...Running head: Life Cycles, Standards and Best Practices 2 Abstract This paper will outline the systems development life cycle as it pertains to both the development of a custom application and the selection of proprietary systems. The major types and classifications of health care information standards and specific organizations that develop and regulate standards will be explained. The need for security information systems will be revealed and the methods to accomplish security of these systems will be addressed. Three best practices for effective IT alignment and strategic planning will be outlined. Running head: Life Cycles, Standards and Best Practices 3 Description of Systems Development life Cycle as it Pertains to Both the Development of a Custom Application and the Selection of Proprietary Systems The Systems Development Life Cycle (SDLC), is a six step project development process that was designed to help the development team develop the end product. The players involved are the users, systems analysts, programmers and technical specialists (Systems Development Life Cycle (SDLC), 2006-2013). In the first step of the Systems Development Life Cycle (SDLC), an examination of the economic, technical, behavioral or organizational aspect of the business is reviewed. A determination will be made as to what needs...
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...Job description Inpatient Medical Coding Inpatient Medical Coding job involves coding charts for patients whose treatment requires hospitalization for more than 24 hours. Inpatient Medical Coders use the coding systems ICD-9-CM, ICD-10 as well as DRG (Diagnoses Related Groups). Inpatient Medical Coding requires greater knowledge and experience because the groupings and sequencing of codes for specific diagnoses and procedures in a hospital are significantly greater. Daily tasks usually include: • Review patient histories, operations, chart reviews, consultation and discharge summaries to support codes selected for billing. • Utilize ICD-9-CM and/or ICD-10 to select the diagnosis-related group (DRG) assignments for each case. • Identify mistakes in reports. • Enter coding information into electronic billing system. Many Inpatient Medical Coders work for hospitals, although insurance companies and long-term health-care facilities may also employ inpatient coders. They typically must have at least 2 years of experience to be hired and may work at the facility or off-site in their homes. Hours vary based on the employer. Accuracy is critical in this position, as much of a hospital’s revenue depends on the correct coding of the diagnoses, procedures, and treatments administered. Coders often interact with physicians, nurses and other medical professionals in order to select the proper codes. Critical thinking and communication skills, great attention to detail and the ability...
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...Healthcare IS Definitions Termika R. Stone HCS/ 533 Health Information Systems May 30, 2011 Professor Linda Mesko The health industry has been under major construction in its efforts to catch up in this age of technology. These efforts are referred to as Health information technology (HIT). HIT imparts the architecture to explain the complete management of health information throughout the various computerized systems. It safeguards the exchange between government, quality entities, customers, suppliers and insurers. Health Information Technology is now viewed as a very promising agent for enhancing healthcare quality, protection and a well-organized and resourceful healthcare delivery system. This assignment has ten terms that fall under the scope of HIT and Health Information Systems (HIS) that are interconnected. Each term will be defined and a concise statement of importance will be explained. AMR • AMR (Automated Medical Records) is a term used at the early stage of electronic medical documentation. It was information retained on a customary personal computer and did not comply with legal ramifications for electronic medical records. Therefore a paper file was maintained. The computer information is used as a working file, and then pages are printed and filed in the chart (Fishman, 2005). • Important aspect of AMR is the aid of premature discovery of conditions of public health issues. For instance, seasonal respiratory illness or atypical occurrences...
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...Health Care Marketing Analysis Shanita V. Brown HCS/539 May 27, 2013 Thomas Sloan Health Care Marketing Analysis “The health marketing mix is vital for a successful health promotion campaign (Pralea pg. 43).” In the health care system today, the marketing mix generally is based on the four P’s known as product, price, place and promotion. The product is concrete and solid products and services. The product is the actual physical item. Pricing is based on being able to price the products at a rate in which customers are willing to pay. This means being aware of supply and demand. Place which also means distribution. Placement is how the products are delivered to the customers. Promotion is the communication in which the hospital uses to bring a positive response from customers. The four P’s are vital in marketing of health care. The four P’s are what guarantees the hospital’s overall success. This can be proven by looking at the marketing mix of Piedmont Henry Hospital in McDonough, Georgia. Product As stated above, the product is the physical products and services in which the hospital provides. Products and services are important to hospital because should cater to the target customers. The product is considered the “platform” of the marketing plan, according to Pralea. Decisions about products and services in a health care facility may involve brand name, functionality, quality, safety, packaging, and repairs and support. Every hospital does not provide all services...
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...No. AB202006 Ken Zielske, Director of Publications Susan Hull, MPH, RHIA, CCS, CCS-P, Technical Reviewer Marcia Loellbach, MS, Project Editor Elizabeth Lund, Assistant Editor Melissa Ulbricht, Editorial/Production Coordinator All information contained within this book, including Web sites and regulatory information, was current and valid as of the date of publication. However, Web page addresses and the information on them may change or disappear at any time and for any number of reasons. The user is encouraged to perform his or her own general Web searches to locate any site addresses listed here that are no longer valid. AHIMA strives to recognize the value of people from every racial and ethnic background as well as all genders, age groups, and sexual orientations by building its membership and leadership resources to reflect the rich diversity of the American population. AHIMA encourages the celebration and promotion of human diversity through education, mentoring, recognition, leadership, and other programs. American Health Information Management Association 233 North Michigan Avenue, Suite 2150 Chicago, Illinois 60601-5800 http://www.ahima.org Contents About the Authors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . v Acknowledgments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ....
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...HIM141 Test 4 Chapters 8-10 Please completely answer the following questions. 1. What is the MPI and what types of information are contained in the MPI? MPI-master patient index, sometimes called a master person index, link a patient’s medical record number with common identification data elements, for example: patient’s complete name, date of birth, gender, mother’s maiden name and social security number. Because most health care facilities house patient records according to a medical record number, the MP becomes the key to locating paper based records in the health information department file system. Thus, the MPI is retained permanently because it serves as the key to finding the patients record, it can be automated or manual. According to the American Health Information Management Association (AHIMA), some recommended core data elements for indexing and searching records include: * Internal patient Identification * Patient Name * DOB * DOB qualifier * Gender * Race * Ethnicity * Address * Alias/pervious name * SS# * Facility identification * Universal patient identifier (if available) * Account number * Admission date * Discharge date * Service type * Patient disposition 2. What are registers and indexes? Registers and registries contain information about a disease or event and are maintained by individual health care facilities, federal and state government agencies and private organizations...
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...In healthcare organizations, data must be recorded, analyzed, and stored accurately. Data represents facts about a patient and any services or care provided. For research and billing purposes, data is grouped into data sets. Each data set needs to be defined to include compatible data elements. Aggregate data is health information that relates multiple patients. It can include such things as, diagnosis, ethnicity, or age groups. Aggregate data can be used to identify common characteristics of diseases and how they should be treated. (Health Information Management: Concepts, Principles, and Practice, 4th Edition., 2013) Aggregate data is considered to be a secondary data source. Advantages of aggregate data include use for disease prevention, and patient education. A disadvantage could be that a patient has to consent for their information to be used as aggregate data. Comparative data is useful in measuring outcomes and research in health services. This data is usually available in healthcare settings. Using existing data does not require a large amount of time. There are also fewer ethical issues since the data is collected routinely. (A E Powell, 2002) There are some disadvantages, such as making sure the data is valid and reliable. Inaccurate data will negatively affect the conclusion. The need for high-quality data is important as well. Patient-centric data are given by the patient or family members in order to research certain health care problems. The patient...
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...BUSINESS/TECHNICAL APPROACH AND IMPLEMENTATION PLAN 8 7.0 BUSINESS PROCESS CHANGES13 8.0 HISTORICAL RESEARCH15 9.0 TECHNOLOGY/BUSINESS PRACTICE19 10.0 CONCLUSION AND OVERALL RECOMMENDATIONS25 11.0 REFERENCE27 1.0 ABSTRACT George Hopesman-Wubarte Hospital (GHW) has been a nationally recognized leader in the healthcare industry for several years. However, in order to remain the innovative leader of its kind, the Greinly and Associates Consulting Group (GACG) has been asked to give some recommendations on how Information Technology can bring some improvements. The results of a conducted study of the patient information and medical records system indicted that a biometric known as Electronic Health Records (EHR) would drastically improve the timeliness and security of this process. A complete comprehensive study of the current antiquated system has been done. This study has allowed for the recommendations of how to implement the business and technical changes of the old system into the new EHR system to be brought forth. A theoretical analysis, backed by the research of previous and current projects with great similarities indicates that the implementation of the EHR system will drastically improve the hospital’s overall process of patient care. The end results being that there will be more satisfied and more loyal patients. 2.0 BRIEF COMPANY BACKGROUND Founded in 1990 by industrialists and the well-respected physician, George...
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...Protection and Affordable Care Act and the Health Care and Education Reconciliation Act. Critics both in support and opponents claim the bills do little to alter healthcare inflation or uneven delivery of care (Ferman, 2010). The goal of the bill is to change a volume based model in to a value based business model. A comment by Moody’s Investor services exclaimed that the reform will undoubtedly require healthcare leaders to focus even more on multi-year strategies to ensure long term financial stability (Kim, Majka, & Sussman, 2011). Leaders will have to establish a long range plan that includes financial projections and goals, long range capital expenditure requirements, debt capacity, capital position analysis, capital shortfall analysis and sensitivity and risk analysis (Kim, Majka, & Sussman, 2011). There will be substantial increases in the number of newly insured that will place a tremendous amount of stress and unknown consequences on an already burdened healthcare infrastructure (Tyson, 2010). The objective of this paper will attempt to examine the implications of reform on strategic planning of health care institutions transitioning from a volume based model to a value based one. The recent passage of Health Care Legislation attempts to address payment and delivery systems currently in place that favor volume driven as opposed to value driven health care (Robert Wood Johnson Foundation, 2009). The current system of fee for service pays a set amount for...
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...GAAP principles. Compile an Operational Budget from the article “Hospital Nursing Costs, Billing, and Reimbursement” An operational budget for a hospital nursing department forecasts this unit’s contribution to the income statement (Gapenski, 2012, p. 234). The operational budget has volume assumptions, revenue assumptions, cost assumptions, and a pro forma profit and loss statement. For nursing departments, volume assumptions drive variable cost assumptions such as labor. The revenue assumptions and the pro forma profit and loss statement typically are not applied as nurses are billed as a fixed cost as part of the hospital’s room rate. Typically, the volume assumptions are based on patient location and tied to the Diagnosis Related Group (DRG) weighting, which distributes nursing care expenses across three categories of care such as routine, intermediate, or intensive (Welton, Fischer, DeGrace, Zone-Smith, 2006). The study documented in “Hospital Nursing Costs, Billing, And Reimbursement” found patient location a less accurate indicator of nursing costs when compared to nursing intensity, indicating the patient location methodology does not link nursing care costs with hospital revenue as accurately as the nursing intensity methodology would. Modifying the billing methodology of nursing care by using the nursing intensity model as described in “Hospital Nursing Cost, Billing, And Reimbursement” would change billing to account for nursing care by patient based on...
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...questions or would like to learn more about our work, please contact us. The Access Project 30 Winter Street, Suite 930 Boston, MA 02108 Phone: 617-654-9911 FAX: 617-654-9922 E-mail: info@accessproject.org Web site: www.accessproject.org Catherine M. Dunham, Ed.D, National Program Director Mark Rukavina, MBA, Deputy Director for Programs and Policy Gwen Pritchard, MPA, Deputy Director for Communication and Administration © 2001 by The Access Project This publication may be reproduced or quoted with appropriate credit. Acknowledgments The Access Project would like to thank and acknowledge the work of Sarah Gunther Lane, Elizabeth Longstreth and Victoria Nixon, who wrote this guide. This manual grew out of research and analysis they and their colleagues did for The Access Project under the supervision of Dr. Nancy Kane at the Harvard School of Public Health. Dr. Kane, whose research is concerned with measures and determinants of financial and managerial...
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...in decline over the past decade. 2.8 A. Cost-based reimbursement A reimbursement methodology based on the costs incurred in providing services. B. Charge-based reimbursement A reimbursement methodology based on charges (chargemaster prices). C. Per procedure. Under per procedure reimbursement, a separate payment is made for each procedure performed on a patient. Because of the high administrative costs associated with this method when applied to complex diagnoses,per procedure reimbursement is more commonly used in outpatient than in inpatient settings. D. diagnosis. In the per diagnosisreimbursement method, the provider is paid a rate that depends on the patient’s diagnosis. Diagnoses that require higher resource utilization, and hence are more costly to treat, have higher reimbursement rates. Medicare pioneered this basis of payment in its diagnosis related group (DRG) system, which it first used for hospital inpatient reimbursement in 1983. E. Per diem A reimbursement methodology that pays a set amount for each inpatient day. F. Bundled (global) pricing. The payment of a single amount for the complete set of services required to treat a single episode. Also sometimes applied to an entire population (capitation). Capitation. A reimbursement methodology that is based on the number of covered lives as opposed to the amount of services provided. See fee-for-service. 2.1 A. 700,000 B. 8,500 3.3 A...
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...HMIS Standards HMIS Standards Lulett Baldwin Grand Canyon University: Health Information Technology and Management HCA-360 September 9, 2012 Chapter Questions 12-1. Define the following terms: a. Medicine – The study and treatment of general diseases or those affecting the internal parts of the body, especially those not usually requiring surgical intervention. (MediLexicon International, LTD, 2012). b. Medical Informatics (MI) – The field of information science concerned with the analysis and dissemination of medical data through the application of computers to various aspects of health care and medicine (TheFreeDictionary, 2012). c. Standards – An acknowledged measure of comparison for quantitative or qualitative value; a criterion. Widely recognized as a model of authority or excellence (TheFreeDictionary, 2012). d. HIPAA – Health Insurance Portability and Accountability Act, the Privacy Rule was enacted on August 21, 1996, by the U.S Congress. This Act was instituted to protect the freedom, security, privacy, and confidentiality of individuals (Tan & Payton 2010). 12-2. What are data standards? Discuss the usefulness of these standards to implementing HMIS? Answer: HIPAA was enacted to expedite the development of data standards. Healthcare professionals have identified that the root cause of inhibition to sharing medical information electronically is the lack of comprehensive data standards. The...
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...179 International Journal of Collaborative Research on Internal Medicine & Public Health Specifics of the Activity-Based Applications in Hospital Management Boris Popesko * Tomas Bata University in Zlin, Czech Republic * Corresponding Author; Email: popesko@fame.utb.cz Abstract Paper analyses the specifics of the application of Activity-Based Costing method in hospital management. Primary objective of the paper is to outline the methodology of the ABC application in hospitals. First part of the paper analyzes the ways of ABC implementation in published foreign studies. Second part describes the individual steps in ABC application and discusses the differences in the application procedures between the manufacturing and hospital organization. Key words: Healthcare Management, Cost Management, Activity-based costing, Introduction In the last decade, many non-profit and hospital organizations started to face difficulties and challenges in balancing limited resources and costs to provide their demand for services. Due to the introduction of modern medical techniques and medicines and consequent increase of consumed costs, many hospitals are under pressure to adopt more advanced cost management techniques usually utilized only in profit organization sector. Hospital managers frequently seek the advanced techniques, for better understanding of relations between the cost and provided services. One of the key factors of effective company management is ability of accurate...
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...Pay-for-Performance HCS/531 January 28, 2013 Jody Sklar Pay-for-Performance Emergence of Pay-for-Performance In 2000, the Institute of Medicine (IOM) released the report “To Err is Human: Building a Safer Health System.” The report catalyzed the attention of health care stakeholder groups in the nation (Stafford, 2000). The research provided a comprehensive, detailed account of health care errors and preventable deaths costing billions of unnecessary dollars in a health care system already spiraling out of control. The IOM recommended that Congress create a Center for Patient Safety within the Agency for Health Care Research and Quality for the purpose of designing a safer health care delivery system. Fifteen months after releasing the patient safety report, the IOM released “Crossing the Quality Chasm.” The report framed underlying reform necessary in the current health care delivery system to ensure patient safety. The framework sought to hold providers accountability for the quality of care they deliver. The introduction of the pay for performance (P4P) as opposed to the prior fee for service and prospective reimbursement guidelines induces delivery of care based upon performance measures. Broadly defined pay-for- performance includes any type of performance-based provider payment arrangements, including those that target performance on cost measures (U.S. Department of Health & Human Services, 2006) Reimbursement Pay-for-performance, synonymous...
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