Evaluation tool for DRG


Since beginning of 2012, acute somatic hospitals in Switzerland are reimbursed according to a DRG-based flat rate per case (SwissDRG, diagnosis related groups).

CISTEC, a company providing healthcare information solutions, implemented in their clinical information system KISIM a module that records all DRG-relevant data of a patient case and calculates the DRG. Because of the large number of data that is stored, a tool for data analysis allowing a coherent presentation of the information had to be developed. 

The requirements specification that was done initially, defined that the tool should enable the users to search for diagnoses and treatments and to review the data as single records or cumulated. Two new tables containing information about the diagnoses or treatment and the provider (responsible surgeon, operating surgeon, assisting surgeon) were implemented. To ensure up-to-date information, an agent responsible for updating the data was programmed for each of the tables. These agents are modules running as discrete threads in a KISIM client instance that check in a user-definded interval the actuality of the data and do an update if necessary.

Outlines of the graphical user interface needed to run the specific queries were drawn. The
most favorable was selected for implementation.

As a result, the user is provided with a tool for data analysis that allows queries for diagnoses and treatments. The data is clearly represented in a table format. The controlling report view displays precise details of the respective diagnoses, treatments and providers. The cumulative report view can be used for statistics.

The basic functionality of the tool is implemented and working well. Further optimization
steps may render the tool even more user-friendly and dynamic.