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Here are some sample functional
requirements for HIS: |
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ADT & Census
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| Incorporate Advance Directive Y/N and communicate to nursing stations and/or Clinical Information System. |
| Integrate Local Medical Review Policies and generate Advanced Beneficiary Notices when required. |
| Automatically purge "no-show" pre-admissions after a hospital-defined time period. |
| Support on-line inquiry of all beds from which patients are awaiting transfer or pending discharge. |
| Print admissions list by 1st insurance, showing 2nd and 3rd, flagging those needing certification within 24 hours. |
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OP Registration
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| Provide on-line pre-registration functions for gathering patient demographic, guarantor, insurance and other data. |
| Support short outpatient registration process (e.g. compared to inpatient admissions) tailored to simpler outpatient service requirements (e.g. blood draws, lab tests). |
| Support "recurring" or "series" outpatient accounts that do not require re-entering registration data at each visit. |
| Support automatic transfer of patient data and charges from ER and outpatient accounts to inpatient account if patient is admitted. |
| Provide quick emergency department registration process (e.g. for stat or John Doe patient) allowing registration records to be completed later. |
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Patient Accounting
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| Support a variety of insurance contract billing requirements such as sending separate bills to IPA versus insurance company. |
| Provide comprehensive user-defined front-end coding and billing edit processes to validate coding, revenue codes, bill type, etc. to support APG assignment. |
| Provide ability to maintain a series (or recurring) outpatient's master record and reflect all changes in individual visit records. |
| Provide third party log functions to track all payments, charges and adjustments for inpatients and outpatients. |
| Support automatic collection processing that routes accounts to specific followup steps per user-defined criteria (e.g. balance > $5,000 and over 90 days). |
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APCs
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| Provide contractual commitment to support all current and future Medicare outpatient prospective payment system (OPPS) information requirements including Ambulatory Payment Classifications (APCs). |
| Provide automatic management of line item charge detail within billing system to support final APC assignment and outpatient code edit checks. |
| Provide ability to include multiple outpatient claims from different sites-of-service onto one consolidated claim. |
| Support up to 450 (or most current government recommendation) service lines per claim on UB-92 to accommodate Medicare OPPS. |
| Provide ability to automatically identify outpatient APC-related claim edit errors and correct them before claim submission. |
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Medical Records
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| Support on-line maintenance and access to medical records for inpatients, outpatients, and emergency patients. |
| Support batch processing of chart locations using report data capture devices (e.g. portable bar code scanners) used to inventory all charts within a location. |
| Provide ability to view and/or print incomplete medical record delinquency reports by physician showing deficiencies. |
| Generate abstracting productivity statistics on amount of work completed and time spent per chart. |
| Provide "quick entry" feature that replaces long medical terminology after short abbreviation is keyed. |
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Resource Scheduling
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| Provide ability to schedule services and resources throughout the care delivery organization regardless of where the service is rendered or where request was initiated. |
| Provide on-line link to patient's insurance benefits information regarding covered services and co-payments, and alert if a referral is required. |
| Allow scheduling of appointments for any point in the future (e.g. schedule follow-up for 6 months or a year in future, not just 4 weeks). |
| Provide ability to limit the number of times a particular procedure can be scheduled for a provider and flag when the limit is reached. |
| Provide ability to inquire and view names and reasons for visit for each patient in an over-booked time slot. |
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Physician Access
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| Provide on-line, easy-to-use system for physicians to access patient demographic, clinical, order, and results information. |
| Provide security confidentiality control features to prohibit physician from viewing and accessing data for other physicians' patients. |
| Provide on-line patient inquiry function showing name and phone of family and emergency contacts for patients of physician who is logged on. |
| Provide electronic signature ID function for physician to electronically record approval and entry of orders. |
| Support on-line graphical display of physician's patient lab test results for trends, etc. |
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HIPAA
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| Support an enterprise-wide single sign-on user authentication process that allows individual users to logon to different systems with one global user ID and password. |
| Support automatic log off of work stations connected to patient information systems after a site-defined time period of inactivity (e.g. 5 minutes). |
| Provide mechanism for entity (e.g. unique individual) authentication such as: biometric (e.g. hand geometry, retinal/iris scan, fingerprint patterns, facial characteristics). |
| Support a nine digit alphanumeric Employer ID field in software all modules that use Employer IDs. The Employer ID format is: 00-0000000 |
| Provide ability to create data files for teaching purposes that meet HIPAA guidelines for compliance (e.g. tracking without specific patient information). |
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General Ledger
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| Support processing of multiple general ledgers for multi-entity organizations. |
| Provide ability to set up and maintain multiple fiscal calendars (e.g. use a monthly calendar for one entity and a quarterly calendar for another). |
| Support allocation of revenue and expenses to profit centers by fixed amount and percentage. |
| Show volume units, revenue per unit, and costs per unit on a units-of-service statistical report. |
| Support uploading of data from standard microcomputer file formats to general ledger system. |
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Budgeting
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| Provide integration and sharing of data between general ledger and budgeting systems. |
| Compute future period projections based on average of prior years' data plus or minus a percentage. |
| Support flexible budgeting of revenue, expense, and labor data based on user-defined volumes. |
| Support capital expense budgeting with automatic calculation of depreciation based on assets useful life. |
| Provide option to automatically interface monthly budget adjustments to general ledger system. |
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Case Mix
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| Interface to and capture patient information automatically from the patient care and financial applications. |
| Provide concurrent review functions to monitor utilization during patient stay. |
| Maintain and allow on-line access to revenue, cost, and payment history data by diagnosis group. |
| Print financial utilization reports of inpatient and outpatient by financial class by MD. |
| Provide ad hoc report writing features within Case Mix system for non-technical users. |
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Accounts Payable
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| Provide ability to compute payment due dates based on the terms of the vendor discount or user-defined period from the invoice date. |
| Maintain employee payment records separately from vendor records for statistical and reporting purposes. |
| Support automated reconciliation of vendor invoices, purchase orders and receipts to verify quantity ordered, received, accepted and billed before payment is authorized. |
| Print vendor aging report of unpaid invoices for user-specified period (e.g. to see the outstanding items as of certain date and reconcile the total to the general ledger). |
| Print trend analysis report showing summary of activity for current month, last twelve months, and YTD by vendor. |
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Fixed Assets
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| Support user-definable asset coing scheme by function, services, structure, cost center, or operational group. |
| Support retroactively transfer of assets including charge of associated depreciation to appropriate departments or accounts. |
| Provide ability to backdate assets additions for the purpose of catching up on depreciation. |
| Print asset recap showing cost, salvage value, accumulated depreciation, current depreciation and book value. |
| Interface depreciation journal entries to the general ledger system. |
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Payroll
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| Support an unlimited number of earnings codes including (but not limited to) salary, hourly rate, vacation, sick, holiday, shift differential, overtime, call back, disability, etc. |
| Monitor annual maximum deduction amounts and stop the deduction once the predefined maximum is reached. |
| Automatically adjust garnishment and child support deduction amounts if the disposable income requirements will not be met after the deduction is taken. |
| Process partial period payments to employees who do not work the entire pay period (e.g. new hires, terminations, on leave without pay, catastrophic leave). |
| Provide ability to restart check printing in the event check stock is damaged or printer malfunctions, with audit controls for damaged check stock. |
| Provide ability to synchronize employee master files in payroll system with time and attendance system. |
| ►More requirements
are included in the actual RFP template. |
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