APP system, Clinics Exclusions

Purpose

This function provides the ability to Specific Exclude APP clinics from Full Episode Creation.

         Hospital Systems generally have three sources of “real” Episodes. Inpatient Stays, Outpatient Clinic Appointments (note the subtle difference between an Appointment and an Attendance), and Emergency Department Attendances. Utilisation that does not link to one of these episode types in TALONS is assigned an “Error” Episode which is only used for that Utilisation event.

         The Use of the APP system for recording Allied Health “Appointments” and Allied Health Inpatient “Bedside Attendances” creates an anomaly in that this would previously have created a Defined APP episode. This would allow utilisation from Diagnostic and Pharmacy Feeders to link to that Allied Health “Episode”. Further, the Bedside Attendance was not connecting to the IP episode.

Changes

IP & AE Episode Linking

All APP utilisation will now link to an Inpatient or Emergency Episode if one exists, ALL Clinics, ALL Appointment Types. Linking is based on Date only criteria, if the Appointment occurs between admit and discharge date, or Arrival in Emergency Date and up to 24 hours later,  it will link to that episode. Please note no times are referenced, as the times in APP are usually “notional” as to the time a patient is seen. This will cover both Allied health IP Bedside attendances, and as well, Patients seen in Outpatients and immediately admitted.

Clinic Exclusions

The Ability to “Exclude” certain APP clinics from Full APP Episode creation has been installed at ALL sites. A Screen to Add clinics has been added to the Mapping and Setup Menu, the heading is like “APP Clinic Episode XCLUDEs” Clinics entered in this screen with a status of “Y” will be excluded from creating Full OP Episodes, but will create “Restricted” Episodes to link the Appointment Utilisation to.

User Actions Required

·         Each site will first, in liaison with their APP system manager, Allied Health Staff etc, need to create a list of clinics requiring Exclusion from Full Episode Creation. These will almost invariable be limited to Allied Health Clinics, however other clinics that logically DO NOT/SHOULD NOT have other utilization link to their “Restricted” type Episode can be added (e.g. Antenatal Classes run by Nursing)

·         The List of Clinics needs to be entered one by one into the Screen, have a status of “Y” assigned, and filed “F”, a limit of Clinic length to 25 characters applies. “?” can be used to view a listing of codes and Assigned numbers.

·         At the Filing prompt, typing FN will list clinics entered so far, with values assigned. Clinics not in the list are assumed to be a status of “N”

Impact on YTD processing

Sites wanting the data for 2003-2004 to be coherent in respect of these episode types, IP linking etc will need to remove all XVI utilisation for 2003-2004 and re-extract/load/post. Please note, that in the change over, it will occur that XVOP records will be duplicated under two episodes. Periodically it will be necessary to purge XVOP episodes that have no Utilisation. Sites wishing to purge all XVOP as well as all XVI for 2003-2004 must contact me as saved lists for XV episodes sent to date must be purged