Databases in a Healthcare Setting
this task, you will use a scenario and hypothetical data in a spreadsheet to identify and analyze trends from a healthcare setting. You will also create a memo that summarizes all your findings.
The purpose of this task is to recognize the impact of healthcare IT systems on healthcare infrastructure and to examine healthcare information systems and the role healthcare information systems have in converting data to organizational knowledge.
SCENARIO
Management of the health information management (HIM) department at Felder Hospital is requesting a report on records waiting to be dropped from the discharge not final billed (DNFB). These patient accounts cannot be coded and billed due to delinquencies like missing reports, missing signatures, or outstanding physician queries. The CFO is regularly asking the HIM director why records are outstanding on the DNFB report. HIM management needs this information to share with the CFO to show that a certain number of the records are waiting for physician documentation. The report will include patient demographics, payor types, reimbursement amount, number of days since discharge, clinical specialty, whether the patient was a readmit, and attending physician.
A HIM systems analyst 1 has pulled the relevant data into the attached “Records Waiting to be Dropped from DNFB” spreadsheet from the EHR and used this data to identify several different trends regarding payor type, hospital unit, and physician.
REQUIREMENTS
Your submission must be your original work. No more than a combined total of 30% of the submission and no more than a 10% match to any one individual source can be directly quoted or closely paraphrased from sources, even if cited correctly. The originality report that is provided when you submit your task can be used as a guide.
You must use the rubric to direct the creation of your submission because it provides detailed criteria that will be used to evaluate your work. Each requirement below may be evaluated by more than one rubric aspect. The rubric aspect titles may contain hyperlinks to relevant portions of the course.
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A. Refer to the attached “Records Waiting to be Dropped from DNFB” spreadsheet and use a data sort to do the following:
1. Describe a trend related to the health information management (HIM) department.
2. Identify the two physicians with the highest pending dollar amount.
3. Explain the relationship between readmits and diagnosis codes.
4. Analyze the financial impact that the findings from parts A1, A2, and A3 have on the hospital.
B. Create a memo addressed to the CFO that summarizes your findings from parts A1, A2, and A3.
C. Acknowledge sources, using APA-formatted in-text citations and references, for content that is quoted, paraphrased, or summarized.
D. Demonstrate professional communication in the content and presentation of your submission.
Introduction to Healthcare IT Systems-MUM1: Databases in a Healthcare Setting
Name
Course
Instructor
Institution
Date
A. DNFB Data
A.1 Trend related to the health information management (HIM) department (if the cardiology department is experiencing patient’s returning more often within a 30 day period, what would you advise the physicians to? The actual diagnosis codes can be listed instead of the alphabets)
There are many readmits in the cardiology department, where twelve had been readmitted. There are a total of 70 patients under the billable ICD coding the primary diagnosis for nephrology is “R” and sometimes “N.” In contrast, the primary diagnosis for neurology is “G.”. In the pediatrics department, it is“P” or sometimes “Q,” while in cardiology it is mainly “I” or “E” and “T.”. For the obstetrics department, this was O or N and “D.” The most significant cases of primary diagnosis were in cardiology, with 25 issues. There was only one case under the VA payor type compared to 15 Medicaid cases. As there are many readmissions in the cardiology department, there is a need to evaluate the risk factors for hospital admission. Additionally, increasing the number of staff and resources in cardiology may help to promote better quality care.
Nephrology
C66.1
N17.9
E08.21
R31.9
R31.0
Neurology
G61.0
G00.9
G46.3
G61.0
A17.81
E08.40
E09.40
I67.9
Cardiology
E08.52
I11.0
I22.1
I23.1
I23.6
I30.9
I33.0
I33.9
I44.39
I46.2
I46.9
I50.22
Q20.5
Q21.9
T82.110A
A.2 Highest pending dollar amount
The highest pending dollar amount was in the cardiology department at $991,745.59. The next highest is also cardiology department, at $768,274.87. The primary diagnosis in the latter case was I23.6, which is “thrombosis of atrium, auricular appendage, and ventricle as current complications following acute myocardial infarction (WHO, 2021). The high pending dollar amount increases the operating costs and volatility in revenue. Emergency visits can raiseprices, with patients facing higher out-of-pocket expenses than expected, including hidden costs (Kliff, 2019). The high pending amounts also indicate constant medical attention and specialized care among patients with cardiovascular issues.
A.3 Readmits and diagnosis codes(name the codes with the descriptions)
The severity of diagnosis affects the likelihood of being readmitted, and the cardiology cases were more likely to be readmitted since cardiology issues tend to be severed. On the other hand, if someone is diagnosed with fewer severe cases and detected early, they are less likely to be readmitted. Out of less than 30 readmits, 52 were “no,” and 18 were “yes,” For patients in the cardiology department, 12 reported less than 30 readmits out of the 18 cases. However, but 13 did not say in the cardiology department. There were less than 30 readmissions for E08.40 (diagnosis for reimbursement purpose), G61.0, I21.9, I22.1, I23.1, I23.6, I33.9, I46.8, I46.9, I50.22, I51.2, N70.12, P07.31, P07.32, R31.9 and T82.110A (breakdown or mechanical of cardiac electrode). There was one case each where there were less than 30 admissions in the nephrology and obstetrics departments compared to two points in the neurology department and two instances in the pediatrics department.
A.4.The financial impact of the findings on the hospital
Cardiologists should be the attending physician for the patients who are readmitted. Cardiovascular complications and symptoms increase the risk of cardiology readmission; attending physicians were cardiologists (Kundu et al., 2016). Therefore, the hospital will gain more if there are more cardiac readmission patients. Some cardiac patients tend to be readmitted for preventable heart failure (HF), but in reality, there is a possibility of more patients being readmitted. Since the cardiology department has the most significant number of patients readmitted, the department will bring in more revenue.
Abboud had a spending dollar amount of $991,745.59, while Carpenter requires $768,274.87, and they both care for pat...