Healthcare Operations

Medical IT System Types

Departmental System – serves only one department or domain

Hospital-wide System – bring together systems of all departments

Enterprise System – brings together multiple providers and locations

External System – shared by multiple organizations to report data to regulatory agencies or for regional health networks

 

IT Project Management

Project Managers:

  • Do review staff performance
  • Do set schedules
  • Do allocate resources
  • Do NOT set your pay rate

 

Work Types

Parallel: each worker does several tasks

Serial: each worker does a variety of tasks in a workflow

Unit Assembly: each worker does a single task, but not necessarily in an ordered workflow.

Unilateral: NOT a real work type, but a red herring

 

Organization Hierarchy

BOD

President

Staffing Coordinator

Billing Coordinator

Office Manager

Staff

 

Methods of Operation

Customs and practices used to achieve the goal of the organization

Scope of Work

The tasks involved in accomplishing goals.

Resource Types

Financial resources, including third-party payers like insurance or the government

Human resources

 

Payments

Provider Type is the service or occupation group of the practitioner.

Customary Charges are the “normal” or reasonable charges usually applied.

Sliding Scale fees, on the other hand, are based on the patient’s ability to pay.

Fee for Service is essentially payment for treatment, rather than payment by diagnosis

Capitulation is the rate charged “per capita” – per individual – in a group plan. Formally, it’s the monthly payment an insurance company sends to a provider as set by an annual capitation contract. The services a patient uses do not determine capitation payments (at least in this year’s contract).

An Indemnity Plan enables the insured to visit any doctor or facility and direct his own care.

A Point of Service plan allows the patient to choose a provider each time healthcare service is required.

 

The Patient Admission Process

This is Registration or Admitting, but it is NOT Intake!

Name, address, contacts, insurance info, next of kin, allergies, medications, prior conditions, etc.

 

Order of Operations

Procedure or service

Dictation of record

Transcription

Coding

Billing

 

Budgets

Operating Budge – forecasts the costs of operations, for instance employees, supplies and leases

Statistical Budget – forecasts future volume of operations by analyzing statistical/historical data

Master Budget – brings together the budgets for all business or operating units

Organizational Budget – perhaps a real thing in other contexts, but a red herring here

 

Planning Chart Types

Gantt Chart – horizontal lines

Venn Diagram – a red herring – a mathematical diagram representing all possible relations between finite data sets

PERT Diagram – a sequence represented by circles connected by lines

Critical Path –

 

Bedside Medication Verification

  1. Scan patient wristband,
  2. medication barcode, and
  3. staff ID

 

Preventive Services

  • Wellness visits
  • Screening diagnostics
  • Routine checkups

 

Filing Systems

Motorized revolving files: for very limited space in low-volume offices with one file clerk. Expensive to buy and maintain.

Filing cabinets with drawers: for small, low-volume facilities. Lockable/fireproof but big.

Compressible units with open files: for limited-space, medium-volume operations with 2-3 file clerks.

Open shelf files: for high-volume operations in which the presence of multiple filing staff provides (some) security. Less secure and bulky but fast.

Thinning is reducing a patient’s physical file for ease of handling. Excess papers are sent to be archived.

 

Document Management

Device Capture – transmitting info directly from a medical device such as an echocardiogram

Document Archiving – ensuring documents in a medical record are stored securely and for an appropriate period

Document Imaging – scanning and indexing paper documents into an electronic system

Clinical Imaging – info in photographs or other imaging devices

 

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