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Chapter 7

Applications for Managing Institutions Delivering Healthcare

Introduction

Definition of health information systems

Marketplace for administrative information systems in healthcare

Chapter focus

Health information systems are “complexes or systems of processing data, information and knowledge in health care environments” (Haux, 2006, p. 270).

Vendors comprise a $12 B marketplace.

This chapter focuses on the administrative applications within health information systems designed to facilitate the management of healthcare delivery. The chapter will consider in turn financial, practice management, material management, human resources, and business intelligence systems.

Basic Financial Systems

General ledger

Payroll system

Patient accounting system

Claims processing and management system

Denial management system

Contract management system

Fixed asset management system

Discuss the systems listed and some of the challenges of FIS.

Challenges with FIS

Integration of Information Systems

Resource Allocation for Information Systems

Financial Information System Architecture

Figure 7-1.

Financial Information System Architecture (Cont.)

Common Reports Used by Healthcare Organizations

Income statement

Balance sheet

Cash flow statement

Financial Information System (FIS)

“Bolt-ons”

Revenue cycle management

Efficiency Tools

Productivity tools

Reporting tools

Discuss Figure 7-3, The revenue Cycle Function

Practice Management Systems

Patient Record

Master patient index

Electronic health record (EHR)

Patient Outreach System

Electronic registry

The Master Patient Index serves as a unique patient identifier.

Discuss how the EHR facilitates the medical records function.

Patient Outreach system facilitates preventive care and the management of chronic illnesses

Practice Management Systems (Cont.)

Online Billing and Payment Tool

Billing at point of service

Follow-up billing

Hospital-Physician Connection

Provider expectations of information systems

Discuss box 7-1

Material Management—Health Care Supply Chain

Definition of material management

Material management within the context of supply chain management

Material Management in healthcare is the storage, inventory control, quality control and operational management of supplies, pharmaceuticals, equipment and other items used in the delivery of patient care or the management of the patient care system.

Material management is a subset of the larger function of supply chain management (SCM); the supply chain also includes the acquisition of materials of care and the logistics or movement of those materials to caregiving facilities and organizations

Why are information systems needed to manage medical materials?

Material Management— Key Files in the Supply Chain Information Management System

Supply item master file

Charge description master file

Vendor master file

Transaction history file

The supply item master file is a list (hardcopy or electronic) of all items used in the delivery of care for a health organization that can be requested by healthcare services providers and managers. This file typically contains between 30,000 and 100,000 items.

The charge description master file is a list of all prices for services (DRGs, HCPCs, CPT-4s for example) or goods provided to patients and serve as the basis for billing.

The vendor master file is a list of all manufacturers or distributors (vendors) who provide the materials needed for the healthcare organization and contain the associated contract terms and prices for specific items. This file typically contains between 200 to 500 different vendors/suppliers. And

The transaction history file is a running log of all material transactions of the healthcare organization.

Material Management—Supply Charge Capture

Integration with clinical point-of-care operations

Information systems that enable efficient charge-capture yield

Principles necessary for success

Material Management—Supply Chain Principles

Strategic factors associated with supply success and enhancement

Information system usefulness, electronic purchasing, and integration

Leadership supply chain expertise

Supply chain expenditures

Surgeon and physician level of collaboration

Nurse and clinical staff level of collaboration

Leadership team’s political and social capital

Capital funds availability

Material Management Clinical—Considerations of Supply Chain Operations

Nursing unit needs and physician needs are addressed.

Physical layout variations may require modification to an accepted standard.

Business process must be efficient before a technological solution can be integrated into the process.

“One size” solution will not fit all.

Human Resources Information Systems

Definition of human resources information systems

Human resources information systems vendors

Human Resources Information System (Cont.)

Personnel Administration

Centralized and integrated management of employee data

Personnel records maintenance

Strategic and Operational Management

Technological infrastructure

Competitive advantage

Human Resources Information System (Cont.)

Staffing and Scheduling

Definitions of staffing and scheduling

Features of enterprise staffing and scheduling software

Innovative scheduling solutions

Open-shift management

Incentive management

Predictive scheduling

Training and Development

Using technology to plan, manage, and deliver training

Human Resources Information System (Cont.)

Compensation, Benefits and Pension

Administration, and Payroll Interface

Automation of financial services

Functions

Oversight of compensation history

Support of payroll and benefits administration

Reference to the budgeted salary pool

Online self-service

Performance Evaluation

“Talent Management” and “Performance Management”

Human Resources Information System (Cont.)

Underrepresented Subsystems

Labor relations

Expense and travel

Health and safety

Competitive Advantage

Five dimensions of managing human resources capability

Business Intelligence Systems

Definition of business intelligence

Business intelligence platform

Survey of business intelligence vendors

Business Intelligence Platform

Figure 7-6 from text

Conclusion and Future Directions

Information technology (IT) productivity paradox—lesson learned

Promises, promises—impact of information technology on:

Quality

Analysis of data