22/01291 - Framework agreement for document checks of patient journal - HDIR

Description

The Health Registers Department in the Norwegian Health Directorate (HDIR) needs assistance from an external supplier to carry out document checks of patient journals. A tenderer is required with competence in medical coding and reviews of this. There will be a need for assistance with various assignments within medical coding and document checks. The contracting authority expects that there will be a need for 1-3 document check assignments a year, and possibly some hours for professional assistance from a consultant. The estimated contract value is NOK 2,000,000 to NOK 5,000,000 over four years. There is some uncertainty regarding the actual need for assistance, and the estimate is not binding for the contracting authority. The maximum value of the contract is NOK 6,000,000. Lot 1: The main assignment that the tenderer will undertake will be to carry out checks of selected patient journals as part of the Health Registers Department's quality work. This can, for example, be cases that are processed in the Settlement Committee where the department has the secretariat function. The Settlement Committee gives HDIR advice in questions regarding medical code practice, and carries out quality checks of reported data in the specialist health service. HDIR is responsible for carrying out document checks of patient journals, which has a legal basis in the Norwegian Patient Register Regulations, § 2-4 Recipient's Responsibility for Quality Control. In order to fulfil this responsibility, HDIR needs to join up with a tenderer that can function as the executing part on behalf of HDIR. The tenderer must also give professional advice and contribute with an understanding of medical coding, journaling, rules, and guidelines. The assistance will be required in different locations depending on which hospital has been picked out in the document check. The tenderer must therefore reckon on some travel to the selected hospitals in Norway, as well as working from the contracting authority's premises if required. See annex 5 for further information on travel costs. An example follows of assignments that can be carried out under the framework agreement (see the first evaluation requirement under 'Solution Description'): 'The document checks must be carried out as a goal-orientated survey of selected stays in a given diagnosis-related group (DRG) at three selected health trusts, one in Eastern Norway, and two in Central Norway. The aim of the survey is to be able to say something about the code quality of the stays, as well as any settled stays that have been given a wrong code. A document check is to be undertaken for 84 stays in ABF-data for 2021. There is a total of 151 episodes/stays in the selection. 44 of these are individual stays and 40 hospital stays, which in turn make up 53 department stays and 54 contacts. As assessment is to be made of whether the registered codes (condition codes and procedure codes) are correct. If there is a wrong code, an assessment must be made of what codes should have been registered. The idea of the document check is to highlight variations such as possible differences and tendencies/patterns in code practice at the different health trusts, but also within each trust.' The above text is based on a previous assignment for document checks. The assignments under the framework agreement will, for example, vary depending on which health trust the document checks are to be carried out at, which DRG is used, and how many stays are to be reviewed. Specific information on each individual assignment will be given at the call-offs for individual assignments.