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Health Management Information Systems

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  1. Health Management Information Systems Administrative, Billing, and Financial Systems Lecture b This material (Comp 6 Unit 9) 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. This material was updated by Normandale Community College, funded under Award Number 90WT0003. This work is licensed under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-sa/4.0/

  2. Administrative, Billing, and Financial SystemsLearning Objectives • Discuss the core elements of a Master Patient Index (MPI) • Describe current trends to establish a Unique Patient Identifier (UPI)

  3. Patient Management and Billing • Systems that support the management of the patient • Example • Patient identification • Supporting technology • Master patient index

  4. Master Patient Index (MPI) • Centerpiece for all subsequent functionality and software applications • Links to the patient health record • Links to scheduling for appointments, reporting lab, x-ray, pharmacy, patient-related images

  5. Master Patient Index (MPI) AHIMA definition “A patient-identifying directory referencing all patients related to an organization and which also serves as a link to the patient record or information, facilitates patient identification, and assists in maintaining a longitudinal patient record from birth to death”

  6. Purpose of the MPI • Provides the index, location of, and access to a patient’s EHR in an enterprise • Facilitates intraoperability and the accurate creation of a longitudinal record • Ensures accurate and complete linking of EHRs for HIE

  7. Purpose of the MPI • Establishes a streamlined governance process • Accurately matches persons being registered for care with their existing medical records

  8. Core Elements of an MPI • Internal patient identification • Person name • Date of birth • Gender • Race • Ethnicity

  9. Core Elements of a MPI • Address • Telephone number • Alias/previous/maiden names • Social security number • Facility identification • Universal patient identifier (UPI) • Account/visit number

  10. Core Elements of an MPI • Admission/encounter/visit date • Discharge or departure date • Encounter/service type • Encounter/service location • Encounter primary physician • Patient disposition

  11. Unique Patient Identifier (UPI) • Value permanently assigned to an individual for identification purposes • Unique across the entire national health care system • Not shared with any other individual

  12. Functions a UPI Must Support • Identification of an individual • Identification of information • Accurate identification functions • Reduce health care operational cost and enhance the health status of the nation

  13. Current Trends to Establish a UPI • HIPAA • Requires unique identification numbers • UPI has not been adopted • ONC’s Health Information Technology Standards Committee (HITSC) • Patient Matching Power Team • Recommendations

  14. Administrative, Billing, and Financial Systems Summary • Applications that need to be integrated in health care information systems; • Strategies used by health care organizations to ensure integration of functions; • Critical elements needed to integrate billing, financial, and clinical systems; • Core elements of a Master Patient Index (MPI)

  15. Administrative, Billing, and Financial Systems References – Lecture b References AHIMA. (2010a, September). Fundamentals for building a Master Patient Index/Enterprise Master Patient Index (Updated) Journal of AHIMA, 81(4), 52-57. Retrieved from http://library.ahima.org/xpedio/groups/public/documents/ahima/bok1_048389.hcsp?dDocName=bok1_048389 AHIMA. (2010b, September). Fundamentals for Building a Master Patient Index/Enterprise Master Patient Index (Updated): Appendix A Recommended core data elements for EMPIs. Journal of AHIMA, 81(4), 52-57. Retrieved from http://library.ahima.org/xpedio/groups/public/documents/ahima/bok1_048390.hcsp?dDocName=bok1_048390 American Health Information Management Association. (2012). Pocket glossary for health information management and technology (3rd ed.). Chicago, IL: Author. Healthcare Information and Management Systems Society (HIMSS). (2010). HIMSS dictionary of healthcare information technology terms, acronyms and organizations (2rd ed.). Chicago, IL: Author. Health Information Technology Standards Committee (HITSC). 2011. Patient matching power team recommendations. http://healthit.hhs.gov/portal/server.pt/gateway/PTARGS_0_12811_955311_0_0_18/08_17_11_Patient_Matching_PT_Recomm.pdf National Committee on Vital and Health Statistics. (1997). Part three: Unique patient identifier. Retrieved from http://ncvhs.hhs.gov/app3.htm#Part3

  16. Administrative, Billing, and Financial SystemsLecture b This material 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. This material was updated by Normandale Community College, funded under Award Number 90WT0003.