Information Systems In Managed Care

Documents

Action Point Executive Managed Care System

This is the Managed Care Information Systems web site. MCIS is a supplier of executive decision support and information systems for healthcare organizations. In particular, the Action Point Managed Care Information System is designed for senior managers and decision support analysts. Persons entering this site will be prompted with the main menu which outlines ten sub-areas. Included in these sub-areas are: Market watch, which allows for analysis of competitive opportunities, product line trends in the community, and market share; Advanced Analysis, which allows you to obtain financial results by patient or group of patients and view resource utilization to identify areas of opportunity; and PayoRate, which calculates contract details and financial results to understand the financial impact of a given revenue resource; Contract Watch, which is a revenue maximization system; Census Watch, which is a utilization monitoring system, Others sub-areas include MD Trend, Product Line, Labor Watch, and CorpRollup. A new version is coming out and free demo disks are available. As already mentioned, it is designed for senior managers and decision support analysts. The site itself is easy to get aroud. As for the program, one should down load and evaluate it for its ease of use. Overall rating 3 stars.

Applications of Mosaic in Health Care Delivery

This doument is a paper published by the Department of Computer Science and Concurrent Engineering Research Center of the West Virginia University. It describes their efforts in building a distributed, patient centered, healthcare informatics system called ARTEMIS. According to the authors, the basic premise of their efforts is that more affordable and effective health care can be achieved by applying computer technology to improve collaboration among the diverse and distributed providers in the helath care arena. The document is technical in nature and difficult to follow. Overall rating 1 star

MedTrieve Managed Reimbursement Information System

The MedTrieve Managed Reimbursement System is a software system which collects, manages and reports reimbursed claims information delivering financial, clinical, and operations management decision support reports. Useful for clinical managers, administartive managers, and production managers, the MedTrieve system provides: graphical management analysis and reports; adjudicated claims performance analysis and reports; detailed production analysis and reports; and integrated database manager and decision support system. Very user friendly. Overall rating: 4 stars

The Electronic Document Distribution Guide

Used by organizations of all sizes in the commercial world, in government, in education, and other placed where people work, the electronic document distribution (EDD) guide is a relatively new technology which increases people's access to the knowledge and information they need to do their work. Among EDD's benefits are cost savings, streamlining access to information, and giving people the tools necessary to handle the increasing flow of information. Pertinent to administrators, this document contains an overview of EDD technology. It reviews the information EDD systems manage, the different EDD approaches and their tradeoffs, the benefits of EDD and who, in particular, benefits from EDD's, and it offers advice on how to evaluate potential solutions and select an EDD supplier. This document would be useful to line managers. Overall rating: 3 stars

The Ultimate Clinic Management Software

Medicare II...the future of clinic management is a software product designed to help manage single to multi-practice clinic environments. Among its many managerial features are appointment tracking, patient recall tracking, inventory control, billing, accounting, and graphical report generation. For the practitioner, it maintains patient records and aids in the dispensing of drugs. As a software package, it would be useful to managers and practitioners. The document has minimal information and users seeking additional information on this product would need to e-mail the company directly. Overall rating: 2 stars

Sites

Benchmark Systems, Inc.

Benchmark Systems is a Healthcare Technology Solutions Company, offering several types of software designed to meet the needs of all types of medical practices from single physician organizations to large multi-physician, multi-specialty group practices. Their Medical Practice Management Software handles billing and accounts receivable, electronic claims, practice management reporting, appointment scheduling, and financial accounting. Another package is the Electronic Medical Records Software designed to help increase the accuracy, efficiency, accessibility, and control of medical records. Manged Care and Outcome Measures Software offers administrative functionality for managing relationships with managed care carriers and for monitoring and analyzing the profitability of each individual managed care contract. Finally, Benchmark Systems has Diagnostic Coding software designed to correctly code diagnoses, thereby avoiding dowcoding and rejected claims; thus, increasing reimbursement. The site is easy to get around, and is useful for individuals involved in the administartion end of medical practices. Overall rating: 3 Stars

Consulec WWW Site for MMIS

This is the Consultec WWW site for Medicaid Management Information Systems (MMIS). MMIS is a management tool designed to track and control expenditures and provide data for program planning and evaluation which, in turn, is used for continuous quality improvement; specifically, improved services for beneficiaries and providers, improving oversight of policy and operations, and supporting improved medical delivery and medical care. Individuals accessing this site will be prompted with five major link groups as follows. The first is titled interesting MMIS links. These include new MMIS guidelines (MB-38), system implication of Medigrant legislation, MMIS technology recommendations, recommendations for decision support systems, MMIS procurement recommendations, increased competition for MMIS projects, MMIS in the 90's, and the HCFA homepage. The second group is state Medicaid agencies, and information seekers can obtain information from the Maine, Mississippi, Texas, Utah, Virginia, and Wisconsin State Medicaid Agencies. The third major group is Federal Medicaid Agencies. The links in this group includes the information network for public health officials, the administration for children and the family, the agency for healthcare policy and research, and the FDA. The fourth group contains information on Medicaid Policy and Research Resources. Included in these are links to the Kaiser Foundation, Robert Wood Johnson Foundation, National Association for the Mentally Ill, Intergovernmental Health Policy Project, and Internet Resources in Aging. The fifth and final group contains health related links. Anyone interested in Medicaid Management Information Systems will find this site helpful. It's easy to get around. Overall rating: 4 stars

Medical Records Institute

This is the Medical Record Institute's (MRI) WWW home page. MRI was founded in 1981 on the principle that the future of health information technology lied in the implementation of electronic health records systems. Among the MRI's missions are: to promote electronic health records systems; participate in organizations concerned with the creation of electronic health records; act as a clearinghouse of information on national and international developments; conduct research and coordinate projects related to the creation of electronic patient record systems; support the process of creating standards which cover the creation of electronic patient reports; and support the acceleration of telemedicine. The document itself does not contain a significant amount of information. It may be useful to individuals interested in electronic health records systems on more of a global scale. Overall rating: 1 star

PenChart

This is the site of Total Healthcare Solution, Inc. - The Complete Patient Record Company. This site is primarily an advertisemnt for a pen based medical record charting system, but is pertinent to the topic. Pen based charting decreases the amount of time spent on documentation by healthcare providers, decreases costs, and improves quality and process management throughout the system. System being the operative word, this particular pen based system has the ability to tie together all areas of healthcare including, but nor limited to, the laboratory, billing, scheduling, physician profiles, and pharmacy. The company suggests that the system is easy to use and can be learned in 20 minutes. The site is easy to get around, and the system seems that way as well. Systems such as this already play a large role in managed healthcare. While informative about its service, it is primarily an ad. Overall rating as it relates to the topic: 2 stars

Telelinks Billing

This is an advertisement for the Telelink Automated Billing Network, an alectronic billing and communications system. It collects billing data for daily charges associated with a patient's telephone and television use during their hospital stay, converts it, and transmits the data to telephone companies nationwide. The end result is a line item on the patient's home telephone bill for their telephone and television charges incurred during their hospital stay. Related to managed care, the company claims that hospital administrators would be interested in this system as it would result in less labor for hospital staff, increased net income, and enhanced patient satisfaction without a need for capital investment. These claims are then supported by eleven questions and answers about the Telelink system. Overall rating: 1 star