Mr James Downie, CEO, presented on the topic 'Moving towards value based funding' at the Healthcare reform, funding and innovation conference, hosted by AventEdge on 27 June 2017.
Mr James Downie, CEO, presented on the topic 'Emergency care costing study and classification development' at the 9th Annual Emergency Department Management Conference, hosted by informa on 31 July 2017.
Mr James Downie, CEO, presented on the topic 'Moving towards value based funding' at the 2017 Activity-Based Funding Conference, hosted by the Health Service Executive, Ireland on 11 May 2017.
Mr James Downie, CEO, presented on the topic 'Independent Hospital Pricing Authority Update' at the HBN/CHASAN Steering Committee, hosted by Catholic Negotiating Alliance on 15 May 2017.
Mr James Downie, CEO, presented on the topic 'IHPA 2017 and beyond' at the Enhancing Performance & Efficiency in Paediatric Care - CHA Annual Benchmarking Forum, hosted by Children's Healthcare Australasia on 25 May 2017.
What Happens After Your Device is Approved? Collecting Data in the Real WorldMedpace
In this workshop, Medpace will discuss key considerations for generating real-world evidence and how to apply critical insights in order to drive late-stage clinical research. To listen to this presentation, visit https://vimeo.com/168768256
Mr James Downie, CEO, presented on the topic 'Moving towards value based funding' at the Healthcare reform, funding and innovation conference, hosted by AventEdge on 27 June 2017.
Mr James Downie, CEO, presented on the topic 'Emergency care costing study and classification development' at the 9th Annual Emergency Department Management Conference, hosted by informa on 31 July 2017.
Mr James Downie, CEO, presented on the topic 'Moving towards value based funding' at the 2017 Activity-Based Funding Conference, hosted by the Health Service Executive, Ireland on 11 May 2017.
Mr James Downie, CEO, presented on the topic 'Independent Hospital Pricing Authority Update' at the HBN/CHASAN Steering Committee, hosted by Catholic Negotiating Alliance on 15 May 2017.
Mr James Downie, CEO, presented on the topic 'IHPA 2017 and beyond' at the Enhancing Performance & Efficiency in Paediatric Care - CHA Annual Benchmarking Forum, hosted by Children's Healthcare Australasia on 25 May 2017.
What Happens After Your Device is Approved? Collecting Data in the Real WorldMedpace
In this workshop, Medpace will discuss key considerations for generating real-world evidence and how to apply critical insights in order to drive late-stage clinical research. To listen to this presentation, visit https://vimeo.com/168768256
Health IT Summit Boston 2014 – Case Study “Beyond MU Stage 2: Maximizing the value of your HER” with Larry Garber, Medical Director of Informatics, Reliant Medical Group
Learn how to leverage effective strategies for global drug development, including expedited regulatory pathways, personalized medicines and genomics. View the full presentation from PAREXEL Consulting experts.
This presentation provides an explanation of each Meaningful Use Core Measure and is required threshold , designed to help you put Meaningful Use Core Measures into practice.
What's Next in RWE_Amy Rudolph_Novartis_mHealth IsraelLevi Shapiro
Overview of the
- Healthcare ecosystem complexity increasing rapidly
- Pharma industry is facing a crisis: trends shaping the industry
- RWE complements RCTs and captures implementation of innovation
- RWE is one component of the integrated evidence needed for stakeholders
- Integrated Evidence: Optimizing patient access
- Integrated Evidence: Label expansion
- Maximizing the value of data requires a scalable platform and expertise
ECO 11: Transfer of Care to Pharmacy - Hassan Argomandkhah, Chair of Pharmacy...Innovation Agency
Hassan introduces the concept and key objectives of transfer of care to pharmacy (TCP). The slides include a project outline, an overview of TCP in Cheshire and Merseyside, and the benefits and potential savings of Electronic Transfer of Care to Pharmacy.
Jennifer Nobbs, Executive Director, Activity Based Funding, presented on the topic 'IHPA and Activity Based Funding' at a meeting of the Australian Stroke Coalition on 27 June 2017.
Real-World Data – What’s Next? by Michael Seewald, AstraZeneca for mHealth Is...Levi Shapiro
Presentation by Michael Seewald, Michael Seewald, Ph.D.
Global Head Evidence, AstraZeneca Biopharmaceuticals for mHealth Israel, October 19th, 2021.
Real-World Data is able to uncover local unmet medical need – Call to action to build Learning Healthcare Systems. Significant Variations in Care and Large Potential for Improvement. Real-World Data helps to benchmark efficient use of resources and detect “waste”. Healthcare systems need to address the problem of waste. But fundamental change is hard, and progress slow. Outcomes Transparency Improves ComplianceExample: Swedish myocardial infarction registry. Outcomes Transparency Improves Compliance. Example: Swedish myocardial infarction registry. Improving Outcomes and Creating Value will continue to guide Learning Healthcare Systems- enabled by RWD. Four technological trends as accelerators on our path. Empowered patients- Molecular screening and 24/7 monitoring driving a step change in diagnosis. Algorithmic decision-making: Artificial intelligence supports physician intelligence. Evidence-generating healthcare systemsLive insights on clinical efficacy from digital monitoring. 360° care delivery. Home replaces hospital via digital therapeutics and on-demand remote support. AstraZeneca Areas of Partnering Interest: (https://www.astrazeneca.com/partnering/our-areas-of-partnering-interest.html).
ECO 11: Medicines Optimisation Through Precision - Sir Munir PirmohamedInnovation Agency
Munir Pirmohamed discusses the potential impact of medicines optimisation in terms of ensuring the right patients get the right choice if medicine at the right time. He presents a case history of over prescription and introduces three examples of medicines optimisation through use of genetics, big data, and pharmacogenetics profiling.
January 23, 2017
The Fifth Annual Health Law Year in P/Review symposium featured leading experts discussing major developments during 2016 and what to watch out for in 2017. The discussion at this day-long event covered hot topics in such areas as health policy under the new administration, regulatory issues in clinical research, law at the end-of-life, patient rights and advocacy, pharmaceutical policy, reproductive health, and public health law.
The Fifth Annual Health Law Year in P/Review was sponsored by the Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics at Harvard Law School, Harvard Health Publications at Harvard Medical School, Health Affairs, the Hastings Center, the Program On Regulation, Therapeutics, And Law (PORTAL) in the Division of Pharmacoepidemiology and Pharmacoeconomics at Brigham and Women’s Hospital, and the Center for Bioethics at Harvard Medical School, with support from the Oswald DeN. Cammann Fund.
Learn more on our website: http://petrieflom.law.harvard.edu/events/details/5th-annual-health-law-year-in-p-review
NVTC Capital Health Tech Summit: Dr. Shannon KeynoteAlexa Magdalenski
The 2017 Capital Health Tech Summit took place on June 15, 2017 at the Inova Center for Personalized Health. Dr. Richard Shannon, Executive Vice President, Health Affairs, University of Virginia provided the Summit's second keynote.
Health IT Summit Boston 2014 – Case Study “Beyond MU Stage 2: Maximizing the value of your HER” with Larry Garber, Medical Director of Informatics, Reliant Medical Group
Learn how to leverage effective strategies for global drug development, including expedited regulatory pathways, personalized medicines and genomics. View the full presentation from PAREXEL Consulting experts.
This presentation provides an explanation of each Meaningful Use Core Measure and is required threshold , designed to help you put Meaningful Use Core Measures into practice.
What's Next in RWE_Amy Rudolph_Novartis_mHealth IsraelLevi Shapiro
Overview of the
- Healthcare ecosystem complexity increasing rapidly
- Pharma industry is facing a crisis: trends shaping the industry
- RWE complements RCTs and captures implementation of innovation
- RWE is one component of the integrated evidence needed for stakeholders
- Integrated Evidence: Optimizing patient access
- Integrated Evidence: Label expansion
- Maximizing the value of data requires a scalable platform and expertise
ECO 11: Transfer of Care to Pharmacy - Hassan Argomandkhah, Chair of Pharmacy...Innovation Agency
Hassan introduces the concept and key objectives of transfer of care to pharmacy (TCP). The slides include a project outline, an overview of TCP in Cheshire and Merseyside, and the benefits and potential savings of Electronic Transfer of Care to Pharmacy.
Jennifer Nobbs, Executive Director, Activity Based Funding, presented on the topic 'IHPA and Activity Based Funding' at a meeting of the Australian Stroke Coalition on 27 June 2017.
Real-World Data – What’s Next? by Michael Seewald, AstraZeneca for mHealth Is...Levi Shapiro
Presentation by Michael Seewald, Michael Seewald, Ph.D.
Global Head Evidence, AstraZeneca Biopharmaceuticals for mHealth Israel, October 19th, 2021.
Real-World Data is able to uncover local unmet medical need – Call to action to build Learning Healthcare Systems. Significant Variations in Care and Large Potential for Improvement. Real-World Data helps to benchmark efficient use of resources and detect “waste”. Healthcare systems need to address the problem of waste. But fundamental change is hard, and progress slow. Outcomes Transparency Improves ComplianceExample: Swedish myocardial infarction registry. Outcomes Transparency Improves Compliance. Example: Swedish myocardial infarction registry. Improving Outcomes and Creating Value will continue to guide Learning Healthcare Systems- enabled by RWD. Four technological trends as accelerators on our path. Empowered patients- Molecular screening and 24/7 monitoring driving a step change in diagnosis. Algorithmic decision-making: Artificial intelligence supports physician intelligence. Evidence-generating healthcare systemsLive insights on clinical efficacy from digital monitoring. 360° care delivery. Home replaces hospital via digital therapeutics and on-demand remote support. AstraZeneca Areas of Partnering Interest: (https://www.astrazeneca.com/partnering/our-areas-of-partnering-interest.html).
ECO 11: Medicines Optimisation Through Precision - Sir Munir PirmohamedInnovation Agency
Munir Pirmohamed discusses the potential impact of medicines optimisation in terms of ensuring the right patients get the right choice if medicine at the right time. He presents a case history of over prescription and introduces three examples of medicines optimisation through use of genetics, big data, and pharmacogenetics profiling.
January 23, 2017
The Fifth Annual Health Law Year in P/Review symposium featured leading experts discussing major developments during 2016 and what to watch out for in 2017. The discussion at this day-long event covered hot topics in such areas as health policy under the new administration, regulatory issues in clinical research, law at the end-of-life, patient rights and advocacy, pharmaceutical policy, reproductive health, and public health law.
The Fifth Annual Health Law Year in P/Review was sponsored by the Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics at Harvard Law School, Harvard Health Publications at Harvard Medical School, Health Affairs, the Hastings Center, the Program On Regulation, Therapeutics, And Law (PORTAL) in the Division of Pharmacoepidemiology and Pharmacoeconomics at Brigham and Women’s Hospital, and the Center for Bioethics at Harvard Medical School, with support from the Oswald DeN. Cammann Fund.
Learn more on our website: http://petrieflom.law.harvard.edu/events/details/5th-annual-health-law-year-in-p-review
NVTC Capital Health Tech Summit: Dr. Shannon KeynoteAlexa Magdalenski
The 2017 Capital Health Tech Summit took place on June 15, 2017 at the Inova Center for Personalized Health. Dr. Richard Shannon, Executive Vice President, Health Affairs, University of Virginia provided the Summit's second keynote.
Clinical Integration: The Foundation for Accountable Care - Presentation delivered by Keynote Speaker Marvin O’Quinn, Senior Executive Vice President and Chief Operating Officer, Dignity Health at the National Healthcare CXO Summit held in Las Vegas Oct 19-21, 2014.
Case Study “Investment in a Health IT Infrastructure, the Future Quality Imperative”
Steven Anderman
Chief Operating Officer & SVP, Operations
Bronx-Lebanon Hospital Center
Presentation on payment reform and changing models given at 2016 Ziegler National Senior Living CFO Workshop, April 6-8, 2016 at The Sheraton New Orleans Hotel.
Edifecs: Demonstrating who you are in CJREdifecs Inc
A hands-on approaches for hospitals to strategically align orthopedic surgeons and post-acute providers under CJR. This Presentation focuses on tools that providers can use to help manage their performance to be successful under the new value-based environment.
The CMS Innovation Center hosted a special webinar featuring Dr. Patrick Conway, CMS Deputy Administrator for Innovation and Quality and CMS Chief Medical Officer, on Monday, November 10, 2014 from 10:30am – 11:30 am ET. Dr. Conway will provided an update about the work of the CMS Innovation Center and the models being tested to improve better care for patients, better health for our communities, and lower costs through improvement for our health care system. Opportunities for questions were provided.
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CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
Health IT Summit Denver 2014 - "Anatomy of a Health System"
This unique discussion series explores behind-the-scenes looks at the most progressive and high performing health systems in the country. Panelists will discuss critical areas such as go-live strategy, vendor management, patient engagement, IT governance and more. Attendees will walk away with a better understanding of how departments can effectively work together, tangible strategies for delivering high quality care while maintaining an efficient and secure health information system.
Moderator: Cynthia Burghard, Research Director, IDC Health Insights
Marc Lassaux, CTO, Technical Director Beacon Project, Quality Health Network
Justin Aubert, Chief Financial Officer, Quality Health Network
Kevin Fitzgerald, MD, CMO, Rocky Mountain Health
CHAPTER 1 SEMESTER V - ROLE OF PEADIATRIC NURSE.pdfSachin Sharma
Pediatric nurses play a vital role in the health and well-being of children. Their responsibilities are wide-ranging, and their objectives can be categorized into several key areas:
1. Direct Patient Care:
Objective: Provide comprehensive and compassionate care to infants, children, and adolescents in various healthcare settings (hospitals, clinics, etc.).
This includes tasks like:
Monitoring vital signs and physical condition.
Administering medications and treatments.
Performing procedures as directed by doctors.
Assisting with daily living activities (bathing, feeding).
Providing emotional support and pain management.
2. Health Promotion and Education:
Objective: Promote healthy behaviors and educate children, families, and communities about preventive healthcare.
This includes tasks like:
Administering vaccinations.
Providing education on nutrition, hygiene, and development.
Offering breastfeeding and childbirth support.
Counseling families on safety and injury prevention.
3. Collaboration and Advocacy:
Objective: Collaborate effectively with doctors, social workers, therapists, and other healthcare professionals to ensure coordinated care for children.
Objective: Advocate for the rights and best interests of their patients, especially when children cannot speak for themselves.
This includes tasks like:
Communicating effectively with healthcare teams.
Identifying and addressing potential risks to child welfare.
Educating families about their child's condition and treatment options.
4. Professional Development and Research:
Objective: Stay up-to-date on the latest advancements in pediatric healthcare through continuing education and research.
Objective: Contribute to improving the quality of care for children by participating in research initiatives.
This includes tasks like:
Attending workshops and conferences on pediatric nursing.
Participating in clinical trials related to child health.
Implementing evidence-based practices into their daily routines.
By fulfilling these objectives, pediatric nurses play a crucial role in ensuring the optimal health and well-being of children throughout all stages of their development.
Navigating Challenges: Mental Health, Legislation, and the Prison System in B...Guillermo Rivera
This conference will delve into the intricate intersections between mental health, legal frameworks, and the prison system in Bolivia. It aims to provide a comprehensive overview of the current challenges faced by mental health professionals working within the legislative and correctional landscapes. Topics of discussion will include the prevalence and impact of mental health issues among the incarcerated population, the effectiveness of existing mental health policies and legislation, and potential reforms to enhance the mental health support system within prisons.
One of the most developed cities of India, the city of Chennai is the capital of Tamilnadu and many people from different parts of India come here to earn their bread and butter. Being a metropolitan, the city is filled with towering building and beaches but the sad part as with almost every Indian city
Explore our infographic on 'Essential Metrics for Palliative Care Management' which highlights key performance indicators crucial for enhancing the quality and efficiency of palliative care services.
This visual guide breaks down important metrics across four categories: Patient-Centered Metrics, Care Efficiency Metrics, Quality of Life Metrics, and Staff Metrics. Each section is designed to help healthcare professionals monitor and improve care delivery for patients facing serious illnesses. Understand how to implement these metrics in your palliative care practices for better outcomes and higher satisfaction levels.
Health Education on prevention of hypertensionRadhika kulvi
Hypertension is a chronic condition of concern due to its role in the causation of coronary heart diseases. Hypertension is a worldwide epidemic and important risk factor for coronary artery disease, stroke and renal diseases. Blood pressure is the force exerted by the blood against the walls of the blood vessels and is sufficient to maintain tissue perfusion during activity and rest. Hypertension is sustained elevation of BP. In adults, HTN exists when systolic blood pressure is equal to or greater than 140mmHg or diastolic BP is equal to or greater than 90mmHg. The
ICH Guidelines for Pharmacovigilance.pdfNEHA GUPTA
The "ICH Guidelines for Pharmacovigilance" PDF provides a comprehensive overview of the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH) guidelines related to pharmacovigilance. These guidelines aim to ensure that drugs are safe and effective for patients by monitoring and assessing adverse effects, ensuring proper reporting systems, and improving risk management practices. The document is essential for professionals in the pharmaceutical industry, regulatory authorities, and healthcare providers, offering detailed procedures and standards for pharmacovigilance activities to enhance drug safety and protect public health.
Medical Technology Tackles New Health Care Demand - Research Report - March 2...pchutichetpong
M Capital Group (“MCG”) predicts that with, against, despite, and even without the global pandemic, the medical technology (MedTech) industry shows signs of continuous healthy growth, driven by smaller, faster, and cheaper devices, growing demand for home-based applications, technological innovation, strategic acquisitions, investments, and SPAC listings. MCG predicts that this should reflects itself in annual growth of over 6%, well beyond 2028.
According to Chris Mouchabhani, Managing Partner at M Capital Group, “Despite all economic scenarios that one may consider, beyond overall economic shocks, medical technology should remain one of the most promising and robust sectors over the short to medium term and well beyond 2028.”
There is a movement towards home-based care for the elderly, next generation scanning and MRI devices, wearable technology, artificial intelligence incorporation, and online connectivity. Experts also see a focus on predictive, preventive, personalized, participatory, and precision medicine, with rising levels of integration of home care and technological innovation.
The average cost of treatment has been rising across the board, creating additional financial burdens to governments, healthcare providers and insurance companies. According to MCG, cost-per-inpatient-stay in the United States alone rose on average annually by over 13% between 2014 to 2021, leading MedTech to focus research efforts on optimized medical equipment at lower price points, whilst emphasizing portability and ease of use. Namely, 46% of the 1,008 medical technology companies in the 2021 MedTech Innovator (“MTI”) database are focusing on prevention, wellness, detection, or diagnosis, signaling a clear push for preventive care to also tackle costs.
In addition, there has also been a lasting impact on consumer and medical demand for home care, supported by the pandemic. Lockdowns, closure of care facilities, and healthcare systems subjected to capacity pressure, accelerated demand away from traditional inpatient care. Now, outpatient care solutions are driving industry production, with nearly 70% of recent diagnostics start-up companies producing products in areas such as ambulatory clinics, at-home care, and self-administered diagnostics.
Telehealth Psychology Building Trust with Clients.pptxThe Harvest Clinic
Telehealth psychology is a digital approach that offers psychological services and mental health care to clients remotely, using technologies like video conferencing, phone calls, text messaging, and mobile apps for communication.
Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
CRISPR-Cas9, a revolutionary gene-editing tool, holds immense potential to reshape medicine, agriculture, and our understanding of life. But like any powerful tool, it comes with ethical considerations.
Unveiling CRISPR: This naturally occurring bacterial defense system (crRNA & Cas9 protein) fights viruses. Scientists repurposed it for precise gene editing (correction, deletion, insertion) by targeting specific DNA sequences.
The Promise: CRISPR offers exciting possibilities:
Gene Therapy: Correcting genetic diseases like cystic fibrosis.
Agriculture: Engineering crops resistant to pests and harsh environments.
Research: Studying gene function to unlock new knowledge.
The Peril: Ethical concerns demand attention:
Off-target Effects: Unintended DNA edits can have unforeseen consequences.
Eugenics: Misusing CRISPR for designer babies raises social and ethical questions.
Equity: High costs could limit access to this potentially life-saving technology.
The Path Forward: Responsible development is crucial:
International Collaboration: Clear guidelines are needed for research and human trials.
Public Education: Open discussions ensure informed decisions about CRISPR.
Prioritize Safety and Ethics: Safety and ethical principles must be paramount.
CRISPR offers a powerful tool for a better future, but responsible development and addressing ethical concerns are essential. By prioritizing safety, fostering open dialogue, and ensuring equitable access, we can harness CRISPR's power for the benefit of all. (2998 characters)
Deep Leg Vein Thrombosis (DVT): Meaning, Causes, Symptoms, Treatment, and Mor...The Lifesciences Magazine
Deep Leg Vein Thrombosis occurs when a blood clot forms in one or more of the deep veins in the legs. These clots can impede blood flow, leading to severe complications.
3. Addendum to the NHRA
• ABF Continues until 2020
• Commonwealth growth capped at 6.5% (price +
volume)
• Reforms to improve efficiency of public hospitals:
‒Healthcare homes
‒Safety and quality considerations
‒Avoidable readmissions
‒Potentially preventable admissions
• New agreement beyond 2020 agreed by 2018
3 www.ihpa.gov.au
4. Strategic intent of ABF
• Transparency
• Value for money
• Independence
• National comparability
• Technical Efficiency
4
5. About IHPA
• Independent of all governments
‒Can not be directed on pricing
• Governed by a 9 member board
• 28 member clinical advisory committee
‒Senior medical, nursing and allied health
• 40 staff
‒Data management, statistical, classification, policy
and comms
• Strong consultation and transparency agenda
5
6. IHPA’s functions
•Set the National Efficient Price
•Classification systems
•Data standards
•Cross border and cost shifting disputes
6
7. Progress so far
• ABF
‒Admitted Acute
‒Subacute
‒Emergency
‒Non-admitted
• Block Funding
‒Community Mental Health
‒Teaching, training and
research
‒Small rural and remote
hospitals
7
9. Private Patients in public hospitals
• IHPA reduces the NEP to account for other payments
made for private patients in public hospitals:
‒MBS payments
‒Prosthesis reimbursement
‒Accommodation fees (default rate)
• Average discount ~35%
• Intent is that private patients are revenue neutral
compared to a public patient.
9
12. Private Patients in public hospitals
• A number of states and territories provide incentives to
pursue private patients:
‒Private patient revenue targets
‒Not implementing price discount
• National model not driving increase in utilisation
• IHPA continues to closely monitor
12
13. Benchmarking portal
•ABF generates masses of data
‒ Cost data collection >1,000,000,000
records
•Used properly this data can help improve
the efficiency of hospitals by reducing
variation
•Have to make it accessible at the
hospital level!
18. Premise
• Australian and international costing studies estimate that adverse
events explain between 12.0% and 16.5% of total costs
• ICD-10-AM data is a rich source of safety and quality data,
currently underutilised
• Literature review:
‒ Good evidence that the provision of timely clinical information to
clinicians & managers leads to improvements in patient
outcomes
• Pricing signals:
‒ Provide clear sign that government values safety and quality
‒ Promote discussion of safety and quality systems amongst
clinicians AND managers
18
19. Approach
• Three areas of focus:
‒Sentinel Events
‒Hospital Acquired Complications
‒Avoidable readmissions
• Data provision to clinicians and managers a critical
component of work
19
20. Sentinel Events
20
1. Procedures involving the wrong patient or body part resulting in death or major
permanent loss of function
2. Suicide of a patient in an inpatient unit
3. Retained instruments or other material after surgery requiring re-operation or
further surgical procedure
4. Intravascular gas embolism resulting in death or neurological damage
5. Haemolytic blood transfusion reaction resulting from ABO incompatibility
6. Medication error leading to the death of a patient reasonably believed to be due
to incorrect administration of drugs
7. Maternal death associated with pregnancy, birth and the puerperium
8. Infant discharged to the wrong family
21. Sentinel Events
• From 1 July 2017 no funding for episodes of care with
a sentinel event
• ~100 events per annum (public hospitals)
• Funding impact ~$5 million per annum
21
22. Hospital Acquired Complications
• Coded data differentiates between conditions present on
admission, and those arising during admission
• Measured using CHADx system:
‒ Too much noise
‒ No measure of preventability
• Hospital Acquired Complications:
‒ Developed by clinicians
• Clear criteria:
‒ Preventability
‒ Patient Impact
‒ Cost Impact
‒ Clinical priority
22
23. 23
Pressure injury Gastrointestinal bleeding
Falls resulting in fracture and intracranial
injury
Medication complications
Healthcare associated infection Delirium
Surgical complications requiring
unplanned return to theatre
Persistent incontinence
Unplanned Intensive Care Unit
admission
Malnutrition
Respiratory complications Cardiac complications
Venous thromboembolism Third and fourth degree perineal
laceration during delivery
Renal failure Birth trauma
Hospital Acquired Complications
24. HACs add cost
24
HAC
Incremental
cost
All HACs 8.6%
Pressure injury 13.8%
Falls resulting in fracture or other intracranial injury 1.7%
Healthcare associated infection 8.8%
Surgical complications requiring unplanned return to theatre 10.9%
Unplanned intensive care unit admission
Respiratory complications 15.9%
Venous thromboembolism 12.4%
Renal failure 21.7%
Gastrointestinal bleeding 10.0%
Medication complications 8.2%
Delirium 9.8%
Persistent incontinence 2.3%
Malnutrition 7.4%
Cardiac complications 11.3%
Perineal laceration 23.2%
Neonatal birth trauma 10.8%
28. Risk Adjustment Critical
• Patient risk factors:
‒Age
‒DRG
‒Charlson Complexity Score (predicts the one year
mortality for a patient with a range of specific
comorbidities)
‒ICU admission
‒Emergency admission
• Can calculate risk score for every patient
28
31. Preventable Readmissions
• All admissions are currently paid for
• Some evidence of preventable readmissions in system
• Currently no nationally agreed, clinically acceptable list
of readmission causes
• List currently being developed – clinically led, data
driven project
• Possible inclusions:
‒Preventable hospitalisations
‒Readmission for HACs
‒Constipation
31