Health Management Information

Systems
Administrative, Billing, and
Financial Systems
Lecture b
This 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)
2
Health 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)
3
Health 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
4
Health 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
5
Health 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
6
Health 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
patients EHR in an enterprise
Facilitates intraoperability and the accurate
creation of a longitudinal record
Ensures accurate and complete linking of EHRs
for HIE
7
Health 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
8
Health 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
9
Health 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
10
Health 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
11
Health 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
12
Health 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
13
Health 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
ONCs HITSC
Patient Matching Power Team
Recommendations
14
Health 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)
15
Health 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 b
References
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 (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). 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



16
Health IT Workforce Curriculum
Version 3.0/Spring 2012
Health Management Information Systems
Administrative, Billing, and Financial Systems
Lecture b