Comp6 Unit9a Lecture Slides

Health Management Information
Systems
Administrative, Billing, and
Financial Systems
Lecture a
This material Comp6_Unit9a 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 a
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
Lecture a
Information System
Automated system
Computer hardware and software
Receives data
Processes data
Outputs data
Supports the functions of the
organization
4
Lecture a
HCIS Components
Patient management and billing
Department management
Care delivery and clinical documentation
Clinical decision support
Financial and resource management
5
Lecture a
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
Lecture a
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
Lecture a
Financial and Resource
Management
Systems that support business functions
Example
Accounts Payable System
Supporting technology
Claims administration
Houses financial and employee data
8
Lecture a
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
Lecture a
Integration
Arrangement of an organizations information
systems
Efficient and effective communication
Bring together related parts into a single
system
10
Lecture a
Application Integration
Patient management and billing
Patient tracking
Department management
Electronic document management
Care delivery and clinical documentation
Order entry and results reporting
11
Lecture a
Application Integration
Clinical decision support
Computerized provider order entry
Financial and resource management
Patient profiling

12
Lecture a
Systems Integration Strategies
Data preservation
Separate information management plan
components for
Data management
Applications and business logic
User interface
13
Lecture a
Key Components of Enterprise
Integration
Master person index
Single sign-on with context management
Data warehouse
14
Lecture a
Key Components of Enterprise
Integration
Standards
Structure and content
Identifier
Vocabulary
SNOMED CT
Content exchange
HL7 Clinical Document Architecture
Privacy and security
NIST encryption algorithm
15
Lecture a
Standards for Certification of EHR
Technology
Content exchange standards
NCPDP SCRIPT Standard
HL7 Clinical Document Architecture (CDA), CCD
Vocabulary standards
SNOMED CT
LOINC
Privacy and security standards
NIST encryption algorithm
NIST hashing algorithm
16
Lecture a
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
Lecture a
Data and Process Integration
Data integration
Interface engine
Process integration
Operational workflow
Human organizational systems
18
Lecture a
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
Lecture a
HL7 Messaging Standard
Health Level Seven (HL7)
Content exchange (messaging)
standard
Supports clinical practice
Move data in standard formats

20
Lecture a
System Integration Example
Revenue cycle
Administrative functions
Clinical functions
Revenue cycle management

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

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

23
Lecture a
Business Intelligence Applications
Examples
Clinical and Financial Analytics and Decision
Support
Query and Reporting Tools
Data Mining
Online Scoreboards and Dashboards
24
Lecture a
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
Lecture a
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 (3
rd
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 (2
rd
ed.). Chicago, IL: Author.
26
Lecture a
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 (3
rd
ed) (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

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Lecture a

Comp6 Unit9a Lecture Slides

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