Mercy Children’s Hospital, Mercy Children’s Hospital, Washington, DCWashington, DC

MED INFO 405MED INFO 405Project DraftProject Draft

Group 2

Lisa Heavilon

David Robbins

Lisa-Marie Williams, RN

Mercy Children’s Hospital, Mercy Children’s Hospital, Washington, DCWashington, DC

• A mid size pediatric hospital • 430 beds

• Non-profit• Medical Resident and Intern

Program (teaching hospital)• Located in an large metropolitan

city

Mercy Children’s Hospital Mercy Children’s Hospital Specializes InSpecializes InPediatric Oncology Infectious Disease Emergency Medicine Anatomic Pathology Reconstructive surgeryEach of these specialties presents a unique

requirement for data flow

Systems Installed at Systems Installed at MercyMercy• New HIT system – Meditech• Automated Pharmacy • Automated Lab • Automated Radiology • Med Stations - AccuDose • CPOE - Meditech Physician Care

Manager • Blood Bank - Meditech• Tissues and Biologics - TIMS

4

Meditech Screen Prints

Automated Lab Results through Meditech on test patient Apple Green.

Meditech Screen Prints

CPOE in Meditech of Continuous tube Feed on test patient Jan08 Documentation.

Systems Installed at Systems Installed at MercyMercy• Infection Control: Infection

Monitor Pro• Human Resources: People Soft• Staffing: Daptiv• Payroll: Kronos• Inventory Control: Home grown• Finance and Accounting: People

Soft

7

Internal Stake HoldersInternal Stake Holders

Physicians, Nurses, other clinicians

PharmacyLab & Blood BankRadiologyAdmissionsDietaryHousekeeping

External Stake HoldersExternal Stake Holders

Physicians and other cliniciansExternal LabsExternal Radiology CentersThe Red CrossOther Hospitals/ Medical CentersRetail PharmaciesState and Local Public Health

AgenciesThe Centers for Disease Control (CDC)Payers

Logical Data FlowsLogical Data Flows

Provider

Pharmacy

Payer

Lab

Imaging

Prescription OrderResults

Claims / Pre-Auth / Benefit CheckOrder

ResultsRemittance / Auth / Eligibility

Public Health Agency

Disease ReportsVital Statistics

Accreditation Organization

External Provider

ReferralRequests

Chart Requests

Health Care Transactions – Logical Data Flow – Team 2

Physical Data FlowsPhysical Data Flows

ProviderPayer

HIPAA 820 - EDI Payroll Deducted and other group Premium Payment for Insurance Products

HIPAA 834 – EDI Benefit Enrollment and Maintenance Set

HIPAA 270 - EDI Health Care Eligibility/Benefit Inquiry

HIPAA 271 - EDI Health Care Eligibility/Benefit Response

HIPAA 276 - EDI Health Care Claim Status Request

HIPAA 277 - EDI Health Care Claim Status Notification

HIPAA 278 - EDI Health Care Service Review Information

HIPAA 278 - EDI Health Care Service Review Information

HIPAA 837 - EDI Health Care Claim Transaction set

HIPAA 835 - EDI Health Care Claim Payment/Advice Transaction Set

Payer Transactions – Physical Data Flow – Team 2

Standards Used at MercyStandards Used at Mercy

CCR: EHRHIPAA (835, 837 276/277, 270/271):

ClaimsNCPDP(5.1): Pharmacy RetailersHL7 (2.5) Meditech in/outboundSNOMED – CT: PathologyJoint Commission: HTTPS/XML: CPOEICD-9: Insurance Collections

Applications with No StandardsApplications with No Standards

Proprietary Interface: Tissues and Biologics◦ Each donor bank has its own way

DiscussionDiscussion