The PCG Monitor system combines user friendly flexible Excel templates and industry standard SQL Server processing to provide the ultimate in configurable solutions to support healthcare organisations in the monitoring and use of Patient Level Cost and Income.
Q: Can the PCG Monitor platform adjust my admitted patient’s length of stay for critical care stays?
A: Users can opt for PCG Monitor to automatically adjust an episode’s length of stay using the critical care minimum dataset files for adult, paediatric and neonatal critical care. There are a number of options that enable full flexibility depending on how extensively you wish to use this functionality. It is possible to use adjustments that have been applied outside of the system exclusively or in combination with the automated process.
Q: I need to be able to process lots of different datafiles. Some are in Access databases, some Excel spreadsheets, one department gives me a csv file and some are stored in SQL Server databases. Can the system use all these files without me having to re-format and import them manually?
A: PCG Monitor includes a Data Loader module that can manage the process of extracting and loading data from multiple sources in multiple formats. There is no requirement to produce files in specified formats with specified column names. Our aim is to minimise the level of manual intervention needed.
Q: Will the system identify any re-admissions within 30 days for me but then let me decide which ones we should be paid for?
A: PCG Monitor will automatically flag every re-admission and allows for specific exclusions to be managed by individual trusts according to their own requirements. The financial impact of any re-admission is then managed via the contract adjustment rules section of the system where again the individual trust is able to configure this locally using the PCG Monitor Excel rule templates.
Q: Can I adjust my admitted patient’s excess bed-day charge to account for delayed discharges but then include a separate charge for the delay so I can bill a separate organisation for that?
A: Yes, this is an inbuilt function of the system. If your admitted patient care data includes the ‘Ready for Discharge Date’ then your excess bed-day charge will be adjusted in line with the number of days that have elapsed between this date and the discharge date and a new record will be generated. You can then set up a local price rule to price the delayed discharge record and set up rules to assign the charge to a different organisation for billing.
Q: Can the system run my data through the Payment Grouper or do I have to group the data before importing my data into the system?
A: PCG Monitor will automatically run all current elements of the payment grouper and utilise the various outputs as part of the process. Users are able to install any version of the grouper software, set up a grouper profile within the system and then choose which grouper to run during the process stage. We support all grouper input files including the National Renal Dataset. All grouper output files are maintained for reporting purposes.
Q: When the Engagement Grouper and tariffs get released I need to be able to quickly run a set of data through it and compare directly with the same data processed using the current payment grouper and tariffs.
A: Because PCG Monitor includes grouping as part of its process you are able to run separate models using the same raw data but different groupers and tariff rules which enables quick and efficient comparisons to be made. This means your data suppliers do not need to provide you with additional information or data extracts to achieve this.
Q: I need to run my activity through the Prescribed Specialist Services Identification tool will the system do this for me?
A: Yes, PCG Monitor will run the Prescribed Specialist Services Identification tool during the process without the need for the user to do anything. There are also other options available if individual trusts prefer to use a set of individually tailored scripts for this purpose. PCG Monitor has functionality that allows non system scripts to be incorporated into the process.
Q: My commissioners will only pay an outpatient follow up rate for specific clinics even if the patient is a new attendance. Can I use a list of clinics that I have in a spreadsheet to do this automatically?
A: Yes. PCG Monitor is designed to achieve most requirements in a way that is straightforward for users to configure and maintain but we have built the system to allow for ultimate flexibility. We have examples where we have assisted trusts to set up their rule templates in a way that enables them to utilise lists and tables to automate some of the rule creation.
Q: We have a number of complicated contract adjustments that we don’t think are necessarily standard. For example, we will only get paid for emergency admissions from A&E up to maximum of 27% of the number of A&E attendances. Is the system flexible enough to set up this kind of rule and others?
A: The PCG Monitor contract adjustment section of the rule template was designed more than seven years ago and since then it has been used in its original state to model numerous different contract adjustment rules many of which were not even considered when the rule format was designed and some of which are certainly specific to individual trusts. With PCG Monitor you will be able to handle all aspects of the contracting journey without needing to calculate adjustments off line.
Q: Our information department currently has some rules to check if there are any patients who have multiple outpatient attendances on one day, or an outpatient attendance on the same day as an A&E attendance or an inpatient discharge. Can the system use these rules so these checks can happen automatically?
A: We aim to ensure that there is no need to start again if you have process and procedures in place that work. Our system is designed to use non system scripts during the process.
Q: Will the system identify whether best practice tariff is applicable without me having to do anything.
A: PCG Monitor is fully compatible with the best practice tariff. We utilise our flexible rule template format to maintain the best practice identification rules in the system which means each year we are able to quickly and easily send you an updat¬ed list of rules each year. There is no need to pre-flag your raw data. This means you are able to apply different best practice rules to the same raw data. PCG Monitor will do everything for you. If you maintain a patient list to determine whether an enhanced best practice tariff should apply in some cases then you can use this too.
Q: Our local prices are quite complex, it’s not always just an HRG and patient type that determines the price, we use a range of other fields such as outpatient clinic, ward code, referral source even month in some cases. Can we set these types of prices up easily?
A: All rules including the local price rules can be set up to reference any field that you have loaded which includes the majority of the fields in the Commissioning Data Set (CDS). This means you decide how to identify which records you wish to apply a specific local price to so you do not need to pre-label your data. You can reference specific clinics, wards, consultants or anything including date ranges or months.
Q: Can the system easily manage running two tariff systems in one year?
A: A number of features within PCG Monitor make it straight¬forward to monitor activity in year using different groupers and payment systems.
Q: Can I decide which national tariff to apply to a particular patient type. For example in some cases we use the outpatient procedure tariff for day cases?
A: PCG Monitor will apply the national tariff in line with the current rules without you needing to worry about it but there is flexibility in how you achieve that if necessary. Applying an outpatient tariff to an admitted patient event is straightforward to achieve. Again there is no need to adjust your raw data to achieve this type of outcome.
Q: Can I set up a feed for Service Line Reporting (SLR) that reflects all income at patient level. This would include all aspects of the spell tariff devolved down to each finished consultant episode together with matched patient level drug and device billing and all other income assigned in a way that I decide?
A: PCG Monitor will allow you to set up rules to devolve your spell income to the contributing episodes. This is part of the Commissioning module. PCG Monitor also includes an SLR module which has been designed specifically to assign all additional billing items to the relevant event. This is done by setting up matching and allocation rules.
Q: I want to continue using our corporate reporting tool and generate data in the same way as I always have done, can I set up the system to support that?
A: We fully appreciate that trusts have well developed reporting systems in place and so PCG Monitor includes a reporting module which is designed specifically to allow users to set up and manage bespoke extract routines. The level of granularity within PCG Monitor means we are able to re-produce existing reports and data structures easily.