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.

  1. Who should be included in the survey/interviews? (provide titles/categories of employees)
  2. 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.

  1. Select the method that you would choose: a single vendor or best of breed (do an Internet search – “best of breed versus single vendor”)
  2. Justify your choice
  3. 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.

  1. Recommend the process(es) that will be used to evaluate systems.
  2. 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.

  1. How would you handle this situation?
  2. What questions would you ask as part of the investigation?
  3. 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).