the National Bowel Cancer Screening Program All other circumstances, report a space in this field. Reported for Episodes where an admitted service is provided under contract, hub and spoke, Coordinated Care Trial arrangements, Rural Patients Initiative, Elective Surgery Access Service (ESAS) or Private Hospital Elective Surgery Initiative. Otherwise, report a space in this field. Reported when A Separation Date is reported in The Episode Record is reported. Code set Code Reporting guide Descriptor 1 Contract 2 Hub and spoke 4 Coordinated Care Trial 5 Rural Patients Initiative 6 Elective Surgery Access Service 7 Private Hospital Elective Surgery Initiative 8 National Bowel Cancer Screening Program 1 Contract Patient receiving contracted hospital care under an agreement between a purchaser of hospital care (contractor) and a provider of an admitted or non-admitted service (contracted hospital). 2 Hub and Spoke Patient receiving a specialist service at another hospital or satellite site (spoke) under a hub and spoke arrangement. This hospital is the hub hospital. (Any service provided at a spoke hospital or satellite site is reported by the hub hospital only.) 4 Coordinated Care Trial Patient identified as a Coordinated Care Trial patient. 5 Rural Patients Initiative Admission under the Rural Patients Initiative. Use code 5 only if the public hospital has been allocated resources through the Rural Patients Initiative. Private hospitals: Do not use code 5. 6 Elective Surgery Access Service (ESAS) Admission under the Elective Surgery Access Service (ESAS). Use code 6 only if the public hospital has been allocated resources through the Elective Surgery Access Service. Private hospitals: Do not use code 6. Proposals for revisions to the VAED for 1 July 2015 Page 21 7 Private Hospital Elective Surgery Initiative Admission under the Public/Private Elective Surgery Initiative. Use code 7 only if approved by DH. Public hospitals: Do not use code 7. 8 National Bowel Cancer Screening Program Admission under the National Bowel Cancer Screening Program. All hospitals can use code 8 (both designated and non-designated) for patients admitted under this program. Use code 8 only if a designated provider. Validations 108 Field(s) Missing From Sep* 410 Illegal Comb Fund Arrang & Contract 416 Invalid Fund Arrangement 423 Invalid Comb Funding/Contract/Transfer 424 Not Separated: Fund Arr S/Be Spaces 456 Contract Leave, No Contract 477 Funding Arrangement 5, not approved for Rural Patients Initiative 478 Funding Arrangement 6, not approved for ESAS 491 Incompat Fields for ESAS 492 Incompat Fields for RPI 626 Invalid combination for Funding Arrangement PHESI 635 NBCSP but Age < 50 Years 638 Private Hosp, Public Account Without Contract ### Funding Arrangement 8, not designated provider [No change to remainder of item] Section 8 Editing Validation 108 Field(s) missing from sep (amended) Effect REJECTION Problem In the E5 Episode Record, one or more of the Separation fields contain data but one or more mandatory fields are missing. Remedy Check Separation Date, Separation Time, Separation Mode, Account Class on Separation, Accommodation Type on Separation, Mental Health Legal Status, Carer Availability and Funding Arrangement, amend as appropriate and re-transmit the E5. • If episode has ended separated, complete all Separation fields • If episode has not ended not separated, delete data from Separation fields containing data (by sending these fields filled with blanks). 424 Not Separated: Fund Arr S/Be Spaces (removed) ### Funding Arrangement 8, not NBCSP designated provider (new) Proposals for revisions to the VAED for 1 July 2015 Page 22 Proposal 8 – Removal of notifiable validations It is proposed to Change effect of notifiable validations to warning, rejection or remove validation Proposed by Data Collections, System Intelligence and Analytics, Department of Health Implementation date 1 July 2015 Reason for proposal To reduce the burden of data correction for health services and reduce work load for Data Collections unit. Health services currently receive control reports produced for each transmission indicating individual records with rejection, notifiable and warning error messages. An additional labour intensive process operates for notifiable errors: • Records are accepted on the PRS2 database and a copy of each record is saved in a table • Data Collections run a monthly extract and send spreadsheets listing uncorrected notifiables to health services • Health services complete details on the spreadsheet to explain why data is correct and return completed spreadsheet to Data Collections. • Health services submit any corrections via PRS2 • Data Collections upload responses to a database and assess the responses for each record. Responses are accepted (for a reasonable explanation of why the data is correct), rejected or a request sent for further information. • The notifiables table is updated with the accepted response • Where data has not been corrected or confirmed as correct, the episodes may be removed from the end of year VAED consolidated file. Details of change • Amendment to introduction of Section 8 VAED • Amendment to effect of validations Section 8 Editing Validation Introduction (amended) This section contains descriptions and remedies for VAED edits validations. Rejection, Fatal, Notifiable and Warning Edits The Control Reports produced with each transmission indicate individual records with rejection, fatal, notifiable and warning edits validations. • The Edit Validation number/s is in the far right column of the report (refer to Section 7: Control Reports). • Control Reports include a list of the short Edit Validation titles (this section provides more detailed information). • Before re-transmitting a record, check all fields related to the field/s that produced the Edit Validation (refer to Section 3: Data Definitions). Rejections Edits An Edit Validation number prefixed by an R signifies a rejection. Proposals for revisions to the VAED for 1 July 2015 Page 23 • The PRS/2 database does not retain a record of the transaction. • Check the record, correct as required and re-transmit. • If there are no rejection edits validations, the record has been accepted on the PRS/2 database. Fatals Edits An Edit Validation number prefixed by an F signifies a fatal edit. Fatals edits are those where the combination of data, including combinations between two different episodes for a patient, is definitely incorrect. • The data combination is accepted to accommodate the PRS/2 logic in the update process. • Check records, correct and re-transmit. Note: Fatal edits validations do not appear routinely on PRS/2 reports; rather the first notification of these edits errors will be from the department. If these episodes are not corrected they may be removed from the end of year VAED consolidated file. Public hospitals will receive no funding for removed episodes. Notifiable Edits (removed) Warnings Edits An Edit Validation number prefixed by a W signifies a warning. Warning edits validations are those where the data is unusual, but may be correct. • The record is accepted by PRS/2. • Check the record, correct if appropriate and re-transmit. X5/Y5 Record Edits Validations A diagnosis or procedure code that causes a rejection or a warning is marked immediately to the left of the code: • Codes causing a rejection are preceded by * (asterisk) • Codes causing a warning or notifiable are preceded by # (hatch) When PRS/2 checks a Diagnosis Record, it checks all diagnosis and procedure codes unless a diagnosis code has caused a rejection Edit Validation, in which case it checks other diagnosis codes but not the procedure codes. Re-transmitting an E5 Episode Record causes the X5/Y5 Diagnosis Record (if previously accepted) to be re-edited validated. Software edits validation Ideally, the hospital’s in-house software should have edits validation similar to VAED edits validations so that errors are detected before transmission to the facilities manager. The receipt of Edit Validation may indicate the transmission of invalid codes or faults in software logic. Contact your software supplier to initiate changes to your software to prevent these errors occurring. Proposals for revisions to the VAED for 1 July 2015 Page 24 061 Married – age not within range (removed) 069 Newborn from overseas (amended) Effect NOTIFIABLE Warning Problem The E5 Episode Record’s age at admission is zero days but the Country of Birth code is not one of those indicating Australia (1100 to 1199). Remedy The department acknowledges that for a small number of episodes this combination of data items is correct. Check Date of Birth, Country of Birth and Admission Date. Where incorrect, amend as appropriate and re-transmit the E5 • Where correct, follow the notifiables edit process outlined at the start of this section. This is possible if the baby has been flown in from overseas for emergency treatment on date of birth, or was born in transit by air or sea from overseas. 080 Sex Indeterminate Age < 90 Days (amended) Effect NOTIFIABLE Warning Problem The E5 Episode Record’s Sex is 3 Indeterminate and age is less than 90 days. Remedy The department acknowledges that for a small number of episodes this combination of data items is correct. Check Admission Date, Date of Birth, and Sex. Where incorrect, amend as appropriate and re-transmit the E5. • Where correct, follow the notifiables edit process outlined at the start of this section. 187 Adm Weight Low (amended) Effect NOTIFIABLE Warning Problem From the E5 Episode Record, age at admission is calculated as less than 1 year and the Diagnosis Record (X5) Admission Weight is less than 400 grams. Remedy The department acknowledges that for a small number of episodes this combination of data items is correct. Check Admission Date, Admission Weight, and Date of Birth. • Where incorrect, amend as appropriate and re-transmit the E5 and/or X5. • If the patient is not under 1 year, amend the Date of Birth and/or Admission Date, and delete Admission Weight. • Where correct, follow the notifiables edit process outlined at the start of this section. Proposals for revisions to the VAED for 1 July 2015 Page 25 222 Unqual Newborn; Adm Date not Birth (amended) Effect NOTIFIABLE Warning Problem The E5 Episode Record’s Care Type is U Unqualified newborn and the Account Class is not NT Newborn (Unqualified, not birth episode) and Birth Date is not the same as the Admission Date or the day before Admission Date. Remedy The department acknowledges that for a small number of episodes this combination of data items is correct. Check Account Class, Admission Date, Care Type and Date of Birth. Where incorrect, amend as appropriate and re-transmit the E5. • If the patient met one of the criteria for being a Qualified newborn, amend the Care Type for the episode and Qualification Status in one or more Status Segments. • If the patient was transferred to this hospital, does not meet the criteria to be a Qualified newborn, and requires hospital accommodation, this should be reported as Account Class NT- Newborn (Unqualified, not birth episode). Where correct, follow the notifiables edit process outlined at the start of this section. 234 Aboriginal/TS Island but not Aust Born (amended) Effect NOTIFIABLE Warning Problem The E5 Episode Record’s Indigenous Status indicates the patient is of Aboriginal or Torres Strait Islander origin (1, 2 or 3) but the Country of Birth is not one of the codes indicating Australia (1100 to 1199). Remedy The department acknowledges that for a small number of episodes this combination of data items is correct. Check Indigenous Status and Country of Birth. • Where incorrect, amend as appropriate and re-transmit the E5. • Where correct, follow the notifiables edit process outlined at the start of this section. 243 Unqual Newborn but Total Days > 9 (amended) Effect NOTIFIABLE Warning Problem The E5 Episode Record’s Qualification Status is U Unqualified Newborn but the sum of the Patient Days Total in one or more of the Unqualified Status Segments is more than 9. Proposals for revisions to the VAED for 1 July 2015 Page 26 Remedy The department acknowledge that for a small number of episodes this combination of data items is correct. Check Qualification Status and Patient Days Total in all the Unqualified Status Segments. • Where incorrect, amend as appropriate and re-transmit the E5. • Where correct, follow the notifiables edit process outlined at the start of this section. If an Unqualified Newborn remains in the hospital when s/he turns 10 days of age and is not receiving clinical care, s/he should be separated. At this point in time the newborn becomes a boarder and the episode being reported to VAED is ended. 289 Adm Sc T’fer & Onset = Adm Date (amended) Effect NOTIFIABLE Warning Problem The E5 Episode Record’s Care Type is P or 6 and the Admission Source is T Transfer from acute hospital/extended care/rehabilitation/geriatric centre, but the S5 Sub-Acute Record’s Onset Date is the same date as the Admission Date in the E5. Remedy DH acknowledges that for a small number of episodes this combination of data items is correct. Check Admission Date, Admission Source, Care Type (E5) and Onset Date (with source hospital if necessary) (S5). Where incorrect, amend as appropriate and re-transmit the E5 and/or S5. Where correct, follow the notifiables edit process outlined at the start of this section. A patient transferred to this hospital to commence an episode of rehabilitation is expected to have an onset date for that condition before the start of this rehabilitation episode. Refer to: Section 4: Business Rules (tabular) Care Type: Designated Rehabilitation Program (6) and Designated Paediatric Rehabilitation Program/Unit (P). 290 Stat Adm Sc & Onset = Adm Date (amended) Effect NOTIFIABLE Warning Problem The E5 Episode Record’s Care Type is P or 6 Rehabilitation and the Admission Source is S Statistical admission (change in Care Type within this hospital), but the S5 Sub-Acute Record’s Onset Date is the same date as the Admission Date in the E5. DH acknowledges that for a small number of episodes this combination of data items is correct. Check Admission Date, Admission Source, Care Type (E5) and Onset Date (S5). Remedy Where incorrect, amend as appropriate and re-transmit the E5 and/or S5. Where correct, follow the notifiables edit process outlined at the start of this section. Where there is a change of Care Type it is expected that the onset date would be before the start of this rehabilitation episode. Refer to: Section 4: Business Rules (tabular) Care Type Designated Rehabilitation Program (6) and Designated Paediatric Rehabilitation Program/Unit (P). Proposals for revisions to the VAED for 1 July 2015 Page 27 324 Incompat ICU Hrs, A/C Class (amended) Effect NOTIFIABLE Warning Problem The X5 Diagnosis Record has a Duration of Stay in ICU but the E5 Episode Record’s Account Class is –N, –5, MR, NT, PI, PJ, PK, PL, PM, PN, PO, PP, PQ, PR, PS, PT, PU, PV (where ‘–’ represents any valid character), and the Separation Mode is not T or D. Remedy DH acknowledges that for a small number of episodes this combination of data items is correct. Check Account Class, Separation Mode (E5) and Duration of Stay in ICU (X5). Where incorrect, amend as appropriate and re-transmit the E5 and/or X5/Y5. Where correct, follow the notifiables edit process outlined at the start of this section. 325 Incompat MV Hrs, A/C Class (amended) Effect NOTIFIABLE Warning Problem The X5 Diagnosis Record has a Duration of Mechanical Ventilation but the E5 Episode Record’s Account Class is -N, -5, MR, NT, PI, PJ, PK, PL, PM, PN, PO, PP, PQ, PR, PS, PT, PU, PV (where ‘-’ represents any valid character), and the Separation Mode is not T or D. Remedy DH acknowledges that for a small number of episodes this combination of data items is correct. Check Account Class, Separation Mode (E5) and Duration of Mechanical Ventilation (X5). Where incorrect, amend as appropriate and re-transmit the E5 and/or X5/Y5. Where correct, follow the notifiables edit process outlined at the start of this section 358 Area Code Restraint Rare diagnosis or procedure code (amended) Effect NOTIFIABLE Warning Problem The X5/Y5 Diagnosis Record has Diagnosis or Procedure Code(s) that are rare in Australia. [On Library File: column L, AREA, code 2] Remedy DH acknowledges that for a small number of episodes this combination of data items is correct. Check Diagnosis and Procedure Code(s). Where incorrect, amend as appropriate and re-transmit the X5/Y5. Where correct, follow the notifiables edit process outlined at the start of this section. Proposals for revisions to the VAED for 1 July 2015 Page 28 403 Qual Newborn W/Out Justificat (amended) Effect NOTIFIABLE Warning Problem The E5 Episode Record has at least one Qualification Status of N Qualified newborn but the only Diagnosis Code is Z38.0, Z38.1 or Z38.2 Single liveborn infant. Check coding, confirm newborn meets criteria for Qualification Status N Qualified newborn. Remedy DH acknowledges that for a small number of episodes this combination of data items is correct. Check Qualification Status (E5) and Diagnosis Codes (X5/Y5). Where incorrect, amend as appropriate and re-transmit the E5 and/or X5/Y5. Where correct, follow the notifiables edit process outlined at the start of this section. There are problems, particularly with interstate payments, if newborns are incorrectly classified as Qualified or are inadequately coded. 406 Rehab Care Type W/Out Rehab PDx (amended) Effect NOTIFIABLE Warning Problem The E5 Episode Record’s Care Type is P or 6 Rehabilitation but the Principal Diagnosis Code is not Z50.- Care involving use of rehabilitation procedures. Remedy DH acknowledges that for a small number of episodes this combination of data items is correct. Check Care Type (E5) and Principal Diagnosis Code (X5). Where incorrect, amend as appropriate and re-transmit the E5 and/or X5. If this is not a Rehabilitation episode, amend the Care Type. If this is a Rehabilitation episode, check Principal Diagnosis code for a miss-code or miss-punch, or for a sequencing error; the Principal Diagnosis Code for a Rehabilitation episode should be Z50.-. Where correct, follow the notifiables edit process outlined at the start of this section. 431 Newborn but not Newborn Accom (removed) 445 Dt of Accid Incompat W TAC Claim Nbr – Notifiable (amended) Effect NOTIFIABLE Warning Problem The V5 DVA and TAC Record’s Date of Accident is incompatible with the financial year of acceptance of the TAC Claim (first two characters of TAC Claim Number): the Date of Accident is more than 20 years before the Claim date (excluding the default claim date of 01/01/1901). Proposals for revisions to the VAED for 1 July 2015 Page 29 Remedy DH acknowledges that for a small number of episodes this combination of data items is correct. Check Date of Accident and TAC Claim Number. Where incorrect, amend as appropriate and re-transmit the E5 and V5 Where correct, follow the notifiables edit process outlined at the start of this section. The Transport Accident Act 1986 normally limits claims to accidents that occurred not more than 3 years earlier (or until a minor attains the age of 18 years). Some patients may have had more than one accident and therefore can have more than one TAC Claim Number. Make sure this is the correct TAC Claim Number for this episode. If TAC confirms that it has accepted a claim for an accident that occurred more than 20 years before the claim, please contact the HDSS Help Desk. 448 ICU Stay but Care Type not Acute (amended) Effect NOTIFIABLE Warning Problem The X5 Diagnosis Record has a Duration of Stay in ICU but the Care Type is not 4 Other care (Acute) including Qualified newborn or 10 Posthumous Organ Procurement. Remedy DH acknowledges that for a small number of episodes this combination of data items is correct. Check Care Type (E5) and Duration of Stay in ICU (X5). Where incorrect, amend as appropriate and re-transmit the E5. Where correct, follow the notifiables edit process outlined at the start of this section. • • • • If the ICU hours were for short periods not extending across midnight, and the patient continued care under the same Care Type, the record is correct. If the ICU hours were longer periods (extending across midnight), the original episode should be statistically separated and a new (Acute) episode started, except if this is a Posthumous Organ Procurement episode (no statistical separations). If the Care Type for the whole episode is incorrect, amend this. If the patient was not in ICU, delete the Duration of Stay in ICU. 465 Adm Duration < 15 Mins (amended) Effect NOTIFIABLE REJECTION Problem The E5 Episode Record’s Separation Date and Time is calculated to be less than 15 minutes after the E5 Episode Record’s Admission Date and Time, excluding episodes with Separation Mode D Death, Z Left against medical advice or T Separation and transfer to other acute hospital/extended care/rehabilitation/geriatric centre. Remedy DH acknowledges that for a small number of episodes this combination of data items is correct. Check Admission Date, Admission Time, Separation Date and Separation Time. Where incorrect, Amend as appropriate and re-transmit the E5. Where correct, follow the notifiables edit process outlined at the start of this section. Proposals for revisions to the VAED for 1 July 2015 Page 30 467 Adm Wt <1000g, LOS <28 Days, Sep Mode ≠ T or D (amended) Effect NOTIFIABLE Warning Problem The X5 Diagnosis Record’s Admission Weight is < 1000g, the calculated Length of Stay is < 28 days, and the Episode Record’s Separation Mode is not T Separation and Transfer to other acute hospital/extended care/rehabilitation/geriatric centre or D Death. Remedy DH acknowledges that for a small number of episodes this combination of data items is correct. Check Admission Weight (X5), Admission Date (E5), Separation Date (E5) and Separation Mode (E5). Where incorrect, amend as appropriate and re-transmit the E5 and/or X5/Y5 Where correct, follow the notifiables edit process outlined at the start of this section. It is unlikely that an episode with an admission weight of < 1000g would be discharged in less than 28 days, unless the patient was transferred to another hospital or died. 468 Not NHT, LOS > 365 Days (amended) Effect NOTIFIABLE Warning Problem The E5 Episode Record’s Care Type is not 1 NHT/Non-Acute or 5T Approved Mental Health Service or Psychogeriatric Program, Mental Health Nursing Home Type, or 5E Mental Health Secure Extended Care Unit (SECU), and the calculated Length of Stay is > 365 days. Remedy DH acknowledges that for a small number of episodes this combination of data items is correct. Check Admission Date, Care Type and Separation Date. Where incorrect, amend as appropriate and re-transmit the E5. Where correct, follow the notifiables edit process outlined at the start of this section. 480 Incompat Adm Source/Age <15 (amended) Effect NOTIFIABLE Warning Problem The E5 Episode Record’s age at admission is less than 15, but the Admission Source is A Transfer from mental health residential facility. Remedy DH acknowledges that for a small number of episodes this combination of data items is correct. Check Admission Date, Admission Source and Date of Birth. Where incorrect, amend as appropriate and re-transmit the E5. Where correct, follow the notifiables edit process outlined at the start of this section. Proposals for revisions to the VAED for 1 July 2015 Page 31 493 Incompat Sep Mode/Age <15 (amended) Effect NOTIFIABLE Warning Problem The E5 Episode Record’s age at admission is less than 15, but the Separation Mode is A Separation and transfer to mental health residential facility. Remedy DH acknowledges that for a small number of episodes this combination of data items is correct. Check Admission Date, Date of Birth and Separation Mode. Where incorrect, amend as appropriate and re-transmit the E5. Where correct, follow the notifiables edit process outlined at the start of this section. 513 Indigenous Status/Preferred Language Mismatch (amended) Effect NOTIFIABLE Warning Problem The E5 Episode Record’s Indigenous Status is 1, 2 or 3 Indigenous but Preferred Language is not 8xxx Australian Indigenous Languages, 1201 English, 9601 Invented Languages or 97xx Sign Languages. Remedy DH acknowledges that for a small number of episodes this combination of data items is correct. Check Indigenous Status and Preferred Language. Where incorrect, amend as appropriate and re-transmit the E5. Where correct, follow the notifiables edit process outlined at the start of this section. 532 Account Class MA: not 4, 5E, 5K, 5G, or U (amended) Effect NOTIFIABLE Warning Problem The E5 Episode Record has an Account Class of MA Reciprocal Health Care Agreement and the Care Type is not 4, 5E, 5K, 5G, 5S, 5A or U. Remedy DH acknowledges that for a small number of episodes this combination of data items is correct. Check Account Class and Care Type. Where incorrect, amend as appropriate and re-transmit the E5. Where correct, follow the notifiables edit process outlined at the start of this section. 542 MH Acute Adult Care Type but Age < 14 Years (removed) 543 MH Acute Adult Care Type but Age > 65 Years (removed) 544 MH APMHS Care Type but Age < 55 Years (removed) 545 MH CAMHS Care Type but Age < 5 Years (removed) 546 MH CAMHS Care Type but Age > 19 Years (removed) 547 MH SECU Care Type but Age < 14 Years (removed) 548 MH Specialist Acute Care Type but Age < 14 Years (removed) Proposals for revisions to the VAED for 1 July 2015 Page 32 554 Date of Accident > Adm Date (amended) Effect NOTIFIABLE REJECTION Problem This V5 DVA and TAC Record has a TAC Account Class (T-) but the Date of Accident is later than the Admission Date. Remedy DH acknowledges that for a small number of episodes this combination of data items is correct. Check Admission Date and Date of Accident. Where incorrect, Amend as appropriate and re-transmit the E5 and V5 Where correct, follow the notifiables edit process outlined at the start of this section. 555 Date of Accident < Date of Birth (amended) Effect NOTIFIABLE Warning Problem This V5 DVA and TAC Record has a TAC Account Class (T-) but the Date of Accident is prior to the Date of Birth. Remedy DH acknowledges that for a small number of episodes this combination of data items is correct. Check Admission Date and Date of Birth. Where incorrect, amend as appropriate and re-transmit the E5 and V5 Where correct, follow the notifiables edit process outlined at the start of this section. 556 Given Name Unusual Length (removed) 557 Surname Unusual Length (removed) 573 Postcode Overseas, Account Public (amended) Effect NOTIFIABLE Warning Problem The E5 Episode Record’s Postcode is 8888 Overseas and the Account Class is MP Public: Eligible. Remedy DH acknowledges that for a small number of episodes this combination of data items is correct. Check Account Class and Postcode. Where incorrect, amend as appropriate and re-transmit the E5. Where correct, follow the notifiables edit process outlined at the start of this section. 574 Postcode Overseas, Locality RHCA, Acct not RHCA (amended) Effect NOTIFIABLE Warning Problem The E5 Episode Record’s Postcode is 8888 Overseas and the Locality is a country with a Reciprocal Health Care Agreement, however the Account Class is not MA Reciprocal Health Care Agreement. DH acknowledges that for a small number of episodes this combination of data items is correct. Check Account Class, Locality and Postcode. Where incorrect, amend as appropriate and re-transmit the E5. Remedy Where correct, follow the notifiables edit process outlined at the start of this section. Proposals for revisions to the VAED for 1 July 2015 Page 33 582 CCU Duration High (amended) Effect NOTIFIABLE Warning Problem The X5/Y5 Diagnosis Record’s Duration of Stay in Cardiac/Coronary Care Unit is greater than 300 hours (12.5 days). Remedy DH acknowledges that for a small number of episodes this data item is correct. Check Duration of Stay in Cardiac/Coronary Care Unit. If this is incorrect, amend as appropriate and re-transmit the E5. Alternatively, contact the HDSS Helpdesk to confirm that information is correct. Where the data has not been corrected or confirmed DH will periodically notify each hospital and ask them to do so. 583 NIV Duration High (amended) Effect NOTIFIABLE Warning Problem The E5 Episode Record’s age at admission is 28 days and over, but the X5/Y5 Diagnosis Record’s Duration of Non-invasive Ventilation (NIV) is greater than 300 hours (12.5 days). Remedy DH acknowledges that for a small number of episodes this combination of data items is correct. Check Admission Date, Date of Birth and Duration of Non-invasive Ventilation (NIV) in ICU. Where incorrect, amend as appropriate and re-transmit the E5 and/or X5. Where correct, follow the notifiables edit process outlined at the start of this section. 585 Sex Code Intersex (amended) Effect NOTIFIABLE Warning Problem The E5 Episode Record’s Sex is 4 Intersex. Remedy DH acknowledges that for a small number of episodes this data item is correct. Check Sex. Where incorrect, amend as appropriate and re-transmit the E5. Where correct, follow the notifiables edit process outlined at the start of this section. 595 Neoplasm Code Missing Effect NOTIFIABLE REJECTION Problem The X5/Y5 Diagnosis Record has a Diagnosis Code indicating a morphology [on Library File: Morphology worksheet, column N, ADD, code 4] but a diagnosis code indicating a neoplasm [on Library File: Diagnosis worksheet, column N, ADD, codes 3 and 5] or another Morphology Code does not immediately precede the Morphology code. Remedy DH acknowledges that for a small number of episodes the diagnosis code is correct. Check Diagnosis Code and sequencing of morphology code. Where incorrect, amend as appropriate and re-transmit the X5/Y5. Where correct, follow the notifiables edit process outlined at the start of this section. Proposals for revisions to the VAED for 1 July 2015 Page 34 633 Delivery Episode, Adm Type not M (amended) Effect NOTIFIABLE Warning Problem The episode Record has a DRG that indicates a delivery episode (O01A, O01B, , O02A, O02B, or O60Z), but the Admission Type is not M Maternity. Remedy DH acknowledges that for a small number of episodes this data item is correct. Check Admission Type, noting that the list of codes is a hierarchy and the first applicable code in the list should be allocated. Where incorrect, amend as appropriate and re-transmit the E5. Where correct, follow the notifiables edit process outlined at the start of this section. 642 Unqual Newborn but Sep Mode D (amended) Effect NOTIFIABLE Warning Problem The Qualification Status in the last status segment is U Unqualified but the baby has a Separation Mode D Death. Remedy DH acknowledges that for a small number of episodes this data item is correct. Check Qualification Status and Separation Mode. Where incorrect, amend as appropriate and re-transmit the E5. Where correct, follow the notifiables edit process outlined at the start of this section. 643 Maternity episode but Sep Mode D (amended) Effect NOTIFIABLE Warning Problem The episode and diagnosis records have the following conditions: Sex = 2 Female, AND Age >= 10 yrs, AND Age < 54 yrs, AND Separation Mode = D, AND One of the following diagnosis codes has been reported: F53*, A34, Z37*, Z34*, Z35*, Z39*, M830*, E230*, O00-O999. Remedy DH acknowledges that for a small number of episodes this data combination is correct. Check Sex, Date of Birth, Separation Mode and diagnosis codes. Where incorrect, amend as appropriate and re-transmit the E5 and/or X5. Where correct, follow the notifiables edit process outlined at the start of this section. Proposals for revisions to the VAED for 1 July 2015 Page 35 654 Mother’s UR does not exist in PRS2 database (amended) Effect NOTIFIABLE Warning (E5) Problem The E5 Episode Record has a Mother’s UR which has not been reported for this campus. This error may trigger when the mother was separated in a previous financial year. Remedy Check the E5 Episode Record Mother’s UR Number, and Admission Source. Where incorrect, amend as appropriate and re-transmit the E5. Where correct, follow the notifiables edit process outlined at the start of this section. 660 Care Type ≠ 5x, LOS Same Day, Procedure Code 93341-xx, MHSWPI mismatch (amended) Effect REJECTION (X/Y5 NEW/UPD, AND E5 UPD) Problem The Care Type in the E5 Episode Record is not equal to 5x, but either: Remedy • The X/Y5 Diagnosis Record contains an ACHI code in the range 93341-xx, and the patient is Same Day (Admission Date and Separation Date are the same) but the E5 Episode Record does not contain a Mental Health Statewide Patient Identifier; OR • The E5 Episode Record contains a Mental Health Statewide Patient Identifier but the X/Y5 Episode Record does not contain an ACHI code in the range 93341-xx, and the patient is Same Day (Admission Date and Separation Date are the same). Check Admission and Separation Date, Care Type, and Mental Health Statewide Patient Identifier and ACHI procedure codes, amend as appropriate and re-transmit the E/X/Y5. 661 Care Type ≠ 5x, Procedure Code 93341-xx, LOS ≠ Same Day MHSWPI mismatch (removed) Proposals for revisions to the VAED for 1 July 2015 Page 36 Proposal 9 – Addition of Year of Arrival It is proposed to Capture year of arrival in Australia for overseas born patients Proposed by Diversity Policy and Projects, Mental Health, Wellbeing and Ageing, Department of Health Implementation date 1 July 2015 Reason for proposal Australia is a diverse nation, with a significant immigrant population. Over 5.5 million people are overseas born and over 800,000 people of refugee background have arrived since the second-world war. Around 4% of the population has low English proficiency. Victoria is the most diverse of all the jurisdictions, 26.2% of Victorians were born overseas (74.5% of this number from non English-speaking countries), and 23.1% of Victorians speak a language other than English at home (http://www.multicultural.vic.gov.au/population-and-migration/victoriasdiversity/2011-census-a-snapshot-of-our-diversity). In addition, Victoria receives the greatest numbers of refugee entrants and asylum seekers, with around 4,000 refugee entrants annually under the offshore program and approximately 10,000 asylum seekers currently living in Victoria. Despite Victoria’s diversity, there is limited ability to monitor, plan, and evaluate health service use over time by migrant communities, in the absence of a measure of when people arrived in Australia in existing administrative datasets. We propose adding ‘year of arrival’ to existing datasets to address this deficiency. The combination of “Year of Arrival”, together with the existing parameters “Country of Birth”, “Preferred Language” and “Interpreter Required” will allow more robust analysis of health service usage and facilitate population based planning in Victoria. The combination will also help identify: • patients who are recent arrivals in Australia • patients with limited English language proficiency - which may be associated with limited health and service literacy • patients of refugee-background and asylum seeker populations (see further discussion below). This information will: • support clinical decision-making • enable monitoring of health service use and service utilisation across migrant population cohorts over time (including language services) at a service and departmental levels • provide more cost effective data collection in relation to burden of disease across migrant population cohorts to inform service design and delivery • enable tracking of long-term health outcomes across different migrant population cohorts • inform targeted service development in response to any identified high risk population cohorts, for example, lack of access to particular services, need for health education, focus on access to earlier intervention programs to minimise higher cost interventions. The combination of country of birth, preferred language, interpreter required and year of arrival can also be used as a proxy for identifying people from refugee backgrounds. The proposed additional data element ‘year of arrival’ will support the Department’s: • priority actions outlined in the new Victorian Refugee and Asylum Seeker Health Action Plan 2014-2018 Proposals for revisions to the VAED for 1 July 2015 Page 37 • implementation of recommendations outlined in the 2014 Victorian Auditor General’s Office (VAGO) report on Access to Services by Migrants, Refugees and Asylum seekers for Department of Health, and Victorian Government more generally, The VAGO report includes specific actions for the Department to develop better data collection, reporting and evaluation mechanisms • ongoing national work to improve identification of refugees and asylum seekers in State, Territory and Commonwealth health datasets to monitor health service usage and costs for this population cohort and improve Commonwealth funding arrangements for this population cohort • ability to evaluate State funded refugee and asylum seeker health programs. Furthermore, limited English proficiency is not currently included in relative State disability assessments by the Commonwealth Grants Commission (unlike Indigenous disadvantage or remoteness) or cost adjustments for activity based funding, which are currently being reviewed by the Independent Hospital Pricing Authority (IHPA). Victoria has the largest population of people with limited English proficiency in Australia, which has significant impacts on the state hospital and health systems. This proposal will enable the Department to gather evidence to support future submissions to the Commonwealth Grants Commission and the IHPA detailing the increased hospital demand and financial pressure resulting from providing services to recent arrived migrants, refugees and asylum seekers. • New data item • New record type • New validation Details of change Section 3 Data definitions Year of Arrival (new) Specification Definition The year in which an overseas born patient first arrived in Australia to live for one year or more Field size 4 Location J Record Reported by Public hospitals Reported for All admitted episodes of care where Country of Birth is not Australia Reported when The J Record is reported. Code set A valid year Layout YYYY or spaces Other code 8888 Reporting guide Year of arrival not known If Country of Birth is not Australia, ask the patient: What year did you first arrive in Australia? (if any difficulty – add ‘to live here for one year or more’) Proposals for revisions to the VAED for 1 July 2015 Page 38 Year (YYYY) can only be 19xx or 20xx 8888 Year of arrival not known Includes: • Patients who are not able to respond to this question at any time during their hospital stay due to their medical condition. • Patients who do not know their Year of Arrival Validations TBA Related items Section 3: Country of Birth and Preferred Language. Administration Purpose To monitor health service use and health outcomes of migrant population cohorts to inform service design and delivery. Principal data users Department of Health Collection start 2015-16 Definition source Department of Health Proposals for revisions to the VAED for 1 July 2015 Page 39 Proposal 10 – Addition of Trial Protocol Number for patients involved in clinical trials It is proposed to Collect the Trial Protocol Number for patients involved in clinical trials Proposed by Integrated Care Unit, Coordinating Office for Clinical Trial Research, Department of Health Implementation date 1 July 2015 Reason for proposal Lack of data to identify clinical trial activity Background: In 2009 the Coordinating Office was established in the Department of Health to streamline regulatory approval for clinical trials to retain and grow clinical trials in Victoria. Clinical trials make available new treatments to Victorian patients sooner (before regulatory registration with TGA) and provide better health outcomes. The majority of clinical trials are commercially sponsored and treatment cost is borne by the sponsor organisation (e.g. pharmaceutical and device industries). The commercial clinical trial industry contributes about $1b to the Australian economy per year and Victoria’s share is 30% (source TGA). Health benefits and economic importance of the clinical trials industry in Victoria is substantial. The Standing Council on Health (and AHMAC) supported clinical trial reform and a streamlined regulatory initiative for multi-site clinical trials at a national level and this was for implementation in 2013. Importance of clinical trial data and metrics: Until recently (past 4 years) there was no consolidated clinical trial data available in Victoria and nationally. The Coordinating Office streamlined system operates with an integrated information management platform (derived for that in NHS, UK). Now available for the first time are the following: clinical trial number and data incorporating features of trials; breakdown of medical conditions treated in clinical trials; estimated patient number for participation in trials; estimated cost saved at public health services for patients treated on clinical trials; timeliness for the regulatory approval for trial start up; a database of identified sponsors and investigators conducting clinical trials. Global competitiveness is a major threat to local clinical trial activity and has eroded market share. For this reason the streamlined system for clinical trial reform in Victoria was implemented (Victorian Innovation Statement, 2008 funded). The streamlined system has addressed timeliness for regulatory approval but aspects such as meeting recruitment targets of patients for trials is recognised as a major limitation to competitiveness and retention of trials locally. A recent KPMG consultation demonstrated the paucity of the data for clinical trials and emphasised the need for reform in this area. Additional data requirements: Current limitations in the data collected by the Coordinating Office: • Patient number recruited and treated in clinical trials is not available currently. VAED - ‘clinical trial’ (Code Z00.6) derived. Use: get trial patient number reported. VAED – addition of ‘Trial Protocol Number’ code and derive. Use: get number of patients recruited in to a particular trial (identified by Protocol Number) Total patient number in trials will be a summation of VAED, VEMD and VINAH. Details of change New data item New record type Proposals for revisions to the VAED for 1 July 2015 Page 40 Section 3 Data definitions Trial Protocol Number (new) Specification Definition Trial protocol number for a clinical trial Field size TBA Location J Record Reported by Public hospitals Reported for Episodes where it is identified that the patient is involved in a clinical trial Reported when The J record is reported. Code set TBA Reporting guide It is industry practice to have an ‘alert’ sticker on the medical record indicating the patient is on a clinical trial. This facilitates identification of relevant files. This obvious identification sticker may not be present in all instances. Layout TBA Validations Related items Administration Purpose To identify clinical trial activity in Victorian hospitals Principal data users Department of Health Collection start 2014 Definition source Department of Health Proposals for revisions to the VAED for 1 July 2015 Code set source Not known Page 41 Proposal 11 – Amendment to reporting guide for Leave It is proposed to Amend reporting guide for leave so that; when a patient is transferred between campuses, report as a transfer even when it is intended that the patient will return to the first campus. Proposed by Data Collections, System Intelligence and Analytics, Department of Health Implementation date 1 July 2015 Reason for proposal Multi campus health services with shared PMI are unable to comply with current VAED business rules regarding leave. They cannot record a patient with concurrent episodes at two campuses within a single health service. Health services have reported problems with having two drug charts open for long term rehab patient ‘on leave’ from subacute campus while receiving care at acute campus . Confusion between two open drug charts could have serious consequences for patient safety and care. • Amendment to reporting guide for Leave • Amendment to reporting guide for Transfer Reporting Details of change Section 4 Business rules Leave (amended) Guide for use Contract Leave Contract leave days are reported only by the contracting (purchasing) hospital, are treated as patient days and included in the length of stay at that hospital. There is no limit to the duration of contract leave. If contract leave is same day, no leave day is counted. Patients commencing a period of contract leave are not separated. Leave With Permission No patient day charges are raised, nor patient days counted, while the patient is on leave with permission. Examples where leave should be recorded are: • Patient presents to hospital for induction of labour, sent home, to return when in established labour. Patient returns the next morning. Patient should only have one episode for this period. If the induction meets Criteria for Admission, the patient should be placed on leave whilst at home, as she is expected to return within seven days for continuing care. • Rehabilitation patient leaves on the 24 December to return the 26 December, so that they can spend Christmas in the care of their family. • Where a Hospital in the Home patient does not receive any admitted type services on a particular date, this day should be recorded as a leave with permission day. • An overnight or multi-day patient transferred to another campus but intending to return to this campus within seven days to continue the current treatment Proposals for revisions to the VAED for 1 July 2015 Page 42 should be placed on leave for the duration of stay at the other campus. Examples where leave should not be recorded: • Patient presents to hospital believing they are in early labour, diagnosed as in false labour and sent home after 2 hours, to return when in labour. This presentation should not be reported on the VAED as this does not meet any Criterion for Admission, and therefore it follows that the patient cannot be placed on leave. • A same-day patient intending to return to this campus within seven days for a further same-day episode (for example same-day dialysis, chemotherapy) • Patient is transferred to another campus for treatment whether or not there is an intention to return to this campus Note Unless the patient is on contract or normal leave, An overnight or multi-day stay patient in one hospital campus cannot concurrently be a patient in another hospital campus. Such a patient must be separated from one hospital campus and admitted to the other hospital campus on each occasion of transfer. Failure to return from leave within seven days A patient failing to return from leave within seven days: • Should be formally separated, effective from the date of leaving the hospital If the patient later returns to the hospital: • A new episode is started Absence starting and ending on the same date A period of absence starting and ending on the same date is not counted as leave with permission but the patient must be recorded as absent in his/her medical record. The patient may be recorded as absent in the hospital’s computer system; however, the system must not report a day’s leave to PRS/2 nor deduct a patient day in other reporting. Newborns Newborns are only permitted to go on leave with permission during a period of accommodation in HITH. Without Permission As it is still the intention of the medical practitioner that the patient return within seven days to continue the current treatment; follow leave with permission guidelines and reporting. Refer to: Section 2: Length of Stay, Overnight or Multi-Day Stay Patient, Patient Day, and Separation. Section 3: Leave with Permission Days Financial Year-To-Date, Leave with Permission Days Month-To-Date, and Leave with Permission Days Total. Proposals for revisions to the VAED for 1 July 2015 Page 43 Transfer Reporting (amended) Guide for use Reporting requirements are listed below: Transfer between hospitals Unless the patient is on contract or normal leave, An overnight or multi-day stay patient in one hospital campus cannot concurrently be a patient in another hospital campus. Such a patient must be separated from one hospital campus and admitted to the other hospital campus on each occasion of transfer when the patient remains at the second campus overnight or longer. • Multi-day patient at first campus is transferred to a second campus for treatment in ICU and remains there overnight or longer. The patient is separated from the first campus. • Multi-day patient at first campus attends second campus for treatment and returns on the same day to continue their current treatment. The same-day attendance at the second campus should be recorded on the patient’s record only. The patient is not separated from the first campus. A patient transferred to another campus but intending to return to this campus should be placed on leave for the duration of stay at the other campus. If the patient attends the other campus as a day-only admission, the leave should be recorded on the patient’s record but should not be reported to the VAED. Hospitals transferring admitted patients to a second hospital Separation Mode: T Separation and transfer to other acute hospital/extended care/rehabilitation/geriatric centre Transfer Destination: Report appropriate hospital campus code. Hospitals receiving patients from another hospital Admission Source: T Transfer from acute hospital/extended care/rehabilitation/geriatric centre Transfer Source: Report appropriate hospital campus code. Refer to: Section 2: Campus, Criteria for Admission, and Hospital. Section 3: Admission Source, Separation Mode, Transfer Destination, Transfer Source. Proposals for revisions to the VAED for 1 July 2015 Page 44 Proposal 12 – Removal of Contract/Spoke Identifier codes for lithotripsy services It is proposed to Remove lithotripsy codes from Contract/Spoke Identifier code set Proposed by Data Collections, System Intelligence and Analytics, Department of Health Implementation date 1 July 2015 Reason for proposal These codes have not been required since 2009. The information below was published in HDSS Bulletin 147 in 2009; however removal of the codes from the VAED manual was overlooked. 147.9 VAED reporting of patients undergoing extracorporeal shock wave lithotripsy St Vincent’s hospital provides all extracorporeal shock wave lithotripsy (ESWL) services in Victoria for public hospital patients. ESWL may be provided at St Vincent’s Hospital or at another Health Service by the St Vincent’s mobile service. VAED reporting of ESWL services provided by the mobile unit is inconsistent between health services and this can have a resultant impact on the funding received by the health service for multi-day stay patients. To ensure consistent reporting and receipt of appropriate funding, from 1 July 2009 public health services should not report ESWL episodes as a Hub and Spoke arrangement or a contracted episode. ESWL episodes should be reported as though the entire episode of care was provided at the location of the care, by that health service. For example if the lithotripsy was performed at Ballarat Health Services, Ballarat Health Services reports the complete episode of care including the lithotripsy procedure code with no contract or hub and spoke details. The cost weight for same day ESWL has been set at zero, as a contract exists between DHS and St Vincent’s to fund these services. The multi-day weight for ESWL cases excludes the cost of the actual lithotripsy procedure and is calculated to cover the other associated costs for the episode. Details of change • Amendment to Contract/Spoke Identifier code set • Amendment to business rules for Contracted Care • Amendments to validations Proposals for revisions to the VAED for 1 July 2015 Page 45 Section 3 Data definitions Contract/Spoke Identifier (amended) Specification Definition This field identifies: • The public or private hospital or day procedure centre involved in contracted care arrangements with this hospital (as purchaser or provider of contracted care). • The Spoke hospital in a Hub and Spoke arrangement for this episode (the Spoke hospital does not report the episode unless it is a multi-day stay). • The exact nature of the contract involving an external purchaser. Data type Numeric Form Code Field size 4 Layout NNNN or spaces. Location Episode Record Reported by Victorian public and private hospitals involved in contracted care arrangements with other hospitals (purchases and providers of contracted care). All other sites, report a space in this field. Reported for This item is mandatory if Funding Arrangement is: 1 Contract or 2 Hub/Spoke Otherwise, report a space in this field. Reported when This field can be reported during the patient’s stay and must be present when the Separation Date is reported in the Episode Record. Code set Where Funding Arrangement is 1 Contract, report the relevant Hospital Campus Code (refer to Hospital Code Table available at http://www.health.vic.gov.au/hdss/reffiles/index.htm), which identifies the other party to the contracted service arrangement, with the following exception: When • Funding Arrangement 1 Contract and • Contract Type 1 Contract Type B, Report the code from the list below that identifies the external purchaser/program relevant to the episode of care. Where the Funding Arrangement is 2 Hub/Spoke, report the relevant Contract/Spoke Identifier or Campus Code from the list below. Code Descriptor 0010 0011 0012 0030 0100 0200 0300 0311 Melbourne Health Same Day ECT – Northern Melbourne Health Same Day ECT - Sunshine Melbourne Health Same Day ECT - Broadmeadows Other Funding Source Australian Health Care Agreement (AHCA) - Elective Surgery Department of Health: HIV AIDS Department of Veterans’ Affairs: Veterans’ Cardiac Agreement Brunswick Dialysis Unit Proposals for revisions to the VAED for 1 July 2015 Page 46 0312 0313 0314 0315 0316 0317 0318 0321 0331 0332 0333 0334 0351 0352 0353 0361 0362 0399 0400 0500 0600 0700 0710 0800 0900 0910 0920 0930 0940 0950 0960 0970 0980 0990 Coburg Dialysis Unit Broadmeadows Dialysis Unit Williamstown Dialysis Unit Sunshine Hospital Dialysis Unit Northern Hospital Dialysis Unit Craigieburn Health Service St George’s Dialysis Caulfield General Medical Centre Dialysis Unit Austin Training Satellite Dialysis Unit Heidelberg Repatriation Hospital Dialysis Unit North East Kidney Service Epping Dialysis Unit Newcomb Dialysis Unit Rotary House Dialysis Unit South Geelong Renal Unit Maroondah Hospital Dialysis Unit Spring Street Dialysis Unit Big Red Kidney Bus Individual contracts with international patients Transport Accident Commission: Alfred Road Trauma Unit Department of Health: Rural & Remote Health Agency Program Department of Health: Bowen Centre - ARMC Department of Health: Interim Payment Victorian Maintenance Dialysis Program St Jude Pacemaker Replacement Program St Vincent’s Lithotripsy Service - Bendigo Hospital St Vincent’s Lithotripsy Service - MMC Clayton St Vincent’s Lithotripsy Service - RCH St Vincent’s Lithotripsy Service - MMC Moorabbin St Vincent’s Lithotripsy Service - West Gippsland Healthcare Group St Vincent’s Lithotripsy Service - Ballarat Hospital St Vincent’s Lithotripsy Service - Geelong Hospital St Vincent’s Lithotripsy Service - Frankston Hospital St Vincent’s Lithotripsy Service - Goulburn Valley Health [Reminder of this item unchanged] Section 8 Editing Validations 410 Illegal Comb Fund Arrange & Contract (change to function only) 419 Invalid Contract/Spoke Identifier (change to function only) Proposals for revisions to the VAED for 1 July 2015 Page 47 Proposal 13 – Removal of Account Class for geriatric respite care It is proposed to Remove Account Class MR Geriatric respite care and remove edit 329 Geriatric Respite – Invalid combination Proposed by Data Collections, System Intelligence and Analytics, Department of Health Implementation date 1 July 2015 Reason for proposal Account Class MR Geriatric respite care is no longer required. Health services now provide either Care Type 9 Geriatric Evaluation and Management or MC Maintenance Care VAED business rules direct use of either Z75.5 Holiday relief care or Z74.2 Need for assistance at home and no other household member able to render care as principal diagnosis however the second code triggers edit 355 Invalid principal diagnosis - warning Details of change • Amendment to Account Class code set • Removal of guide for us and table from Business rules • Removal of validation Section 2 Concepts and derived items Geriatric Respite (removed) Section 3 Data definitions Account Class (amended) Section 4 Business rules Geriatric Respite (removed) Account Class: Geriatric Respite (removed) Section 8 Editing Validation 329 Geri Respite – Invalid Comb (removed) Proposals for revisions to the VAED for 1 July 2015 Page 48 Proposal 14 – Amendment to validation 590 Diag Code Prefix M, not Morph It is proposed to Amend validation 590 Diagnosis Code prefix M Morphology, not Morphology code to also check for a Morphology code which is not prefixed M Proposed by Data Collections, System Intelligence and Analytics, Department of Health Implementation date 1 July 2015 Reason for proposal Morphology codes must have M prefix. Current validations do not prevent reporting of a morphology code with an incorrect prefix. Details of change Amendment to validation Section 8 Editing Validation 590 Diag Prefix M/, not Morph Code mismatch (amended) Effect REJECTION Problem The X5/Y5 Diagnosis Record has either: • a Diagnosis Code prefixed with an M Morphology, but the Diagnosis Code is not a Morphology Code or • a Morphology code which is not prefixed with an M Morphology. [On Library File: Morphology worksheet, column N, ADD, code 4] Remedy Check Diagnosis and Prefix codes, amend as appropriate and re-transmit the X5/Y5. Proposals for revisions to the VAED for 1 July 2015 Page 49 Proposal 15 – Addition of free text field Clinical Group It is proposed to Add a free text data item for health services to record either a clinical/discharging unit, doctor code or any other clinical group. Proposed by Business Intelligence, System Intelligence & Analytics, Department of Health Implementation date 1 July 2015 Reason for proposal Inclusion of the proposed item in the VAED will allow health services to undertake analysis of mortality, readmissions and length of stay performance indicators at the sub-hospital level using the Dr Foster benchmarking tool. Details of change • New data item • New record type required Section 3 Data definitions Clinical group (new) Specification Definition A free text field that hospitals can use to record a clinical or discharge unit or clinician to allow sub-hospital analysis of Dr Foster performance indicators. Field size 12 Location J Record Reported by Public hospitals Reported for All admitted episodes of care (optional) Reported when The J Record is reported Code set Free text field Reporting guide None Validations No validations will be applied Layout Characters or space Administration Purpose To facilitate sub-hospital analysis of Dr Foster performance indicators Principal data users Health Services Collection start 2015 Definition source DH Proposals for revisions to the VAED for 1 July 2015 Value Domain Source None Page 50