Factors Considered by HMA When We Develop an Integrated Health Evaluation Data Management System (IHDMS)

1. Factors Considered by HMA When We Develop an Integrated Health Evaluation Data Management System (IHDMS) David Chenoweth, Ph.D., FAWHP President, Chenoweth & Associates, Inc. 128 St. Andrew’s Circle New Bern, North Carolina 28562-2907 (252) 636-3241 Copyright, Chenoweth & Associates, inc.

2. Integrated Health and Evaluation Data Management System What is an IHDMS? “Group of health-related databases linked by software that can identify specific types of data from individual databases to determine relationships between and among the data.” Typical Databases Found in Business & Industry • Personnel records • Inpatient health care claims • Safety/accidents records • Health promotion participation • Chemical exposure • Disability (workers’ comp) • Employee Assistance Program • Occupational exams • Health risk appraisal data • Employee medical records • Demographic profiles • Outpatient health care claims • Productivity

3. Major Categories of Factors Health Mgmt Goals Administrative & Logistical Personnel Policies Types of Data Legal & Ethical Vendors Financial

4. Developing & Implementing anIntegrated Health Data Management System IHDMS Identify a list of people who can benefit from IHDMS, benefits manager, human resources, nurse, safety, rehab/case mgmt., health promotion, etc. Visualize what an IHDMS can do for the organization; establish a simple definition of IHDMS that can be conveyed to key decision-makers. A. Conceptualization Determine what an IHDMS can do for the organization that isnt’ being done now. Review the corporate mission statement, short-term, and long-term business plan. Identify strengths and how an IHDMS would enhance them; identify weaknesses and show how an IHDMS would minimize or eliminate them. B. Assessment Assess organization’s ability to develop an IHDMS: • Identify existing in-house databases and networks • Identify databases maintained by outside firms • Identify inhouse personnel interested in an IHDMS Assess the business environment and geographic location(s) to determine the feasibility and specificity of an IHDMS; for example, shift to managed care, aging workforce, benefits restructuring, etc.

5. Developing & Implementing aIHDMS Consider all in-house databases and solicit input from all users; identify each user’s needs and formulate a list of common denominators. Prioritize needs and subject them to specific feasibility criteria, i.e., cost, number of beneficiaries, developmental time, corporate-wide application, etc. C. Prioritization Assess outside* database functions, data value, and vendor’s ability to collaborate with organiz. D. Organizational Structure Prepare a preliminary proposal for a recommended IHDMS structure; submit to inhouse staff only for feedback. Check proposed structure against corporate mission statement, short-term, and long-term cost-management plans for next 3-5 years. Based on preceding findings, revise initial proposal accordingly and develop a structure that meets all designated criteria. *Third party administrators, insurers, MCOs, etc.

6. Developing & Implementing anIntegrated Health Data Management System IHDMS How IHDMS will be used by current database users and potential users if new programs are planned or downsizing leads to greater workloads. Involve key personnel to decide : • IHDMS Goal • IHDMS Objectives & timeframe • Specialists needed E. Data Strategy Consider the feasibility, practicality, and comparative cost of developing an inhouse centralized IHDMS vs. small modifications in the current arrangement. Compare costs to expected benefits using: * benefit- cost analysis * Costs as % of client’s current benefits budget Estimate implementation costs and additional database maintenance costs. • Hardware • Software • Consultants • Staff time • Management Time

7. Developing & Implementing anIHDMS Determine evaluation protocols: • What variables(outcomes) will be measured? • What timeframe will be used? • Who will perform evaluation? • What measures will reflect progress? • How will outcomes be quantified, i.e., time savings, earlier diagnostic findings, interdepartmental efficiencies. less dependence on outside vendors, etc.? F. Outcome Planning Do a Beta trial: subject a common health problem to different hypotheses and check for inter-database capabilities. G. Pre-Operational Testing Establish protocols: • Report formats • Specific report requests • Personnel access • Technology implications

8. Integrated Health Data Management Third Party Administrator Company Locations Site-Specific Data Group Data In-House Microcomputer at Headquarters Electronic Data Interchange* Medical Benefits Safety Wellness H.R. Personnel * Permits multiple functions between various databases to occur, i.e., what percentage of 30-35 year olds have recently filed a workers’ compensation claim.

9. Identify External Health Claims DataAdministrators & Internal Data Recipients M.D./P.T., Chiropractor, etc. Employees use health care services from various providers Hospital HMO Diagnostic Related Groups CPTs (procedures) Company Third Party [claims] Administrator (TPA) Insurer • Human Resources • Benefits • Personnel Group Reports (semi-annual/ annual) • Major Diagnostic Categories • ICDs • DRGs