OPCS-4.7 Planning for implementation

OPCS-4.7 Implementation
Preparing for implementation
Presented by
Clinical Classifications Service
OPCS-4.7 checklist
• Here’s a checklist to help you in planning
and managing OPCS-4.7 implementation
– You may not find everything here necessary
– But, it might help you identify what you need
to happen.
• Take what is useful for you and your
organisation ….
Topics covered
• Overview of OPCS-4.7
• Implementation planning and strategies
• Go live preparation
Overview of OPCS-4
Overview of OPCS-4.7
• OPCS Classifications of Interventions and
Procedures, Version 4.7
• Commonly referred to as OPCS-4.7
Overview of OPCS-4.7
What is OPCS-4?
• Fundamental information standard and
mandated for use by healthcare
• Used to classify hospital interventions and
surgical procedures for statistical purposes
/ secondary uses
• Comprises list of alphanumeric codes
organised into mainly anatomically based
Overview of OPCS-4.7
OPCS-4 applies to:
• All “in-patient” episodes and day cases that
contain surgical procedures and hospital
interventions and must be coded to the
mandated version of OPCS-4
Overview of OPCS-4.7
OPCS-4.7 use cases include:
• National data collections including Admitted
Patient Care Commissioning Data Sets
• Hospital operational and strategic planning
to support business processes including
• NHS suppliers to build/update software to
support NHS business functions and
Overview of OPCS-4.7
OPCS-4 updating cycle:
OPCS-4 version:
• OPCS-4.2
• OPCS-4.3
• OPCS-4.4
• OPCS-4.5
• OPCS-4.6
• OPCS-4.7
NHS implementation on:
• 1 April 2006
• 1 April 2007
• 1 April 2009
• 1 April 2011
• 1 April 2014
Overview of OPCS-4.7
OPCS-4.7 compliance
• 1 April 2014
• compliance date for NHS implementation of
• Inpatient episodes and day cases ending
on or after 1 April 2014 will be coded using
Overview of OPCS-4.7
NHS and system supplier formal notification
• Advanced Notification (AN) – gives warning of
update and implementation requirement
published by the Information Standards Board
on 10 May 2013:
• Information Standards Notice – mandating
implementation published by the Information
Standards Board in November 2013
Overview of OPCS-4.7
Impact of OPCS-4.7 change
• Minor impact
• Processes understood and in place
• Requires upload of new data into systems
• People ready and trained where
Overview of OPCS-4.7
No change to architecture of OPCS-4
• new entries fall within existing chapters
• Addition of new codes
• Retirement of some codes
• Modifications to existing code descriptions
includes and excludes
Overview of OPCS-4.7
New codes include:
• Craniofacial procedures
• Operations for disorders of sex
• Total ankle replacements
• Subcutaneous cardioverter defibrillators
• Peranal resection of rectum using staples
(STARR procedure)
• Leech therapy
Overview of OPCS-4.7
Products delivered centrally
• Draft Summary of Changes (Aug 2013)
• OPCS-4.7 data files, technical specification and final
summary of changes (7 Nov 2013)
• OPCS-4.7 eVersion (Feb 2014)
• OPCS-4.7 Tabular List and Index via The Stationary
Office (Feb 2014)
• National clinical coding standards Ref book (Feb 2014)
• Coder self teach PowerPoint materials (Feb 2014)
• Trainer materials (Feb 2014)
Overview of OPCS-4.7
National Tariff
• Healthcare Resource Groups will group to
new codes
• 2014-15 National tariff will include updates
in OPCS-4.7
planning and strategies
Implementation planning and strategies
Consequences of poor preparation
• Compliance issues
• Coding backlogs
• Decisions based on inaccurate data
• Incorrect reimbursement
Problems can be mitigated with proper
advance preparation
Implementation planning and strategies
Don’t delay getting started
• Early initiation of the planning process,
thorough preparation, adequate education
and proper testing will result in smoother
implementation and earlier realisation of
Implementation planning and strategies
• Who is leading within your organisation
to prepare a plan for implementation?
Implementation planning and strategies
Suggested timeline
• Phase 1 – organisation readiness
• Phase 2 – systems readiness
• Phase 3 – coding readiness
• Phase 4 – go live preparation
Phases may vary, depending on the type,
size and complexity of the organisation,
phases may overlap
Implementation planning and strategies
Phase 1:
• Project team established
• Assess organisational readiness
• Conduct survey of all business areas to
determine extent of the impact
• Analyse impact on all business processes
Delay to impact assessment will jeopardise
ability to complete all OPCS-4.7
implementation tasks by compliance date
Implementation planning and strategies
Phase 2:
• Perform systems’ audit
• Identify new or upgraded hardware or software
requirements (if necessary)
• Consider impact on electronic tools (eg
• Ensure access to legacy data
• Build flexibility of IT systems under
development to ensure compatibility with
Implementation planning and strategies
Systems/applications potentially impacted
• Electronic Patient Record
• Clinical systems
• Patient Administration
• Encoding software
• Medical record
abstracting systems
• Decision support systems
Resource Utilisation
Quality management
Casemix systems
Case management
Compliance software
Implementation planning and strategies
Determine your business readiness
• Assess business associate readiness
• Determine vendor readiness and timelines for
software upgrades
• Information Standards Notices are included in
NHS Contracts but check:
• Which systems upgrades or replacements are
needed if any to accommodate OPCS-4.7?
• Will upgrades be covered by existing contracts,
what other costs are involved?
Implementation planning and strategies
Determine system supplier readiness
• When will upgrades be available for testing
and implementation?
• What customer support and training will
they provide if required?
• How will their products and services
accommodate OPCS-4.6 and OPCS-4.7?
• How long will their products accommodate
both code sets?
Implementation planning and strategies
Project plan is in place
• Project lead to ensure all the activities and
tasks required for local Trust
implementation are included in the project
schedule tracking tool and estimates for
these tasks are regularly reviewed for
Implementation planning and strategies
Phase 3
• Review “draft summary of changes”
available on NHS Classifications Service
website from August 2013
• Feedback where appropriate
• Consider local impact of proposed changes
and plan accordingly
Implementation planning and strategies
Gap analysis
• Conduct gap analysis of coding
professionals’ knowledge and skills
• Assess coding professionals’ knowledge
• Refresh coding staff’s knowledge as
needed on basis of assessment results
Implementation planning and strategies
Assess quality of medical record
• Evaluate samples of various types of
medical records to determine whether
documentation supports level of detail
found in OPCS-4.7
• Implement documentation improvement
strategies where needed
Implementation planning and strategies
Coding and documentation - always work
toward better documentation
• Avoids misinterpretation
• Provides a more accurate clinical picture of the
quality of care provided
• Supports current and future initiatives aimed at
improving quality and improved patient care
• Issues related to poor documentation must be
resolved by the provider
Implementation planning and strategies
Determine education and training plan
• Who will need education?
• What type and level of education will they
• How will the education be delivered?
• Clinical coder training should not be provided
until ? Months before implementation
• Hospital inpatient coders require ? hours of
Implementation planning and strategies
Consider education needs for data users
Clinical coders
Information personnel
Senior management
Information technology
• Clinical department
• Data analysts
• Researchers
• Epidemiologists
Implementation planning and strategies
Data uses
• Performance improvements
• Corporate compliance
• Data quality management
• Data security
• Clinical documentation
Implementation planning and strategies
Identify all implementation expenses and
estimate associated costs including:
Education / training
Hardware/software upgrades if applicable
Staff time / Temporary or contract staff
Systems’ testing related costs
Data conversion
Maintenance of dual code set
Implementation planning and strategies
Additional implementation preparation
• Refine project plan, timeline and budget as
• Assess potential reimbursement impact
• Develop strategies to minimize problems and
maximise opportunities
• Assess impact of
• Decreased coding productivity
• Decreased coding accuracy
Implementation planning and strategies
Register now ….
• Agree the authorised person within the
organisation to accept licence agreements
• Pre-register on TRUD for the OPCS-4 subpacks in readiness to download the data
files when released. Requestor to be
notified when files become available.
Go live preparation
Go live preparation
Phase 4
• Follow-up on readiness status of business
• Develop contingency plan for continuing
operations if critical systems or other problems
occur when the OPCS-4.7 implementation
goes live
• Develop communication plan
• Provide senior executives and stakeholders
with updates
Go live preparation
Information Standards Notice (ISN)
• Review ISN and Standard Specification
and ensure business associates have read
and are taking appropriate actions to meet
planned deliverables (ISN published
November 2013)
• http://www.isb.nhs.uk/documents/isb0084/amd-10-2013/index_html
Go live preparation
OPCS-4.7 data files
• Download data files released via
Technology Reference Update data
Distribution (TRUD) in November 2013:
OPCS-4.7 codes and title
OPCS-4.7 metadata
OPCS-4.7 table of equivalences
Technical specification documents
Go live preparation
For terminology users
• Download released data via Technology
Reference Update data Distribution (TRUD) in
March 2013:
• SNOMED CT to OPCS-4.7 Cross-maps
• Technical Specification document
• Legacy data
• Read Version 2 to OPCS-4.7 Cross-maps
• Clinical Terms Version 3 to OPCS-4.7 Crossmaps
Go live preparation
Complete tasks identified in Phase 1 during impact assessment
• Implement system changes
• Provide education to users
• Implement and monitor documentation
improvement strategies
• Re-engineer processes and workflows identified in
Phase 1 if necessary
• Complete internal testing
• Begin external testing once business associates
are ready
Go live preparation
Training and education
• Deliver local awareness sessions and training
requirements previously identified
• Ensure protected time for clinical coders
• Download key learning points for coding
• Register for:
• Clinical Coding Standards – OPCS-4
• Purchase from The Stationary Office:
• OPCS-4.7 Volumes I-II for clinical coders
Go live preparation
Data analysis
• Determine impact on longitudinal data
• Will legacy data be converted? If so, how will
it be converted?
• Determine which data will be linked by using
mapping applications and which data will be
maintained separately according to the source
code set
Go live preparation
• Equivalences are mappings to assist users
in navigating the complexity of translating
meaning from the content of one code set
to another code set
• They should not be used for coding
medical records
• The OPCS-4 Table of Coding Equivalences
is available in Excel from TRUD
Go live preparation
Continue to assess and improve coding
• Continue to assess quality of medical record
documentation, implementation documentation
and strategies as needed, and monitor impact
of documentation improvement strategies
• Coders should continue to gain familiarity with
OPCS-4.7 codes and coding guidelines and
improve skills in areas identified in gap
Go live preparation
Links to central resources
Technology Reference Update data Distribution (TRUD)
• http://www.uktcregistration.nss.cfh.nhs.uk/trud3
Health and Social Care Information Centre – clinical classifications service
• http://systems.hscic.gov.uk/data/clinicalcoding/codingstandards/opcs4
New interactive environment that provides information about emerging and changing
standards and encourages
• http://www.infostandards.org
Information standards helpdesk
• [email protected]
Go live preparation
Lessons Learned
• Implementation follow-up
– What can you learn for next time?
– What can we learn for next time?
• Awareness Pack - let us know if it helped, and
how we can improve

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