How Northern Health turned a fragmented audit workflow into measurable NWAU uplift in under two months

How Northern Health turned a fragmented audit workflow into measurable NWAU uplift in under two months

Organisation: Northern Health, Victoria  |  Product: Code Focus, Coding Intelligence  |  Results in: First two months post go-live

Executive Summary

Northern Health is one of Victoria’s largest public health services, providing care to a rapidly growing community in Melbourne’s north. Like many health services operating under activity-based funding, their coding team faced a familiar challenge: the tools available to manage NWAU optimisation were disconnected, limited, and heavily dependent on manual workarounds. Following the implementation of Code Focus’ new Coding Intelligence module in June 2025, Northern Health captured 51% more NWAU in July and 30% more in August compared to their pre-implementation baseline, not by doing more work, but by finally having the right visibility.

Results at a glance

“Code Focus has streamlined our audit processes at Northern Health, providing a smarter, integrated platform that reduces workload and enhances NWAU outcomes.”

Patricia Savino, Coding Audit Coordinator, Northern Health

The Challenge

A health service doing everything right, with tools that couldn’t keep up

Northern Health operates across multiple campuses in Melbourne’s north, delivering acute, subacute, and community-based care to one of Australia’s fastest-growing regions. Under Australia’s Activity Based Funding model, the NWAU (National Weighted Activity Unit) is the currency of hospital funding. Every coded episode generates NWAU, and the accuracy and completeness of clinical coding directly determines how much funding a health service receives.

Northern Health’s coding and audit team understood this well. They had built a rigorous internal audit process using MultiB&C flags, ICU checks, error DRG reviews, and clinician query workflows. The intent was sound. But the infrastructure holding it all together was not.

What the team was working with

At the heart of the problem was the LDDi screen in iPM, the primary mechanism for recording audit outcomes. It was, by the team’s own description, very limited. A coder or auditor could record a single audit change per episode. They could note one NWAU figure. Everything else was free text, with no structure, no categorisation, and no easy way to report across the dataset.

The MultiB&C audit flags that had been built with the Decision Support Unit (DSU) were effective at surfacing inlier cases, those requiring one or fewer diagnosis change letters to optimise the DRG. But the moment a case became an outlier, it disappeared from view. High outliers, low outliers: none of them were captured in the optimisation workflow. The team knew NWAU was being left unclaimed but couldn’t easily see where.

CDI operated on its own dashboard, inaccessible to coders. CDI’s clinician queries were raised and resolved in a silo, a separate workflow that coders had no visibility into. Coders could raise their own queries and receive feedback at the time of coding, but neither query stream was connected to a shared NWAU tracking workflow. Even when a CDI clinician query led to a coding change with real NWAU implications, that value was invisible to the coding team and impossible to track systematically. And because audit flag changes required going through the DSU, the team had limited ability to respond quickly when priorities shifted.

The cumulative cost of fragmentation

What the Northern Health team faced is a pattern we see across health services nationally. The tools exist, the clinical knowledge exists, the intent to optimise exists, but the lack of integration means effort is duplicated, visibility is incomplete, and potential NWAU consistently slips through the cracks.

For a health service the size of Northern Health, even small improvements in coding capture rate translate directly into significant funding. The question was never whether better tools would make a difference. It was how much difference, and how quickly.

The Solution

Code Focus: one platform, every workflow

In June 2025, Northern Health went live with Code Focus ECCS, the clinical coding audit, CDI, and NWAU optimisation platform built specifically for Australian health services operating under activity-based funding.

The implementation was designed around Northern Health’s existing workflow, not against it. The MultiB&C audit flags the team had developed with the DSU were incorporated directly into the Code Focus platform. Code Focus worked with the team to extend coverage beyond inliers, building in full support for low outliers and high outliers so that the entire case population was now visible within the optimisation workflow.

Everything in one place

The most immediate change for the coding team was visibility. Where previously CDI sat on a separate dashboard and CDI clinician queries generated no NWAU data that coders could see, Code Focus unified everything. CDI clinician queries now surface potential NWAU uplift in real time. Audit results feed directly back to coders as they happen. CDI communications sit alongside the clinical record, visible to everyone who needs them.

Reporting was transformed. Instead of a single audit change per episode recorded in free text, Code Focus supports multiple audits per episode, each categorised by error type. Third and fourth character errors. Coding convention issues. NCA and ACS flags. Every change is structured, searchable, and reportable. Coders could now see their own error profiles. Managers could identify education gaps with precision.

Operational independence

One of the less visible but equally important outcomes was the shift in autonomy. Before Code Focus, any change to an audit flag required DSU involvement, a bottleneck that slowed the team’s ability to respond to new priorities. With Code Focus, the audit team manages their own flags. When funding rules change, when a new DRG issue emerges, when internal quality priorities shift, the team can act immediately.

Before and After

The Results

51% more NWAU in month one. 30% more in month two.

The results arrived quickly. In July 2025, the first full month after go-live, Northern Health’s optimisation audits identified 525 NWAU, compared to 347 in the same period the prior year. That is a 51% increase, representing 178 additional NWAU from a coding and audit team doing largely the same work, with better tools.

August held strong. 447 NWAU with Code Focus, compared to 344 without it, a 30% uplift and a further 103 NWAU captured. Two months in, the pattern was clear: this was not a one-time spike. It was a structural improvement in the team’s ability to identify and act on coding optimisation opportunities.

It is worth emphasising what these numbers represent. Under activity-based funding, NWAU is the direct input to hospital funding calculations. Additional NWAU captured through legitimate, accurate coding is additional funding the health service receives for care it has already delivered. Northern Health did not change what care they provided. They changed their ability to ensure that care was accurately reflected in the coded record and funded accordingly.

Outcome Detail

What changed and why it matters

Full outlier coverage

For the first time, the audit process captured inliers, low outliers, and high outliers in a single workflow. Cases that had previously generated no optimisation activity were now flagged, reviewed, and acted on.

Richer, structured reporting

Where previously only one audit change per episode could be recorded, Code Focus enabled multiple changes per episode, all categorised by error type, including third/fourth character errors, coding convention errors, and NCA/ACS issues.

Real-time coder feedback

Audit feedback is now delivered directly to coders as it happens. Individual error profiles mean education can be targeted precisely where it is needed, rather than relying on generalised training or manual follow-up.

CDI fully integrated

CDI clinician queries are no longer siloed on a separate CDI dashboard invisible to coders. With Code Focus, CDI clinician queries show potential NWAU uplift in real time and are visible alongside the clinical record, closing the loop between CDI and coding. Coders continue to raise and receive feedback on their own queries at the time of coding, now within the same integrated platform.

Self-managed audit flags

Northern Health’s audit team can now create, modify, and retire audit flags without any DSU involvement. This autonomy means the team can respond quickly to funding rule changes, DRG updates, or internal quality priorities.

Audit effort prioritised

With clear visibility of NWAU potential across all case types, auditors can now direct their time to higher-yielding cases, a meaningful shift in productivity that compounds over time as the team becomes more targeted in its approach.

“What stands out most is the capability and dedication of our team. By removing fragmented systems and giving staff real visibility, the Coding team has pivoted to focusing the work where it delivers the greatest impact. We are very proud of how quickly and confidently our Coding team has adapted to this new way of working.”

Odette Taylor, Director of Health Information Services, Northern Health

Implications for Health Services

What Northern Health’s experience tells us

Northern Health’s results are significant, but they are not exceptional. What makes this story useful for other health service leaders is precisely how ordinary the starting conditions were. The team was competent. The intent was there. The audit process was thoughtful. The problem was structural: a set of tools that could not connect the dots between CDI, auditing, coding feedback, and NWAU reporting.

Health services that are currently managing NWAU optimisation through PAS screens, DSU-dependent flag management, or disconnected CDI dashboards are likely in a comparable position. The NWAU they are missing is not the result of poor clinical coding, it is the result of limited visibility. What cannot be seen cannot be acted on.

The speed of Northern Health’s results also matters. In activity-based funding environments, the return on investment from better tooling is not theoretical or long-term, it shows up in the next month’s data. Within sixty days of go-live, Northern Health had a clear picture of what better visibility was worth.