Health Management Information Systems

Transcription

1 Health Management Information Systems Administrative, Billing, and Financial Systems

2 Administrative, Billing, and Financial Systems Learning Objectives 1. Explain applications that need to be integrated in health care information systems 2. Describe the strategies used by health care organizations to ensure integration of functions 3. Discuss the critical elements needed to integrate billing, financial, and clinical systems 2

3 Administrative, Billing, and Financial Systems Learning Objectives 4. Discuss the core elements of a Master Patient Index (MPI) 5. Describe current trends to establish a Unique Patient Identifier (UPI) 3

4 Patient Management and Billing Systems that support the management of the patient Example Patient identification Supporting technology Master patient index 4

5 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 5

6 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 6

7 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 7

8 Purpose of the MPI Establishes a streamlined governance process Accurately matches persons being registered for care with their existing medical records 8

9 Core Elements of an MPI Internal patient identification Person name Date of birth Gender Race Ethnicity 9

10 Core Elements of a MPI Address Telephone number Alias/previous/maiden names Social security number Facility identification Universal patient identifier (UPI) Account/visit number 10

11 Core Elements of an MPI Admission/encounter/visit date Discharge or departure date Encounter/service type Encounter/service location Encounter primary physician Patient disposition 11

12 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 12

13 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 13

14 Current Trends to Establish a UPI HIPAA Requires unique identification numbers UPI has not been adopted ONC s HITSC Patient Matching Power Team Recommendations 14

15 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) 15

16 Administrative, Billing, and Financial Systems References References AHIMA. (2010a, September). Fundamentals for building a Master Patient Index/Enterprise Master Patient Index (Updated) Journal of AHIMA, 81(4), Retrieved from 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), Retrieved from American Health Information Management Association. (2012). Pocket glossary for health information management and technology (3 rd ed.). Chicago, IL: Author. Healthcare Information and Management Systems Society (HIMSS). (2010). HIMSS dictionary of healthcare information technology terms, acronyms and organizations (2 rd ed.). Chicago, IL: Author. Health Information Technology Standards Committee (HITSC) Patient matching power team recommendations. PT_Recomm.pdf National Committee on Vital and Health Statistics. (1997). Part three: Unique patient identifier. Retrieved from 16