Amnis reveals that teamwork is the key to effective coding

According to the specialist healthcare quality, innovation and productivity improvement enabler, Amnis, although there has been an increase in the accuracy of clinical coding in the healthcare sector, some 33 per cent of hospital trusts continue to overcharge commissioners by up to six per cent, while a similar number of hospital trusts are undercharging.

In a significant percentage of trusts, mistakes could exceed 20 per cent of all healthcare resource groups (HRGs) codes - resulting in either overcharges or undercharges, claims Amnis.

“The real solution to improving clinical coding accuracy and effectiveness is to be found in a combination of teamwork, continuous improvement and respect between teams,” believes Mark Eaton, Amnis’ managing director.

“These are not easy things to achieve for any organisation,” he said. ”They require planning, communication and a consistent approach from the organisational and departmental leaders that encourages openness and constructive feedback.”

Yet, as Amnis’ Mark Eaton, has pointed out: “The solution to clinical coding errors is not additional bureaucracy but more about creating effective and continuously improving processes that work - and this can only be done by teams working together.”

For more information, visit Amnis at www.amnis.uk.com, email info@amnis.uk.com or call 0870 446 1002.

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About Clinical Coding

Clinical coding was introduced following the injection – in 2002 - of patient choice into the NHS and the abolition of locally negotiated block contracts between primary care trusts and providers.

This produced a system where hospitals are paid for the activity they undertake under a system called payment by results (PbR). PbR is designed to encourage healthcare providers to lower their costs to the national tariff or below and, in so doing, retain any surplus to plough back into providing services more efficiently.

PbR does not allow healthcare providers to compete on price.

Under PbR, the Government has drawn up a list of procedures, such as hip replacements or treatment for heart attacks, each with its own healthcare resource group (HRG) code. An HRG represents a group of clinically similar treatments and diagnoses that consume similar levels of healthcare resource and are priced accordingly.

The Department of Health (DoH) intends the HRG codes to reflect the treatment a patient receives in hospital and also treatment that is received in different care settings across the patient’s care pathway. The price for each HRG procedure is fixed in relation to a national tariff, based on its average costs across the NHS.

The DoH is also considering further adjustments to the HRG price to allow for more efficiency in high-volume care treatments such as treatment for acute stroke; caesarean section, cholecystectomy, primary hip replacements, primary knee replacements; and treatment for fractured neck of femur. While these cases cover only 19 of the 548 HRGs, they account for almost ten per cent of hospitals’ total costs.

About Amnis Limited

Working with both public and private sector organisations, Amnis is a consultancy which specialises in innovation, transformation and organisational improvement, helping clients plan and deploy strategies for successful transformation. Its goal is to help clients not only deliver sustainable change but also to develop their capability to tackle their next challenges.

Providing both consultancy and training services, Amnis’ team includes specialists in Lean/Six Sigma, organisational development, strategic planning, change management and systems thinking.

Further information from:

Ruth Bodman, Amnis, 00 44 (0) 870 446 1002; ruthbodman@amnis.uk.com
Bob Little, Bob Little Press & PR, 00 44 (0)1727 860405; bob.little@boblittlepr.com