Module 04 Assignment – Business Analysis of a Healthcare Process

Module 04 Assignment – Business Analysis of a Healthcare Process

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Module 04 Assignment – Business Analysis of a Healthcare Process

Title: Scripted Portrayal of the Business Analysis of a Patient Encounter

Setting: Imagine a general office setting with 2 people sitting at a table:

Business Analyst, “Linus.” Dressed in “business casual” attire, this is a person who has good “people

skills,” but also understands how to translate everyday activities into computer structures.

Nurse, “Mary.” Dressed in medical scrubs, this person helps manage care of patients within a

freestanding, multiple-physician practice. Like many nurses, she dislikes having to do “paperwork” but is

very dedicated to her job helping patients and supporting physician needs.

Dialog:

Linus: Hi, Mary. I am very glad to meet you. I hope you had time to read over the introductory

materials, on the plans to develop and convert to a system that will have your patient care processes

and documentation recorded on computer. The reason for this initiative is that quality of care may

improve; it will be easier to generate care reminders to patients; and ultimately patients themselves

may access their own visit results and details, using a secure internet Patient Portal from their own

homes! What did you think about this project, so far?

Mary: I admit I have some concerns and hesitation about this. We provide really good care here at

Maxwell clinic already. I don’t like computers so much, and physicians are not used to doing much

beyond dictating their reports for transcription. I will try to keep an open mind though; especially for

something that may improve the quality of care. I sure hope you don’t try to change everything we do

around here, though.

Linus: Yes, I hear those concerns often. But rest assured, our way of helping to customize a system for

your practice, could make the system feel like second-nature to you after just a few weeks or perhaps,

months.

Mary: OK, well, here is the form that we use to take a Patient History already. So let’s just get on with

putting that into the computerized format.

Linus: Well, I’m afraid it’s not quite as simple as taking a paper form and putting it directly onto a

computer file, Mary. Those paper forms are not usually structured in the way we need to store items in

the database; or even the best order in which to enter them. We first need to understand, what you do

with a typical patient, step by step; what order you do it in; and then we will construct the data storage

structures later. Your forms had a particular good purpose before; but now, you will be documenting

each piece of the visit as you go, real-time. So please start by telling me, what is the first thing that a

patient does when they come in the door of your practice? I am interested not only in the nurse’s role,

but all materials going into the record.

Mary: The patient stops at registration desk first. Our clerk confirms their name, address, collects their

insurance information, and any copays due for the visit. The patient has to show a photo ID if they have

one, too, to prevent fraudulent claims to their policy. All that is entered and confirmed on our practice

management and billing system—so the practice can get paid. That’s about the extent of what I know

on that.

Module 04 Assignment – Business Analysis of a Healthcare Process

Linus: Good, that helps! So we first have a registration clerk, and they have to confirm or collect all the

demographics on the patient, and their insurance carrier. Then some payments/copays may be

processed right away before the visit, right? I can ask the registration clerk a few questions later on.

Then what happens next?

Mary: The clerk gives them the patient history form. The patient works on that, writing up their

personal and family medical history. When it is time for them to be called back to exam room, the

Medical Assistant takes the vital signs. You know, weight, height…

Linus: OK, slow down a second. Who uses that patient history form, and what is it for? Is it for the

nurse, the doctor, who?

Mary: I guess it’s both. The nurse may check to see if there are big missing areas or “red flags” we

would alert the doctor about. The doctor reviews the family and personal history as they talk with the

patient. But all the docs like to ask their own questions of the patient to clarify. Like, if the patient

checked that they have diabetes, you know, we may ask how long the patient has had it, how their sugar

levels have been, etc. Sometimes I even wonder if the docs look all that closely at the forms. What they

ask (for history) kind of depends on whether it’s a new patient or one we already know well. I also help

to ask the patient how things have been going, clarify the main reason for their visit today.

Linus: Of course. Sounds like the patient history will need some free-form entry areas. Probably some

customizing of a template/data entry form for each physician’s preferences, as well. Ok, let’s go back to

the vital signs. The medical assistant has to write those all down, or does she enter them into your old

system? Tell me each one in detail.

Mary: Sure, this is how it works:

 Height: That is how many feet and inches tall they are.

 Weight: write down the pounds, obviously.

 Temperature: In degrees, and was it a fever or not.

 Blood pressure: the two numbers Diastolic and Systolic.

 Then we calculate BMI using our BMI calculator, tell the patient if that looks OK or if they should

lose some weight.

 We just highlight if anything looks out of line, for the doctor, too.

Linus: Great, this is very helpful. I can mock up that data entry screen and the underlying tables based

just on what you said. Tell me, for patient’s temperature, do you use Fahrenheit or Celsius?

Mary: Fahrenheit.

Linus: Fantastic. Ok, then what happens? The doc asks the questions; the patient answers; and the doc

does the diagnosis thing, right?

Mary: As you know, often the physician might need to order some more tests on the patient first. Blood

tests, urine, x-rays: that all feeds into what you just called the “diagnosis thing,” for sure.

Linus: Of course. Our system has to allow ordering all those tests. The results may come in from the

laboratory’s own system though. That tells me we will need some system-interfaces; interoperability.

Module 04 Assignment – Business Analysis of a Healthcare Process

Mary: You know what would be helpful? All those lab tests and such come in on different screens, one

at a time. Some of the labs even send us faxed results. If we could get all the test results put together

like on a “dashboard” for nurses and the physician, I think we would like it. When the patient calls in to

ask about test results, then I would not have to hunt for each one, too.

Linus: Now we are talking! How about procedures on the patient? Are some done in-office, like a mole

removal?

Mary: We do some in-office procedures. Usually that ends up being a separately scheduled visit for the

future. We have to keep to those visit timeframes and you know how patients hate to wait these days!

Linus: Great. Later on I will ask for a list of the more common in-office procedures. Right now, I think I

have enough to go on, to develop some of our basic data tables, and to mock-up a few data-entry and

data-recall screens to see if those would be what you can use and understand.

Mary: Is that all?

Linus: It is for now. Like I mentioned, I’ll have to design and try out some different structures for the

data; and do some mock data entry screens for you folks who have to actually use the system. How does

your schedule look for about a week from now? I could show you a couple proposed screens and

templates then.

Mary: Thursday afternoon is my best time, thanks.

Linus: Good. Looking forward to working with you again.


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