Closing
date: 21 Apr 2017
date: 21 Apr 2017
OVERVIEW:
In
collaboration with the Ministry of Health in Rwanda, MSH is seeking to hire an
international consultant who will work together with a local Rwandan consultant
to carry out the tasks described in the following terms of reference:
collaboration with the Ministry of Health in Rwanda, MSH is seeking to hire an
international consultant who will work together with a local Rwandan consultant
to carry out the tasks described in the following terms of reference:
Over
the past decade, the Rwandan health system has strengthened various health care
demand- and supply-side policy initiativ
the past decade, the Rwandan health system has strengthened various health care
demand- and supply-side policy initiativ
es, including Community-Based Health
Insurance (CBHI), Community Health Worker (CHW) program, and a Performance
Based Financing mechanism.
Recently,
the CBHI was integrated into the Rwanda Social Security Board (RSSB) with an
aim to consolidate the many separate insurance pools into a single national
pool, where it can be managed alongside the civil servants’ social health
Insurance (RAMA) and other social protection pools like the national pension
fund. In order to manage these funds and process a large number of claims more
efficiently, there is a great need for automation (particularly with the claims
processing system).
the CBHI was integrated into the Rwanda Social Security Board (RSSB) with an
aim to consolidate the many separate insurance pools into a single national
pool, where it can be managed alongside the civil servants’ social health
Insurance (RAMA) and other social protection pools like the national pension
fund. In order to manage these funds and process a large number of claims more
efficiently, there is a great need for automation (particularly with the claims
processing system).
In
a parallel initiative, the Ministry of Health (MoH) is pushing forward with an
ambitious plan to implement an electronic medical records system (EMR) with an
automated billing module in all public hospitals. However, in order for these
two systems to exchange data there is a critical need for standardization of
coding systems.
a parallel initiative, the Ministry of Health (MoH) is pushing forward with an
ambitious plan to implement an electronic medical records system (EMR) with an
automated billing module in all public hospitals. However, in order for these
two systems to exchange data there is a critical need for standardization of
coding systems.
In
a separate initiative, the Ministry of Health and its partners have completed
comprehensive costing exercises for both the public and private sector health
services that have been used to establish standardized tariffs. Through this
process, a list of over 1000 separate medical procedures have been identified
by Rwandan providers as the most commonly provided medical services and
procedures, however, this list is not linked to any standard classification
system.
a separate initiative, the Ministry of Health and its partners have completed
comprehensive costing exercises for both the public and private sector health
services that have been used to establish standardized tariffs. Through this
process, a list of over 1000 separate medical procedures have been identified
by Rwandan providers as the most commonly provided medical services and
procedures, however, this list is not linked to any standard classification
system.
Earlier
efforts to select coding standards for Rwanda have resulted in the adaptation
of a sub-set of ICD-10 for diagnostic coding and the anatomical therapeutic
chemical (ATC) codes for drugs and medical supplies. However, efforts to select
the most appropriate coding system for medical acts and procedures have not
been as straightforward. A variety of options have been considered such as the
ICD-10-PCS (Procedure Coding System), ICPC-2 (International Classification of
Primary Care), the Office of Population Censuses and Surveys’ Classification of
Interventions and Procedures version 4 (OPCS-4) and SNOWMED.
efforts to select coding standards for Rwanda have resulted in the adaptation
of a sub-set of ICD-10 for diagnostic coding and the anatomical therapeutic
chemical (ATC) codes for drugs and medical supplies. However, efforts to select
the most appropriate coding system for medical acts and procedures have not
been as straightforward. A variety of options have been considered such as the
ICD-10-PCS (Procedure Coding System), ICPC-2 (International Classification of
Primary Care), the Office of Population Censuses and Surveys’ Classification of
Interventions and Procedures version 4 (OPCS-4) and SNOWMED.
There
is an urgent need for technical support from an international expert in medical
nomenclature and coding systems to work with a local consultant and a core team
of stakeholders to complete the following tasks:
is an urgent need for technical support from an international expert in medical
nomenclature and coding systems to work with a local consultant and a core team
of stakeholders to complete the following tasks:
·
Reach a consensus about the most appropriate medical procedure coding system
for Rwanda
Reach a consensus about the most appropriate medical procedure coding system
for Rwanda
·
Map the existing lists of procedures to the selected coding system
Map the existing lists of procedures to the selected coding system
·
Advise on how the list should to be computerized and curated over time
Advise on how the list should to be computerized and curated over time
·
Define how clinicians and administrative staff within health facilities should
be trained to use the codes effectively.
Define how clinicians and administrative staff within health facilities should
be trained to use the codes effectively.
SPECIFIC
RESPONSIBILITIES:
RESPONSIBILITIES:
The
international consultant in coordination with the local consultant will:
international consultant in coordination with the local consultant will:
- Conduct
a comprehensive desk review of the current procedures, coding systems and
nomenclature in use in Rwanda. - Review
the procedure lists developed during the recent public and private sector
costing exercises. - Conduct
on site visits to selected health facilities at each level. - Map
the current lists of medical acts and procedures to the recommended
international agreed nomenclature and coding systems. - Organize
a workshop of key stakeholders to confirm the procedure coding standards
with which Rwanda should be aligned and gather any initial procedure lists
that already exist or may have been coded. - Prepare
guidelines explaining how the Rwandan procedure codes are structured and
should be maintained over time and propose how they could be linked to
different levels of the health services (service packages). - Incorporate
the medical acts and procedure coding system into a web-based electronic
system. - Develop
a user friendly manual which will guide users over time. - Work
with the local support team to train and mentor them on the use of the
coding system and to develop a training strategy and curriculum for
training of trainers and health professionals who will use the system. - Provide
any other recommendations which will lead to the successful implementation
of the developed nomenclatures.
Deliverables
include:
include:
- Inception
report with an agreed methodology and timeline. - Facilitation
of a workshop that selects the most appropriate procedure coding schema
and determines how the can be mapped to commonly used procedures in
Rwanda. - Document
and describe the agreed nomenclature and coding system for medical acts
and procedures. - Final
report on progress and processes developed. - A
Procedure manual for end users (Providers, Insurances). - Integration
of the selected nomenclature and coding system into the existing
terminology server (OpenHIE) or propose an alternate software or database
system to curate and disseminate the Rwandan medical procedure codes.
QUALIFICATIONS
AND EXPERIENCE
AND EXPERIENCE
The
international consultant must demonstrate:
international consultant must demonstrate:
·
At least 5 years’ experience in nomenclature of medical acts and procedures,
and coding.
At least 5 years’ experience in nomenclature of medical acts and procedures,
and coding.
·
Medical or nursing background with academic qualification at master’s degree
level in relevant field of Public Health, Medicine, Hospital Management.
Medical or nursing background with academic qualification at master’s degree
level in relevant field of Public Health, Medicine, Hospital Management.
·
Experience conducting at least two similar projects successfully, with evidence
of hands on skills gained in the assignment.
Experience conducting at least two similar projects successfully, with evidence
of hands on skills gained in the assignment.
·
Previous working knowledge in the domains related to medical software
development, healthcare management, and quality assessment is an added
advantage.
Previous working knowledge in the domains related to medical software
development, healthcare management, and quality assessment is an added
advantage.
·
Ability to mobilize different local medical professional societies/ councils to
develop a consensus on coding standards.
Ability to mobilize different local medical professional societies/ councils to
develop a consensus on coding standards.
·
Ability to perform all required tasks in English (French is also desirable), excellent
reporting and writing skills, and analytical capacity to generate relevant
recommendations. co}L={
Ability to perform all required tasks in English (French is also desirable), excellent
reporting and writing skills, and analytical capacity to generate relevant
recommendations. co}L={