Course Proposals Help Course Name:Clinical Data Management for Quality Care & Revenue Cycle Integrity  Course Prefix: HIM Course Number: 5030              Submitted by (Name & E-Mail):  Patricia Shaw, pshaw@weber.edu Current Date:  11/4/2009 College: Health Professions Department:   Health Admin Services                               From Term: Fall  2010  Substantive new  Current Course Subject N/A Current Course Number New/Revised Course Information: Subject:  HIM             Course Number: 5030 Check all that apply:     This is for courses already approved for gen ed.     Use a different form for proposing a new gen ed designation. DV  SI  CA  HU  LS  PS  SS  EN  AI  QL  TA  TB  TC  TD  TE Course Title: Clnical Data Management for Quality Care & Revenue Cycle Integrity Abbreviated Course Title: Quality & Revenue Cycle Integr Course Type:  LEL Credit Hours:  3  or if variable hours:    to Contact Hours: Lecture 2  Lab 2   Other Repeat Information:  Limit 0   Max Hrs 0  Grading Mode:  standard This course is/will be: a required course in a major program a required course in a minor program a required course in a 1- or 2- year program elective Prerequisites/Co-requisites: Course description (exactly as it will appear in the catalog, including prerequisites): This course prepares the student to collect,analyze, present and organize data to improve quality of patient care and revenue cycle management. The management of clinical data required in reimbursement systems and prospective payment systems in health care delivery are discussed. Justification: This course is designed for students to develop skills in the collection, organization, analysis and presentation of clinical data to improve quality of care and health care reimbursement. The students in this certificate program need to develop these skills in data management to fulfill HIM management and data quality positions in health care organizations. The content covered in this course is required knowledge for the certificate student to be successful on the Registered Health Information Administrator (RHIA) certification examination. INFORMATION PAGE for substantive proposals only 1. Did this course receive unanimous approval within the Department? true If not, what are the major concerns raised by the opponents? 2. If this is a new course proposal, could you achieve the desired results by revising an existing course within your department or by requiring an existing course in another department? This course is a combination of course material in two courses in the health information management bachelors degree. It is necessary to combine the content into one course to achieve the learning outcomes required for certification. 3. How will the proposed course differ from similar offerings by other departments? Comment on any subject overlap between this course and topics generally taught by other departments, even if no similar courses are currently offered by the other departments. Explain any effects that this proposal will have on program requirements or enrollments in other department. Please forward letters (email communication is sufficient) from all departments that you have identified above stating their support or opposition to the proposed course. Data analysis skills are taught in many courses on campus, but do not address the analysis of clinical data for improvement of health care quality and reimbursement. 4. Is this course required for certification/accreditation of a program? yes If so, a statement to that effect should appear in the justification and supporting documents should accompany this form. 5. For course proposals, e-mail a syllabus to Faculty Senate which should be sufficiently detailed that the committees can determine that the course is at the appropriate level and matches the description. There should be an indication of the amount and type of outside activity required in the course (projects, research papers, homework, etc.).

Health Information Management
HIM 5030 Clinical Data Management for Quality Care & Revenue Cycle Integrity

 

Texts:  Shaw, et.al. (2010). Quality and Performance Improvement in Healthcare, 4^th Edition. Chicago, IL:  AHIMA

            Casto & Layman.  (2009). Principles of Healthcare Reimbursement, 2^nd Edition. Chicago, IL:  AHIMA

Course description:  This course prepares the student to collect, analyze, present and organize data to improve quality of patient care and revenue cycle management.  The management of clinical data required in reimbursement systems and prospective payment systems in health care delivery are discussed.

Learning Objectives:

1. Identify various ways in which statistics are used in healthcare.
2. Differentiate between descriptive and inferential statistics.
3. Define and calculate the following:  hospital-related inpatient and outpatient statistics, community-based morbidity and mortality rates, measures of central tendency and variability.
4. Display healthcare data using tables, charts, and graphs, as appropriate.
5.  Define quality within the context of clinical healthcare services.
6. Differentiate performance improvement initiatives of accrediting agencies, regulatory bodies, and payers.
7. Describe the significance of core performance measures in regard to data comparison, performance improvement, and data-driven accreditation.
8. Define the rationale behind the patient safety initiatives and the role played by the private sector and the government.
9. Understand the historical development of healthcare reimbursement in the United States.
10. Describe the current reimbursement processes, forms, and support practices for healthcare reimbursement.
11.  Describe the purpose of the fee schedules, chargemasters, and auditing procedures that support the revenue cycle.
12.  Understand the components of the revenue cycle.
13.  Describe the importance of effective revenue cycle management in a provider’s fiscal stability.

Schedule:

Unit 1   A Performance Improvement Model

            Shaw, Chapters 1-5

            Student Activities: 

PI Model Paper:  3-4 page paper; comparing and contrasting quality and performance improvement models used in healthcare.
           

Unit 2   Continuous Monitoring and Improvement Functions

            Shaw, Chapters 6-13
            Student Activities:   

Pre-certification assignment
            Hazard Vulnerability Analysis assignment
            National Patient Safety Goals analysis
            Credentialing case analysis

Unit 3   Management of Performance Improvement Programs

            Shaw, Chapters 14-21
            Student Activities:   

PI Plan Paper:  3-4 page paper evaluating an organizations performance improvement plan

Midterm Exam

Unit 4   Healthcare Reimbursement Methodologies

            Casto, Chapters 1-2
            Student Activities:   

Compliance Plan Development

Unit 5   Healthcare Payment Structures

            Casto, Chapters 3-7
            Student Activities:

            Reimbursement Analysis for Inpatients and Outpatients

Unit 6   Revenue Cycle Management

            Casto, Chapters 8-9
            Student Activities:

            Revenue Cycle Case Study Analysis

            Final Exam

Grading:

Examinations:
            Midterm                                                           100 points
            Final                                                                100 points

Assignments:

PI Model Paper                                               25 points
Pre-certification assignment                           15 points
Hazard Vulnerability Analysis assignment      15 points
National Patient Safety Goals analysis          15 points
Credentialing case analysis                            15 points
PI Plan Paper                                                  25 points
Compliance Plan Development                      25 points
Reimbursement Analysis                                25 points
Revenue Cycle Case Study                           25 points