[email protected] Patient Management Systems Team Sherrie Szekalski Director Thank you for spending your lunch time learning about the Patient Management Systems team! What I’ve been ask to tell you: Function of my team The projects we support Where we fit within the Hopkins Institutions Types of positions in the group Qualifications required for positions in the group Pictures, with names, of group members Patient Management Systems Team Mission We support JHH systems for: • • • • • • • • • Patient Identification Outpatient Scheduling and Registration Admitting Bed Management Document Image Capture Hospital Billing and Coding Self-service Kiosks Denials and Appeals Executive Information Integrated Patient Experience Pre-visit Forms – other forms – Med List Appointment On-going Communications between patient and physician, office, and hospital services Pre- Registration Pre-service Instructions Education – Require Sequence of Tests Request and Scheduling Day of appointment Patient checks in Patient - Hospital Check-in Self Registration Office Visit Check-in Examination Lab Draw Clinical Data Collection – On-line Dictation Hospital Services Requested – Scheduled or unscheduled Results to Patient Virtual patient Radiology Exam List – Active Surgery Patients Lab Draw Exception Clinical Data Reporting – Collection – Results On-line Other? Dictation Hospital Staff Virtual Patient List – incoming patients Pre-scrub data Verify Sequences Manage Resources On-line Order Form Completed and Forwarded So … who we think we are… Who we really are… We juggle projects and priorities And…. We connect systems to share data And… We communicate, communicate, communicate What is Patient Identification? • Selecting the right patient ensures patient safety: – Identifying the right patients allows the clinicians to pull the correct medical history – A sophisticated search algorithm is used to search through 4.5 million patient records. – Linking patients across Johns Hopkins Medicine will allow for retrieval of medical history across the JHM family. • Systems: – Quadramed – a vendor application which provides the searching algorithms – PID - a “homegrown” application which assigns the patient’s medical record number What is Outpatient Scheduling and Registration? • Schedules a patient with the right department and care provider in the desired time slot • Captures registration information to prepare the clinician for seeing the patient • Captures important insurance information to ensure that the services are successfully billed • System: Epic What is Admitting? • Captures information for patients admitted to the Hospital: – Demographic information - who is this patient, where do they live? – Insurance information – who will we bill for this Hospital visit? – Where is the patient located in the Hospital? • Systems: – SMS ADT is currently in use – Keane ADT will replace SMS ADT in July, 2010 What is Bed Management? • Captures information for all patients currently admitted to the Hospital: – Who is in each bed in the Hospital? • Allows patients to be transferred to another clinical service or bed. • Provides a discharge function for when the patient leaves the Hospital. • Provides a Hospital-wide view of current occupancy to plan for incoming patients. • System: EBB – a “homegrown” system What is Document Image Capture? • Captures scanned documents: – For outpatients – picture ID, insurance card, referral form – For inpatients – pre-admission test information from other providers – For other business functions, including HR, Accounts Payable, and the Executive Offices. • Patient data is integrated with the EPR for access by clinicians • System: Documentum AX. System is also known as WebX, EDMS, Legato, and OTG. What is Hospital Billing and Coding? • Produces bills for Hospital services for: – Insurance companies – Patients • Tracks the Accounts Receivables for JHH • Processes payments from insurance and patients • Codes the services provided to using national standards – ICD-9, DRG, CPT-4 – For billing to insurance – For regulatory reporting • Systems: – Keane is used for Hospital Billing – HDM is used for coding What is the Self-service Kiosk? • Allows patients to: – – – – – electronically check-in in a clinic upon arrival review and change demographic information review insurance information scan insurance cards and referral forms review and accept the outpatient agreement form • System: Vecna What is Denials and Appeals? • Tracks: – Payor denials for payment – JHH appeals to payors in response to denials – Medicare audits to verify medical necessity for treatments provided to patients • System: Morrisey What is the Executive Information System? • Provides access to consolidated financial, administrative and clinical data for decision support. • System: TSI Org Chart Director Sherrie Szekalski Staff Assistant Pam Thompson Manager Tony Greico Manager Walt Frizzell Project Lead Kathy Gonano Project Lead Pam Mioduszewski Positions in our team Programmer Analyst • • • Work requires an understanding of a variety of technical skills, based on the vendor or homegrown system supported. Some of these skills include MS SQL, Oracle, Visual Basic, Cobol, CICS, Mumps. Work also requires analytical ability to study a problem, and create a specification document for a solution. There are four levels to this position: – – – – • Programmer Analyst A Programmed Analyst B Programmer Analyst C Programmer Analyst D Educational and experience requirements increase with each level of position. Project Leader • Responsible for coordinating, and providing experienced leadership to software projects from planning to implementation of various departmental or enterprise wide applications. Bachelors Degree + 5-7 years experience. • Project Coordinator • Assists with special projects and project budgets. Also performs administrative tasks. Tony’s Team Tony Greico Diana Knight Project Leader Keane and SMS Keane and SMS ADT Team: Bob Horst Linda Anakaraonye Michelle Moore Sandy Webster Tony’s Team Tony Greico Harold Felinton TSI Analyst EBB Team Dawn Chiafari and Kathy Weininger Walt’s Team Walt Frizzell Nancy Shipley Project Leader Quadramed and PID 2020 Marc Peters Project Leader Documentum AX George Baier Project Leader HDM and Morrisey Walt’s Team continued Bill Gary Epic Data Warehouse Analysts Pete Hajewski Donna Young Stephany Gilbert Sofiya Weinman Evelyn Nyarko-Ahlijah Kazue McHugh Kevin Johnson Charlene Nelson Rob Dunham PID 2020 Analyst The EPIC and Kiosk Teams Kathy Gonano Epic Project Leader Pam Mioduszewski Kiosk Project Leader Kara Morton Epic Analyst Becky Forrester Kiosk Analyst Administrative Support Pam Thompson Project Coordinator Team Director Sherrie Szekalski Patient Management Systems BS in Business Administration, IT Concentration 30 years with [email protected] Any Questions? Thanks for Listening!