1. Dialysis Reporting Adapting to the New Reality
Virginia Guthrie
Manager Health Data and Analysis

2. Current State ADT system is STAR (HBO)
Abstracting/Encoding system is 3M, with a manual interface
350 patients treated within the Dialysis Program at St. Joseph’s Healthcare (each with potentially 3 visits per week)

3. Support Groups ACRTF Ambulatory Care Reporting Task Force
St. Joseph’s Task Force
Dialysis Focus Group
Health Records
Finance
MIS
Registration IT

4. Volumes Average 5250 patient episodes per month
Plus approximately 400 second contact abstracts per month

5. Preliminary Challenges
How do we accurately and efficiently register all patients?
How are our MIS Functional Centre resources allocated?
How are we going to code all this?

6. Patient Profile in STAR
Based on Physician documentation (clinic summary)
ICD-10-CA codes are assigned by coding staff (proactive)
Codes are entered into User Defined fields in STAR
These fields reside at the MPI level and therefore can be loaded for every series contact

7. User Defined Fields in STAR
ICD-10-CA MAIN Dx (table)
ICD-10-CA Dx2
ICD-10-CA Dx3
ICD-10-CA Dx4
ICD-10-CA DX5
CCI INTERVENTION (table)
Inst. To
Inst. From

8. Customization of 3M abstract
User Defined fields from STAR are added to the load file (actual codes appear in abstract)
All possible fields are defaulted to the most common value
Mode of visit
Visit Disposition
Lab MIS FC

9. Coding by exception Coders maintain Patient Profiles in STAR
Coders review abstract and compare to Dialysis Flowsheet
Codes are changed or added as required (only exceptions to the normal coarse of treatment)
Initiate encoder and compute

10. Information Flow
Flowsheets are received from the Dialysis unit on a weekly basis
But there is a full month lag time due to information needs for patient care within the unit
Coders review and then the documentation is filed

11. Present Productivity Productivity goal is 400 abstracts per day
Actual productivity average is presently 325 abstracts per day
most productive day - 476
least productive day - 263
Anticipate passing productivity goal within the next 3 weeks

12. Lessons Learned
Identify key stakeholders and make sure they participate
Communicate with your peers
Learn to adapt
Streamline processes
Compile clear policies and procedures
BE CREATIVE!