THE NORTH EAST MEDICAL PRACTICE
Dr. Francis Decker owns a multi-city medical practice located in NY, PA, NJ and MA. Newark is the headquarters location with 10 doctors, 2 doctor’s assistants, 2 receptionists, 3 billing/accounting staff, 1 appointments scheduler, and 1 office manager. There are 11 other locations across the 4 states that differ in staffing only by having 7 doctors instead of 10 and 2 billing/accounting staff. All offices are open every day but Sunday, but are on call when offices are closed.
Dr. Decker seeks to modernize his 12 practices in order to create new efficiencies and introduce new services such as user-booked appointments. Each day, every practice sees 110 patients each on average, except Newark, which averages 150 patients daily. On average, every patient is billed $195 per appointment through their insurance. Straightforward office visits cost $85, the rest comes from additional services such as blood testing, EKG etc. Cash-only patients are also accepted.
Physical therapy and a few diagnostic tests, e.g., ultrasounds, X-Rays, EKGs and some blood tests are performed in the practices. Others are referred to specialists. Dr. Decker believes that volume could be increased by 20% daily through investing in technology and in making billing more efficient. As it is, 8 of the 12 practices are not taking any new patients.
The new system must satisfy the following requirements:
1. Manage patient records electronically—this will also require conversion of several hundred paper and Oracle-based records to Electronic Health Records (EHRs).
2. Perform appointments scheduling. All appointments will be stored on the system and available as a daily report. The system should also be able to call and remind patients one day before.
3. Consultation documentation. Each interaction with the doctor or physical therapist will be entered into the EHR. Medical dictation and transcription are necessary sub-features to improve the efficiency and speed of consultations.
4. Laboratory and integrated chart documentation. Every lab, including X-Rays, MRIs, biopsies, PET Scans and so on will be stored within the patients’ EHRs.
5. Billing. Efficient billing will be the cornerstone of the system. It will be capable of billing various agencies, namely: medical insurance companies, auto insurance companies, patients, worker’s compensation agencies etc.
6. Collections. The system will flag past due accounts and generate dunning (overdue payment) letters, plus provide reports to assist collection staff.
7. A practice website will be created to provide patients with information and in the future, allow self-service, e.g., patient scheduling and patient access to their EHRs.
8. HIPAA Compliance, to conform to industry standards.
9. Auditable: The system will be able to provide audit reports showing proper access to sensitive data as well as validation of financial record keeping.
There are older PCs at the all current locations that will be disposed of. All practices should be fully computerized and networked within a total budget of $250,000. Your group must consider appropriate form factors for computing equipment used by medical personnel and allow BYOD (Bring-Your-Own-Device) as well. Compare and contrast SaaS solutions versus shrink-wrapped solutions. Enterprise-wide analyses and reporting are required.
As mentioned earlier, Dr. Decker wants the new website to enable customers to set appointments over the Internet. Development costs (excluding IT personnel) must be paid for out of the project budget of $250K. All networking equipment, software and/or external services must also be paid for out of the budget (services for 3 years). You are also not allowed to increase your budget by firing people. Assume any existing equipment has no resale value.
The practice also seeks to conduct data discovery and business analytics using its newly-hired data scientist, so a business analytics software program must be selected.
The development team should undertake the following assignments:
1. Select software for the medical practice to handle the practice’s requirements. The software should handle front-end and back-end requirements, and may be cloud-based or onsite server-based.
2. Select all computer hardware for the medical practice including computing platforms used by the listed doctors and other medical staff and the server(s), if used. No parts of the current architecture may be used.
3. Select networking hardware and services to support the communication requirements of the medical practice.
4. Select the database architecture and data warehousing architecture to support the daily transactions and the data analytics requirements of the practice.
5. Describe how the medical practice will use social media and integrate that into their data analytics effort.
6. Produce a schematic that graphically shows the architecture of the new system i.e., hardware, software, data, people and networking components.
7. Define the expected benefits of the new system and for intangible benefits, produce your assumptions using equivalent real-life case studies and/or best practices.
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