comp6 unit9b lecture slides
TRANSCRIPT
Health Management Information Systems
Administrative, Billing, and Financial Systems
Lecture bThis material Comp6_Unit9b was developed by Duke University, funded by the Department of Health and Human Services,
Office of the National Coordinator for Health Information Technology under Award Number IU24OC000024.
Administrative, Billing, and Financial Systems
Learning Objectives
1. Explain applications that need to be integrated in health care information systems (Lecture a)
2. Describe the strategies used by health care organizations to ensure integration of functions (Lecture a)
3. Discuss the critical elements needed to integrate billing, financial, and clinical systems (Lecture a)
2Health IT Workforce Curriculum Version 3.0/Spring 2012
Health Management Information Systems Administrative, Billing, and Financial Systems
Lecture b
Administrative, Billing, and Financial Systems
Learning Objectives
4. Discuss the core elements of a Master Patient Index (MPI) (Lecture b)
5. Describe current trends to establish a Unique Patient Identifier (UPI) (Lecture b)
3Health IT Workforce Curriculum Version 3.0/Spring 2012
Health Management Information Systems Administrative, Billing, and Financial Systems
Lecture b
Patient Management and Billing
• Systems that support the management of the patient – Example
• Patient identification– Supporting technology
• Master patient index
4Health IT Workforce Curriculum Version 3.0/Spring 2012
Health Management Information Systems Administrative, Billing, and Financial Systems
Lecture b
Master Patient Index (MPI)
• Centerpiece for all subsequent functionality and software applications– Links to the patient health record– Links to scheduling for appointments,
reporting lab, x-ray, pharmacy, patient-related images
5Health IT Workforce Curriculum Version 3.0/Spring 2012
Health Management Information Systems Administrative, Billing, and Financial Systems
Lecture b
Master Patient Index (MPI)
AHIMA definition “A patient-identifying directory referencing all
patients related to an organization and which also serves as a link to the patient record or information, facilitates patient identification, and assists in maintaining a longitudinal patient record from birth to death”
6Health IT Workforce Curriculum Version 3.0/Spring 2012
Health Management Information Systems Administrative, Billing, and Financial Systems
Lecture b
Purpose of the MPI
• Provides the index, location of, and access to a patient’s EHR in an enterprise
• Facilitates intraoperability and the accurate creation of a longitudinal record
• Ensures accurate and complete linking of EHRs for HIE
7Health IT Workforce Curriculum Version 3.0/Spring 2012
Health Management Information Systems Administrative, Billing, and Financial Systems
Lecture b
Purpose of the MPI
• Establishes a streamlined governance process • Accurately matches persons being registered for
care with their existing medical records
8Health IT Workforce Curriculum Version 3.0/Spring 2012
Health Management Information Systems Administrative, Billing, and Financial Systems
Lecture b
Core Elements of an MPI
• Internal patient identification• Person name• Date of birth• Gender• Race• Ethnicity
9Health IT Workforce Curriculum Version 3.0/Spring 2012
Health Management Information Systems Administrative, Billing, and Financial Systems
Lecture b
Core Elements of a MPI
• Address• Telephone number• Alias/previous/maiden names• Social security number• Facility identification• Universal patient identifier (UPI)• Account/visit number
10Health IT Workforce Curriculum Version 3.0/Spring 2012
Health Management Information Systems Administrative, Billing, and Financial Systems
Lecture b
Core Elements of an MPI
• Admission/encounter/visit date• Discharge or departure date• Encounter/service type• Encounter/service location• Encounter primary physician• Patient disposition
11Health IT Workforce Curriculum Version 3.0/Spring 2012
Health Management Information Systems Administrative, Billing, and Financial Systems
Lecture b
Unique Patient Identifier (UPI)
• Value permanently assigned to an individual for identification purposes
• Unique across the entire national health care system
• Not shared with any other individual
12Health IT Workforce Curriculum Version 3.0/Spring 2012
Health Management Information Systems Administrative, Billing, and Financial Systems
Lecture b
Functions a UPI Must Support
• Identification of an individual• Identification of information• Accurate identification functions• Reduce health care operational cost and
enhance the health status of the nation
13Health IT Workforce Curriculum Version 3.0/Spring 2012
Health Management Information Systems Administrative, Billing, and Financial Systems
Lecture b
Current Trends to Establish a UPI
• HIPAA– Requires unique identification numbers
• UPI has not been adopted• ONC’s HITSC
– Patient Matching Power Team• Recommendations
14Health IT Workforce Curriculum Version 3.0/Spring 2012
Health Management Information Systems Administrative, Billing, and Financial Systems
Lecture b
Administrative, Billing, and Financial Systems Summary
• Applications that need to be integrated in health care information systems;
• Strategies used by health care organizations to ensure integration of functions;
• Critical elements needed to integrate billing, financial, and clinical systems;
• Core elements of a Master Patient Index (MPI)
15Health IT Workforce Curriculum Version 3.0/Spring 2012
Health Management Information Systems Administrative, Billing, and Financial Systems
Lecture b
Administrative, Billing, and Financial Systems
References – Lecture bReferences• AHIMA. (2010a, September). Fundamentals for building a Master Patient Index/Enterprise Master Patient Index
(Updated) Journal of AHIMA, 81(4), 52-57. Retrieved from http://library.ahima.org/xpedio/groups/public/documents/ahima/bok1_048389.hcsp?dDocName=bok1_048389
• AHIMA. (2010b, September). Fundamentals for Building a Master Patient Index/Enterprise Master Patient Index (Updated): Appendix A Recommended core data elements for EMPIs. Journal of AHIMA, 81(4), 52-57. Retrieved from http://library.ahima.org/xpedio/groups/public/documents/ahima/bok1_048390.hcsp?dDocName=bok1_048390
• American Health Information Management Association. (2012). Pocket glossary for health information management and technology (3rd ed.). Chicago, IL: Author.
• Healthcare Information and Management Systems Society (HIMSS). (2010). HIMSS dictionary of healthcare information technology terms, acronyms and organizations (2rd ed.). Chicago, IL: Author.
• Health Information Technology Standards Committee (HITSC). 2011. Patient matching power team recommendations. http://healthit.hhs.gov/portal/server.pt/gateway/PTARGS_0_12811_955311_0_0_18/08_17_11_Patient_Matching_PT_Recomm.pdf
• National Committee on Vital and Health Statistics. (1997). Part three: Unique patient identifier. Retrieved from http://ncvhs.hhs.gov/app3.htm#Part3
16Health IT Workforce Curriculum Version 3.0/Spring 2012
Health Management Information Systems Administrative, Billing, and Financial Systems
Lecture b