Deliverable SIX: Apply, Analyze, Evaluate HIM Challenges To fully understand

Deliverable SIX: Apply, Analyze, Evaluate HIM Challenges To fully understand the role of each of the six professionals interviewed at the VVL, several HIM challenges are presented here. Analyze each of the challenges and determine which professional’s skills would be applicable and needed for the resolution. To do so, complete the three steps outlined below to resolve the HIM challenges listed here. A. Use the skills/experience and education in Deliverable TWO and THREE of the six professionals in the VVL to reflect on the HIM Challenges below. Determine which HIM professional you would recruit to work on this challenge with you. Explain how their skills/experience/education will apply or be useful in the challenge. B. Next, research Rasmussen Library resources or government publications (.gov websites) to identify causes or issues that contribute to this kind of problem. For example, what person/process/system failed and contributed to this HIM challenge? Make inferences and find evidence to support input. (At least one resource should be cited, and a proper resource page created for each scenario.) C. Finally, present a brief step-by-step solution to resolve the challenge using the identified professional(s) skills and support your idea with the research you completed. (You are NOT solving the challenge, you are recording brief steps needed to resolve the issue.) HIM Challenge – Cancer Registry The cancer registrar, Greer, at LiveWell, is pleased to have received notice that the cancer program has achieved accreditation from the American College of Surgeons. As part of the accredited cancer program, LiveWell must submit all annual cancer data to the National Cancer Database using the cancer registry software, just as all accredited programs do. Greer, however, has no idea how to gather up all cases to submit electronically to the National Cancer Database. This is an HIM challenge. ANSWER to Deliverable SIX – Cancer Registry A. B. C. HIM Challenge – Print, Fax, Sign, Fax, Scan After converting to an EHR, LiveWell still has pages that originate with a paper version – such as a cancer staging form or an ambulance transport form. There are also other challenges, for example, to facilitate completion of the medical record for a physician who rarely comes to the hospital, sometimes LiveWell must: • PRINT a form that originates in an electronic form – for example, a computerized physician order (a verbal order by the doc entered as a written order by a nurse), • FAX it to the physician, • obtain a HANDWRITTEN signature on the sheet from the remote physician, which is • FAXED back to LiveWell, and then • SCAN the Signed Physician Order back into the electronic record. This is an awkward, time-consuming process that LiveWell wants to improve, simplify and automate. This is an HIM Challenge. ANSWER to Deliverable SIX – Print, Fax, Sign, Fax, Scan A. B. C. HIM Challenge – Revenue Cycle Team There are operational issues in the Revenue Cycle at LiveWell. A Revenue Cycle team must be formed to engage all the leaders in the Revenue Cycle. The team will allow for the sharing of recent information, such as: • A problem occurred, and a discussion was necessary to determine if it originated in any one of the three departments composing the Revenue Cycle • A patient issue was uncovered, and resolution either needed one of the three departments or involved one of the three departments • New staff, new process, new software shared with Revenue Cycle. These weekly meetings will help reinforce the Revenue Cycle’s functionality by keeping communication lines open and flowing. Who will organize the Revenue Cycle team, who will join the team? This is an HIM Challenge. ANSWER to Deliverable SIX – Revenue Cycle Team A. B. C. HIM Challenge – CDI Job Description Kamal, from Human resources, is asking for a job description for a Clinical Documentation Integrity specialist – the department indicates that they do not have one on file. There are job opportunities in this field for HIM graduates, but many CDI jobs are filled by nursing personnel. Kamal needs a job description to recruit an additional CDI specialist. A job description for a CDI specialist must be prepared for HR. This is an HIM Challenge. ANSWER to Deliverable SIX – CDI Job Description A. B. C. HIM Challenge – Data Dictionary The data dictionary considers the fields used for electronic data and proposes a compromise that attempts to bring the old system together with the new system. At the time of EHR go-live at LiveWell, the coders had always entered their initials when they opened an account and continued to do so with the new EHR. However, the EHR would not pass the coded account to the billing system even though they were coded and complete. The research found that the EHR was asking for a ‘coder ID#,’ and the coded accounts were deemed incomplete without that number. Therefore, a data dictionary was needed to set up a coder ID# table. Then coders will need to be trained to use it PLUS to correct all previously coded accounts and be updated and pushed through to billing again. This is an HIM challenge. ANSWER to Deliverable SIX – Data Dictionary A. B. C. HIM Challenge – Record Completion Rate Each month, the HIM department must determine its Record Completion Rate to determine if the required rate from state regulation was being met. If the rate was not being met, corrections in the HIM department must be made to get the Record Completion Process right. A report was needed – the Record Completion Rate Report – the percentage of patient admissions from the previous 30 days with complete records. (Complete record meaning all documentation and all signatures/dates.) How would this be completed with the new EHR at LiveWell, and what steps need to be taken to meet the rate regularly? This is an HIM Challenge. ANSWER to Deliverable SIX – Record Completion Rate A. B. C. HIM Challenge – Diversity Awareness Training An exciting presenter on diversity just wrapped up her session. The speaker shared that employee surveys indicate that new hires across the country reflect dissatisfaction with diversity relations. The speaker indicated that diversity covers a lot of territory, including: • The obvious things like race, religion, gender, and age • Social status – homelessness, education, physical disabilities, etc. • Internal environment – job titles, job relations, full-time/part-time, length of service, etc. • External environment – personal preferences – biking, bus, personal car for transportation; home-based communication modes/sayings, etc. Because all employers benefit from peaceful relations in a work unit, in a department, and across the facility, LiveWell wants to make improvements in this area. A peace-filled environment will flow more smoothly and be more productive. The HIM needs an educational session so that this diversity presentation can be shared with all department members. This is an HIM Challenge. ANSWER to Deliverable SIX – Diversity Awareness Training A. B. C. HIM Challenge – Case Mix and Revenue at LiveWell Case Mix is the combination of DRG weights assigned for inpatient accounts at an individual facility. The CEO at LiveWell wants to understand better Case Mix and how it impacts the revenue at LiveWell. The CEO has questions about Clinical Documentation Improvement and its connection to Case Mix. The Board of Directors has questions, and the CEO wants to be educated on Case Mix and LiveWell Revenue. The CEO wants to be prepared for next month’s Board meeting. This is an HIM Challenge. ANSWER to Deliverable SIX – Case Mix and Revenue at LiveWell A. B. C.

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