An independent review was conducted in 2012.
BackgroundThe National Health Reform Agreement (NHRA) established a data reliant policy and administrative environment. While the reforms focussed primarily on the public hospital sector, some elements of the reforms, particularly those focussed on accountability and transparency, also applied to the private hospital sector.
In 2012, the Department commissioned KPMG to undertake an expert examination and evaluation of the feasibility of harmonising data set provision by private hospitals to the Commonwealth in order to reduce the burden of reporting.
The information contained in this Report does not necessarily reflect the view(s) of the Department and no endorsement should be assumed for the directions or recommendations proposed.
Private Hospitals Data Collection HarmonisationIn conducting this review, KPMG was examining the feasibility of aligning the three main data sets reported by private hospitals into one set:
1 National Admitted Patient Care Dataset (APC), established 1991-92;
2 Hospital Casemix Protocol (HCP), established 1995; and
3 Private Hospital Data Bureau (PHDB), established 1997-98.
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List of RecommendationsThe Review has made the following recommendations:
- HCP and PHDB alignment should be proceeded with as an extension to the current HCP ECLIPSE enablement project as it requires only marginal changes to the datasets to allow collection and minor enhancements ECLIPSE Hub, is feasible and
- Alignment of the HCP/ PHDB and APC into a single dataset, collected once from private hospitals through an electronic transmission hub should be pursued subject to a cost benefit analysis and associated business case.
- A cost / benefit analysis and associated business case should be conducted to investigate in detail and report on the viability and potential for APC data collection for private hospitals being incorporated in a single process with HCP/ PHDB collection within a three year timeframe.
- DoHA should initiate discussions with NHISSC to establish a working group to look at a national Common Data Set Specification (DSS) for private hospitals data items not already in APC.
- Additional checking points should be implemented into the software at the private hospitals level before information flows elsewhere.
- Data checking and validation should be performed through accessing views of data, once collected within the Transmission Hub. Jurisdictions should retain the right to check/ validate and release the data they receive more widely, consistent with their current powers in this regard.
- Governance structures need to be set up early in the project and be an extension of current structures. The governance structure will include working groups to define access rules to consolidated database, set policies and resolve disputes.
- The governance structure needs to be based on an agreement between the stakeholders on the scope and objectives of the harmonisation process and should identify the likely parties to such an agreement. Funding responsibilities will need to be dealt with in such an agreement
- The governance structure will need to be developed in a staged way as States & Territories do not need to be a party to arrangements initially but will need to join in later.
- ICT enablement will be required for a small number of systems in Health Funds and Private Hospitals.
- All dataset metadata should be managed in the AIHW MeTEOR data dictionary.
- A Reference Group should be set up to agree on ways to rationalise jurisdictions' data collections from private hospitals. The Reference Group should develop a national private hospitals data set and encourage jurisdictions to use this vehicle instead of initiating their own collections.
- ECLIPSE should be enhanced to manage non-claim related private hospital episode data and to direct/ re-direct information flows to support an on-line, real time data checking, validation and authorisation processes for PHDB/HCP Stage 1 alignment.
- The market should be tested for a transmission hub for a Stage 2 HCP/PHDB/APC alignment aligned process (provided a decision is made after the cost/ benefit study to proceed).
- Additional helpdesk support and training should be put in place for private hospitals and insurers. Documentation could be produced centrally, but one option is for day-to-day contact to remain local, as the relationships already held with the jurisdictions should be considered.