Health Management Information Systems

1. Health Management Information Systems Administrative, Billing, and Financial Systems Lecture a This material (Comp 6 Unit 9) 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. This material was updated by Normandale Community College, funded under Award Number 90WT0003. This work is licensed under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-sa/4.0/

2. Administrative, Billing, and Financial SystemsLearning Objectives • Explain applications that need to be integrated in health care information systems • Describe the strategies used by health care organizations to ensure integration of functions • Discuss the critical elements needed to integrate billing, financial, and clinical systems

3. Information System • Automated system • Computer hardware and software • Receives data • Processes data • Outputs data • Supports the functions of the organization

4. HCIS Components • Patient management and billing • Department management • Care delivery and clinical documentation • Clinical decision support • Financial and resource management

5. Patient Management and Billing • Systems that support the management of the patient • Example • Patient identification • Supporting technology • Master patient index • Patient-identifying directory • Links to the patient record • Facilitates patient identification • Assists in maintaining a longitudinal patient record

6. Admission-Discharge-Transfer (ADT) “The name given to software systems used in healthcare facilities that register and track patients from admission through discharge including transfers; usually interfaced with other systems used throughout a facility such as an electronic health record or lab information system.” (AHIMA, 2012)

7. Financial and Resource Management • Systems that support business functions • Example • Accounts Payable System • Supporting technology • Claims administration • Houses financial and employee data

8. Practice Management • Practice management system (PMS) • Combination of financial and administrative functions • Patient appointment, scheduling, registration, billing, and payroll functions • PMS and electronic medical records integration

9. Integration Arrangement of an organization’s information systems • Efficient and effective communication • Bring together related parts into a single system

10. Application Integration • Patient management and billing • Patient tracking • Department management • Electronic document management • Care delivery and clinical documentation • Order entry and results reporting

11. Application Integration • Clinical decision support • Computerized provider order entry • Financial and resource management • Patient profiling

12. Systems Integration Strategies • Data preservation • Separate information management plan components for • Data management • Applications and business logic • User interface

13. Key Components of Enterprise Integration • Master person index • Single sign-on with context management • Data warehouse

14. Key Components of Enterprise Integration • Standards • Structure and content • Identifier • Vocabulary • SNOMED CT • Content exchange • HL7 Clinical Document Architecture • HL7 Consolidated Clinical Document Architecture (C-CDA) • Privacy and security • NIST encryption algorithm

15. Standards for Certification of EHR Technology • Content exchange standards • NCPDP SCRIPT Standard • HL7 Clinical Document Architecture (CDA), C-CDA • Vocabulary standards • SNOMED CT • LOINC • Privacy and security standards • NIST encryption algorithm • NIST hashing algorithm

16. Critical Integration Elements • Information is available when and where it is needed • Users must have an integrated view • Data must have a consistent interpretation • Adequate security must be in place

17. Data and Process Integration • Data integration • Interface engine • Process integration • Operational workflow • Human organizational systems

18. Interface Engine • Translates functions from different systems and protocols • Outcome is a common format • Facilitates information sharing • Controls data flow between applications • Central connecting point for all interfaces

19. HL7 Messaging Standard Health Level Seven (HL7) • Content exchange (messaging) standard • Supports clinical practice • Move data in standard formats

20. System Integration Example • Revenue cycle • Administrative functions • Clinical functions • Revenue cycle management

21. (Agosta, 2010) Image courtesy of Dr. Agosta From Islands of Information to Meaningful Use

22. Business Intelligence Applications Allow for • Data analysis • Correlation • Trending • Reporting of data across multiple sources

23. Business Intelligence Applications Examples • Clinical and Financial Analytics and Decision Support • Query and Reporting Tools • Data Mining • Online Scoreboards and Dashboards

24. Administrative, Billing, and Financial Systems Summary – Lecture a • Administrative, billing, and financial systems integrated in health care information systems • Health care organizations’ strategies to ensure integration of front-end clinical data collection and back-end billing functions • Critical integration elements • Data analysis and trending

25. Administrative, Billing, and Financial Systems References – Lecture a References Agosta, L. (2010, June 1). Data integration delivers healthcare meaningful use. Alleingang Research. Retrieved from http://www.pervasiveintegration.com/dcontent/Collateral/PervasiveHITR.pdf American Health Information Management Association (AHIMA). (2012). Pocket glossary for health information management and technology (3rd ed.). Chicago, IL: Author. Clinfowiki. (2011). Business intelligence. Available from: http://www.informatics-review.com/wiki/index.php/Business_Intelligence_&_Data_Warehousing_for_Healthcare Healthcare Financial Management Association. (n.d.). HFMA glossary. Retrieved from http://www.hfma.org/forms/glossary/search.aspx/search.aspx Healthcare Information and Management Systems Society (HIMSS). (n.d.a). About HIMSS. http://www.himss.org/ASP/aboutHimssHome.asp Healthcare Information and Management Systems Society (HIMSS). (n.d.b). Interoperability & standards. Retrieved from http://www.himss.org/ASP/topics_integration.asp Healthcare Information and Management Systems Society (HIMSS). (2007). Enterprise integration: Defining the landscape. Retrieved from http://www.himss.org/content/files/Ent_Integr_whitepaper_030807.pdf Health Level Seven International. (2011). About HL7. Retrieved from http://www.hl7.org/about/index.cfm?ref=nav Healthcare Information and Management Systems Society (HIMSS). (2010). HIMSS dictionary of healthcare information technology terms, acronyms and organizations (2rd ed.). Chicago, IL: Author.

26. Administrative, Billing, and Financial Systems References – Lecture a References Loshin, D. (2003). Business Intelligence: The Savvy Manager's Guide, Addison Wesley, 2003 Office of the National Coordinator for Health Information Technology. (July 28, 2010). Health Information Technology: Initial Set of Standards, Implementation Specifications, and Certification Criteria for Electronic Health Record Technology; Final Rule, 45 CFR Part 170. Retrieved from http://edocket.access.gpo.gov/2010/pdf/2010-17210.pdf The Data Warehousing Institute Faculty Newsletter. (2002, Fall). Vogel, L.H., & Perreault, L.E., (2006). Management of information in healthcare organizations. In Shortliffe. E. H., & Cimino, J. J. (Eds.), Biomedical informatics: Computer applications in health care and biomedicine (3rded) (pp. 476-510). New York, NY: Springer Science + Business Media. Image Slide 22: Agosta, L. (2010). From islands of information to meaningful use [image on the Internet]. Available from: http://www.pervasiveintegration.com/dcontent/Collateral/PervasiveHITR.pdf

27. Administrative, Billing, and Financial SystemsLecture a This material 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. This material was updated by Normandale Community College, funded under Award Number 90WT0003.