|Title:||HA215B Reporting Rules and Guidelines for Non Admitted Patient Services|
|Document ID:||Operational Directive OD 0357/12|
|Date of issue:||Monday, 9 January 2012|
|Status:||NO LONGER APPLICABLE|
|Description:||The purpose of this operational directive is to describe the counting rules and reporting cycle for non admitted patient services, as required for Department of Health (DOH) purposes and meet reporting requirements of the National Healthcare Agreement, National Health Information Agreement and the National Partnerships Agreement.|
|Applicable to:||All public hospitals and health services in Western Australia. Joondalup and Peel Health Campuses (for public patients only).|
|Period of effect:||from 1 November 2011 to 1 December 2012|
|Review date:||1 June 2012|
|Authorised by:||Kim Snowball, Director General, Western Australian Department of Health, 01-Dec-2011|
|Print version:||View print version|
HA215B Reporting Rules and Guidelines for Non Admitted Patient Services
This Operational Directive is applicable to:
2.0 Purpose of this Directive
The purpose of this Operational Directive is to define the counting rules and reporting frequency for non admitted patient services using the HA215B form.
These requirements are to comply with the following:
Historically, non admitted patient care activity has been reported at an aggregate level through the HA215B form. The implementation of Activity Based Funding and Management (ABF/ABM) has required WA Health to reform the way data are collected, managed and reported. As such, WA Health will be phasing out aggregate reporting via the HA215B form and implementing electronic reporting of patient level unit record data for each occasion of service or service event.
In 2010‑11 the outpatient funding allocation to Area Health Services was based upon 2009‑2010 outpatient expenditure, with adjustments for growth in population and prices. Starting with 2011‑2012, the funding level for outpatients will be based upon expected activity levels. To allocate funds in this manner requires the provision of timely and accurate patient level (unit record) activity data by all non admitted patient services.
It is a National minimum requirement that there be provision of quarterly aggregate level data (i.e. counts of occasions of services) for all non admitted patient services, provided by all public hospitals and public activity at JHC and PHC. Non-admitted patient activity data are needed from all public hospitals so that baseline and change in non-admitted care activity can be measured to determine Commonwealth contribution to growth funding from 1 July 2014 onwards. This includes the ability to identify the subacute, mental health and hospital/non-hospital delivered community health components of non-admitted care services.
From a costing perspective, the collection of expenditure data for in-scope non-admitted patient services is a requirement in all states/territories. This is to occur via automated electronic systems able to collect and report non-admitted patient services activity and expenditure data by the NHCDC Tier 2 clinic type (rolled up as appropriate for smaller hospitals). These automated systems must be capable of supporting activity based costing of non-admitted patient services. Until suitable and approved electronic systems are in place to report all patient level non admitted activity, services will be required to continue reporting aggregate activity through the HA215B form.
3.1 Exclusion of mental health services from HA215B reporting requirements
The reporting of non admitted patient mental health services are not subject to this Operational Directive and this activity is to be captured in accordance with the following Directives:
3.2 Regular review of this Operational Directive
This Operational Directive will be subject to review in accordance with developments to non admitted care reporting requirements.
4.0 Definition: Non Admitted Patient
Non admitted patients are those who receive care from a health service but who do not undergo the hospital’s formal admission process. The categories of non admitted patient services offered by hospitals are:
5.0 Definition: Occasion of Service 
An occasion of service is defined as any examination, consultation, treatment or other service provided to a patient, or a group of patients, in each functional unit of a health service or hospital on each occasion that such a service was provided. Other occasions of service to be recorded for counting include outreach clinic services, services delivered in a multidisciplinary mode and services delivered in group sessions.
A service does not have to be provided in person. As long as the criteria for a valid occasion of service are met, a telephone consultation that is conducted as a substitute for face-to-face contact with the patient or a telehealth service should be recorded as an occasion of service. The location of the provider and patient is not relevant.
5.1 Examples of an Occasion of Service
6.0 Reporting requirements
Effective 1 July 2011 (2011/2012 reporting onwards), data are to be provided in parallel using both the HA215B form and electronic systems. This is to ensure consistency and accuracy of data being reported. Patient level details of Occasions of Service should be provided electronically for the following outpatient clinic categories:
Clinics of these four categories must use automated electronic systems to collect and report non-admitted patient services activity and expenditure data by the NHCDC Tier 2 clinic type (rolled up as appropriate for smaller hospitals). The automated systems must be capable of supporting activity based costing of non-admitted patient services; such as the core systems:
Please note, a ‘non-core’ application will only be approved for use where the above listed core applications are demonstrated to be inaccessible to the clinical service or where the clinical service requires additional functionality not provided by a core application e.g. Cardiobase.
Until a service has a suitable and approved electronic system in place to report patient level non admitted activity, the service will be required to continue reporting aggregate activity through the HA215B form. Only when an approved automated electronic system is in use, and the site can confirm that all non admitted activity is being captured electronically, will the service be allowed to cease HA215B reporting for outpatients.
For further information regarding the counting and reporting rules for services provided in the outpatient clinics above, refer to the Patient-level Information Reporting for Non Admitted Outpatient Services Operational Directive.
The following non admitted care services are to continue reporting activity through the HA215B form until indicated otherwise:
All activity reported through the HA215B form must be forwarded to the Data Integrity Directorate by the fifteenth day of the following month. For example, July 2011 data would be required by close of business on 15 August 2011. If information reported on the HA215B form changes after it has been sent to Data Integrity Directorate, a revised form should be completed and the revised box ticked.
All HA215B data should be submitted preferably via email to HA215B@health.wa.gov.au or fax to 9222 4236. Definitions, counting rules and a template of the HA215B form are attached.
6.1 Exclusions for HA215B reporting
Note: the following non admitted patient services no longer require reporting via the HA215B form:
7.0 Changes to reporting of cancelled same day discharge elective procedures
Admissions with a principal diagnosis of Z53.x (“Procedure not carried out…”) are not included in calculations of hospital inpatient activity, as they do not meet the National admission and reporting criteria. However, Z53.x principal diagnosis coded episodes will be used for local reporting and cost modelling.
These events are not to be reported as outpatient occasions of service under any circumstances. For further information on reporting cancelled elective procedures, please refer to the Western Australia Coding Standards.
This circular last updated: Monday, 9 January 2012 at 12:54pm