Health Information Management
Case Study 5
Your facility has decided to purchase a new Encoder. You have just developed a survey instrument with interview questions to be used in determining the functional requirements of the software.
- Who should be included in the survey/interviews? (provide titles/categories of employees)
- Justify why you choose these job titles.
The surveys have been returned and combined, and the responses to which functional requirements desired in an encoder are shown below. Your job is to identify which of these functions are mandatory and which are optional requirements for the system that you choose. Justify your classification for each functional requirement. (You may want to do some research on encoders on the Internet)
| Encoder Functional Requirements | ||
| Function | Mandatory or Optional | Justification |
| Ability to connect to MPI for demographic information download | ||
| capability to update codes each year when new codes come out | ||
| Coding resources available online | ||
| competence to show estimated reimbursement for our facility | ||
| Provides a list of charts not coded | ||
| power to enter code(s) directly | ||
| efficiency to write notes | ||
| skills to transfer codes and other information back into hospital financial system | ||
| effectiveness to sort codes | ||
| strength to create and print out physician queries | ||
| intelligence to save codes when you are unable to complete the coding | ||
| Includes multiple groupers | ||
Before you can submit an RFP, you have a decision to make. You have to decide if you want to purchase systems from your existing vendor or use the best of breed model. how you are considering the pros and cons of each choice of vendors. if You want to have the RFP submitted to the vendor(s) in three months, and you cannot finish writing it until this decision is made.
- Select the method that you would choose: a single vendor or best of breed (do an Internet search – “best of breed versus single vendor”)
- Justify your choice
- Explain the downsides to the model that you selected
You now need to gather some basic information on the vendors and their products that are on the market in which to provide RFP’s.
| Information on Encoders | ||||
| Information | Vendor 1 | 2 | 3 | 4 |
| Name of company | HIM Technologies | |||
| Name of product | Encoder Supreme | |||
| Logic or automated | Logic | |||
| Phone number of vendor | 555-555-1234 | |||
| Address | 123 Main Street
Plymouth, NJ 12345 |
|||
| Summary of additional coding/compliance resources beyond encoder | Grouper and coding resources (e.g. Coding Clinic for ICD-10-CM/PCS) are included but the compliance products must be purchased | |||
| Number of years on market | 11 | |||
The functional requirements and RFP have been developed and RFP’s are due back from the vendors in one week. Your facility wants to make the decision about which system to choose within three months. Your assignment is to evaluate the RFPs returned and to develop a plan to guide the team in the evaluation and selection of the final system.
- Recommend the process(es) that will be used to evaluate systems.
- Identify how you will evaluate the individual RFPs.
Your team and you have decided between two encoder systems: Choose two from the information you found above.
It was decided that the coders would vote for the system they preferred, and that you would cast the deciding vote in the event of a tie. Half of the coders want [Vendor 1] and half want [2]; and the coders are adamant about their choices.
- How would you handle this situation?
- What questions would you ask as part of the investigation?
- If price, quality of system, references, and other evaluations are relatively equal, which system would you choose and why? (Be sure to include management, computer, and reimbursement issues).
