Clinical Coders on the Frontline
- The story of the Clinical Coding students who collect hospital activity data to help in the fight against COVID-19 whilst also studying for their TU Dublin Certificate
As this year’s graduates in TU Dublin’s Certificate in Clinical Coding look back on the successful completion of their studies they certainly might reflect that this has been a year like no other. It is usually around this time of the year that the School of Computer Science holds a special Graduation ceremony for our recently graduated Clinical Coders, and it is always a very special event with families joining in the celebrations. The fact that such a ceremony recognising their achievements is not able to happen this year due to the ongoing public health crisis holds a certain unfortunate irony, for these clinical coding students have themselves been on the frontline of the Irish Health services helping in the fight against Covid-19 since early 2020.
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Clinical Coding Graduation Ceremony held in November 2017
Recognition for the training, skills and expertise of clinical coders within the Irish healthcare system is a primary aim of the TU Dublin Certificate in Clinical Coding and we felt it was particularly important to congratulate the efforts of this year’s cohort of graduates. Clinical coders across all acute public hospitals in Ireland are part of the health information army collecting critical information to inform in the fight against COVID-19. This year’s graduates conducted their part-time studies at the same time as working in the Health Service in the fight against COVID-19.
Acknowledging their contribution and the course contribution to national efforts
During this unprecedented health crisis the efforts of the clinical coders has been acknowledged by Slaintecare and the HSE. Coders have had to take on new WHO issued ICD-10 codes and guidelines to identify COVID-19 patients and also follow new stricter deadlines for the reporting of these cases. The coders must be diligent to ensure that the data is available in as timely and accurate a way as possible. This data is in immediate and constant use by the HSE and Department of Health as well as affiliated research organisations.
Clinical coders extract the clinical information from patient records by reviewing the entire record either as a hard copy chart or an e-health record, and often a combination of both. They work to tight deadlines; 30 days post patient discharge, which can be a challenge when waiting for patient records to be released or for test results to be available. Patients with a COVID-19 diagnosis are required to be coded within 48 hours of patients discharge.
Clinical Coders are vital to the Healthcare system during the Covid-19 crisis, tasked with providing quality data to support an evidence based response to an unprecedented public health crisis
While hospital administration systems can provide downloads for much of the administrative data the work of extracting and coding the information from the patient’s chart is the most challenging and demanding aspect of this job. This course ensures that clinical coders are fully aware of the exacting standards that apply to both extraction and clinical coding.
Successful and ongoing collaboration
The CPD part-time course in Clinical Coding is a joint programme run by the Healthcare Pricing Office at the HPO and TU Dublin School of Computer Science. This collaboration began in 2015, (originally between the ESRI and DIT) and has gone from strength to strength with 150, out of a national cohort of approx. 250 clinical coders now having gained this recognition through the certification with TU Dublin.
Deirdre Murphy Head of the HIPE at the HPO believes that ‘TU Dublin is the perfect partner for the HPO as it states in its mission statement that it ‘provides an innovative, responsive and caring learning environment for a diverse range and level of programmes to students of all ages and backgrounds.’ This approach is well suited to these students and their participation in the course.
When you speak with Ms. Murphy it quickly becomes evident that this course is not just innovative in it content but pioneering in of itself in relation to the current Irish educational landscape:
“This certification is the single most important advancement for Irish clinical coders since HIPE began in 1970 in terms of providing recognition and visibility of these key skilled hospital staff.”
Course Content
The content of the course is designed to improve and consolidate clinical coder’s skills through a series of five assessments and a final face to face examination. The pass rate for this course is 80% simply because the information extracted and coded by the coders is of such critical importance and must be of the highest possible quality. The data is used the healthcare system and internationally to report, review, plan and predict acute hospital activity.
On-The-Job experience is also an essential part of this course of study and all those who partake are currently employed as HIPE clinical coders. Many of the clinical coders who undertake this course of study will have been working in the role for many years attending on-going training with the HPO, many not having studying formally or taken examinations for a long time.
This most recent iteration of this course started in late January 2020 with the first assignment due in late February. All but one of the students continued through the course of study through the very depths of the lockdown. The majority of clinical coders worked in their hospitals as access to the patient charts is critical to their work. Availability and access to full eHealth records for patients remains a challenge, so clinical coders were required to continue working On-site.
Examination Process during Covid-19
Through careful planning and consultation with students & HIPE Managers The final face to face examination was held across five sites nationally in early September with HPO staff travelling to each site to facilitate the examination being held simultaneously and fairly for all students.
COVID-19 compliant face to face examination were held at 5 sites across the country in September 2020
Speaking about this year’s final examination process Marie Glynn, Education Manager, HPO said:
“The final examination is paramount in measuring students’ coding skills. To facilitate the examination during COVID-19 was challenging but the HPO team and the TU Dublin School of Computer Science, were committed to finding a solution that would allow students to sit the examination in a safe environment
Overall feedback and results were positive with students very relieved to be able to sit the exam as scheduled and although under pressure, were very grateful for this opportunity to complete the course and gain their certification despite the most difficult of situations.
Recognition
After six long months of study, while still working, there are now 16 more qualified clinical coders recognised for their skill and expertise in this very specialised role. For HIPE clinical coders obtaining this certification it is a great recognition of the value placed on this highly skilled and often overlooked hospital team member. The certification provides validation for clinical coders of the critical and skilled work they carry out daily. It gives students recognition for their role and confidence in a very challenging environment, in their abilities as certified clinical coders