All registrations must be paid in full by GMT 17:00 on 26th September 2022.
Please note that any registration post GMT 17:00 on 11th September 2022 must be paid in full immediately via credit card or other immediate payment transfer.
Welcome to PCSI Conference in Iceland, 2022
On behalf of the Icelandic Ministry of Health, I would like to welcome you to the 2022 conference, in collaboration with the Patient Classification Systems International (PCSI) and the Nordic Casemix Centre (NCC). The 2022 conference will be the 35th PCSI conference, following the long tradition of conferences hosted in various international locations, partnering with local organisations.
Although the world has moved to meeting virtually, I would like to invite you in person for this conference, to benefit from informal interactions in addition to the formal conference content. And as an opportunity to visit and experience our unique country.
The theme “Casemix as a foundation for sustainable health management” reflects where Iceland and many other countries are at the moment – thinking deeply about processes and solutions to support health systems to face challenges into the future, including pandemics, population ageing, increased rates of chronic disease, workforce shortages and rising costs.
I welcome you to Iceland, to come and think deeply together.
Maria Heimisdóttir MD, PhD, MBA
Maria Heimisdottir is the CEO of Iceland Health Insurance. Her background is in medicine, she holds an MD from the University of Iceland and completed her training in public health in the USA. She holds a PhD in public health from the University of Massachusetts as well as an MBA from the University of Connecticut. Dr. Heimisdottir previously served as the CFO of Landspitali University Hospital. She has been active in teaching and research, mainly in the fields of health care policy and management, clinical decision support and health care informatics.
Dr. Jason Sutherland (ABF expert, funding policy reform)
Professor, Centre for Health Services and Policy Research, University of British Columbia.
Dr. Jason Sutherland is a Professor in the Centre for Health Services and Policy Research (CHSPR), School of Population and Public Health, in the University of British Columbia’s Faculty of Medicine, and the Program Head of Health Services and Outcomes at the Centre for Health Evaluation and Outcome Sciences.
Dr. Sutherland is the editor-in-chief of Healthcare Policy and associate editor of Health Policy. Sutherland has been Canada’s Harkness Fellow in Clinical Practice and Health Policy (Washington D.C.), recently the Province of Ontario’s Provincial Lead of the Value for Money program, and former Scholar of the Michael Smith Foundation for Health Research.
Dr. Sutherland has been studying funding policy, methods for improving cross-continuum care, and health systems’ variations in efficiency, effectiveness, and quality of care. He has been leading research evaluating health system performance, health care funding policy, patients’ outcomes, and has been advising governments on healthcare funding policy in Canadian provinces.
Loraine Hawkins is an expert adviser to WHO on health financing, health systems, governance and the interface between health financing systems and public financial management. She has over 30 years’ experience spanning 33 countries worldwide. She is a Director of the Health Foundation, a health policy think tank and research NGO in the United Kingdom. She was Chief Analyst at NHS England from 2014-2016. Prior to that she worked as an expert advisor to WHO, World Bank and UNICEF in countries in Europe, the Middle East, Asia, and Pacific. She was a World Bank Lead Health Specialist from 1998-2006.
Dr. Robert Jakob
Dr. Jakob is Unit Lead for Classifications, Terminologies, and Standards in WHO, with responsibility for all aspects relating to classifications and terminologies, leading the WHO Network for the Family of International Classifications, that comprises collaborating centres, NGO and other partners, strategies and work related to ICD (diseases, quality and safety, traditional medicine, linkage to terminologies and more), ICF (functioning), ICHI (interventions) and Verbal Autopsy. This includes the 11th revision of ICD, its release and implementation, as well as production and modernization of ICF and ICHI on a common ontological platform. He has provided policy advice to countries in designing strategies for implementation support of classifications and terminologies, and training programs, and drives the design of tools for joint use of the classifications and terminologies.
Dr. Jakob started at WHO in 2005 as a medical officer at WHO in charge of the ICD and derived classifications maintenance, updating and implementation. Besides developing classifications in a modern environment (protégé) and on a web platform, he was involved in country implementation projects on civil registration and causes of death, using DHIS2, developed the ODK based WHO VA questionnaire. Before he led at the German Institute for Medical Documentation and Information (DIMDI) the health telematics team that formulated a German emergency data set and other data sets for the German electronic health card, as well as creating a registry for “electronic objects” (OID) in health. He was earlier in charge of ICD use in mortality statistics, the ICD adaptation for Oncology, the ICF (International Classification of Functioning, Disability, and Health), and consulting for the classification of procedures in medicine. Dr Jakob worked earlier as a surgeon and set up and ran the hospital information system besides writing software for statistical analysis and billing. Dr Jakob is a member of the German Society of Medical Informatics, Biometry and Epidemiology, holds diplomas in medical quality management (German Medical Board) and management of health and social institutions (Univ. Kaiserslautern). He is a board-certified surgeon.
Mr. Stensland is a Principal Policy Analyst with MedPAC, an independent federal body that advises the U.S. Congress on issues affecting the Medicare program. His areas of research include hospital payment, geographic variation, rural health, and physician-hospital integration. He has been involved in the refinement of the Medicare inpatient prospective payment system for the past 15 years. Prior to joining MedPAC, Mr. Stensland was a Senior Research Director with the Project HOPE Center for Health Affairs. He has extensive experience conducting research on the financial performance of hospitals and rural health issues. His findings have been published in health policy and health care financing journals. In addition to his research experience, Mr. Stensland worked in the banking industry as a financial analyst and holds the Chartered Financial Analyst certification. He has a Ph.D. from the University of Minnesota Department of Applied Economics with a minor in Health Services Research and Policy.
WHO WILL BE INTERESTED? Anyone whose work is in clinical costing at any level, finance, hospital management, technical aspects of casemix, the specification of costing services or the selection of costing software packages and services.
The workshop will present costing methodology and the use of costing methods, rather than examples of specific costing software. The workshop does not reference vendors or specify software solutions, instead the intent is to explain how the costing process works, issues that need to be resolved and provide practical examples.
The presentation makes use of simplified Excel based models to demonstrate the major aspects of the costing process. Schemas of the costing models used and demonstrated will be provided to participants following the workshop.
Each segment of the workshop introduces the costing definitions, methods and provides practical tasks to commence or improve hospital costing activities.
Emphasis is given to establishing costing processes. Costing activities are broken down into several steps:
- Identification of Scope
- Validation poof finance files
- Structure of the costing ledger; cost centres and cost items
- Comparisons of major methods
- Overhead Direct and Indirect cost allocation methods
- Ideas for implementation or improvement
Costing methods ranging from the use of external costing relativities through RVU Costing to Microcosting using local consumption data will be presented with examples of the use of these approaches, and discussion on the rationale for the selection of the various approaches.
WHO WILL BE INTERESTED? The workshop is aimed to introduce newcomers to the basics of casemix and give a taste of the schools held by PCSI. The audience is broad, from coders to decision makers.
WORKSHOP OBJECTIVES: To provide a comprehensive foundation in casemix, including to:
- Understand the origins of casemix and theoretical underpinnings
- Understand the various applications of casemix
- Describe principles for casemix funding and key design choices and implications
- Understand the impact of casemix on quality of care and use in quality improvement
Each of the presenters will lead a part of the session on one of the many and varied aspects of casemix. We will start with the origins and theoretical underpinnings of DRGs and casemix followed by an overview of diagnosis and procedure clinical coding systems and terminologies that underlie casemix classifications. We will move on to cover the principles of casemix funding as well as issues surrounding the implementation of casemix systems around the world.
Extending into other uses of casemix, we will discuss how it is used in assessing and improving quality of care. As new models of care delivery emerge, casemix continues to have a role. Our workshop will include discussion on casemix systems for integrated care.
The session will conclude with an overview of the two schools run by PCSI:
- Casemix and Healthcare: What you need to know and do (formerly called The Summer School); and
- Advanced Design and Implementation of Case-Mix Funding Models (formerly called The Winter School).
WHO WILL BE INTERESTED? Those responsible for collecting, maintaining and using the collected health data, the foundation of the healthcare system.
All countries face the challenge of creating and sustaining structures to collect, store safely and allow appropriate access to high quality data on health service activity and outcomes. These challenges are especially prescient in low- and middle-income countries. Without good structures data integrity may be poor, the data may not be analysed (or only rarely) and the findings from analysis widely questioned.
A primary purpose of good data governance is to improve quality of health data. This includes system wide data from primary, secondary, and tertiary care settings. However the emphasis of low-income countries can be on the primary care sector while that of high-income countries will most likely be on the tertiary sector. There may be other differences.
Countries seek, as part of the remedy, to build the capacity of a cadre of people involved in data governance as custodians or stewards (these roles may be filled by the same person). How effectively (appropriate and comprehensive attainment of learning outcomes) and efficiently (as quickly as possible and for the least cost) this cohort of data quality champions are developed is critical for those countries wishing to build sustainable systems.
WORKSHOP OBJECTIVES: By the end of this workshop, participants will be able to:
- Identify the learning needs of data stewards and custodians in countries with varying levels of development of data quality systems
- Have an overview of the existence and availability (regional and world-wide) of appropriate learning opportunities (courses, study tours, online learning, scholarships, etc.) that could or do satisfy the identified learning needs
- Be able to consider the gaps / deficiencies (including inefficiencies) in the current worldwide and regional availability of appropriate learning opportunities for data stewards and custodians
WHO WILL BE INTERESTED? This workshop will be particularly relevant to attendees from all disciplines, from clinicians, administrators, clinical coders and informatics professionals, as it will provide an overview of Patient Level Costing and Data Analysis principles using worked examples, case studies and attendee participation.
Participants will take an active role in defining the GL and Patient Costing methodologies. Participants, in groups, will be asked to review case studies and identify sub-optimal performance, the potential reasons for it and initiatives that may be used to overcome the problems.
Interactive participation will be encouraged through the use of question and answer sessions and workgroups.
Handouts will be provided, and the workshop will assume that participants have an awareness of Patient Costing and Data Analysis principles but little understanding of them.
WORKSHOP OBJECTIVES: Following attendance at this workshop, participants will have an understanding of patient costing and data analysis principles. In particular, they will understand:
- The concept of the GL Cost Allocation process, including the concept of Overhead and Patient Care Cost Centres, the use of Cost Allocations statistics such as Floor Area, Number of Meals Served, etc, the need to refine the GL for Patient Costing purposes and the methodologies for reconciling each step
- The patient level data feeds required and their elements
- The concept of Relative Value Units (RVUs) and their application to Patient Costing
- The concepts of loading, processing and reconciling patent level and general ledger data.
- Uses of Patient Level Costing data
- Methods for analysing the variability and quality of clinical practices from the Patient Level Costing results
- Methods for analysing Patient Level Costing results to improve financial performance
- Methods for using the Patient Level Costing results to document best practice and to support value-based management of care and services
WHO WILL BE INTERESTED? Delegates who are involved in the setup, training, auditing, reporting and managing of a patient classification system locally in a hospital or nationally
WORKSHOP OVERVIEW: An efficient national system for collecting admitted patient activity data has several crucial parts managing different aspects of the collection. The workshop will bring the attendees through the different systems, processes, and people involved in the overall collection. The workshop will cover
- Background of coding in Ireland
- The current setup for clinical coding in Ireland
- The training opportunities and requirements for clinical coders
- The data quality work implemented as part of the data collection (including audits)
- Managing coder resources in hospitals
- Communication and collaboration with the system
Specific case studies in the area of training, auditing and other data quality work will be outlined during the workshop
- Describe the different parts of a national data collection system
- Outline the components needed at the hospital level
- Understand how clinical coders are trained and progress through their career
WHO WILL BE INTERESTED? Clinicians dealing with casemix, IT experts, casemix economists, clinical coding staff. Ideally participants should be knowledgeable about their local casemix system, have some clinical background and have some knowledge of data structures and content that is today mainly used for casemix.
WORKSHOP OBJECTIVES: To discover the added value for clinical work and for the measurement of quality in healthcare systems that can be drawn from routinely collected casemix data.
In this workshop, we will learn from examples from a range of countries and discuss the ins and outs of the issues raised. We will incorporate:
- Presentations on the use of casemix data in clinical contexts
- Background information on existing methods of quality evaluation in healthcare
- Discussion to inspire participants, leading to possibilities for international collaboration
Topics that will be addressed include:
- Extending the benefits of casemix data
- Quality indicators (AHRQ, OECD, others)
- Prevalence or incidence statistics drawn out of the data
- Follow-up on local clinical improvement programmes
- Implementation of innovations
- Casemix effects of introducing new clinical practices
- Opportunities and limitations
- Are the allegations among clinical researchers real limitations or is it a question of communication culture?
- What could be done to promote multidisciplinary use of the data?
- International implications
- Where do we have data that could be used for international comparisons?
WHO WILL BE INTERESTED? The workshop is aimed to introduce new ways of health care delivery, from an institutional to a patient-focused approach, and the appropriate funding, preparing for the shift from treating disease to maintaining health. The audience is hopefully broad, from providers to decision makers.
All around the globe policy makers are faced with controlled increases in health care costs, with growing number of patients with multiple conditions, less trained clinical personnel and a decrease of the health of their population. The sustainability of the healthcare system is at stake. Due to the enormous vested interests of the current providers, short term solutions are not available, and the holy grail to shift from treating patients to maintaining the health of the population is hard to find.
But the good news is that the COVID-19 pandemic has intensified the use of digital tools in care provision, which seems to have changed the equation. Both patients and providers have accepted the benefits of new modalities of care provision. This seems nicely to coincide with initiatives like the green deal to help to fight climate change. It will have great impact on health care, requiring a shift to more circular operations in the sector. So the time is right to rethink the organization and delivery of health care.
The journey we started at the PCSI conference in Scheveningen, The Hague, where the conference theme was Towards a sustainable health system, will be extended by this workshop, which will focus on the imperative requirements for the introduction of health care provision in the network of care. The workshop will introduce examples of changes in health care payment and delivery, based on real life experiences in different countries with a focus on person-centred care supported by digital tools and appropriate funding. A special focus will be given to the contribution of casemix to fund the new arrangements.
The workshop will address:
- the impact of Digital Care
- from Guidelines to Integrated care
- person-centred care coordination
- towards appropriate funding
- the new role of casemix
- the drivers for change
WORKSHOP OBJECTIVES: The aim of this workshop is to:
- Understand the origins of integrated care
- Share best practices of digital supported care
- Identify the imperative requirements for the introduction of integrated care and its appropriate funding and key design choices for the transition and the governance
- Discuss the new dimension of casemix on quality of care and use in quality improvement
The networking event starts with a 15 minute bus drive to Hellisheidi, a geothermal power plant outside of Reykjavík. The Power Station is the third-largest geothermal power station in the world. We will get an introduction on how the city gets its hot water for heating the houses, learn about the 100% renewable energy and enjoy the beautiful surroundings. From Hellisheidi we move to Skidaskalinn, a next door lodge for refreshments and hope to see the Northern lights in the sky. The networking event is included in the conference fee.