Teaching Notes:
Have students define all key terms as an assignment. Then, in class, ask each student to define one key term aloud.
Optional assignment: Have students do an Internet search of one key term and write a short paragraph describing what they learned about that term from looking at a few websites.
Teaching Notes:
Have students define all key terms as an assignment. Then, in class, ask each student to define one key term aloud.
Optional assignment: Have students do an Internet search of one key term and write a short paragraph describing what they learned about that term from looking at a few websites.
Learning Outcome: 2.1 Describe the functions of practice management programs.
Pages: 28-32
Teaching Notes:
AHIMA is one of the groups that sets standards for management of HIT. http://www.ahima.org/ American Health Information Management Association.
Learning Outcome: 2.1 Describe the functions of practice management programs.
Pages: 28-32
Teaching Notes:
Many offices now use Electronic Medical Records which merge the front office computer software with the patient treatment information. Stress that an EMR is different from a PMP. If an office has used a PMP, then goes from paper to EMR, the person supervising the change must make sure that the two programs can communicate with each other.
Medisoft is a PMP. It is actually used in physician’s offices in the real world. Using a PMP helps save time and eliminate errors.
Large corporations usually use the same PMP throughout their system as well as tying that PMP to the computers in the hospital. This allows the physician to access information from hospital admissions.
Scheduling is easier, patient information input has less errors. Claims are submitted faster and money received faster. Patients account are easy to track. Financial reports can be pulled to justify purchases, staffing etc.
Learning Outcome: 2.1 Describe the functions of practice management programs.
Pages: 28-32
Teaching Notes:
There is a charge for handling practice management services. There are several companies that a practice can choose. Clearinghouses standardize claims and perform a detailed edit of the information making sure a claim is “clean,” meaning it is free of errors and has no missing information. This facilitates expedited payment from the insurance company.
A report, the audit/edit is sent to back to the practice stating the claim is either clean and it will be forwarded to the insurance company or that it contains errors and those errors are identified so the practice can correct them. Once corrected, the claim must be resent to the clearinghouse to be reviewed again.
Learning Outcome: 2.1 Describe the functions of practice management programs.
Pages: 28-32
Teaching Notes:
Although most offices file insurance for patients, they still need a walkout receipt. They may participate in a flexible spending plan and want to get reimbursed for their copay and/or coinsurance.
Autoposting saves time but the RA still needs to be reviewed to identify payments that are not as expected.
Learning Outcome: 2.2 Identify the core functions of an electronic health record system.
Pages: 32-38
Teaching Notes:
EMR’s are different from a PMP. They can include information from other places where the patient has been seen, such as laboratories, hospitals, pharmacies etc. A lot of hospitals now use hospitalists to take care of patients when they are admitted to the hospital instead of the patient’s primary physician. EMR’s allow the patient’s personal physician to access the information from a hospital visit when the patient is in the office for a follow-up appointment.
PHR’s are the information contained in the EMR. This is the information that you must have permission to release from the patient. Information comes from multiple providers and facilities.
Electronic prescribing is part of order management. It also helps save time and increase accuracy.
Learning Outcome: 2.2 Identify the core functions of an electronic health record system.
Pages: 32-38
Teaching Notes:
The following EHR functions are suggested by the Institute of Medicine
Key Data-Problem List, procedures, medication lists, allergies, medication list, allergies, demographics, diagnostic test results, health maintenance, advance directives. Clinical and Patient Narrative-signs and symptoms, diagnosis, procedures, level of service, treatment plan.
Results reporting, results notification, multiple views of data/presentation, multimedia support (images, scanned documents)
Computerized provider order entry(CPOE)-electronic prescribing, laboratory, pathology, x-rays, consultations
Access to knowledge sources, drug alerts, reminders, clinical guidelines and pathways, chronic disease management, clinician work list, diagnostic decision support, use of epidermiologic data, automated real-time surveilance
Provider-provider, team coordination, patient-provider, medical devices external partners (pharmacy, insurer, laboratory, radiology) integrated medical record (within setting, across settings, inpatient-outpatient
Patient education (access to patient education materials), family and informal caregiver education, data entered by patient, family, and/or informal caregiver (home monitoring, questionnaires)
Scheduling management (appointments, admissions, surgery and other procedures), eligibility determination (insurance, clinical trials, drug recalls, chronic disease management)
Patient safety and quality reporting, public health reporting, disease registries.
Learning Outcome: 2.3 Discuss the advantages of electronic health records.
Pages: 39-41
Teaching Notes:
Safety: medication and physician orders (illegible handwriting), electronic alerts allergies and drug reactions, alerts to physicians, record preservation, timely communication of information
Quality: reminders for patients for preventative care and screenings, patients w/chronic illnesses can monitor from home via internet
Efficiency: retrieval of information is immediate--essential in critical care situations, also increases efficiency of workflow, refilling of prescriptions, receiving payments, organization of the record and prevents loss of records.
Learning Outcome: 2.3 Discuss the advantages of electronic health records.
Pages: 39-41
Teaching Notes:
EHR’s facilitate evidence-based medicine by allowing physicians to share information quickly
HITECH is part of the American Reinvestment and Recovery Act of 2009, provider must show “meaningful use” of the EHR to qualify for the incentives.
Learning Outcome: 2.4 Describe the impact of health information technology on documentation and coding.
Pages: 41-44
Teaching Notes:
Electronic workflow is most efficient when the PMP and EHR being integrated in an office can easily exchange data with each other. It is always the goal to increase office efficiency.
Computer-assisted coding: Some programs assign codes based on keywords in a template, others analyze words, phrases, and sentences in the electronic documentation. They still need to be reviewed for accuracy before filing the claim.
Learning Outcome: 2.4 Describe the impact of health information technology on documentation and coding.
Pages: 41-44
Teaching Notes:
Discuss the importance of accuracy and compliance in documentation and coding.
Learning Outcome: 2.5 Discuss how the HIPAA Privacy Rule and Security Rule protect patient health information.
Pages: 44-51
Teaching Notes:
Have students discuss scenarios that might compromise HIPAA privacy rules.
Examples: Talking to friends about patients, talking on the phone to a patient within earshot of other patients.
Learning Outcome: 2.5 Discuss how the HIPAA Privacy Rule and Security Rule protect patient health information.
Pages: 44-51
Teaching Notes:
HIPAA Electronic Transaction and Code Sets Standards: Purpose is to reduce administrative costs and complexities by requiring use of standardized electronic formats for transmission of data.
EDI involves sending information from computer to computer using publicly available communications protocols.
EFT puts money directly into a designated bank account
Learning Outcome: 2.5 Discuss how the HIPAA Privacy Rule and Security Rule protect patient health information.
Pages: 44-51
Teaching Notes:
Claim formats
837P professional claim
CMS 1500- some small offices are exempt from HIPAA requirement to send electronic claims so they use this paper form
NPI-any individual or health care provider must have an NPI
Learning Outcome: 2.5 Discuss how the HIPAA Privacy Rule and Security Rule protect patient health information.
Pages: 44-51
Teaching Notes:
Covered entities (health plans, health care clearinghouses, and health care providers and their businesses associates) must follow all rules.
-adopt a set of privacy practices
-notify patients about their privacy rights
-train employees so they understand privacy practices
-appoint a staff member to be privacy official
-secure patient records
Learning Outcome: 2.5 Discuss how the HIPAA Privacy Rule and Security Rule protect patient health information.
Pages: 44-51
Teaching Notes:
3 categories of security standards
Administrative is assigned to one person
Physical threats include hackers, disgruntled employees, or angry patients. Unauthorized intrusion is access by individuals who do not have a “need to know”
Technical access is granted on a “need to know” basis. Passwords are designed to allow customized access.
Learning Outcome: 2.5 Discuss how the HIPAA Privacy Rule and Security Rule protect patient health information.
Pages: 44-51
Teaching Notes:
HIPAA enacted 1996
While the proliferation of health information networks provide many points of access to patient information, it also increases the possibility of unauthorized access.
Learning Outcome: 2.6 Explain how the measures put in place by the HITECH Act strengthen HIPAA privacy and security requirements.
Page: 51
Teaching Notes:
Breach notification: Requires notification of patients by covered entities of any breach of information. Also must notify the federal government and the media
Monetary penalities: Penalities for breaches ranging from $100-$50,000
Advanced enforcement: Office of Civil Rights is required to conduct audits to ensure compliance with HIPAA rules