1. Home grown workforce solution
Tony kalathil Jose JP
health information manager
orange health service

2. Background
Coding workforce shortfall is a nationwide issue identified in “the coding workforce shortfall” report (AIHW, 2010) also in “Health Information Workforce report” by Health Workforce Australia 2013
Ageing workforce –around 50% aged 45 years or over
Around 50% working part time, female majority
Increased need for quality and efficiency to meet ABF requirements
Nearly 1 in 5 facilities engaged with coding contract companies
175 FTEs are vacant across Australia
E-Health and other clinical information systems require an additional 150 FTE to meet the requirements

3. Orange Health Service Rural referral hospital for WNSWLHD
Largest rural hospital in NSW
Both acute and Mental health
130 bedded hospital
Health Information services
Health information manager
Deputy Health information manager –MH
3 clinical coders
2 data officers
2 medico legal clerks
4 HIS clerks

4. Challenges at Orange Health Service
In 2014, OHS identified there will be shortage of clinical coders in 2016
Geographical location of facility
Cost of training for individuals- around $6000 per candidate

5. Program Wanted a sustainable and long term workforce succession plan
Clinical coding training offered to current staff at Orange
Shows organisation’s commitment towards investing in people
Formalising program
Training modules
Cost involved
Duration of the training

6. Program-stages Expression of interest sent out
Literacy tests
Interviews
Training –three modules by HIMAA
Medical terminology
Introductory ICD-10-AM, ACHI, and ACS
3 to 6 months of on the job training at OHS then
Intermediate ICD-10-AM, ACHI, and ACS

7. Outcome- Financial Cost of training
Course fees $4150 for both medical terminology and introductory course
Training cost $25920, 6 months fulltime traineeship
Total cost $30070
On an average 2400 separations coded during traineeship
Cost to use a coding contractor/company to code 2400 separations - $48000, at $80 per hour, 4 separations per hour
Savings - $17930

8. Outcome – Meeting immediate needs
3 staff members started training in 2014
A clinical coder retired in June 2016, we have successfully recruited to this position from the program
All candidates have successfully completed the introductory course – pass mark 80%
1 candidate secured the job
second candidate started on the job training
Third candidate took up another role in district
Existing candidates have started intermediate course

9. Outcome – Sustainable
In 2015, a further 3 staff members were selected through the EOI to undertake training
These candidates completed medical terminology in June and started introductory course
Potential to support the LHD in their clinical coding activities

10. Outcome – CORE Values
Collaboration - candidates from different departments were supported
Openness – HIS unit is open to staff participate in the program, supportive, engaged
Respect – The existing clinical coders are valued as the organisation is addressing the gap in their workforce
Empowerment – staff members were provided opportunity to enhance their career in health

11. Acknowledgements Catherine Nowlan, General Manager
Previous health information managers
Several department managers
My team – Health Information Department