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Data is at the heart of VAHI’s work. We transform data into trusted, accurate and useful information that can be used to drive improvements. VAHI ensures the data it collects and uses are complete and accurate, protected from unauthorised access, and available when needed.

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Following best practice in information management 

VAHI’s information management practices ensure that we handle and govern data in compliance with all relevant legislation and policies. We share data and information as much as possible to support system improvement, while protecting the privacy of patients and organisations. We follow best practice principles for all data and information management. 

During 2018–19, VAHI continued to refine documentation that describes the way we collect, store, use, analyse, share and govern information. Our Information Management Framework and Policy documents have been developed to address recommendations from an internal data governance audit and to approve new governance roles for VAHI data holdings. We have started to develop the detailed procedures that underpin the policy document, which will be finalised in 2019–20.

VAHI has continued to document the specifications and calculations for all measures it reports. This provides transparency and aids analysis. During 2018–19, we finalised specifications for all measures that appear in Monitor, Board safety and quality report and Inspire, pending final approval.

Ensuring integrity of health data

Accurate data are essential for the allocation of funding, performance monitoring, policy development, planning and clinical research. VAHI plays a critical role in building the trust that stakeholders have in Victorian health data.

VAHI through the Health Data Integrity (HDI) program, is responsible for ensuring the integrity of performance and activity data reported by health services to the Department. This means ensuring datasets accurately reflect the care provided to patients and that health services are compliant with various departmental policies such as the elective surgery and specialist clinics access policies.

The focus of our HDI program has moved from random reviews (or audits) to a more targeted audit approach based on data analytics and risk assessment.

One element of the HDI program is a three-year Victorian Admitted Episodes Dataset (VAED) audit where, during 2018–19, VAHI audited the admitted patient data reported by 43 public health services. This included metropolitan, regional and small rural health services.

The audit program focused on the accuracy of coded data for acute and, where applicable, mental health episodes; and the reporting of hospital acquired complications (HACs) data derived from diagnosis and prefix coding. The results showed variations in coding accuracy between health services, which VAHI will work with health services to address. VAHI provided a series of recommendations to be actioned, such as greater adherence to departmental policies and workforce education.

During the year, VAHI purchased Relative Indicators for Safety and Quality (RISQ) software that provides a method to measure and compare the relative safety and quality performance based on the prefix data and the incidence of HACs. This measurement and auditing tool enhances VAHI’s capability for HACs reporting, benchmarking, coding and clinical service improvement.

VAHI also commenced a comprehensive program of desktop analysis of health services’ emergency department and elective surgery waiting list data to identify and monitor any shifts, anomalies, patterns or other trends in the reported data. We then worked with health services on issues identified through this analysis.

Supporting classification and coding

Clinical coding is used to classify clinical concepts into code. Health information managers and clinical coders assign clinical codes to a patient’s record using the diagnoses and clinical interventions (surgeries and investigative procedures) that clinicians have documented in the patient’s medical record.

The clinical codes are reported in the VAED, which is one of the key health datasets in Victoria for public and private hospital data. The VAED and the coded data are used widely to support quality and safety monitoring in health services, clinical research, health service planning and public hospital funding.

During 2018–19, Victoria contributed to the development of the latest edition of the clinical coding classification (Eleventh Edition of the ICD-10- AM/ACHI/ACS), which was published on 1 July 2019. This national update revises the Australian Coding Standard for Additional Diagnoses (ACS 0002). The revision draws significantly on work undertaken by VAHI on standards for additional diagnoses coding. It is a good example of how Victoria is providing strong leadership in classification development at the national level.

This year, VAHI set up the Health Classifications Advisory Group to strengthen relationships between the Department and health services relating to health classification information. The group meets quarterly and allows VAHI, the Department and SCV to engage with health information managers, clinical coders and health service executives to better understand variations in the coded data reported by public health services.

VAHI’s Victorian ICD Coding Committee continues to respond to a growing number of coding queries submitted by public and private hospital clinical coders. In 2018–19, VAHI resolved 136 coding queries.

Building information management infrastructure

VAHI receives data from numerous systems and uses a variety of processes to store, transform, analyse and report on the data.

We have started to design and build VAHI’s Information Management Environment (VIME), which will provide infrastructure for data storage, data processing and analytics, and online reporting capabilities. When fully implemented, VIME will integrate multiple data sources to create a single trusted source of data.

VIME will improve consistency and use of information management across the Department, SCV and VAHI. Other benefits will include increased accessibility of data, improved timeliness of data releases and improved data quality controls.

VIME will also support data visualisations in our new, interactive data website. The first release of the data website is ready for launch.

Spotlight

A focus on HACs reporting

A HAC is defined as a serious complication that a patient has suffered after admission to hospital. Results following the audits of HACs reported by 43 public health services showed the accuracy varied, with 15 health services over-reporting and 23 under-reporting the incidence of HACs.

VAHI’s audit program aims to ensure that health data collections accurately reflect the care provided to patients and coding to clinical truth. Audit recommendations were forwarded to health services for their action and VAHI requests evidence that health services have completed these actions.

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Outcomes of these actions have included:

  • improved compliance to departmental policies and procedures for coding and data collection purposes
  • greater adherence to coding standards and education to support more accurate reporting of diagnosis and procedure codes
  • improved health service internal auditing practices against relevant standards, polices and guidelines
  • working toward and improving internal IT system capability to support the collection of data to inform more accurate data submissions
  • workforce development
  • identifying and remediating underlying issues which impede the collection of good data
  • increasing awareness of the need for improved clinical documentation for HACs reporting purposes.

VAHI’s focus on HACs will continue in 2019–20 and improving HACs coding in partnership with health services will be a major priority. This will help ensure health services are reporting data in a compliant and consistent manner, to mitigate any risks associated with reporting of inaccurate data as VAHI seeks to monitor and measure the quality and safety of services provided to patients in Victorian health services.

 

Responding to data requests

VAHI continues to focus on delivering high quality, timely responses to health data requests from across the community.

Since VAHI was established in 2017, demand has steadily grown for hospital data (HosData), perinatal data and mental health, alcohol and other drugs (AOD) data. In addition, VAHI receives freedom of information (FOI) requests, media requests and a range of other ad hoc data requests from research institutes, health services, private companies, government agencies and members of the public.

A key achievement in 2018–19 was a substantial reduction in overall open data request cases, as we continue to improve our customer responsiveness.

In July 2019, VAHI launched a flagship new service called the VAHI Data Request Hub. The hub provides a single point for requesters to connect with VAHI and get the health data they need. The service has been designed with our customers at the forefront and includes a simplified way to submit a range of data requests, 24/7 self-tracking functions to monitor progress and a range of tools to improve communication with VAHI’s data analysts.

The new Data Request Hub simplifies the data request process while maintaining our trusted standards of accuracy and privacy compliance.

Australian Health Performance Framework

VAHI is the Victorian representative on the national working group overseeing the national implementation of the Australian Health Performance Framework. The framework brings together the previous National Health Performance Framework and the Performance and Accountability Framework to provide a single, contemporary framework for presenting information about the performance of Australia’s health system and to assist in identifying areas for development and improvement.

The overarching vision of the framework, as agreed by the Council of Australian Governments (COAG) Health Council, is to assist all Australians to make informed health decisions by tailoring health performance information to be transparent and easy to navigate. The aim is to support improved health outcomes for all Australians and ensure the sustainability of the Australian health system. While the framework focuses on the contributions of the healthcare system, it takes a broader view of what impacts the health of Australians by including social determinants of health, demographics and local context.

VAHI’s existing measures have been mapped to the framework and, during 2019–20, we will start to reflect the framework in our reporting.

VAHI has also worked closely with stakeholders in the Department to promote adoption of the framework where feasible. For example, with VAHI’s support, the Department is developing a framework for measuring the performance of community services and considering how the framework domains could be incorporated into quality and safety measures.

Page last updated: 13 Nov 2019

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