Identifying data required for nKPI reporting

The nKPI reports extract data from clinical items in patient records and Medicare claims.

Conditions

Many of the performance indicators depend on recognising patients because of a documented condition. This is done by referencing ICPC codes attached to the Communicare condition clinical items.

System administrators can review ICPC codes.

To review codes for a single condition:
  1. Select File > Reference Tables > Clinical Item Types.
  2. In the Clinical Item Type Maintenance window, double-click an item and click Advanced.
The ICPC code and term are listed in the ICPC 2 Plus section.
Example ICPC-2 Plus code in a clinical item
To review all items with the same or similar codes:
  1. In the Clinical Item Type Maintenance window, right-click and select Show Hidden Columns.
  2. Scroll to the right to find the ICPC Code column and click the header to order by ICPC code.
    Example Clinical item types sorted by ICPC-2 Plus code
Tip: To move a column, click and drag the header.
Conditions are recorded in Communicare by adding a clinical item of type Condition to the patient. For chronic conditions the date of diagnosis is disregarded. For some conditions, if specified, the date of diagnosis will be required to be within the report period.
Note: Conditions added to a patient record have no status other than Complete, so all such items are considered to be confirmed. Any informal comment that may indicate that the condition is not yet confirmed are disregarded.

For details of which ICPC codes are referenced for specific indicators, check the indicator.

Procedures and immunisations

Because health services may have configured local ways of documenting specific procedures and immunisations, the reports will often look for a system code or, more often, an export code. Review codes in the same way as ICPC codes.

Because both procedures and immunisations can have a status of Recall, Cancelled, Incomplete or Complete the indicator will consider the status. In most cases the status must be Complete in order to be counted, but for some indicators, such as PI04 (immunised children), recalls are considered as well. See each indicator for details.

System codes

Three-character system codes are often used within Communicare to identify clinical items to the Communicare program but are also used for identifying items for reporting. For example, AHC is used to identify annual adult Aboriginal health checks.

Note: No local items should have system codes unless they have been verified as suitable and correctly identify the item.
To review system codes:
  1. Select Report > Reference Tables > > System Codes and Rule Codes.
  2. To review local items, use the following settings:
    • From the Item or qualifier list, select Clinical Items.
    • From the Item or qualifier list, select Local Only.
  3. To review central items, use the following settings:
    • From the Item or qualifier list, select Clinical Items.
    • From the Item or qualifier list, select Central Only. To review both local and central items, select <All>.

For details of which system codes are referenced for specific indicators, check the indicator.

Export codes

Export codes are used exclusively for reporting. They can be up to eight characters in length. For example, CST is used to identify procedures that are evidence of a cervical screening or equivalent having been performed.

For immunisations, the codes used as export codes are the AIR immunisation codes. For example, VAXGRP identifies an adult Vaxigrip immunisation when reporting on influenza immunisations.

Review codes in the same way as ICPC codes or run Report > Reference Tables > > System Codes and Rule Codes

For details of which system codes are referenced for specific indicators, check the indicator.

Qualifier codes

Qualifiers are attached to clinical items, and are used in Communicare to capture detailed data relating to such things as blood pressures, HbA1cs, ACRs, eGFRs, and so on. Because qualifiers can also be locally defined, we use system codes and export codes to formally identify them for reporting purposes. For example, an HbA1c recorded as percent has a system code of HBA; for HbA1cs recorded in mmol/mol, a system code of HBM is used.

Note: Local qualifiers must be are reviewed for both system and export codes.
To review codes for a single qualifier:
  1. Select File > Reference Tables > Qualifier Types.
  2. In the Qualifier Type Maintenance window, double-click an item.
The system code is listed in the System Code field.
To review all system and export codes, in the Qualifier Type Maintenance window, right-click and select Show Hidden Columns.
Example qualifier system and export codes
To generate a report of qualifier system codes:
  1. Select Report > Reference Tables > > System Codes and Rule Codes.
  2. To review local qualifier codes, use the following settings:
    • From the Item or qualifier list, select Qualifiers Items.
    • From the Item or qualifier list, select Local Only.

Medicare claims

Where an indicator refers to evidence of a Medicare claim for a specific item or items, the data is collected on the patient encounter, often referred to in Communicare as a service.

For inclusion in both nKPI and OSR reporting, the claim has only to be selected to be included. The following statuses are included:
  • Selected
  • Sent
  • Accepted (which is interpreted as paid)
  • Rejected
Claims that have been discarded by the local claims administrator are excluded from reporting. Claims can be discarded only following rejection by Medicare.
To assess if a patient has a specific item claimed within a specific time period:
  • In the clinical record, click Medicare claims history iconClaims.
  • In the Service Record window, on the Medicare tab, click MBS items history iconMBS Items History.