Project management Healthcare sytems

HIMT-370 Y.White

Milestone #4 – Systems Analysis: Requirements Gathering

Purpose

In this milestone you will start gathering the requirements for the new system at Universal Wellness Group (UWG). Requirements gathering is one of the most critical activities an analyst needs to perform. If we do not correctly identify the needs of the stakeholders, we will have little chance of a successful implementation. In this milestone we are focused on “what” the system needs to do. We are not interested in “how” we will implement these requirements within this milestone. We need to identify the requirements of the system and the tasks in this milestone will uncover the requirements for UWG.

Background

UWG asked you to perform a preliminary investigation for a new business support system. You had several meetings with Dr. Jones to discuss office records and accounting systems. Anita Davenport, UWG’s office manager, participated in those meetings. You also completed a project management plan for UWG. Now, you are ready to develop a system requirements model.

In the preliminary investigation report, you recommended a detailed analysis of four key areas:

1. patient scheduling

2. billing and accounts receivable

3. human resources

4. payroll.

Because these areas are highly interactive, you suggested that an integrated system would provide the greatest benefits. Dr. Jones and the partners agreed, but they also expressed interest in a medical practice support system and asked whether the business support system could be expanded. After research and analysis, you concluded that medical practice support should be a separate system to be considered in UWG’s long-term strategic plans. Because future integration would be very important, the business support system design should be compatible with a future medical practice support system.

In your meetings with Dr. Jones and Anita, you stressed that IT projects are much more successful when users have a sense of ownership, and the best way to create that “buy-in” is to get them involved in the development process. In your view, joint application development (JAD) would be ideal method to develop the new system, and everyone agrees. Your next task is to form a JAD team and conduct the requirements modeling process.

Tasks

1. Review the organization chart you prepared in Chapter 1 and determine who should be on the JAD team, and why. Also, how will you create a sense of team ownership from the start?

2. Develop a list that includes several requirements for system output, input, process, performance, and control for the proposed system. Be sure to reference the interview summary provided for the project.

3. Design a questionnaire to learn how UWG patients feel about insurance procedures and appointment scheduling. Your questionnaire should be designed for a sample group of patients and should follow the suggestions in this chapter. After you complete the questionnaire, select a sampling method, and explain your choice.

Format

Task 1)

JAD Team Member	Why
Lisa Sung	Is the appointment clerk. She will be able to provide what is needed for appointment scheduling. Such as scheduling and confirming appointment what data is needed from patients and insight what is needed from the clinical side. She would be able to assist with patient scheduling.
Anita Davanport	She is the office manager. Would be part of the team to lead the billing and accounts receivable staff. She supervises the administrative staff and has knowledge of the clinical needs
Susan Gifford	She is a part of medical records knows what is need for each position to work in the EHR. For scheduling, clinical staff and billing.
Tammy Alipio	Tammie is the billing specialist and her role links to frank in account receivables. She can explain what is needed to bill payors and to receive their payments.
Fred Brown	Fred brown would be a representative for Human resources. He would be able to provide payroll information, tax reporting and the staff company profiles.

How will you create a sense of team ownership from the start? To create a sense of team ownership it is important to go in with open communication. To come in with a clear direction and explain what the project is and the goals of the project. Also, to provide people with a direct purpose and role for the team. Sharing the project plan and timeline. Open the floor for feedback and input.

Task 2)

Output Requirements	Input Requirements	Process Requirements	Performance Requirements	Control Requirements
Patient Scheduling provide an appointment list and call list.	Client name and demographics, insurance info, provider, appt date and time, Provider’s schedules, appointment types with allotted time	System must allow for appoint changes, changes to patient’s information, ability to track availability of providers, an automated call or MSM system for appt reminders Collaborate with the registration system Integrated system to PT Records	Will be one complete electronic appointment book for all providers, the ability to add new patients and new providers, ability to select appoint type to the procedure and block the allotted time.	Ability to select appointment type to the procedure and block the allotted time. A secure database
Billing /account receivable system. Should pull the codes and appointments from the prior day and create an insurance claim, post balance due to PT account, run reports of insurance billed and paid, claim status	Input should include payor information for claim billing, and UWG info to receive payment, Patient with guarantee to bill self-pay balances, procedure codes and fees,	The ability to intertwine with other UWG systems. Must be able to recognize when a payment is posted to PT account. To Run reports of claims outstanding, payments received, and UGW expenses	Generate self-pay statements to be fold and mailed, run statement batches twice a week to create smaller batches for new visits and one monthly statement. Generate claim forms and send electronic file or mail to insurance company.	System is password protected. Each billing and accounting have their own login.
Patient records created electronically as a new patient account is created. Integrate paper records to electronic PT records.	Pt medical encounters with clinic. Pt insurance claims that have been billed with status Log of billed charges and payments received	System must interface with billing, scheduling, and registration	Providers should be able to input codes to be billed and document PT status at each appt.	Secure system to protect PT info. Only staff that need access to records or PT charts will. System will keep a log of whom accesses charts and what was accessed.
Registration / PT records	Pt demographics, Payor information,	Create an open encounter once PT is registered. To integrate with the billing system to pull encounters to be billed	Registered PTs for the day will alert provider there Appt is ready. Integrated to scheduling system.	Secure system to protect PT info.
H/R, Payroll will house employee information, benefits, payroll, hiring documents, termination documents.	PT demographics, metrics, benefits, position, performance reviews, PTO, Employee, tax and direct posit information.	The ability to track employee hours, and automatic calculation of pay to included deductions and taxes. Allow for deduction, salaries changes.	The ability to continue and add to employee file, able to complete and process payroll by Wednesday 10am.	Restricted access to H/R employees.

Task 3)

No template provided. Be sure your questionnaire is capturing all of the requirements for appointment scheduling.

I would use a random sampling process. UWG has thousands of patients and random sample would allow for all input. I would set some input to select appropriate date only they guarantee should be pulled and half be insured patients and half be self-pay patients. Random sampling will allow UWG receive unbiases opinions from the patients.

UWG Survey

You have been selected to complete a United Wellness Group survey. With our goal to provide better serve and improve our company process we ask for your feedback. If you could please take some time to complete the questionnaire below and return it in the mail in the enveloped provided by November 1st. Thank you for your continued support and feedback.

Appointment Scheduling

Please answer by selecting one option for each question.

1. On a scale 1 to 5 how easy is it to schedule with UWG? (1 being very easy to 5 being very difficult)

2. Thinking of your most recent appointment where you satisfied with the date and tine provided?

a) Very satisfied

b) Satisfied

c) Somewhat satisfied

d) Dissatisfied

e) Very dissatisfied

3. How do you prefer to make appointments?

a) Phone

b) Online

c) Text

d) Email

4. Did you receive an appointment reminder?

a) Yes

b) No

5. How do you prefer to receive appointment reminders?

a) Phone

b) Text

c) Email

Insurance Procedures

6. Do you currently have insurance coverage?

a) Yes

b) No

7. Before your appointment where you asked to verify your current insurance?

a) Yes

b) No

8. How long after your visit did you receive billing Statement from UWG?

a) 14-30 days

b) 5-8 weeks

c) 9-12 weeks

d) 13-16 weeks

9. Were there any errors on the billing statement?

a) No

b) Yes

If yes, please explain:

Share any other feedback or suggestions you may have: