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PATIENT ACCESS 

 health systems management network 
 
Methodologies for Continuous Quality Improvement: 

Effective case management, control of hospital resources, quality of care and accurate medical records begin when the patient enters your hospital. With the proliferation of specialized clinics, ambulatory and outpatient services and increasing public reliance upon emergency units, the avenues by which patients gain access to the system are growing. Health Systems Management Network believes that most institutions, their patients and payors can benefit from an analysis of, and plan to manage, patient access. 

Integration of Patient Access 

Healthcare, like any human endeavor, has the best chance of success when quality is built into the process from the very beginning. As the first interface between institution and patient, Admitting and Registration functions have the important role of ensuring that the process of quality care begins on the right path. Too often, there is no centralized management of the Admitting functions. Patients can enter the system through many avenues outside traditional Central Admitting, such as Operating Room Booking, Outpatient Clinics or Emergency Rooms. These avenues often have their own data- gathering criteria and systems, and often there maybe poor communication with Admitting/Registration. Health Systems Management Network has developed systems for consolidated Patient Access Services for hospitals across the nation. Without closing any doors, Patient Access Services bring all avenues back together for efficient resource management and improved quality assurance. 

The Mission of Patient Access Services 

The Admitting and Registration functions of an institution should have the purpose, staff, training and tools required to accomplish three fundamental and indispensable tasks. First, assure the most appropriate setting for each patient to obtain quality of care with efficiency. Second, assure that all clinical, financial and demographic data are gathered, assembled and maintained in a consistent and usable manner. And third, assure that patient access is managed for the appropriate use of resources. Patient Access Services should have close links to Insurance Verification, Utilization Review and Quality Assurance staff; again to assure that these functions are brought in early for proactive case management. 

Implementation and Training 

Health Systems Management Network can develop a system and implementation plan for the close integration of Patient Access Services with care providers. Communication through a dynamic, interactive documentation system will provide critical information for continuous improvement of revenue resulting from real resource management. For example, care providers can be made aware of preapproved third-party limits, and Admitting can be kept aware of transfers, discharges and progress toward discharge. 

Health Systems Management Network can provide a complete management plan for a Patient Access Services system that addresses: 

  • Organizational mission and needed structuring 
  • Admission management ofpatient data 
  • Effective patient and paper (data) flow 
  • Management roles 
  • Full support for case management models 
  • Meaningful reporting for decision- makers and clinicians 
  • Training requirements for all levels of staff 
  • Operational automated-systems support 
  • Space requirements and location 
If requested, we also can assist in the efficient implementation of our recommendations and provide progress and results analysis. 
 
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Health Systems Management Network, Inc. is a healthcare consulting firm specializing in the following practices: healthcare consultants; consulting. managed care. subacute care, patient flow, information systems. electronic patient record management. Electronic medical records, billing,insurance, acute care, case mix, case management, ambulatory care, and resource management are areas of experience. We are familiar with UB, length of stay, DRG, in patient, out patient and TQM methods. More recently Health Systems Management Network, Inc has been pioneering work with APC, (All Patient Grouper). clinical data, clinical documentation. benchmarking. critical paths and receivables. We work with utilization review. acute care hospitals. practice groups. ICD, ICD-9, ICD-9-CM, CPT, CPT-4, HCPCS, HCFA, medicare, referrals. JCAHO, claims, RBRVS, HMO, reimbursement, Joint Commission compliance, regulations, training, reengineering, (re-engineering) total quality management for both inpatient, outpatient.