How to Answer Using These Case Questions (Complete Guide)
Understanding this question requires applying core subject principles.
What This Question Is About
This question relates to using these case and requires a structured academic response.
How to Approach This Question
Break the problem into smaller parts and analyze each logically.
Key Explanation
This topic involves using these case. A strong answer should include explanation, application, and examples.
Original Question
Using these case studies, choose 2 problem statements and projects to review. You will need to research the topic, provide guidance on what suggestions you may have to solve the problem, deliverables you would expect and challenges or resources you would use for the project. Case 1: The UCSD coding department uses a coding tool within Epic called Simple Visit Coding (SVC). SVC allows accounts to be coded without human interaction. The account is coded from the doctor’s order. However, because coding can be complex accounts can be held-up by claim edits. Reasons can be third party payer coverage, medical necessity, or just the wrong code. Without human interaction these encounters would go unpaid and need to be written off. UCSD has tasked us to organize one weeks’ worth of claim edits from all UCSD departments that utilize SVC. By analyzing the data, we will be able to look for and identify any trends that are occurring. Equipped with this information, UCSD can then decide the best path forward in reducing their claim edits. Case 2: Facility X is an acute care hospital that will be implementing the 21st Century CURES Act Information Blocking which seeks to improve data exchange via disparate systems and healthcare standards. The facility is not planning on purchasing any new software and the IT department will handle any electronic exchange challenges. The Director is concerned about how to specialize training according to departments, upper management and which departments will be affected. There is also a need for a plan to create a secondary review team to work with the end user to help complete the request or determine if the request is not obtainable. Who will make up the team? Case 3: At our organization, we have two clinics, a lab, and a telemedicine service focused on providing dermatological care. We strive to stay current and competitive in the industry and currently we lack the ability to provide accurate cost-estimating services for our patients at our dermatology clinics. Most dermatology practices are able to provide this service, so we are looking to provide this service for our patients as well. Having a cost-estimating service in place will also benefit our inhouse workflow processes as the front desk staff deal with the frustrations of lacking the ability to provide accurate patient responsibility costs, in relation to the services they are receiving. Management have been receiving complaints from the front desk, of staff using calculators to manually attempt to provide the patient with a rough estimate of anticipated costs based on their determined copay and coinsurance. By having a cost-estimating tool in place at our clinics, we are hoping to provide ease of workflow for our front desk staff. A tool in place will allow for our front desk staff to provide cost estimates for our patients hassle-free. Case 4: A north county district hospital is currently experiencing high volume of release of information (ROI) requests that is severely affecting department’s productivity and efficiency. With the accompanying complexities, guidelines and procedures in executing ROI functions and services, the Medical records director decided to outsource the ROI services to cope up with the demand for information from all possible sources such as patients, families & legal representatives, other providers, payees, relevant authorities, and court orders. Case 5: UCSD requires a review of their health analytics dashboards to ensure that they are accurately reflecting health equity and disparities in our region. We are to consider health equity items such as, REAL, SOGI, HPI, SVI, and homelessness. The deliverable will be a recommendation for how UCSD can better display Health Equity disparities on their dashboards. We are to present our findings to the Analytics Standards and Health Disparities Committees. Case 6: A local medical group must report all STD and Covid-19 positive results to the local public health department within regulatory obligations to limit the spread of communicable diseases. Currently, the providers are filling out the Confidential Morbidity Report (CMR) form manually and faxing the completed form to the county. To improve workflow efficiency and reduce cost, the medical group is looking at the feasibility of a self-populating form using data elements extracted from their database, generated upon a positive result of an STD or Covid-19 test. Case 7: In 2020, a health system’s HIM department changed its EHR documentation workflow. Instead of sending all documentation each day to a central site for processing, each site is responsible for processing its documentation into the EDCO/Solarity system. Any documents EDCO/Solarity cannot process are deemed “exceptions” and are placed into the appropriate workbasket or work queue to be processed by the Information Data Integrity Specialists. We are tasked with creating the policies and procedures for processing the exception documents. Case 8: A Specialty Clinic has an inconsistency with the provider’s documentation standards. They can access EHR templates yet rely on copying and pasting old notes into the patient’s current encounter to save time clicking back and forth through the chart. This causes note bloat or nonessential information in the patient’s documentation. The purpose of the patient’s medical record is to communicate what happened during the visit between the provider and the patient to someone who is not there. It is a communication tool to support the patient but should not be used as a review tool for the author. The practice must determine how to decrease the provider’s documentation time while supporting the patient’s treatment plan with accurate/efficient documentation.
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