US Medical Service Lines2013 - 2014

Rex Osborn HIT SME

HealthCare IT Layered Application View

Segment Setting Applications / Functions

E Health Acute / Ambulatory PHR Patient Health RecordCCR Continuity of Care Record

(Enterprise Access CDA Foundation)

Referral / Clinician Portal (Scheduling & Ordering)

Clinical Web Portal "Physician Access"

Executive Information Desktop (Dashboard)

C L I N I C A L

Acute

CPOE Nursing Documentation eMAR electronic Medication Administrative Record Interdisciplinary Clinical Notes EDMS Electronic Document

Management System

High Acuity (ICU) Flowsheet & Documentation

Patient Monitoring / Device Management real-time Bed Board Patient Education Multi-Disciplinary Care Planning

Clinical Pathways Problem List Management & Support

Transcription / Dictation (H&P, Discharge Summary etc.) **

Case Management / Discharge Planning **Voice Recognition (VR)

Critical Care Management Palliative Care System Skilled Nursing Facility Management Home Health Monitoring High Acuity Monitoring

Residency Support Charting Assessments / VSIO Care Planning Credentialing / Clinician CME Telemetry / RFID

Ambulatory

EMR (Electronic Medical Record) Clinician Level CPOE Closed Loop Medication &

Results Management Episodes of Care Management **Voice Recognition (VR)

EDMS Electronic Document Management System Telephony Patient Education EKG / Spirometry Enabler E/M Evaluation & Management

Coding & Calculation

Problem List Management & Reporting Care Planning Social Welfare

Specialties SupportedCardiology, Dermatology, Endocrinology, Family Practice, Pediatrics, Gastroenterology, General Surgery, Infectious Disease ICU, CCU, NICU, Internal Medicine, Obstetrics

& Gynecology, Occupational Therapy, Respiratory Therapy, Radiation Oncology / Therapy, Physical Therapy, Speech Therapy, Ophthalmology, Plastic Surgery, Pulmonology, Rheumatology, Urology, Vascular Surgery, & Prosthetics

DepartmentalED Emergency Department Surgery: Pre-Operative,

Perioperative, Post-Operative Anesthesia Oncology: Radiation Therapy - Planning

Cardiology / Cardiovascular Intervention

Dialysis Sleep Lab

Ancillaries

Acute Pharmacy Ambulatory Pharmacy Radiology (PACS / RIS) Cardiology (CVIS / CPACS) Women's Imaging (U/S, Mammo)

Clinical Laboratory Reference Laboratory DentalPathology

(Anatomical, Clinical, Dermatopathology, Hematopathology, Oral & Maxillofacial and Forensic Pathology)

M HealtheMAR w/ Barcode / Flowsheets Inventory Control

(ERP - Logistics)Clinical Data Access / VR /

Flowsheet Entry Telemedicine / Tele-Imaging Tele-Behavioral health

Surveillance Home Health Monitoring - Rehabilitation

Patient Kiosk (Wayfinding) Surgery Instrument Tracking

Health Information Management Chart Deficiency Tracking EDMS Management Quality / HEDIS Reporting HIPAARelease of Information (ROI) Coding & Abstracting

US Medical Service Lines

US Medical Service Lines

Segment Setting Applications / Functions

Intake / Eligibility

AcuteADT / Registration EMPI Registration Enterprise

SchedulingAuthorization & Pre-Certification Tracking Eligibility Tracking

Help Desk Bed Management Rounds Management

AmbulatoryEnterprise Registration Enterprise

SchedulingReferral Tracking &

Management POS Benefit & Health Alerts Eligibility Tracking

ABN Tracking

Call Management / CRM Call Management Customer Relationship Management (CRM) Nurse Triage

Decision Support

Clinical Decision Support

Acute / Ambulatory

Evidence Based Medicine (EBM) Outcomes Based Medicine (OBM) Health Maintenance CDM

Chronic Disease ManagementDrug Knowledge Database

(Interaction / Contraindication)

Medication Dosing Support Safety Monitoring ADE(Adverse Drug Event) Clinical Alternatives Formulary Compliance Protocols / Pathways

Diagnosis-based Order Sets Active Guidelines Population Management Nomenclature Services (UMLS) Duplicate Therapy / Orders

Alerting

Financial Decision Support

Acute / Ambulatory Financial Alternatives Duplicate Orders Alerting Decrement ERP Inventory Management Benefits Summary Champus / Alternative

Insurance

Revenue Cycle

HOSPITAL

Hospital Billing &Patient Accounting Anesthesia Billing Accounts Receivable Inventory Management (ERP) Abstracting & Coding

Electronic Claims & Remittance Collections"Acute & Ambulatory" Financial Reporting Authorization & Pre-

Certification Concurrent Review

PROFESSIONAL

Professional Billing & Patient Accounting

Point-of-Service Copay & Prior Balance Collection Benefits Engine Claims Management

(Charge & Claim Scrubbing) Electronic Claims & Remittance

Expected Reimbursement Tracking Credit Card Payment System Dental Billing Home Health Billing Telemedicine Billing

Segment Setting Applications / Functions

Health Plan PayorsEnrollment & Benefits Premium Billing Utilization & Case Management Provider Contracting AP Claims Adjudication

Claims Processing Workers Compensation Claims & Capitation Reconciliation Clearinghouse

Enterprise Foundation Acute / Ambulatory

Patient Registry (Research) Cancer Registry Data Analytics

(Enterprise Content Management) Analytical "Data" Warehouse X12 EDI Transactions

Enterprise Master Patient Index(EMPI - Community Master)

Clinical Data Repository (CDR) Ad Hoc Reporting Cost Accounting

DEERS(US Military

Master Patient Index)

TimeKeeping

HealthCare IT Standards Acute / AmbulatoryDICOM SNOMED RxNorm LOINC Health Level 7 (HL7)

UMLS Clinical Document Architecture (CDA) MeSH NCPDP/SCRIPT

(Dentistry) X12

Interface Considerations

HITSP basedAcute / Ambulatory

Radiology – Modalities via DICOM, IHE (framework)& HL7;o Diagnostic Radiologyo Advanced Visualizationo Computerized Radiography (CR)o Direct Radiography (DR)o Computerized Tomography (CT)o Ultrasoundo PET Scannero Magnetic Resonance Imaging (MRI)o Picture Archiving & Communication System (PACS)o Nuclear Medicine

IMAGING subspecialties:- Radiation Therapy- Molecular Imaging- Ophthalmology- Pathology- Orthopedics- Endoscopy

Cardiology – DICOM, ASTM, ISO, IHE & HL7o Cardiology PACSo EEG / EKGo Physiological Monitors

Laboratory – Standard Instrumentation – ASTM - LOINC

Reference Laboratory - LOINC

Endoscopy – Camera – ASTM & HL7

Patient Tracking – ASTM, DICOM& HL7o L&D Obstetrics Patient Trackingo Ultrasound (real-time)o RFID patient tracking in behavioral health, pediatrics, geriatrico Ultrasound (real-time)

Pharmacy – ASTM, HL7, SnoMED, IHE, ISO & optional LOINC / RxNORMo Roboticso Dispensing Unitso Medication Infusion Pumpo eMAR – Barcode Patient Identificationo eRx (electronic prescription)

Emergency Department - Surgery & Critical Care – IHE, HL7, DICOM, ASTM, ISO & CORBAo C-ARMo Portable DRo Invasive Monitors / Devices § Ventral Venous Catheters (CVC) / Central Venous Pressure (CVP) § Arterial Catheter § Hemodynamic Monitors § Right Atrial Catheter (RAP) § Left Atrial Catheter (LAP) § Ventilator (Invasive & Non-Invasive) § Intracranial Pressure Monitor

Non-Invasive Monitors / Devices§ ECG§ Pulse-Oximeter § Respiratory Rate Measurement§ "Non-Invasive" Blood Pressure§ End Tidal CO2 Monitor (ETCO2)§ Near Infrared Spectroscopy (NIRS)

US Medical Service Lines