Internship

Fairview 2014

MICHAEL SCOTT

HIMC 2870 HIT CAPSTONE EXPERIENCE

Professional Practice Experiences (PPE)

• Overview of the facility:Fairview

What is the facility name, address, telephone number?

What type of healthcare delivery system is the facility?

Who is the Chief Executive Officer?

If the facility is a hospital or residential care facility, what is the daily

census? Number of beds (adult and children)?

Is the facility accredited by the Joint Commission or other accrediting

organizations?

What is the facility

name, address,

telephone number?

• Fairview Billing(Hospitals and Clinics)400 Stinson Blvd. NEMinneapolis, MN 55413

• Business office:612-672-6724888-702-4073 (toll free)

What type of healthcare delivery

system is Fairview?

Fairview Health Services is an award-winning nonprofit health care system based in Minneapolis which provides exceptional, coordinated health care—from preventing illness and injury to caring for the most complex medical conditions.

Fairview has a more than 100-year history of meeting community needs and achieving breakthrough medical advances in care. We are committed to delivering great value for our patients—higher quality, better experience and lower cost.

In partnership with the University of Minnesota, Fairview is an academic health system committed to nation-leading research and educating tomorrow’s physicians and health care professionals. We serve patients from across the state of Minnesota, the upper Midwest and beyond.

In addition to our employed physicians, we work closely with the academic physicians at University of Minnesota Physicians and with Fairview Physician Associates, a network of independent, affiliated physicians.

Who is the Chief

Executive

Officer? Rulon F. Stacey,

PhD, FACHE, president and

chief executive officer

As Fairview president and CEO, Rulon oversees the mission, vision and

operations of the entire Fairview system, which includes hundreds of

primary and specialty care clinics, five community hospitals and

University of Minnesota Medical Center. Fairview’s 21,000 employees

and 2,300 aligned physicians care for more than 625,000 people each

year.

Rulon’s entire professional life has been devoted to health care. He

began his career while serving on active duty in the United States Air

Force, where he was recognized for his achievements in the Medical

Service Corps. In 1996, he became CEO of Poudre Valley Hospital

System, where he worked for 16 years. Under his leadership, the

system was the only health care organization in the country in 2008 to

receive the prestigious Malcolm Baldrige National Quality Award, the

nation’s highest presidential recognition for performance excellence.

Most recently, Rulon was president of University of Colorado Health, a

system that combined academic and community medicine.

Fairview at a glance (2013 data)If the facility is a hospital or residential care facility, what is the daily census?

Number of beds (adult and children)?

Fairview at a glance (2013 data)

21,000+ employees

2,300 aligned physicians

7 hospitals & medical centers

2,530 licensed beds 1,475 staffed beds

40-plus primary care clinics

55-plus specialty clinics

53 senior housing locations

30-plus retail pharmacies

Volumes

5.87 million outpatient encounters

1.54 million clinic visits

72,291 inpatient admissions

74,905 surgeries 9,229 births167,837 emergency

department visits

9,808 behavioral inpatients served

285 blood and marrow transplants

319 organ transplants

Affiliated physician

organizations :@ Fairview

Behavioral Healthcare

Providers

Fairview Physician

Associates

University of Minnesota Physicians

Is the Fairview, accredited by the

Joint Commission or other

accrediting organizations?

Yes, please find the link to the Joint Commission for your review of

Fairview’s Credentials,

http://www.qualitycheck.org/consumer/searchresults.aspx?nm=Fairview+

&ddstatelist=MN&st_nm=MN&st=MN

Frequently Asked Questions

Fairview System Credentialing Office

GENERAL QUESTIONS

What is credentialing?

Credentialing is a term that usually encompasses two separate processes: credentialing and privileging.

Credentialing:

Primary source verification of a health care practitioner’s education, training, work experience, license, etc. A variety of resources are used to verify the information involving direct communication from the educational and training institutions, past and current hospital affiliations and employers, peer reference letters, certification boards, licensing agencies and other sources.

Privileging:

Granting approval for an individual to perform a specific procedure or specific set of privileges based on documented competence in the specialty in which privileges are requested.

Frequently Asked Questions

Fairview System Credentialing Office

Who is credentialed?

Each individual working in the hospital or clinic setting must be either: 1) credentialed through a Fairview medical staff process; or 2) employed by Fairview through a Human Resources process. Therefore, an individual must be credentialed, if not employed by Fairview.

Practitioners who are independently responsible for patient care by virtue of their license and hospital authority must be credentialed even if they are employed by Fairview. Licensed independent practitioners who must be credentialed regardless of whether they are Fairview employees or not are physicians, dentists, certified nurse midwives, podiatrists, nurse practitioners, physician assistants and psychologists.

Why does Fairview credential?

Fairview, like other health care organizations, is legally responsible for knowing that individuals providing patient care are qualified and competent to do so. Over the past 30 years there have been multiple legal cases where hospitals were held accountable because they had not done adequate credentialing.

The Joint Commission, The Centers for Medicare and Medicaid Services (CMS), National Committee on Quality Assurance (NCQA), Minnesota Department of Health and Human Services and other oversight organizations require that members of the medical and allied health staff be credentialed and privileged before working in the facility.

Questions about the HIM professional:

What is your job description? What work experience or education have

you had to prepare you for this job?

What are your department’s hours of operation?

How are weekends and holidays staffed?

What provisions are there for credentialed employees to obtain continuing

education yours and what is the facility’s philosophy on involvement in

HIM professional association events?

What is your job description? What work experience or education have you

had to prepare you for this job?

I was assigned to the Robyn Socha Hanson, as she reports directly to the HIM

System Director Pat Gastonguay. Robyn discussed with me her education and

background in private. Robyn, works in a wide variety of dual roles, as on of her roles she serves as a Registered Healht Information Administrator.

HIM System Director

Pat Gastonguay

FMG HIM

Optimization Staff

Lisa Garrity

HIM Compliance Coordinator

Robyn Socha Hanson

Health Information Hierarchy

First level:

• HIM System Director:

Pat Gastonguay

• HIM Compliance Coordinator

Robyn Socha Hanson

• FMG HIM Optimization Staff

Lisa Garrity

What are your department’s hours of operation?

In meeting with Robyn we discussed both the schedule and the expectations.

The First exception was the completion of the internship orientations as they

were provided in the format of an on-line presentations via the Fairview’s

Intranet site.

As the on-line presentations were both video as well as interactive.

Discussed the Fairview Mission and Goals process.

Safety As well as Patient Safety

. Business hours Monday through Friday 8-5pm.

What are your department’s hours of operation

Robyn also provided the HIM Departmental Chart, Chain of Command. As well Robyn also discussed with me the expectations regarding the coding testing project and the various protocols involved in the process.

She orientated me a to the on-line log-in process regarding this particular testing and as well the various on-tools and resources that were to be utilized in this process, specifically the 3m Decoder,

as well as the Patient Record and documentation along with the reference point the Excel Spread Sheet and where these resources were located within the Fast Apps log-in.

Robyn also trained me in the use of the 3M Electronic encoder within Fairview’s EMR/Epic.

How are weekends and holidays staffed?

As for staffing of the weekends this information was provided in the

Hierarchy chart of the Health Information Management Structure,

Evening/Night/ and Weekend Supervisor, UMMC East Bank,

Ragu Karmacharya.

Admissions, Registration, Health Record

Storage/Retrieval/Retention and Health Information Systems:

Description of the confidentiality, ethics, and accuracy mandates.

1PM – 1:30PM – Meet with Lois Dahl, Director of Information Privacy.

In meeting with Lois Dahl we both shared our professional backgrounds such as education and

working experience’s. In our conversation we also shared some personal experiences. As Mrs.

Dahl did provide a real time examples of past experience regarding Data Breaches what

necessary steps that she had to take in at dealing with the issue such as the action plan, as well

she also discussed with me some of Fairview’s Policies and protocols along with HIPPA Guidelines

in taking action on matters of Data Breeches. Mrs. Dahl discussed the organizational chart with me within Fairview’s Health Information Systems.

Admissions, Registration, Health Record

Storage/Retrieval/Retention and Health Information Systems:

What is the mission, philosophy, objectives of the facility?

At Fairview Health Services, we care for our patients and their families in ways

that honor our mission, vision and values. Each of us at Fairview follows a

high ethical standard of conduct. Together, we are dedicated to fulfilling our role as a responsible corporate citizen. As we strive each day to fulfill our

mission, achieve our vision and live our values, we are supported by our

Corporate Compliance Program.

The Code of Conduct is based on our mission, vision and values and provides

information about our standards of behavior. The code also lets employees and

others who interact with Fairview.

What guides us….Fairview

MissionTo improve the health of the communities we serve. We commit our

skills and resources to the benefit of the whole person by providing

the finest in health care, while addressing the physical, emotional and

spiritual needs of individuals and their families. We further pledge

to support the research and education efforts of our partner, the

University of Minnesota, and its tradition of excellence.

VisionTo be the best health care delivery system for America, in partnership with the University of Minnesota

ValuesDignity: I value the uniqueness of each person. I respect each individual’s culture, values and beliefs. I honor each person’s unique talents and contributions.

Integrity: I say what I mean and do what I say.

Service: I work to make a difference in people’s lives and in our communities.

Compassion: I create a caring environment, conducive to healing, growth and well-being for all, including myself.

Admissions, Registration, Health Record

Storage/Retrieval/Retention and Health Information Systems

What is the admission or registration process of a new client/patient?

Pre-registration for Hospital Services

Convenience Our convenient online pre-registration tool saves you time

prior to admittance. Online pre-registration requires at least

24 hrs notice before arrival. You may pre-register for:

•childbirth•any inpatient procedure or service•any outpatient procedure or service.

.

AccessTo access online pre-registation, please select the facility from the list below:

•Fairview Maple Grove Medical Center•Fairview Northland Medical Center•Fairview Ridges Hospital•Fairview Southdale Hospital•University of Minnesota Amplatz Children's Hospital•University of Minnesota Medical Center, Fairview•Fairview Lakes Medical Center

The Revenue Cycle In Epic:

Admissions, Registration, Health

Record Storage/Retrieval/Retention and Health Information Systems

Describe the computer applications that are used for this position

(hardware and software).

Hardware- was pretty much the standard computer hard drives and monitors

as in this case they use dual monitors.

Software- Epic, Scanners, Microsoft word, excel, outlook and 3M Encoder. As

well as current coding books.

Admissions, Registration, Health

Record Storage/Retrieval/Retention and Health Information Systems

What are the facility’s

policies and procedures

about release of

information?

Purpose:

The purpose of this policy is to provide a mechanism to assure that in accordance with federal and state laws, only those individuals with a legitimate business need are allowed access to Fairview information systems that contain confidential information, including Protected Health Information (PHI).

Admissions, Registration, Health

Record Storage/Retrieval/Retention and Health Information Systems

Policy: Fairview will strictly monitor and

control access into systems that

contain confidential information and

will be able to demonstrate that users

are not accessing confidential

information inappropriately.

Internal Users: An authorized internal user is any person who has been authorized to access, create, read, update, and /or delete information created or held by Fairview Health Services. Internal users would generally be defined as members of the Fairview workforce, including employees, credentialed medical staff, students, and volunteers.

External Users: Authorized external users include organizational entities and third parties distinct from Fairview with contractual permissions for information exchange with Fairview such as Business Associates who are performing a service on behalf of Fairview. Authorized external users, Business Associates, and their designated agents are required to comply with Fairview’s policies and procedures governing the privacy of patient information.

Admissions, Registration, Health

Record Storage/Retrieval/Retention and Health Information Systems

User Identification and Passwords: The designated / authorized

application security administrator is responsible for setting up and

distributing user identification codes and passwords that allow access into

Fairview’s information systems that contain protected health information

or confidential information (e.g., Epic, Imagecast, etc.).

Admissions, Registration, Health

Record Storage/Retrieval/Retention and Health Information Systems

What type of filing system is used? Terminal digit.

What type of numbering system is in use? Serial

Is off-site storage used? Yes, Hospital/clinic owned and commercial.

What type of medium is used for storage? Both Paper and Electronic and there was discussion on this as to what they will do with the paper files.

How long are records retained and when are they purged?, Records are kept in accordance with compliance guidelines

Statistics, Coding, and Quality Management:

What type of data, information, and statistics are produced by this HIM

professional or his/her department

The HIM professional is an important connection between doctors,

patients, insurance providers, and other movers and shakers in the

healthcare field. By maintaining, collecting, and analyzing health

information, the HIM professional makes an important contribution to the

delivery of quality care. Besides working with cutting-edge technology,

the job is an ongoing challenge.

Statistics, Coding, and Quality Management:

What type clinical vocabulary or classification system does this facility use for billing and reimbursement?

Neither a clinical terminology nor a classification can, by itself, serve all of the purposes for which health information is currently used or will be used in the future. Terminologies and classifications are designed for distinctly different purposes and satisfy diverse user data requirements.

Classification systems such as ICD-9-CM, ICD-10-CM, and ICD-10-PCS group together similar diseases and procedures and organize related entities for easy retrieval. They are typically used for external reporting requirements or other uses where data aggregation is advantageous, such as measuring the quality of care, monitoring resource utilization, or processing claims for reimbursement. Classification systems are considered “output” rather than “input” systems and are not intended or designed for the primary documentation of clinical care. They are inadequate in a reference terminology role because they lack granularity and fail to define individual clinical concepts and their relationships. Yet they are the most common source of clinical data today, readily available as a byproduct of the healthcare reimbursement process.

Statistics, Coding, and Quality Management:

What procedures are in place for monitoring quality?

Ensuring that data collected through national health information systems are of

sufficient quality for meaningful interpretation is a challenge in many resource-

limited countries. Does this facility have a continuous improvement plan?

Are there performance standards and/or measurements of productivity?

Which records are analyzed for completeness?

Statistics, Coding, and Quality Management:What procedures are

in place for

monitoring quality?

HIM Supervision:

What methods and styles do you want people to use when they communicate with you?

What do you like to see most in an employee?

What do like to see the least in an employee?

What weaknesses do you observe in the ways people communicate at work?

What is the primary management and leadership style? (Student only: From the information that has been gathered – Is it effective?)

What kinds of problems have he or she faced and how have the problems been solved?

Is there employee training? What type? How effective is it?

What changes has he or she seen or have heard of in the workforce during the past 5-10 years?

What is his or her speculation on how their work will change in the next ten years?

What is the facility’s dress code?

What kinds of internal and external networking do they engage in? How

would they describe their organization’s grapevine? Do they have their

own approach to using the workplace grapevine? How has informal

communication helped them, and how has it hurt them?

Sources

http://www.fairview.org/billing/index.htm

http://www.fairview.org/About/whoweare/OverviewofOurServices/index.

htm

http://www.fairview.org/About/NewsandStories/S_103687

http://www.qualitycheck.org/consumer/searchresults.aspx?nm=Fairview+

&ddstatelist=MN&st_nm=MN&st=MN

http://www.fairview.org/credentialing/About/index.htm

http://www.fairview.org/fv/groups/public/documents/web_content/s_097

480.pdf

http://news.unchealthcare.org/heartandvascular/news/2013/epic-unc-

helpful-information-and-tips

http://www.fairview.org/fv/groups/internet/documents/web_content/s_03324

9.pdf

http://drmichaelstearns.com/data-integrity-fundamentals/