Data Analysis in the EHR

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Western Governors University *

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D190

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Mechanical Engineering

Date

Dec 6, 2023

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docx

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Running head: DATA ANALYSIS IN THE EHR 1 Data Analysis in the EHR Jessica Blair WGU

DATA ANALYSIS IN THE EHR 2 Data Analysis in the EHR A1. Based on the data the cardiology department has not only the highest amounts owed but also have a higher number of readmissions. According to the spreadsheet, patients with cardiac related diagnoses have an outstanding balance which is unsustainable to not collect when its hundreds of thousands of dollars per patient. I would ask if they were being documented correctly, because many of the codes for cardiac events state unspecified or due to underlying conditions. A2. The physicians with the highest pending dollar amount are Aboud of cardiology with $1,547, 606, and Carpenter who is also from cardio with $768,274.87. A3. There are a few outliers in the data, but within each department readmissions for similar diagnosis codes are common. I would also like to point out that in cardiology patients with the ICD code of I46.- for cardiac arrest seem to be most likely to return to the hospital within 30 days. In nephrology patients are returning for R31.- for a hematuria. In neuro, there is two readmits for I67.- for brain stem stroke as well as two patients with the code I67.- for cerebrovascular disease. Obstetrics has a couple patients with O08.- for complications with an ectopic pregnancy. Finally, pediatrics has four readmissions for newborns. A4. When physicians have incomplete documentation, it puts a hold on the revenue cycle because billers cannot submit a claim yet. If physicians wait too long the facility could be in danger of reaching the timely filing limit for the claim- especially if it is returned for a correction or an appeal needs to be made. The physicians with the highest outstanding payments could be bringing in revenue for the hospital, and those claims need to be prioritized. Readmission rates affect payment to the facility by CMS. If patients continuously need to return, then the facility will not see that income. A plan needs to be put in place, such as strong

DATA ANALYSIS IN THE EHR 3 discharge policies for aftercare and continued communication with patients particularly with those that have cardiac issues, complicated neurological statuses, postpartum patients, and parents of newborns.

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