HM311

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Introduction to Information Systems
for Health Information Technology
Chapter 7: Administrative Information Systems
© 2020 American Health Information Management
Association

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Learning Objectives
Determine what administrative information system is needed for a
particular task
Differentiate among the administrative information systems
Differentiate between a decision support system and an executive
information system
Describe how administrative systems impact health information
management practices

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Introduction
Administrative information systems manage the business of
healthcare
• The first information systems used in healthcare
• Data collected are mainly financial/business-oriented, rather than clinical

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Administrative Information Systems, 1
Hospital information system (H I S): Major information system
used by a healthcare facility, is made up of many administrative
systems, such as the financial information system and the MPI
Financial information system
Human resources information system (H R I S)
Decision support system (DSS)
Master patient index (MPI)

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Administrative Information Systems, 2
Patient registration system
Scheduling system
Practice management system
Materials management system
Facilities management system

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Financial Information System, 1
Critical to fiscal health of the healthcare facility
Healthcare facility must receive accurate financial information in a
timely manner to monitor and manage finances of healthcare facility
Information can be used to plan and control expenses of day-to-day
operations and long-term investments

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Revenue Cycle Management (RCM)
Revenue cycle: Very complex process involving several
departments and many employees who perform:
• Reviewing services provided for claims submitted
• Reviewing outstanding claims
• Returned claims
• Denials
• Missing accounts
• Bill holds
• Other claims involving the revenue of the healthcare facility

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Financial Information System, 2
Includes functions related to:
• Patient accounting
• Accounts receivable
• Accounts payable
• General ledger
• Investment management
• Contract management
• Payroll
• Billing and claims management

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Chargemaster, 1
A financial management software that contains information about the
healthcare facility’s charges for the services it provides to patients
Also called a charge description master (CDM)

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Chargemaster, 2
Chargemaster has such an impact on the healthcare facility, periodic
updates are required
Classification system codes must be updated annually
H I M professionals must ensure chargemaster updates are
completed annually by healthcare facility’s information systems (I S)
department when software updates are received

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Diagnostic and Procedural Coding
Coding professional staff will populate diagnosis and procedure
codes either through direct data entry or from an interface to an
encoder
H I M and coding staff have always played an integral part in the
financial viability of the healthcare facility

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Clinical Documentation Improvement (CDI)
Process an organization undertakes that will improve clinical
specificity and documentation that allows coding professionals to
assign more concise disease and procedural classification codes
Quality of documentation is vital to properly evaluate patient care,
meet regulatory requirements, and obtain appropriate amount of
reimbursement

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Human Resources Information System (H R I S)
Healthcare facilities require many staff members to operate
Many healthcare facilities operate 24 hours a day, 7 days a week
Because of staffing requirements, payroll expenses make up large
part of the operating budget

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H R I S Functionality
Tracks employees within the healthcare facility, including:
• Promotions
• Transfers
• Terminations
• Performance appraisal due dates
• Absenteeism

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H R I S Data Elements, 1
Data elements collected
• Employee name
• Employee number
• Department
• Title
• Salary
• Benefit information

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H R I S Data Elements, 2
• Hire date
• Results of performance appraisal
• Previous titles
• Termination date
• Certifications
• Disciplinary actions
• Eligibility for rehire

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H R I S Reporting, 1
Track items such as:
• Turnover rate
• Open positions
• Labor costs
• Benefits
• Budget
• Overtime
• Employee satisfaction and report on findings of surveys

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H R I S Reporting, 2
Track mandated classes/training for all employees that require
annual attendance:
• CPR
• Fire and safety
• OSHA standards
• Privacy and security

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Decision Support System (DSS), 1
An information system that gathers data from variety of sources and
assists in providing structure to data
• Using various analytical models
• Visual tools
• Facilitate and improve the ultimate outcome in decision-making tasks
associated with the nonroutine and nonrepetitive problems

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Decision Support System (DSS), 2
Utilizes the data in data repositories and data warehouses
Runs analyses such as “what if” scenarios

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Decision Support System (DSS), 3
Executive information system (E I S): A type of decision support
system that is designed to be used by healthcare administrators
Must be easy to use and have access to a wide range of data
• Internal data
• External data

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Enterprise Information System (E I S) Advantages
Improved competitiveness of the healthcare facility
Knowledge of how the healthcare facility works
Making information available to authorized users throughout the
healthcare facility
Assistance in making strategic decisions about the healthcare facility

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Enterprise Information System (E I S)
Dashboard:
• report gives administration-structured information to make intelligent decisions
for the future
• view detailed data by types of graphs that are selected, depending on the
software used
• data from E I S planning tool is a visual representation to administration of
where the problem is greatest and where the priority should be focused

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Master Patient Index (MPI), 1
Part of H I S
Patient-identifying directory, referencing all patients related to a
healthcare facility
Serves as link to patient health record or information
Facilitates patient identification

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Master Patient Index (MPI), 2
Assists in maintaining a longitudinal patient record from birth to
death
MPI identifies every patient who has been admitted to the healthcare
facility
Key to locating all patient health records

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Master Patient Index (MPI), 3
MPI to be kept permanently, as mandated by legal statutes
Include both demographic data and visit-specific information
MPI is a database of every patient visit from the opening of the
healthcare facility’s doors

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Master Patient Index (MPI), 4
Soundex: Phonetics-based indexing
Overlays
Duplicates
Could be hundreds or thousands of patient visits depending on age
of healthcare facility (when it began treating patients)

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Enterprise Master Patient Index (E M P I), 1
Integrated delivery systems (I D Ss) typically have an enterprise
master patient index (E M P I)
• I D S: An organizational arrangement of a network of health providers that
provide coordinated services along the continuum of care from ambulatory,
acute, and long-term care
• May include hospitals, physicians, and health maintenance organizations (HMOs)
• May extend across a geographical region

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Enterprise Master Patient Index (E M P I), 2
Provides access to multiple repositories of information from
overlapping patient populations that are maintained in separate
information systems and databases through out the related network
of I D Ss

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MPI/E M P I Impact on H I M
H I M department is a key user of the E M P I
• Look up health record numbers
• Identify discharge dates
• Confirm that the health record contains all patient visits
• Look up when the patient was last seen in the healthcare facility
• Merge duplicate health record numbers
• Correct errors in data entry
• Unmerge overlays: when one patient’s record is overwritten by another patient
record; these records must then be separated into their original files

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Patient Registration (Registration—Admission, Discharge,
Transfer)
Frequently known as R-A D T
Reports include:
• Daily admission list
• Discharge list
• Used by H I M to confirm all discharged records are in department for processing
• Census report
• Transfer list
• Bed utilization reports

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Scheduling System
Controls use of resources throughout the healthcare facility
• Includes staff, equipment, rooms, etc.
May be centralized or independent
• Centralized: Allows scheduling of all services
• One call can make multiple appointments
• Decentralized: Utilizes scheduling features of individual systems in each
department
• Requires calls to multiple locations to schedule multiple tests

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Practice Management System, 1
Used by physician practices
• Scheduling
• Patient accounting
• Patient collections
• Claims submission
• Appointment scheduling
• Human resources
• Other functions all are built into this single information system

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Practice Management System, 2
H I M professionals in physician office manager roles will utilize the
practice management information system in
• Financial information system
• Master patient index
• Other administrative systems
• Chargemaster management
• Entering codes for billing
• Reporting
• Tracking patient visits

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Materials Management System
Healthcare facilities manage a large amount of equipment and
supplies
Typically automates
• Purchasing process
• Inventory control
• Menu planning
• Food service

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Materials Management System Functions, 1
Create requisitions
Gain the necessary approvals for the purchases
Comparing the purchase to budget to ensure that necessary funds
are available
Automatically order supplies and equipment based on
predetermined thresholds for inventory supplies

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Materials Management System Functions, 2
Generate bar codes to be applied toward supplies to be used and
charged to the patient correctly
Dietary component of materials management system tracks the
patient’s dietary needs, healthcare facility’s food inventory, and food
costs

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Facilities Management System
Physical plant requires constant maintenance and upgrades
• Building structure
• Surrounding grounds
• Parking lots/decks
• Building equipment, such as elevators
Facilities management system is used by a healthcare facility to
manage all aspects the physical plant

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Facilities Management System Functions, 1
Track routine maintenance:
• Elevator inspections
• Fire extinguisher inspections
• Equipment preventive maintenance
• Filter changes
• Inspection of electrical cables
• Other tasks
Preventive maintenance will save the healthcare facility money
• Enables equipment to last longer

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Facilities Management System Functions, 2
H V A C system temperature can be controlled
• Healthcare facility more energy efficient
• Saves money
Doors can be locked and unlocked automatically at a prescheduled
time
Employees can be given/denied access to restricted areas