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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.

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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.

integrated health and evaluation data management system
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
major categories of factors
Major Categories of Factors

Health Mgmt

Goals

Administrative

& Logistical

Personnel

Policies

Types

of

Data

Legal

& Ethical

Vendors

Financial

developing implementing an integrated health da t a management system ihdms

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.

developing implementing a ihdms

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.

developing implementing an integrated health data management system ihdms

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

developing implementing an ihdms

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

integrated health data management
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.

identify external health claims data administrators internal data recipients
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