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SA Health | Allied Scientific and Health Office – September 2013 1

SA HEALTH

ALLIED HEALTH

ACTIVITY MINIMUM DATA SET

AND

DATA DEFINITIONS

SA Health Allied Health Data Working Party 2013 Allied and Scientific Health Office Level 5, Citi Centre

11 Hindmarsh Square

Adelaide SA 5000


Table of Contents

1.0 BACKGROUND ............................................................................................................................................................. 3

2.0 EXECUTIVE SUMMARY ................................................................................................................................................ 6

3.0 PRINCIPLES OF DATA COLLECTION ............................................................................................................................. 7

4.0 CLINICAL CARE ACTIVITY DATA .................................................................................................................................. 8

5.0 NON-CLINICAL CARE ACTIVITY DATA ......................................................................................................................... 9

6.0 ACTIVITY MINIMUM DATA SET AND DATA ITEMS .................................................................................................. 10

7.0 ACTIVITY MINIMUM DATA SET DEFINED ................................................................................................................. 12

7.1 OCCASION OF SERVICE (OOS)/SERVICE EVENT ........................................................................................................ 12

7.2 NEW/REVIEW ATTENDANCE TYPE............................................................................................................................ 14

7.3 DURATION OF ACTIVITY ........................................................................................................................................... 15

7.4 CONTACT TYPE & CONTACT MODE .......................................................................................................................... 16

7.5 PATIENT CATEGORY .................................................................................................................................................. 18

7.6 LEVEL 1 ACTIVITY (PRIMARY ACTIVITY) .................................................................................................................... 19

7.7 LEVEL 2 ACTIVITY (SUB-LEVEL ACTIVITY) ................................................................................................................. 19

7.8 OUTPATIENT/NON-ADMITTED SERVICE CODES ...................................................................................................... 20

7.8a HOME SUPPORTS .................................................................................................................................................... 22

8.0 PRACTICAL APPLICATION OF FRAMEWORK : DATA DEFINITIONS AND EXAMPLES ............................................... 23

8. 1 CLINICAL CARE ACTIVITY: Individual Patient Attributable ..................................................................................... 23

8.2 CLINICAL CARE ACTIVITY: Non- Individual Patient Attributable ............................................................................. 36

8.3 WHEN THINGS GET COMPLICATED .......................................................................................................................... 37

8.4 ALLIED HEALTH ASSISTANT STATISTICS .................................................................................................................... 40

8.5 STUDENT STATISTICS ................................................................................................................................................ 42

8.6 CLINICAL SERVICE MANAGEMENT ACTIVITIES ......................................................................................................... 44

APPENDIX 1: Data Items Ready Reckoner: Definition and Guide For Use .................................................................... 46

APPENDIX 2: Allied Health and/or Clinical Nurse Specialist Interventions Classes Tier 2 ........................................... 49

APPENDIX 3: Non-hospital based services/programs in scope for Tier 2 clinics ........................................................... 50

REFERENCES .................................................................................................................................................................... 51

Version control and change history:

1.0 01/08/2013 Tracey Kroon 2.0 25/09/2013 Annette Grist


1.0 BACKGROUND

The robust collection, recording and reporting of inpatient, outpatient and out of hospital activity data is a

key strategy in supporting the performance monitoring, program measurement, service planning and

funding. Such data is required at both state and commonwealth levels. Data informs state-based inpatient

and outpatient costings via the SA Casemix Funding Model (Version 7) and provides costings under the

Activity Based Funding (ABF) model. The consistent collection of data is also invaluable for the purposes of

Allied Health benchmarking exercises both locally and nationally.

Allied health, for the first time, has agreed to align across the State the nationally mandated allied health

data activity requirements (or minimum data set) for service delivery. This will capture an allied health

clinician’s time in relation to Clinical Care activity and Non Clinical activity. Clinical Care activities will reflect

individual patient-related (IPA) and non-individual patient-related (NIPA) activities including groups and

clinics. Teaching and Training (TT), research (R) and clinical services management (CSM) activities and the

time associated with undertaking them will be reflected as non-clinical activities.

To ensure reported activity is accurate, reproducible and standardised between and within professions and

service locations data definitions are required. This document focuses on data definitions in relation to

allied health workflows and as such should not be extrapolated to other professions.

The data definitions suit a number of purposes:

• Allied Health department management, benchmarking and workforce planning.

• SA Casemix Funding costing for inpatients and the Monthly Management Summary System (MMSS) for

outpatients

• ABF requirements

• Information required for external submission (e.g. Health Round Table, site specific program funding

etc.).

To facilitate uptake and ease of applicability the following data definitions have been informed by the SA

Health data collection guidelines for outpatients (Monthly Management Summary System (MMSS) and IHPA

Tier 2,sub-acute and non-acute admitted and non-admitted documents, modified and applied across

inpatient, outpatient and out of hospital settings.

It is acknowledged that due to the need for a consistency across a wide range of professions and service

settings, there may be occasions where the proposed data definitions do not align strongly with the actual

clinical presentation or scenario. In such circumstances, the best fit principle should be applied. Feedback

regarding such instances are encouraged and this document will be updated as required.

Contact: Allied and Scientific Health Office website or [email protected]

Note: For EPAS users, this document is to be read in conjunction with the Allied Health Business Rules. The

development and application of business rules and these data definitions will assist in driving

improvements to the functionality and future build of the EPAS system for allied health.


SCOPE

The following allied health professions* across SA Health will be required to record activity data in line with

these data definitions

• Audiology

• Art Therapy

• Diversional Therapy

• Exercise Physiology

• Music Therapy

• Nutrition/dietetics

• Occupational Therapy

• Orthoptics

• Orthotics

• Physiotherapy

• Podiatry

• Prosthetics

• Psychology

• Social Work

• Speech Pathology

In some settings/agencies, additional data may be required.

*The following allied health professionals/professions are not within the scope of this document:

• State-wide Clinical Services including Medical Radiation, Pharmacy and Medical and Grant Funded

Scientists (SA Pathology);

• Cardiac Perfusionsists;

• Sonographers;

• Mental health professionals working in a dedicated purpose-funded mental health service.

This document and the Minimum Data Set (MDS) and related definitions refer to data surrounding the

services provided and the manner in which they were provided. It is understood that additional data items

may be collected by some sites and services relating to client/patient characteristics e.g. demographics,

diagnosis, client outcomes and characteristics of episodes of care e.g. open and close dates, referral dates.

GOAL

Standardised clinical activity information and data entry within and between in scope allied health

professions and sites and sites across SA Health.


ACKNOWLEDGEMENT

As Chief Allied and Scientific Health Advisor I would like to thank those who have contributed to this

significant project for SA Health. This is an extraordinary achievement for the allied health professions who

have agreed to standardize their existing allied health activity data definitions into one statewide dictionary

to enable improved client service care and planning. It has been the clinicians focus on clients that has

facilitated the efficient decision making on the often complex data recording issues.

This document follows extensive consultation with a range of state and interstate allied health clinicians,

managers and performance, costing and data units. Those involved in providing examples and clarification of

data definitions are recognised and thanked for their considerable contribution.

In particular I would like to note the outstanding assistance provided by Kym Piper and Phillip Battista and

their team in explaining the complex world of ABF, MMSS and Casemix to ensure allied health is collecting

the critical elements required for costing and funding. The SA Health Allied Health Data Working Party, SA

Health Allied Health Executive Group and EPAS Allied Health Team especially Debbie Grigg and Bruce Harris

also need congratulating on this final product which is a living document that can be improved and updated

as allied health professionals become experts in understanding clinical activity analysis, data collection and

funding and costing planning.

I also thank Queensland Health (2011) and the NSW South Eastern Local Hospital District, Illawarra Shoal

Haven Local Hospital Districts and Sydney Children’s Hospital (2012) who granted permission to use and

modify their documents. This has resulted in SA Health allied health now being aligned with national allied

health clinical activity data collection which will prove invaluable for future planning and service model

design to ensure clients receive the right care, by the right person, in the right place.

Finally, my sincere thanks to Tracey Kroon, Annette Grist and Jeanette Routley from the Allied and Scientific

Health Office who have undertaken this work in such a short period with tenacity, persistence and most

importantly humour.

Catherine Turnbull

Chief Allied and Scientific Health Advisor

SA Health

20th

September 2013


2.0 EXECUTIVE SUMMARY

In order to accurately capture all relevant patient level activity data, the following general rules should be

observed.

1. Activity and time that provides a service to an individual, group or community to influence their health

status is considered Clinical Care Activity.

2. Within Clinical Care, all activity/time that can be attributed to a specific patient with a unit record

number (UR or URN) should be recorded against that patient. This includes group activity. This is

considered ‘UR attributable’ data or Individual Patient Attributable data (IPA) data.

3. Clinical Care Activities that cannot be attributed to a specific patient but are provided to a group or

community to influence health status should be recorded as Clinical Care Activity - Non-Individual

Patient Attributable data (NIPA) data. This is considered non-UR attributable data.

4. An occasion of service (OOS) is recorded on initial contact and subsequent review(s) of the patient

and/or their family/carer within an episode of care. Follow up activities related directly to the initial

and review contacts (e.g. report writing, prosthesis modification, collecting equipment, analysis of

results etc.) are not recorded as additional OOS however all the-time involved in the provision of a

service to the individual should be recorded as IPA.

5. All occasions of service must contain new clinical content, be face-to-face or a substitution of face-to-

face e.g. telephone and be verified by documentation in the patient’s medical record. It is

recommended that clinicians document immediately following client contact, where possible.

6. Where the patient requires two or more clinicians of either the same or a different profession to

complete the session simultaneously, each health professional records an OOS and all activity time.

7. For multiple non-admitted/outpatient services, patients can be counted as having multiple OOS on the

same day; provided each visit meets the OOS (service event) definition and appointments are booked

separately. This will be explained further within the document.

8. OOS and intervention times provided directly to individuals by students are recorded by students.

Supervisors are to record any time related to students, but not spent in direct one to one supervision,

as Non-Clinical Activity, Teaching and Training.

9. Activities that cannot be attributed to Clinical Care Activity should be recorded as Non-Clinical Activity.

These may be classified as Clinical Services Management (CSM), Research (R), Teaching and Training

(TT). Travel time to an outreach site that is required as local services are not available and it’s

inefficient to breakdown the travel against individual UR numbers can be recorded under this category

(Tr).


3.0 PRINCIPLES OF DATA COLLECTION

1. Data Collection Framework

The National Allied Health Casemix Committee (NAHCC) Health Activity Hierarchy (HAH v1.1) provides the

basis for the classification of activity data8.

The first level (clinical decision) breaks activity into Clinical Care (IPA or NIPA) and Non-Clinical Care (CSM, TT,

R, & (Travel time for block outreach services required as local services are not available).

The second level breaks clinical care activities into (1) Individual Patient Attributable (IPA) - also known as UR

Attributable and (2) Non-Individual Patient Attributable (NIPA) - also referred to as Non UR Attributable

activity.

1.1 Clinical Care Activity:

Activities provided to an individual, group or community to influence health status. This includes Individual

Patient Attributable (IPA) and Non-Individual Patient Attributable (NIPA) activity.

1.2 Non-Clinical Care Activity:

Activities performed which are not directly related to a particular patient/individual, group or community to

influence health status. These include activities that support and are essential to clinical care such as

teaching, research and administrative functions.

2. Minimum Data Set & Data Dictionary:

To ensure reported activity is accurate, reproducible and standardised between and within professions and

service locations a standardized minimum data set and data definitions are required.

Outreach

Travel

(Tr)


4.0 CLINICAL CARE ACTIVITY DATA

This is data about activities which provide services to an individual, group or community to influence their

health status. Where ever possible and appropriate, classify activity as Clinical Care (8)

.

Clinical Care activities are separated into two categories - IPA and NIPA. Where possible and practical,

clinicians should allocate time to an individual patient. This will assist with providing an accurate reflection

of activity costings.

Individual Patient Attributable (IPA) Activity:

Any clinical care activity that can be assigned to an individual patient (including travel associated with care

provision). This includes any Direct or Indirect patient care. Hence the patient does not need to be

physically with the staff member in order for the staff member to attribute time to an IPA activity.

Examples of Direct Individual Patient Attributable (IPA) data:

• Time spent in face to face management/therapy

• Delivery of a group program with time allocated to patients individually (i.e. the average time provided

to each person in the group was 5 minutes or more and the individual URNs can be attributed with this

time).

Examples of Indirect Individual Patient Attributable (IPA) Activity:

• Family or team meeting about a patient and their care needs Preparation of a handout or equipment for

a patient

• Clinical record keeping or documentation without the patient present

• Any activity related to the patient who did not attend an appointment such as waiting time, session

preparation

• Travel to an individual patient’s location in order to provide a clinical care activity.

Non-Individual Patient Attributable (NIPA) Activity:

Any clinical care activity that cannot be assigned to an individual patient(s).

Examples of NIPA activity:

• Groups where URN for the patients attending are not available for some reason (e.g. “walk in groups”)

• Design, preparation and implementation of clinical/education materials/resources/products.

• Clinical planning – time spent reviewing, developing and evaluating clinical services

• Health promotion targeting a large group /population

• Situations where the identity of the patient(s) cannot be determined or is not a patient of the service i.e.

general enquiries or the overhead to determine is excessive.

• Travel related to any of the above*

*For clinicians who travel to an outreach facility for a block clinic (as local services are not available) for

the delivery of IPA activities, the travel component should be recorded as Outreach Travel (Tr) (see 5.0).


5.0 NON-CLINICAL CARE ACTIVITY DATA

Definition:

Activities performed which are not directly related to a particular patient/individual, group or community to

influence health status. These include activities that support and are essential to clinical care such as

teaching, research and administrative functions.

There are four categories of non-clinical allied health activity:

1. Clinical Services Management (CSM)

2. Teaching and Training (TT)

3. Research (R)

4. Outreach Travel (Tr) –only for travel for outreach clinical blocks


6.0 ACTIVITY MINIMUM DATA SET AND DATA ITEMS

Data Item

Data Domain

(i.e. options to select/enter into your information

classification system)

Health Activity

Hierarchy

Level 1

Health Activity

Hierarchy

Level 2

Mandatory Status/scope :

Core Agency specific

1. Occasion of Service • Numerical eg 1 Clinical Care IPA

�

2. Attendance Type (only for IPA) • New

• Review

Clinical Care IPA

�

3. Duration of Activity • 5 minimum increments Clinical Care & Non-

Clinical Activity

IPA

NIPA

CSM,R,TT

�

4. Contact type • Individual

• Group (must also indicate number in the group)

• Multi-clinician

• Community-initiative

Clinical Care IPA

NIPA

�

5. Contact mode • Telephone (includes multiple on the line i.e.

teleconference)

• In person

• Telehealth/telemedicine/videoconference

Clinical Care IPA

NIPA

�

• Postal/courier

• Electronic mail

• Other

� OOHS requirement*

6. Patient category • Admitted/Inpatient (same day admitted & inpatient)

• Non-Admitted/Outpatient (outreach, OP)

• Emergency

Clinical Care IPA

�

all hospital admitted

or Tier 2 non-admitted

services

*Out of Hospital Services9 include: Child and Family Health, GP Plus health services, Community health centres, Community Palliative care, Drug and Alcohol Services, Prison

Health services, Royal District Nursing society, SA Dental Service. Community mental Health Centres (including CAMHS) are OOHS but not in scope of this document.


Data Item

Data Domain

(i.e. options to select/enter into your information

classification system)

Health Activity

Hierarchy

Level 1

Health Activity

Hierarchy

Level 2

Mandatory Status/scope :

Core Agency specific

7. Primary Activity

• ICD- 10-AM 7th

procedure code set

• Reflects the profession of the clinician providing the

service or of the profession the work relates to

when performed by an AH assistant eg Allied Health

Intervention: Physiotherapy

Clinical Care

&

Non-Clinical

Activity

IPA

NIPA

CSM,R,TT

�

8. Sub-level Activity *Used to record next level of activity specificity

• Common data set under development that maps to

ICD- 10-AM 7th edition procedure code set (for

EPAS users and other SA Health acute services)

• Consistent Code sets for other services yet to be

determined

• May be a multi-pick field depending on site

• Non clinical activity (clinical services management

teaching, training and travel(CHSA only)) & NIPA

Clinical Care

&

Non-Clinical

Activity

IPA

NIPA

CSM,R,TT

�

at manager’s

discretion

9. Non-Admitted/ Outpatient

Clinic Type

• ABF: Tier 2 Non-Admitted Clinic Codes

&/or

• MMSS clinic codes

&/or

• Site specific clinic codes- will be mapped to Tier 2

codes and MMSS codes

Clinical Care IPA �

Hospital

outpatient,

outreach clinics &

selected non –

hospital based

services

(see Appendix 3 for

listing of in scope

programs & services)

10. Home Supports • Enteral Feeds(tube or oral)

• Parenteral Feeds

• Oxygen

11. Sub- and non-acute Care Type • Rehabilitation, Palliative, GEM, Palliative,

Psychogeriatric

Clinical Care IPA

NIPA

�

Any sub-acute


7.0 ACTIVITY MINIMUM DATA SET DEFINED

7.1 OCCASION OF SERVICE (OOS) / SERVICE EVENT

Definition:

“Any examination, consultation, treatment or other service provided by a health service provider … to a

client/patient on each occasion such service is provided.”1

Occasion of service is the term used at a state level to inform patient costings. Service Event is the term

utilized in relation to Activity Based Funding. For the purposes of Data Definitions for Allied Health, the term

Occasion of Service (OOS) will be the term used.

The occasion of service must contain/be:

• New clinical content and

• Face to face or a substitute for face to face e.g. telephone/telemedicine and

• Documented in the patient’s medical/clinical record, clinical file or information system.

New Clinical Content is difficult to define as it varies greatly between professions however as a general

recommendation if new information is gained and/or it is considered important enough to be reflected in

the medical record (and is not administrative) then it constitutes new clinical content.

The data definitions have been written to capture all OOS and activity time within the data reporting

system provided the activity meets the OOS definition. The data reporting system should then enable

data extraction and reporting in line with either ABF and/or MMSS requirements, both of which are

required for State and Commonwealth costing and funding. See Appendix 1.

OOS constitutes a minimum of 15 minutes to reflect clinical care activity, planning time, administration,

and other activities usually associated with an occasion of service.


Includes:

• Individual and group activity

• Telephone/teleconference or telemedicine/telehealth calls initiated by the patient/carer or service

provider where significant new clinical information is discussed.

• Family conference where patient and/or carers are present

• Total Parenteral Nutrition (TPN), Home Enteral Nutrition (HEN) and Home Oxygen.

Excludes:

• Services provided where an URN cannot be identified (i.e. NIPA)

• Medical/case note documentation/report writing as a standalone activity i.e. is not aligned to a clinical

activity performed that day

• Case conferences (patient and/or carers are NOT present) / Case management

• Planning/preparation and administrative tasks associated with the service provision

IPA time should always be recorded against a patient and the correct OOS recorded where compliance

with the definition is evident.

Example:

A Dietitian visits a patient on the aged care ward and performs the following activities/interventions: reads

the patient medical record, interviews the patient, calculates and prescribes an enteral feeding regime,

discusses with the medical team and liaises with the kitchen to deliver the feed.

Record:

OOS =1.

See Section 8.0 Practical Application of Framework: Data Definitions and Examples for further examples

specific to this data item.


7.2 NEW/REVIEW ATTENDANCE TYPE

The attendance type indicates whether an interaction is either the initial (new) or subsequent (review)

attendance during a single course of treatment (episode of care) from your service or profession. This applies

to both admitted and non-admitted patients.

Definition:

New:

New attendance is defined as the first patient/ client contact or attendance to the service and/or profession

(not to each clinician within the profession for that episode of care).

Review:

All other attendances following the initial (new) attendance for that episode of care within that profession.

Episode of Care:

An episode of care is a phase of treatment. There may be more than one episode of care within the one

hospital stay. An episode of care ends when the principle clinical intent changes or when the patient is

formally separated from the facility.

If the patient has a chronic or long term condition, there is an expectation that a review attendance would

occur within the twelve month period.

The current activity based funding model (ABF) utilises episodes of care and new: review ratios to inform

costings. It is therefore essential that all clients are discharged when the current episode of care relevant to

their involvement is complete. Any subsequent engagement with your service will therefore be identified as

“New”.

Example:

A patient with a brain injury attends an outpatient clinic every 12 months for a reassessment. Usually this

consult results in a further consultation being booked in 12 months’ time. Each of these consultations are

treated as new and the episode of care is closed after the appointment with the patient. This time however,

the patient is offered 4 weeks of occupational therapy after this appointment.

Record:

Health Activity Hierarchy: IPA

Attendance Type = new for the 12 month review appointment and the subsequent 4 appointment are

‘review’ attendances

Contact mode=Individual

Patient Category = Outpatient/Non-admitted

Note: The episode of care would be closed after the last appointment.




7.3 DURATION OF ACTIVITY

Definition: This is a significant field and the total time, attributable to a specific patient’s care and related

activities must be recorded. This is measured in minutes. Intervention time is used in combination with the

primary contact mode.

It is recognised that recording exact time may be difficult as many minor activities will occur during a

clinician’s working day (e.g. a brief 3 minute patient handover to a colleague). In an effort to reduce the

overhead involved in recording all minor activities, only activities of 5 minutes duration or longer or activities

grouped into 5 minutes or longer should be recorded. I.e. Time is generally rounded to the nearest 5

minutes.

Also includes the following activities:

• Medical note reading/writing

• Discussions specific to the patient with other members of the multi-disciplinary team e.g. medical,

nursing, other allied health and support staff.

• Time spent in case conferences discussing specific patients planning/preparation time

• Travel time (as part of either IPA or NIPA if clinical care activity)

• Time spent waiting for patient who fails to attend or is late.

Example:

An Orthoptist spends:

• 15 minutes reading a patient’s medical notes

• 10 minutes discussing the patient with the multi-disciplinary team

• 45 minutes assessing the patient

• 15 minutes writing medical notes

• 10 minutes retrieving resources for the patient

Record: 95 minutes total clinical care (IPA) activity time




7.4 CONTACT TYPE & CONTACT MODE

Definitions: The Contact type refers to the primary environment of service delivery.

Contact mode refers to the primary method of service delivery provided to a patient in a given consultation

context.

Contact type

Individual:

Definition: “Any examination, consultation, treatment or other service provided by a health service provider

to a patient of a health service establishment” 1.

Group:

Definition: Group activity is recorded when two or more patients/clients receive the same service, at the

same time, from the same health care employee. Groups can be inpatient or outpatient based and must

contain content of therapeutic benefit.

Exceptions to this definition include situations where:

• All individuals in the group belong to the same family; the session should be reported as being provided

to the “Individual”. Family members can only be counted as an outpatient (non-admitted patient)

service event if they are a patient of the service and a dated entry is made in each family member’s

medical record.

Multi-Clinician Involvement (also referred to as ‘multi-disciplinary clinics’):

Definition: Service events involving multiple healthcare providers where a single patient is being treated by

two or more clinicians from either different or the same profession at the same time.

Contact mode:

Telephone/teleconference:

Definition: “Patient and provider(s) not in same physical location and communicating by telephone”1. Service

provider(s) is talking directly to the patient or carer and must be a substitution for a face-to-face consult.

Administrative phone calls, booking schedules must not be counted as an occasion of service.

Telehealth/Tele-medicine/videoconference

Definition: as above for phones but communication occurring via secure telecommunication or video-

communication mediums to patient or carer and must be a substitution for an in person consult.

In Person:

Definition: patient is present at the time of the contact

Postal/courier:

Definition: Communication is made via a written document

Electronic:

Definition: Communication is made via electronic means eg email

Other

Definition: all other including not well defined elsewhere


Example:

Two outpatient Podiatrists treat a patient. One is responsible for administering the anaesthetic, the other

performs nail surgery. The first Podiatrist then assists the second Podiatrist for the remainder of the

appointment.

Record:

Contact type= Multi-Clinician Involvement

Contact mode = In-person

Example:

A mother calls the Speech Pathology outpatient service and speaks to a Speech Pathologist regarding teat

recommendations for bottle feeding her premature infant. The Speech Pathologist provides advice and

recommendations over the phone and arranges for the infant and mother to attend an appointment in 2

weeks. The Speech Pathologist makes a record of clinical recommendations in the patient’s medical record.

The appointment is created (and checked into scheduler in EPAS). Total time is 20 minutes.

Record:

Contact type = Individual

Contact mode = Telephone

NB: this intervention is recorded against the infant as the patient, not the mother.




7.5 PATIENT CATEGORY

A classification designed to assist with ABF reporting requirements for hospital patients or patients who are

deemed to provide services. Patients are considered as either admitted/inpatient, non-admitted/outpatient

or emergency.

Definitions:

Admitted/Inpatient:

An admitted patient is an individual who undergoes a formal admission process as either an:

• Inpatient

• Same-day admitted patient: The person receives treatment and then goes home on the same day.

Non-Admitted Patient/Outpatient:

A patient who does not undergo a hospital’s formal admission process. There are three categories of these

patients:

• Emergency Department:

A person who receives emergency care in an emergency department.

• Outpatient/non-admitted:

A person who attends, usually by appointment, and receives non-emergency outpatient/non-admitted

services from a healthcare provider(s) at a hospital or primary care facility.

• Outreach:

An individual who receive services from a healthcare provider(s) at locations outside the hospital or

facility premises e.g. service provided in patient’s homes, at special locations outside the

hospital/primary care facility such as mobile clinics or remote clinics manned on a part-time basis.

Emergency:

A patient who attends an Emergency Department for treatment. They may be admitted subsequently but if

seen by an allied health professional prior to admission, their patient category is Emergency.

Example:

An Occupational Therapist completes a “Rehab in the Home-based” intervention program aimed at

improving a patient’s confidence showering and dressing. The therapist spends 60 minutes plus 20 minutes

travel to and from the patient’s home and 10 minutes recording in the patient’s medical notes.

Record:


OOS = 1

Attendance Type = Review

Patient Category = Admitted/Inpatient

Duration = 90 mins

Contact type = Individual; Contact mode = in person

Level 1/Primary Activity= Intervention occupational therapy

Level 2/sub-level Activity (site –specific mandatory) = XXXX




7.6 LEVEL 1 ACTIVITY (PRIMARY ACTIVITY)

This relates to the profession of the allied health clinician.

For an Allied Health Assistant working across professions, the profession selected should be that for which

the most activity has been performed.

Example:

An AHA assists a physiotherapist with walking a patient, due to the patients’ increased risk of a fall.

Record:

Allied Health Assistant records: Level 1/Primary Activity = Physiotherapy.

Physiotherapist records: = Level 1/Primary Activity = Physiotherapy.



7.7 LEVEL 2 ACTIVITY (SUB-LEVEL ACTIVITY)

The Level 2 activity breaks activity down into sub-categories such as assessment, treatment, travel etc.

Inclusion of Level 2 activity is optional, dependent on departmental management.

Codes in this field should be compliant be able to map to ICD-10-AM 7th

edition procedure codes.


7.8 OUTPATIENT/NON-ADMITTED CLINIC TYPE CODES

At the point of data entry at the service level different services and organizations may use a number of code

sets to describe their outpatient/non-admitted services. If a local code set has been used, these will be

mapped back to the MMSS code and Tier 2 code set to enable appropriate costing in the Department of

Health and Aging. It is preferable that sites progress to using the Tier 2 code lists at the point of data

collection or ensure that local code lists are correctly mapped to a corresponding Tier 2 code.

7.8.1 Tier 2 Service Classification

The Tier 2 Service Classification data and definition set provide a framework for categorising; classifying and

counting non-admitted patient interventions (see Table 1 and Appendix 2). They are based on an assessment

of both the type of clinician providing the service and the nature of the service provided. This has resulted in

a number of classes (groupings) within an Outpatient Category that offer clinical meaningfulness and/or

exclusivity across the spectrum of non-admitted services.

The classes are grouped into four categories that reflect the type of service provided and the clinicians that

typically provide the service. Allied Health clinicians will enter against the Allied health and/or clinical nurse specialist intervention category and select the appropriate class/clinic (see Table 1).

Category Description Range of classes

Procedures Procedures provided by a surgeon or other medical specialist. 10.01 – 10.18

Medical consultation Medical consultations provided by a general physician or medical

specialist 20.01 – 20.51

Stand-alone diagnostic Diagnostic services, within a specific field of medicine or

condition (e.g. epilepsy). 30.01 – 30.08

Allied health and/or clinical

nurse specialist

intervention

Services provided by an allied health professional or clinical

nurse specialist. 40.01 – 40.51

Table 1: Tier 2 Non-Admitted Clinic Codes

7.8.2 MMSS Codes

A standardized list of outpatient clinics is currently used by Department of Health and Aging. Some

outpatient clinics may use this exact code list whilst others will use locally generated lists (see 7.8.3).

7.8.3 Site-Specific Codes

Local sites may also have their own local terminology for their outpatient clinics. These will be mapped by

the Department of Health and Ageing in conjunction with hospital/facility patient costing staff. There needs

to be an understanding that some existing IT systems are not conducive to completely accurate mapping of

current clinics to the Tier 2 or MMSS categorisations.


Example:

A patient isn’t well enough to attend in person at the GP Plus Centre for their second appointment, so in

place of a face-to-face visit, the Psychologist makes telephone contact with a carer, providing the

information which would have otherwise been provided directly to the patient at a face-to-face visit (20

mins).

Record:


OOS*= 1


Duration = 20 mins


Contact mode= Telephone/teleconference

Patient Category = Outpatient/Non-Admitted

Level 1 Primary Activity= Intervention psychology

Level 2 Activity (site –specific mandatory) = XXXX

Outpatient/Non-Admitted Clinic Type/ Code =40.29 Psychology (Tier 2 Clinic code)

* In the case of EPAS users, EPAS data extraction processes will then delineate between MMSS and ABF OOS as the reporting requirements and

definitions are different for telephone interventions. Other data extraction and reporting systems will need to be able to differentiate between the

type of OOS for ABF and MMSS also.


7.8a HOME SUPPORTS

There is an exception in the recording of an OOS for Oxygen, Total Parenteral Nutrition (TPN) and Home

Enteral Nutrition (HEN) performed by the patient in their own home without the presence of a healthcare

provider.

This may be counted as an outpatient/non-admitted OOS provided there is documentation of the procedure

in the patient’s medical record. Documentation should occur at the commencement of the outpatient

episode of care (see new/ review section) and is entered indicating home supports are required. The

appropriate Outpatient/Non-Admitted Service/clinic code should be recorded.

This data can be entered as an aggregate entry at the end of the month (see examples below)

Example

A patient performs Home Enteral Nutrition (HEN) in their own home on a daily basis. There were no

disruptions or changes to this routine in August (31 day month). The dietitian enters into the clinical

information system at the end of the month in 1 entry

Record:


OOS = 31*


Duration = X mins for time spent implementing procedure and documenting in clinical notes


Contact mode = Other

Patient Category =Non-Admitted/Outreach

Level 1 Primary Activity= Intervention Nutrition/dietetics


Home Supports: Enteral Feeds

Example

A patient performs HEN every day in their own home in October (a 31 day month), the patient is admitted to

hospital for five days and during their admission HEN is performed by the patient in the hospital.

Record:


OOS = 26*


Duration = X mins for time spent implementing procedure and documenting in clinical notes


Contact mode = Other

Patient Category =Non-Admitted/Outreach

Level 1 Primary Activity= Intervention Nutrition/dietetics


Home Supports: Enteral Feeds

*EPAS will then delineate between MMSS and ABF OOS as the reporting requirements are different for HEN.


8.0 PRACTICAL APPLICATION OF FRAMEWORK: DATA DEFINITIONS AND EXAMPLES

In order to capture all relevant patient level and activity data accurately, the following examples

demonstrate the application of the framework. Examples across a number of professions are included.

E X A M P L E S

(Remembering that IPA (direct & indirect) activity and time should always be recorded against a patient

whether there is an OOS or not)

8. 1 CLINICAL CARE ACTIVITY: Individual Patient Attributable

8.1.1 OOS, DURATION, CONTACT TYPE AND CONTACT MODE EXAMPLES

8.1.1a Individual Contact type

Example 1

A Physiotherapist receives a referral for a patient on the ward. The clinician performs the following activities:

reading the patient medical record (10mins), assessment of respiratory status related to immobility/bed rest,

deep breathing exercises, range of motion exercises, (40mins), discusses patients and management

requirements with the nurse and doctor (20mins) and documents all of the above (10mins).

Record:


OOS = 1

Attendance Type = New

Duration = 80 mins

Contact type= Individual


Patient Category = Inpatient

Level 1 Primary Activity= Intervention Physiotherapy


Example 2

A Physiotherapist sees an inpatient in the afternoon subsequent to an initial assessment performed earlier in

the day (see Example 1). He/she repeats the interventions from the earlier intervention and also walks the

patient and documents in the medical record.

Record:


OOS= 1 (total OOS for the day = 2: see Example 1)


Duration = 30 minutes



Patient Category = Inpatient

Level 1 Primary Activity= Intervention Physiotherapy



Example 3

An Occupational Therapist travels in a government vehicle (20mins) to visit a stroke patient who has just

been referred and lives at home. Whilst there he/she performs the following interventions: initial

assessment/evaluation (40mins), environmental modifications (20mins), equipment prescription (20mins),

and documentation (15mins). The Occupational Therapist returns to their service (20mins) and makes a

phone call to the equipment supply company to arrange delivery of the equipment (15mins).

Record:


OOS= 1 (all activities are directly related to the provision of the OOS).





Patient Category = Outpatient/non-admitted

Level 1 Primary Activity= Intervention Occupational


Example 4

A Speech Pathologist performs a swallowing assessment on a patient and has a second clinician to assist with

the assessment because of the difficulties with this particular patient (45 mins each). 1 clinician documents

the assessment (15mins) and orders the diet (10mins). The other clinician also records their duration of the

assessment (45 mins).

Record:


OOS= 1 per clinician

Attendance Type = New for 1 clinician and Review for the other clinician entry

Duration

Clinician 1 = 45 mins (assessment), 15 mins (documentation), diet (10mins) = 70 minutes total

Clinician 2 = 45 mins (assessment)



Patient Category = Admitted/Inpatient

Level 1 Primary Activity= Intervention Speech Pathology


Example 5

An ACAT assessor, a Social Worker, visits a patient for the first time. The patient is at home and the following

activities/interventions are performed: travels to the patient’s home (40mins return), reads the patient

medical record (15mins) and performs the ACAT assessment (45mins). Then afterwards on the same day,

rings the patient’s family to clarify some issues (15mins) and documents in the patient record (15mins).

Later, the Social Worker writes an ACAT report (50mins).

Record:


OOS= 1


Duration = 180 mins




Patient Category = Outpatient/non-Admitted

Level 1 Primary Activity= Intervention Social Work


Outpatient/Non-Admitted Intervention Class = 40.02 Aged Care Assessment

Example 6

An Orthotist fits a custom made orthosis to an outpatient made from a cast taken at a previous encounter

(cast modification (120 mins), manufacture (180 minutes)). The Orthotist fits and adjusts the orthosis,

provides device information and related patient education and writes in the patient medical notes (total time

on day of fitting is 90 minutes).

Record:


OOS = 1


Duration = 90 mins

Contact Type= Individual

Contact Mode = In-person


Level 1 Primary Activity= Intervention orthotist


NB: a new OOS is recorded due to new clinical content; previous encounter: 1 OOS and 300 minutes.

Example 7

A family has twins with cystic fibrosis. The children attend a single review outpatient appointment of 60

mins duration at the Women’s and Children’s hospital. Both children’s appointments have been booked

separately. Therapeutic / clinical advice is provided by a physiotherapist for each child and an entry made

into each child’s medical records.

Record:


OOS = 1 per child


Duration = 60 mins per child

Contact Type = Individual

Contact Mode = In-person


Level 1 Primary Activity= Intervention physiotherapy


Outpatient/Non-Admitted Clinic Type = 40.09 Physiotherapy (Tier 2 Outpatient classification)


Example 8

A Dietitian goes to the ward and reads the patient’s notes (10 mins). They are unable to talk with the patient

due to the patient’s condition but have a conversation with the patient’s partner for 25 minutes. This is

followed by a phonecall to the GP (15 mins) and then a discussion regarding the patient’s plan with the

medical team (15 mins) and documents in the notes and updates the patient’s diet order in medical records

(15 mins). The entire process takes 90 minutes.

Record:


OOS = 0

Attendance Type = N/A

Duration = 80 mins


Contact Mode = N/A

Patient Category =Admitted

Level 1 Primary Activity= Intervention dietetics


Example 9

A community based Psychologist completes a home visit for an outpatient recently discharged from hospital.

However on arrival the patient is not home. The Psychologist drives 15 minutes to the patient’s home, waits

15 minutes and then drives back to their office (15 mins).

Record:


OOS = 0

Duration = 45mins


Contact Mode = N/A

Patient Category =Outpatient/Non-Admitted

Level 1 Primary Activity= Intervention Psychology


Example 10

A Social Worker spends 90 minutes collating a report for a guardianship tribunal hearing for an outpatient,

including compiling information gained from the patient’s friends and family, liaising with Centrelink and

writing the report.

Record:


OOS = 0


Duration = 90 mins


Contact mode = N/A

Level 1 Primary Activity= Intervention social work

Patient Category = Outpatient/Non-Admitted



Example 11

A Dietitian enters the ward, reads the medical notes, talks to the medical team, goes to see the patient but

they are not in their bed and is not able to see the patient for the remainder of the day. The Dietitian

documents in the medical notes.

Record:


OOS = 0.


Duration = 90 mins


Contact mode = N/A



Example 12

A Psychologist attends a case conference for an hour where 10 patients are discussed. However the

Psychologist is only actively involved in 4 of the 10 patients’ care. One of the other team members records

which clinicians were present at the case conference and provides an overview of the new care plan in each

of the patient’s medical records.

Record:


OOS = 0 per patient of the psychologist


Duration = 15 mins per patient of the psychologist


Contact mode =N/A

Level 1 Primary Activity= Intervention psychology


Example 13

A Physiotherapist spends 55 minutes time preparing a program for an individual prior to seeing the patient

later that day in outpatients.

Record:


OOS = 0


Duration = 55 mins


Contact mode =N/A

Level 1 Primary Activity= Intervention physiotherapist


Outpatient/Non-Admitted Intervention Class=40.09 Physiotherapy Intervention


Example 14

A Speech Pathologist spends 45 mins preparing for an outpatient session; however the patient does not

show for their appointment.

Record:


OOS = 0


Duration = 45 mins


Contact mode = N/A

Level 1 Primary Activity= Intervention speech pathologist


Outpatient/Non-Admitted Clinic Code=40.18 Speech Pathology Intervention (Tier 2 Outpatient classification)

Example 15

A patient attends a falls and mobility clinic and is seen sequentially by a nurse, a physiotherapist (20 mins),

and a geriatrician. After wards, the healthcare providers have a case conference meeting to discuss the

patient and treatment plans (30 mins).

Record:


OOS = 0 for a specific physiotherapy intervention (NB: one of the health care providers records OOS =1 for

a Falls Prevention Clinic

Attendance Type = review

Duration = 50 mins





Outpatient/Non-Admitted Clinic code=40.09 Physiotherapy Intervention (Tier 2 Outpatient classification)

Example 16

A patient and a Social Worker cannot be in the same location for a consultation. They have a consultation

using a telephone while the patient is located at home and the Social Worker is at a GP Plus Centre. The

Social Worker provides counselling, assists the patient with accessing services in their local area and

documents the interaction in the patient’s medical record. These activities take 55 minutes.

Record:


OOS = 1 per clinician

Duration = 55mins


Contact mode= Telephone

Level 1 Primary Activity= Intervention social worker



Example 17

A child with cerebral palsy cannot be in the same location as an Occupational Therapist due to the regional

location of the child. The child and her mother attend an appointment at regional hospital, for a scheduled

telehealth consultation with an Occupational Therapist at metropolitan children’s hospital. The Occupational

Therapist assesses the patient and provides advice on equipment and activities of daily living skills. The

appointment takes 60 minutes.

Record:


OOS = 1 per clinician*

Duration = 60mins


Contact mode= Telehealth/Telemedicine

Level 1 Primary Activity= Intervention occupational therapist


*EPAS will then delineate between MMSS and ABF OOS and activity times as the reporting requirements and definitions are different

Example 18

An Orthotist reviews a patient’s orthosis on the ward (20 mins), and immediately takes the orthosis to the

department (10 mins return) for adjustment (30 mins). They return the orthosis to the patient upon

completion of that adjustment and fit the orthosis (10 mins).

Record:


OOS= 1


Duration = 60 mins


Contact mode= In Person

Patient Category = Inpatient/Admitted

Level 1 Primary Activity= Intervention orthotist


Example 19

The Occupational Therapist contacts the patient by phone to discuss their progress with the new equipment

and home modifications and documents the outcome in the patient’s medical record. The appointment is

created and checked into scheduler. Total time is 30 minutes.

Record:


OOS= 1 (all activities are directly related to the provision of the OOS).




Contact mode= Telephone.

Patient Category = Outpatient/non-admitted

Level 1 Primary Activity= Intervention Occupational Therapy



8.1.1 b Multi-Clinician Contact type

Example 1

An infant is brought to an outpatient clinic and assessed by the Dietitian (20mins), Speech Pathologist

25mins), Physiotherapist (20 mins), and Occupational Therapist (30mins). The attendance is noted in the

infant’s medical record.

Record:



Duration = 20mins for dietitian, 25 mins for speech pathologist, 20 mins for physiotherapist, 30 mins for

occupational therapist



Level 1 Primary Activity= Intervention nutrition and dietetics, Intervention Speech Pathology, Intervention

Physiotherapy, Intervention occupational therapy, as aligned to the clinician’s professions


Outpatient/Non-Admitted Clinic Code =40.18 Speech pathology; 40.09 Physiotherapy; 40.06 Occupational

therapy (Tier 2 Outpatient classification)

Example 2

An outpatient attends a brain injury clinic led by a rehabilitation specialist. The visit involves a review by the

rehabilitation physician who spends 30 minutes with the patient, Speech Pathologist, who spends 25

minutes and the Psychologist who consults for 40 mins. Only one appointment is booked.

Record:



Duration = 40mins for psychologist, 25 mins for speech pathologist



Level 1 Primary Activity= Intervention occupational therapy, Intervention Speech Pathology, Intervention

Psychologist as aligned to the clinician’s professions


Outpatient/Non-Admitted Clinic Code = 40.12 Rehabilitation (Tier 2 Outpatient classification)



8.1.1 c Group Contact mode

Example 1

An Exercise Physiologist runs a weekly 1 hour group within the community, with 6 patients who attend for an

hour. Each attendance is recorded in the patient’s individual medical records.

Record:


OOS= 6 (one for each patient that the Exercise Physiologist is actively involved).


Duration = 60 mins per patient

Contact type=Group



Level 1 Primary Activity= Intervention exercise physiologist


Outpatient/Non-Admitted Clinic Code =40.29 Exercise Physiology (Tier 2 Outpatient classification)

*EPAS will then delineate between MMSS and ABF OOS as the reporting requirements and definitions are different for groups.

Other reporting systems will need to be able to differentiate between the type of OOS for ABF and MMSS also.

Example 2

Five patients participate in a hydrotherapy session where a Physiotherapist directs the patients through a

range of exercises for 60 minutes. A dated entry is made in each patient’s medical record following the

session.

Record: 5 OOS, *60 Clinical Care (IPA) minutes, Contact mode: Group.

Record:


OOS= 5

Duration = 60* mins per patient-

Contact type=Group

Contact mode = in person




Outpatient/Non-Admitted Clinic Code =40.05 Hydrotherapy (Tier 2 Outpatient classification)



8.1.2 ATTENDANCE TYPE: NEW/ REVIEW SPECIFIC EXAMPLES

Example 1

A patient with diabetes has 6 monthly appointments with the diabetics department.

Record:


Attendance Type:

• Initial appointment following referral = New

• Subsequent appointments = Review

•

Example 2

A patient with COPD is seen for chest physiotherapy whilst an inpatient and discharged following

improvement. One week later, whilst still an inpatient within the same clinic/ward, the patients is referred

back to physiotherapy for further chest physiotherapy due to deterioration in their condition.

Record:


Attendance Type = review because there is continuation of the patient’s original episode of care. The

clinical intent remains the same and the patient is still in the same clinic/ward.

Example 3

A Paediatric patient attends Speech Pathology for language delay in a community setting. The patient

attends an initial assessment appointment followed by a group program (x1 per week for 6 weeks). The

patient attends for a review of progress 4 months after completing the group therapy program.

Record:


Attendance Type = initial appointment = ‘new’, subsequent group sessions and review of progress at 4

months are considered ‘review’ attendances

Example 4

An outpatient within the acute phase of lymphoedema is seen monthly for a period of twelve months. They

are then shifted to 6 monthly appointments for the ongoing maintenance phase of treatment.

Record:

There is an episode of care for the initial twelve months consisting of 1 ‘new’ attendance type an ‘11’

review attendance types. The episode of care is then closed. The initial 6 month review is a ‘new’

attendance and the subsequent 6 monthly contacts are a ‘review’.

Example 5

A patient attending a falls prevention clinic weekly for intervention is subsequently admitted to hospital for

an unrelated condition.

Record:

2 concurrent episodes of care will be active*- the first for the outpatient treatment and the second for the

unrelated inpatient admission.


Attendance Type = any allied health professional seeing the patient whilst in hospital for the purposes of

addressing issues relating to the reason for admission should record the Attendance type as ‘new’ for the

initial contact.* The outpatient episode of care will remain open and resume (with ‘review’ attendance

types)


8.1.3 PATIENT CATEGORY- SPECIFIC EXAMPLES

Example 1

An Occupational Therapist conducts a ‘discharge home visit’ for a patient admitted for a fractured neck of

femur. The medical team is holding the bed open, awaiting clearance of the patient from the OT before they

are discharged i.e. the patient is still an inpatient of the hospital. The patient is picked up from the ward and

transported by hospital vehicle to their home (the trip takes 30 minutes) where their equipment is set up and

demonstrated. The Occupational Therapist, calls the medical team and confirms the patient is clear for

discharge, returns to the hospital and makes a note in the patient’s inpatient medical file. Total time is 2

hours.

NB

• This example assumes the patient’s bed is held open. I.e. there is the option to return the patient to

hospital if the home visit fails.

• If the patient had already been discharged prior to leaving the hospital the intervention should be

counted as an outpatient service (and recorded in your facility’s booking system).

Record:


OOS = 1


Patient Category =Admitted/ Inpatient

Duration = 120 mins


Level 1 Primary Activity= Intervention occupational therapy


Example 2

A Speech Pathologist who works in a Day Rehabilitation Unit (DRU) completes an assessment, provides

aphasia intervention and documents in the medical notes. With each attendance, patients who attend the

DRU undergo a formal admission process as same-day patients. Total time 30 minutes

Record:


OOS = 1


Patient Category =Admitted/ Same Day

Duration = 30 mins


Level 1 Primary Activity= Intervention speech pathology



Example 3

A Dietician who works in a community based setting visits a patient’s home completes an assessment,

provides intervention and documents in the medical notes. Total time including travel is 50 minutes.

Record:


OOS = 1


Patient Category =Non Admitted/Outreach

Duration = 50 mins

Contact mode= Individual



Example 4

An Audiologist has a telephone consultation with a specialist to discuss a mutual inpatient and plan future

interventions.

Record:


OOS = 0


Patient Category =Admitted/ Inpatient

Duration = 20 mins

Contact mode= N/A

Level 1 Primary Activity= Intervention audiology


Example 5

A patient attends a Day Rehabilitation Clinic and is sequentially seen by a geriatrician, a Physiotherapist, an

Occupational Therapist and a Social Worker. On the same day three other patients attend the clinic and see

the same three healthcare providers. Once all four patients have been seen, the health professional have a

case conference meeting to discuss each of the patients and treatment plans. Only one appointment is

booked in your facilities booking system.

Record:




Patient Category =Admitted/ same day OR Non-admitted/Outpatient (dependent on how the DRC manages their

service).

Duration = time spent per patient (mins)

Contact type= multi-clinician involvement



**EPAS will then delineate between MMSS and ABF OOS and activity times as the reporting requirements and definitions are different


Example 6

A metropolitan based Prosthetist and Physiotherapist complete a follow-up consultation via video-

conference with the patient and their Physiotherapist within their local community to review how the

patient is managing their prosthesis one month post the patient discharge from the hospital. The

appointment takes 70 mins and the appointment is booked in the facility’s booking system.

Record:




Patient Category = Non-admitted/Outpatient

Duration = 70 mins

Contact mode= Telehealth/Telemedicine

Level 1 Primary Activity= Intervention prosthetics or Physiotherapy (depending on the profession of the

clinician entering)



Example 7

A Social Worker provides advice to a husband and wife on the same home visit, so that both receive a

separate individual service, and this is documented separately in each of their individual records i.e. they are

both registered clients. This takes 90 minutes. The Social Worker drives 10 minutes to and from the patient’s

home.

Record:


OOS = 2 total (one for each patient)*


Patient Category = Non-Admitted/Outreach

Duration = 55 mins per patient entry

Contact mode= In person

Contact Type: Individual

Level 1 Primary Activity= Intervention social work


*EPAS will then delineate between MMSS and ABF OOS and activity time as the reporting requirements and definitions are different


8.2 CLINICAL CARE ACTIVITY: Non- Individual Patient Attributable 8.2.1 OOS AND DURATION-SPECIFIC EXAMPLES

Example 1

The service has identified a gap and the need to develop an educational resource. The Audiologist spends 75

minutes preparing an education package for outpatients. The Audiologist does not know the specific

patients who will receive the resource.

Record:

Health Activity Hierarchy: NIPA

OOS= 0

Attendance Type =N/A

Duration = 75 mins

Contact mode=N/A

Patient Category = N/A



Outpatient/Non-Admitted Clinic Code/Type =N/A

Example 2

Approval has been gained to develop, design and deliver a new outpatient service to patients with lower

limb amputation. A Prosthetist spends 300 minutes preparing designing and developing specific program

materials including session structure, content and research for the program including a literature review.

Record:


OOS= 0

Attendance Type =N/A

Duration = 300 mins

Contact mode=N/A

Patient Category = N/A

Level 1 Primary Activity= Intervention prosthetics

Level 2 Primary Activity (site –specific mandatory) = XXXX

Outpatient/Non-Admitted Clinic Code/Type =N/A

Example 3

A community service provider offers a drop-in support group for patients with dementia and their carers. A

Social Worker facilitates the group discussion and provides information on dementia and services that are

available to patients and their carer. The numbers of members attending each month varies and no medical

records are created.

Record:


OOS= 0

Duration = 60* mins per patient

Contact Type=Group

Contact Mode= in person


Outpatient/Non-Admitted Clinic Code/Type =40.08 Primary Care (Tier 2 Outpatient classification)

*EPAS will then delineate between MMSS and ABF OOS and activity time as the reporting requirements and definitions are different


8.3 WHEN THINGS GET COMPLICATED

Should you encounter difficulty in interpreting how an allied health activity should be recorded, please refer

to the flow chart located at the end of this document. If you are still unsure of how to record your time and

OOS please contact your immediate manager.

Managers are encouraged to send the example to their local data integrity committee for comment and

further clarification if required. Resolved and unresolved examples can be emailed to the Allied and Scientific

Health Office for consideration and/or resolution through the State-wide AH Executive Committee.

The result of the enquiry should be used to provide further education to all allied health staff to ensure

consistency in data capture.

Some questions to help you in how/where to enter your stats may be:

• Can I identify an URN for this activity?

• Where did the activity take place?

• Whose medical record is this being documented in? That person is the patient (even if you have been

talking to someone else about an issue).

COMPLEX EXAMPLES

Example 1

A Physiotherapist is running a pulmonary rehab exercise group for 10 patients in the community for 80

minutes. 2 patients require individualized attention during the group and the Physiotherapist spends 10

minutes with each of them. All patients have an entry in their medical record for attending the group and

specific entries are made for the 2 patients receiving individualised attention.

Record: 10 group *OOS of *80 minutes Clinical Care (IPA) and 2 individual OOS of 10 minutes each, Contact

type= Individual + Group, Contact mode = in person; Patient Category: Non Admitted/Outpatient. Level 1

Activity: Physiotherapy.

Example 2

A Social Worker provides bereavement support via email to the adolescent child of a deceased patient who

passed away a week ago. The email correspondence takes 20 minutes to write. This is not able to be

captured against the patient’s medical file as this has been closed and should be recorded as Non-Individual

Patient Attributable time.

Record: 0 OOS, 20 minutes Clinical Care (NIPA), Contact type = individual; Contact mode: electronic mail,

Patient Category: Non-admitted/ Outpatient, Level 1 Activity: Social Worker. Outpatient/Non-Admitted

Clinic Code/Type =40.11 Social Work (Tier 2 Outpatient classification)


Example 3

The adolescent as described above continues to require intervention and monitoring. The Social Worker

provides phone counselling for 60 minutes.

A URN and medical record is created for the adolescent (with their permission), they are now a registered

patient. An entry is made in the adolescent’s medical file.

This is an example of the carer/parent/child becoming a patient. The decision regarding when a

carer/parent/child becomes a patient in their own right is at the discretion and clinical judgment of the allied

health professional in conjunction with health service eligibility.

Record:

1 *OOS, 60 minutes Clinical Care (IPA), Contact type = individual, Contact mode: Telehealth/Telemedicine,

Patient Category: Non-Admitted/Outreach, Level 1 Activity: Social Work Intervention, Outpatient/Non-

Admitted Clinic Code/Type =40.11 Social Work (Tier 2 Outpatient classification)

Example 4

A Psychologist provides counselling to a paediatric patient’s mother and father together (or separately) on a

home visit. The intervention takes 60 minutes and is documented in the patient’s records i.e. only the patient

is a registered client.

Record: 60 minutes Clinical Care (IPA), Contact type: Individual, Contact mode: in person; however whether

an OOS is recorded will be dependent on the type of service being provided.

• Outpatient – Record: 1 OOS (if the patient (child) is present), Patient Category: Non-Admitted/Outpatient,

Level 1 Activity: Intervention Psychology; Outpatient/Non-Admitted Clinic Code/Type = 40.29 Psychology

(Tier 2 Outpatient classification)

• Patient (child) is currently admitted to a hospital- Record: 0 OOS (as the patient is not present), Patient

Category: Admitted/Inpatient, Level 1 Activity: Intervention Psychology.

Example 5

A Diversional Therapist sees a patient on the ward in the morning and performs the following interventions:

reads the patient medical record, performs a Leisure Assessment, conducts leisure education, and

documentation. This takes 80 minutes. The patient attends a Diversional therapy group session in the

afternoon based on their leisure interests for 70 minutes. The group has 6 participants and attendance is

recorded in the medical notes.

Record: 1 OOS, 80 minutes Clinical Care (IPA), Contact type: Individual, Contact mode: in person; Patient

Category: Inpatient (for the morning).

6 *OOS, *70 minutes Clinical Care (IPA), Contact type: Group, Contact mode: in person; Patient Category:

Admitted/Inpatient, Level 1 Activity: Diversional Therapist (for the afternoon).

Example 6

An Orthotist and Podiatrist run concurrent, unrelated outpatient sessions for the convenience of the patient,

who would otherwise have to attend individual sessions for each health professional. The appointments

have been created independently. The Social Worker also sees the patient for 10 minutes to provide an

update of their housing application however has not booked an appointment with the patient nor

documents the medical records.

Record: 2 OOS, (i.e. 1 Orthotist and Podiatrist), Clinical Care (IPA), Contact type: Individual, Contact mode: in

person; Patient Category: Outpatient, Level 1 Activity: each record their own profession (Orthotist and

Podiatrist); Outpatient/Non-Admitted Clinic Code/Type =40.25 Podiatry, & 40.24 Orthotics (Tier 2 Outpatient

classification)


The Social Worker does not record an OOS however must record Clinical Care (IPA), Contact type: Individual,

Contact mode: In person; Patient Category: Non-Admitted Outpatient, Level 1 Activity: Social Worker.

Example 7

A patient is admitted to hospital for treatment of a cardiac condition. The patient has a pre-existing

outpatient appointment at the Audiology Department of the same hospital and is transported from the ward

to attend this appointment.

Record: 1 *OOS, Clinical Care (IPA), Contact type: Individual, Contact mode: in person; Patient Category:

Inpatient, Level 1 Activity: Audiology.

*EPAS will then delineate between MMSS and ABF OOS and activity time as the reporting requirements and definitions are different.


8.4 ALLIED HEALTH ASSISTANT STATISTICS

Allied Health Assistants (AHA) should record all their therapy time against specific patients wherever

possible.

AHA can also record an OOS where:

• They are providing an intervention/therapy independent of other staff;

• Their intervention/therapy is documented separately in the patient’s medical record;

• They provide an intervention for the patient alongside another health worker where they are required, for

either assistance with the intervention or from a patient safety perspective.

Where AHAs are assisting an allied health professional (AHP) in their task then the AHP records total time

and OOS, the AHA records total time and an OOS. In this instance the AHA would document in the AH Data

Collection Note.

A H A E X A M P L E S

Example 1

An AHA assists a physiotherapist with walking a patient, due to the patients’ increased risk of a fall. The

session takes 15 minutes.

Record: AHA – 1 OOS, 15 minutes Clinical Care (IPA), Contact type: Multi-Clinician Involvement, Patient

Category: Admitted/Inpatient, Level 1 Activity: Physiotherapy.

Physiotherapist = 1 *OOS, 15 minutes Clinical Care (IPA), Contact type: Multi-Clinician Involvement, Contact

mode: in person; Patient Category: Admitted/Inpatient, Level 1 Activity: Physiotherapy.

Example 2

An AHA assists a patient to complete some paper based memory retraining activities set by the Speech

Pathologist with the Stroke Rehabilitation Unit. The session takes 30 minutes and the Speech Pathologist is

not present.


Category: Admitted/Inpatient, Level 1 Activity: Speech Pathology.

Example 3

A Physiotherapist provides supervision for 2 AHAs who take 2 patients through an exercise program for 30

minutes.

Record: The Physiotherapist records 2 *OOS, 15 minutes Clinical Care (IPA) for each patient, Contact type:

Multi-Clinician Involvement, Patient Category: Admitted/Inpatient, Level 1 Activity: Physiotherapy.

Each AHA records 1 *OOS and 30 minutes Clinical Care (IPA) for their respective patients, Contact type:

Multi-Clinician Involvement, Contact mode: in person; Patient Category: Admitted/Inpatient, Level 1 Activity:

Physiotherapy.


Example 4

An OT assistant carries out one handed dressing practice in the bathroom for 1 hour. The assistant also

educates the carer on how best to assist the patient to complete the tasks during this time.


Category: Admitted/ Inpatient, Level 1 Activity: Occupational Therapy.

Example 5

The OT has requested that the OT assistant takes a patient to the ADL unit and demonstrate how to use

modified kitchen aids. The Physiotherapist attends at the same time to assess the patient’s balance using a

walking stick in the kitchen environment. The session takes 20 minutes. The AHA then provides some

documentation to the patient regarding suppliers and options of models/styles. This takes 10 mins.

Record: AHA 1 *OOS, 30 minutes Clinical Care (IPA), Contact type: Multi-Clinician Involvement, Contact

mode: in person; Patient Category: Admitted/Inpatient, Level 1 Activity: Occupational Therapy.

Physiotherapist 1 *OOS, 20 minutes Clinical Care (IPA), Contact type: Multi-Clinician Involvement, Contact

mode: In person; Patient Category: Admitted/Inpatient, Level 1 Activity: Physiotherapy.

Example 6

An Exercise Physiologist conducts an exercise program for an outpatient and is assisted by an AHA. The

intervention takes 60 minutes and recorded within the medical records. Both clinicians are required for

conduction of the group and to ensure patient and staff safety.

Record: Exercise Physiologist– 1 *OOS, 60 minutes Clinical Care (IPA), Contact type: Multi-Clinician

Involvement, Contact mode: in person; Patient Category: Outpatient, Level 1 Activity: Exercise Physiology.

AHA 1 *OOS, 60 minutes Clinical Care (IPA), Contact type: Multi-Clinician Involvement, Patient Category:

Non-Admitted/Outpatient, Level 1 Activity: Exercise Physiology

Example 7

The Occupational Therapist who has been completing the “Rehab in the Home-based” intervention, jointly

visits to hand over the treatment program to an AHA. The therapist spends 30 minutes plus 20 minutes

travel to and from the patient’s home. The AHA spends 60 minutes plus 20 mins to and from the patient’s

home. Both clinician and AHA document in the patients’ medical notes (5 minutes).

Record: AHA 1 *OOS, 85 minutes Clinical Care (IPA), Contact type: Individual, Contact mode: in person;

Patient Category: Admitted/Inpatient, Level 1 Activity: Occupational Therapy.

Occupational Therapist 1 *OOS, 55 minutes Clinical Care (IPA), Contact type: Individual, Contact mode: in

person; Patient Category: Admitted/Inpatient, Level 1 Activity: Occupational Therapy.

Example 8

The AHA attends a 15 minute hand-over session with the Speech Pathologist and patient regarding the next

extension steps for a communication program.

Record: AHA 0 *OOS, 15 minutes Clinical Care (IPA), Contact type: Individual, Contact mode: N/A Patient

Category: Inpatient, Level 1 Activity: Speech Pathology.

Speech Pathologist 1 *OOS, 15 minutes Clinical Care (IPA), Contact type: Individual, Contact mode: In Person;

Patient Category: Inpatient, Level 1 Activity: Speech Pathology.



8.5 STUDENT STATISTICS

Student statistics must be captured as part of the service provision data. Accordingly the following model is

agreed:

1. Where the student is treating the patient unaided with the supervisor observing, the student enters an

OOS and all student time should be entered into IPA. The supervisor’s time is recorded as Non Clinical

Activity – Teaching and Training.

2. If the student is treating a patient without a supervisor present the student records:

• An OOS, and

• All therapy time (IPA – direct and indirect care)

• The remaining time (i.e. discussing the case, countersigning the notes etc.) is to be recorded by the

supervisor as Non-Clinical Activity – Teaching and Training.

3. Where the patient would normally need to be treated by two people and a student and staff members

are treating the patient together then:

• Both the student and supervisor should enter time as Clinical Care (IPA) and record an OOS.

• They will be also required to indicate multi-clinician involvement and their profession in the profession

specific structured note.

4. Where the supervisor is treating the patient and a student is observing and/or participating in the

treatment:

• The supervisor enters an OOS and time that would have been taken to treat the patient to Clinical

Care (IPA). The student records activity time only.

• Any additional time taken due to the need to give explanations to student etc. should be entered as

Non-Clinical Activity – Teaching and Training.

5. Supervisor activities associated with students NOT involving patient treatment should be recorded as

Non-Clinical Activity – Teaching and Training. This included liaison with the tertiary institution,

preparation time, supervisory time, reporting and feedback and travel.

S T U D E N T E X A M P L E S

Example 1

A Physiotherapist is supervising 5 students during an exercise rehabilitation class. Each student provides an

hour of therapy to one patient each (total 5 patients). The Physiotherapist divides their attention evenly

between the 5 students. The students write the medical note entry and this is countersigned by the

supervisor.

Record: Each student records 1 OOS per patient and 60 minutes Clinical Care (IPA), Contact type: Individual,

Contact mode: in person; Patient Category: Inpatient, Level 1 Activity: Physiotherapy.

The supervisor records 0 OOS and 60 minutes of as Non-Clinical Activity – Teaching and Training.

Example 2

An Exercise Physiologist introduces themselves and their student to the patient. The supervisor discusses

the treatment plan briefly with the patient (10 minutes) then allows the student to complete the treatment

while the supervisor observes (20 minutes).

Record: The supervisor records 1 OOS, 10 minutes Clinical Care (IPA) and 20 minutes Non-Clinical Activity –

Teaching and Training. The student records 0 OOS and 20 minutes Clinical Care (IPA), Contact type:

Individual, Contact mode: in person; Patient Category: Inpatient, Level 1 Activity: Exercise Physiology.


Example 3

A Dietitian allows a student to conduct a nutritional assessment of an outpatient while they see another

outpatient. The student takes 60 minutes to complete the assessment. The Dietitian and student spend 20

minutes discussing the case, ensuring the care plans are accurate and the supervisor countersigns the notes.

Record: The student records 1 OOS, 80 minutes Clinical Care (IPA), Contact type: Individual, Contact mode: in

person; Patient Category: Outpatient, Level 1 Activity: Dietetics + Nutrition; Outpatient/Non-Admitted Clinic

Code/Type =40.23 Nutrition/dietetics. (Tier 2 Outpatient classification)

The supervisor does not record an OOS but records 20 minutes Non-Clinical Activity - Teaching and Training.

The supervisor also accounts for time and OOS for the other patient.

Example 4

A leisure assessment is conducted on a patient by a student with the Diversional Therapist supervisor

observing. The student takes 45minutes to complete the assessment. The Diversional Therapist and student

spend 15 minutes afterwards discussing the assessment and documenting in the medical record; the

supervisor countersigns the notes.

Record: The student records 1 OOS and 45 minutes Clinical Care (IPA), Contact type: Individual, Contact

mode: in person; Patient Category: Inpatient, Level 1 Activity: Diversional Therapist. The supervisor does not

record an OOS, but records 60 minutes Non-Clinical Activity – Teaching and Training time.

Example 5

A podiatry outpatient would normally need to be treated by two people and a student and staff members

are treating the outpatient together. This session takes 50 minutes to complete.

Record: Both the student and supervisor record an *OOS and 50 minutes Clinical Care (IPA), Contact type:

Multi-Clinician Involvement, Contact mode: in person, Patient Category: Inpatient; Level 1 Activity: Podiatry;

Outpatient/Non-Admitted Clinic Code/Type =40.25 Podiatry (Tier 2 Outpatient classification)



8.6 CLINICAL SERVICE MANAGEMENT ACTIVITIES

CSM E X A M P L E S

Clinical Service Management: Professional and management activities which support and are essential to

clinical care. Includes:

General

• Staff meetings

• OHS activities

• Staff management

• Financial management

• Recruitment and performance appraisal

• Administration generally

• Travel related to any CSM activities

• Email management

Professional Development

• Attending in-services, lectures, interest groups, seminars and conferences or any other means of

receiving teaching and training

• Journal reading and journal clubs

Quality

• Planning and conducting project work

• Activities in preparation for accreditation

• Program evaluation or new program development

Provision of Supervision

Supervision provided on clinical issues, or regarding a number of patients/clients. Includes clinical

supervision provided to staff from other hospitals or workplace, workload planning etc.

Does NOT include:

• Student supervision or clinical education;

• Specialist consultation or supervision provided, regarding workplace or career.

Receipt of Supervision

Supervision received on clinical issues, or regarding a number of patients/clients Includes clinical

supervision provided to staff from other hospitals or workplaces. Does NOT include

• Student supervision or clinical education

• Specialist consultation or supervision provided, regarding workplace or career


Teaching and training: Formal teaching and training activities which relate to the imparting of knowledge,

skills and clinical competency to undergraduate and postgraduate students, health practitioners within one’s

own professions or health practitioners from another profession, as part of a structured program.

Includes:

• Administration for general teaching and training activities

• Supervision of work experience placements

• Imparting knowledge, skills and clinical competency to undergraduate + postgraduate students, to

practitioners within one’s own profession and to other professions.

Excludes:

• one-to one staff supervision

• informal or adhoc sessions with staff

• your own professional development

• (all exclusions would be coded as CSM)

Research: Activities undertaken to advance the knowledge of the delivery of care to an individual, group or

community. Research is limited to activities that lead to and follow formal approval of the project by a

research committee or equivalent body.

Includes:

• all time spent on research activities including meetings,

• telephone calls,

• administrative activities,

• consultation, preparation, planning, ethics committee approval and activities associated with the

implementation phase of the research project, including the documentation and final reports of the

project

Excludes

• Literature review (unless done as part of a formal research project).

Travel:

Travel to outreach sites where assessment/intervention is then conducted is recorded under travel time as

an exception. This is to specifically enable the collection of costs associated with the provision of outreach

services when a local service is not available.

Please note:

Unless otherwise advised, travel is normally recorded as Clinical Care Activity – IPA or NIPA for patient

attributable activity and CSM for non-patient attributable activity).


APPENDIX 1 Data Items Ready Reckoner: Definition and Guide For Use

Data Element Group Definition & Guide for Use

Occasion of Service (referred to as a Service Event in ABF)

Occasions of Service

(Service Event)

Any examination, consultation, treatment or other service provided by a

health service provider … to a client/patient on each occasion such service is

provided.

The service must contain / be:

� New clinical content

� Face to face or a substitute for face to face e.g. telephone and

� Documented in the patient’s medical record, clinical file or information

system.

New or Review

New or Initial The first patient attendance to the service / profession (not to each clinician

within the profession for that episode of care)

Review or Subsequent All other attendance following the initial (new attendance)

Episode of Care An episode of care is a phase of treatment. There may be more than one

episode of care within the one hospital stay. An episode of care ends when

the principle clinical intent changes (and thus care type) or when the patient is

formally separated from the facility

Referrals/Consult Orders Each episode of care requires a referral or ‘consult order’. The presentation of

an unrelated illness or condition will initiate a new course of treatment (or

episode of care) in which case a new referral or consult order is required.

Clinical Care Activity

Clinical Care Activity Activities provided to an individual, group or community to influence health

status. Includes: Individual Patient Attributable (IPA) and Non-Individual

Patient Attributable (NIPA) activity.

Individual Patient Attributable

(IPA)

Any clinical care activity that can be assigned to an individual patient

(including travel). This includes direct and indirect patient care (i.e. the

patient does not need to be physically with the staff)

Non- Individual Patient Attributable

(NIPA)

Any activity that cannot be assigned to an individual patient but is patient

related.

Contact mode

Telephone Patient and provider(s) not in same physical location and communicating by

telephone. Service provider(s) is talking directly to the patient or carer and

must be a substitution for a face-to-face consult. Administrative phone calls,

booking schedules must not be counted as an occasion of service.

In person Patient is present at the time of the contact.

Telehealth/telemedicine/videoconference Communication occurs via a secure telecommunication or video-

communication mediums carer and must be a substitution for a face-to-face

consult.

Postal/courier Communication is made via a written document.

Electronic mail Communication is made via electronic means e.g. email.

Other

All other methods not defined elsewhere.


Contact type

Individual

Any examination, consultation, treatment or other service provided by a

health service provider to a patient of a health service establishment.

Group

Group activity is recorded when two or more patients/clients receive the

same service, at the same time, from the same health care employee.

Groups can be inpatient or outpatient based and must contain clinical

content.

Multi-Clinician Involvement (referred as

‘multi-disciplinary clinics’ in ABF)

Service events involving multiple healthcare providers where a single patient

is being treated by two or more clinicians from either different or the same

profession at the same time.

Patient Category (referred to a Service Category in ABF)

Admitted/ Inpatient An admitted patient is an individual who undergoes a formal admission

process into a SA Health hospital either an:

� Inpatient (acute + subacute)

� Same-day admitted patient: The person receives treatment and then goes

home on the same day.

Non-Admitted/ Outpatient Patient A patient who does not undergo a hospital’s formal admission process.

There are two categories of non-admitted patients:

Outpatient: A person who attends, usually by appointment, and receives non-

emergency outpatient services from a healthcare provider(s) at a hospital or

community based setting.

Outreach: An individual who receives services considered as Tier 2 from a

healthcare provider(s) at locations outside the hospital or facility premises e.g.

service provided in patient’s homes, at special locations outside the hospital,

facilities such as mobile clinics or remote clinics manned on a part-time basis.

Emergency � Emergency Department: A person who receives emergency care in a

hospital emergency department.

Activity

Activity Correlates to the profession of the allied health clinician e.g. Exercise

Physiologist.

Sub-Level Activity The sub-level activity breaks activity down into sub-categories such as

assessment, treatment, travel etc. Inclusion of this level of activity is optional,

dependent on departmental management.

Outpatient Clinic Codes (ABF)

Non-Admitted/Outpatient Used for ABF Tier 2 funding. Hospital outpatient clinics and select other non-

admitted services are required to report against Tier 2 code sets. The classes

are grouped into four categories that reflect the type of service provided and

the clinicians that typically provide the service. These include:

� Procedures

� Medical consultation

� Stand-alone diagnostic

� Allied health and/or clinical nurse specialist intervention

Sub-Acute & Non-Acute Admitted Care Type

Sub- Acute “sub-acute is specialised multi-disciplinary care in which the primary need for

care is optimisation of the patient’s functioning an quality of life….Subacute

care comprises the defined care types of rehabilitation, palliative care,

geriatric evaluation and management and psychogeriatric care.9”

"type of maintenance care often require care over an indefinite period.” P13

Maintenance (or non-acute) care Maintenance (or non-acute) care is care in which the primary clinical purpose

or treatment goal is support for a patient with impairment, activity limitation

or participation restriction due to a health condition. ... Patients with a care

type of maintenance care often require care over an indefinite period.9”


Home Supports

Home supports Refers to Total Parenteral Nutrition (TPN) and Home Enteral Nutrition (HEN)

either oral or via a tube performed by the patient in their own home without

the presence of a health care provider.

Non-Clinical Activity Data Definitions

Non-Clinical Care Activities

Non-Clinical Care Activities Activities performed which are not directly related to a particular

patient/individual, group or community to influence health status. These

include activities that support and are essential to clinical care.

There are three categories of non-clinical care activity:

1. Clinical Services Management (CSM)

2. Teaching and Training (TT)

3. Research (R)

4. Travel (Tr)- outreach block clinics

Clinical Services Management (CSM) Professional and management activities which support and are essential to

clinical care.

Teaching and Training

(TT)

Formal teaching and training activities which relate to the imparting of

knowledge, skills and clinical competency to undergraduate and postgraduate

students, health practitioners within one’s own professions or health

practitioners from another profession, as part of a structured program.

Research

(R)

Activities undertaken to advance the knowledge of the delivery of care to an

individual, group or community. Research is limited to activities that lead to

and follow formal approval of the project by a research committee or

equivalent body.

Travel

(Tr)

Travel time to outreach site when local services are not available.


APPENDIX 2 Allied Health and/or Clinical Nurse Specialist Interventions Classes Tier 2

40 Allied health and/or clinical nurse specialist interventions classes

40.01 Aboriginal and Torres Strait Islander Peoples

Health Clinic

40.02 Aged care assessment

40.03 Aids and Appliances

40.04 Clinical Pharmacy

40.05 Hydrotherapy

40.06 Occupational therapy

40.07 Pre-Admission and Pre-Anaesthesia

40.08 Primary health care

40.09 Physiotherapy

40.10 Sexual health

40.11 Social Work

40.12 Rehabilitation

40.13 Wound management

40.14 Neuropsychology

40.15 Optometry

40.16 Orthoptics

40.17 Audiology

40.18 Speech pathology

40.21 Cardiac rehabilitation

40.22 Stomal therapy

40.23 Nutrition/dietetics

40.24 Orthotics

40.25 Podiatry

40.27 Family planning.

40.28 Midwifery and maternity

40.29 Psychology

40.30 Alcohol and other drugs

40.31 Burns

40.32 Continence

40.33 General counselling

40.34 Specialist mental health.

40.35 Palliative care

40.36 Geriatric Evaluation and Management

(GEM)

40.37 Psychogeriatric

40.38 Infectious diseases

40.39 Neurology

40.40 Respiratory

40.41 Gastroenterology

40.42 Circulatory

40.43 Hepatobiliary

40.44 Orthopaedics

40.45 Dermatology

40.46 Endocrinology

40.47 Nephrology

40.48 Haematology and immunology

40.49 Gynaecology

40.50 Urology

40.51 Breast

40.52 Oncology

40.53 General medicine

40.54 General surgery

40.55 Paediatrics

40.56 Falls prevention

40.57 Cognition and memory

40.58 Hospital avoidance programs

40.59 Post-acute care


APPENDIX 3: Non-hospital based services/programs in scope for Tier 2 clinics

I n s e r t o n c e i d e n t i f i e d b y A H E x e c f o l l o w i n g r e v i e w o f P B a t t i s t a ’ s l i s t


REFERENCES

1. Independent Hospital Price Authority 2012, Tier 2 Non-admitted Services Compendium 2013–2014 V1.0,

viewed 6 May 2013,

http://www.ihpa.gov.au/internet/ihpa/publishing.nsf/Content/non-admitted-care

2. Independent Hospital Price Authority 2013, Tier 2 Non-admitted Services Definitions Manual 2013–2014

– V2.0, viewed 6 May 2013,

http://www.ihpa.gov.au/internet/ihpa/publishing.nsf/Content/non-admitted-care

3. Independent Hospital Price Authority 2013, National Efficient Price Determination 2013-2014, viewed 6

May 2013,

http://www.ihpa.gov.au/internet/ihpa/publishing.nsf/Content/national-efficient-price-2013-14

4. Dept. of Health 2011, Monthly Management Summary System (MMSS) Guidelines, Government of South

Australia, Adelaide South Australia.

5. Allied Health Workforce Advice & Coordination Unit 2011 Allied Health Information Management

Business Rules Version 3.1, Queensland Health, Brisbane, QLD.

6. Cerner Allied health System Project 2012, Data Definitions for Allied Health, South Eastern Local Hospital

District, Illawarra Shoal Haven Local Hospital Districts and Sydney Children’s Hospital, Sydney NSW.

7. Independent Hospital Price Authority 2013, Tier 2 Non-admitted Services Definitions Manual 2013–2014

v2.0.

8. National Allied Health Casemix Committee 2001, Health Activity Hierarchy Version 1.1, An Australian

Standard describing the range of activities provided by health professionals.

http://www.nahcc.org.au/pdfs/hah.pdf

9. OOHS MDS Data Dictionary, 2007Basso,P ; Hardin, T; Biggins,J; Shepherd,M.

10. IHPA, Australian Institute of health and Welfare 2013, Development of nationally consistent sub-acute

and non-acute admitted patient care data definitions and guidelines, pp9,13.

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