Data Gathering for Decision Support
KREG’s Decision Support system aggregates data from your Hospital’s Information System via text files. We have experience with all the major systems and can provide the specs for many of them. These systems include McKesson Paragon, Siemens Envision, McKesson Star, and Meditech. We have extensive experience with Meditech clients and guarantee having you up and running in 90 days if we are given access to the system. Even if we don’t have the specifications for the specific source system, the file requirements are straightforward and we can be flexible on the exact format or order of the file. We can successfully install your system within 90 days once we have the data files from your IT.
The data gathering process is easy. We will start with meeting with the staff involved with implementing the project and discuss specific data requirements. Each file will be discussed in detail so everybody has an understanding of which field we are asking for. This is also an opportunity to identify additional data elements that are not part of the standard requirements. These user defined fields can be additional medical data, demographic data, or financial information. They may reside in different systems at your facility, but as long as they are linked by a common account number they may be used together in PLM for enhanced reporting.
The illustration below shows the various data feeds for PLM:
When PLM is up and running it will provide data to other systems in your organization. For example, if you license KREG’s Contract Management Analytics system (CMA) PLM will populate the claims with cost. Many organizations use the data in PLM to populate other systems for benchmarking or providing data for various projects.
This file contains the general information on the patient, including admission and discharge dates, patient type, zip code and financial class information.
Posted Charge Transactions
PLM needs a file with all posted detailed charges in a given time frame. These charge transactions include the procedure, department, CPT4™ and revenue code.
Posted Payments and Adjustments
These are non-charge transactions such as payments and adjustments. These include a transaction code that is used to identify the type such as a patient payment or insurance write-off.
Procedure and Diagnostic Codes
PLM needs ICD-9s and ICD-10s in separate files. Since it stores ICD-9s and ICD-10s in separate tables it is possible for a patient to have both types of codes.
KREG stores multiple payers for each patient.
PLM will import several different doctor types per account. These include surgeons, attending and admitting physicians, and consulting physicians.
PLM stores multiple types of DRGs. These DRGs have weights and product lines associated with them.
PLM takes in the soft coded ®CPT4 in a direct file. It will also pull ®CPTs from the charge transactions and charge master file.
User Defined Fields
These are additional fields not included in KREG’s basic data requirements. You may import data elements from different sources as long as they may be linked to the HIS data using the same account number.
These are master files that contain all of the codes and their associated descriptions.
Once KREG’s implementation team gets the sample submission we will review and test the data files. If all is well the load will start and reconciliation reports will be provided back to the client like the one below:
When the implementation is complete you have access to reports like the one below. If you license our Contract Management Analytic system (CMA), you will be able to populate the claims with cost data and import the expected payments from CMA into PLM.