MEDITECH
Abstracting
functionality brief

The Abstracting functionality in MEDITECH's Health Information Management product collects and reports various patient information, such as prospective payment and Peer Review Organization (PRO) data, as well as data for state and federal reporting requirements.

Highlights:
The Abstracting functionality enables users in multiple- and single- facility health care organizations to:
   • Calculate Diagnostic Related Groups (DRGs) automatically
   • Review patient charges concurrently
   • Generate DRG statistics for case mix analysis
   • Create organization-defined case mix reports
   • Create and maintain patient abstracts on-line
   • Generate abstract statistics
   • Create and maintain various projects on-line.

The functionality helps health care organizations to calculate DRGs accurately, monitor charges as patients approach reimbursement limits, ensure that patient abstracts are completed in a timely manner, and analyze case mix management at the hospital. Integrated with MEDITECH's Revenue Cycle application, the functionality provides an easy method of capturing and reporting patient and financial data. The functionality also offers:
    • Coding of both inpatients and outpatients using ICD-9, CPT-4 coding and modifiers
    • Connectivity to other encoding products via HL7 compliant interface
    • Customer-defined edit checks to guarantee information is completed before finalizing abstracts
    • Ability to combine abstracting information for all patient classes in one Abstracting (ABS) database
    • Queries which can be utilized to display information from other applications
    • Standard fields that can accept APG and APC information via encoding interfaces
    • CPT modifiers that can be entered or captured through an encoding interface.

Standard Features

Grouper Routines for Managing DRGs
The functionality includes grouper features which automatically calculate DRGs, display patients' DRG data, and provide for easy creation of various reports. The features include:
• Ability to assign separate DRG admit statuses, intermediate, and final DRG
• Display of reimbursement amount and length-of-stay data
• Ability to recalculate the DRG if edits are made to other key fields
• Ability to flag patients for concurrent review
• Ability to store multiple grouper versions
• Concurrent and retrospective coding features available.

Concurrent Review
A concurrent review feature helps to identify which patients' charges are approaching the DRG reimbursement amounts and/or approaching their DRG maximum or standard length of stay. These reports signify the potential day and cost outliers of those patients still in the hospital. Users may identify any or all of the following criteria:
• Patients flagged for review
• Patients whose actual length of stay (LOS) is within an organization-specified limit of their assigned LOS
• Patients whose actual LOS is within an organization- specified limit of the maximum DRG LOS
• Inventory valuation using Average Cost (AVG)
• Patients whose actual charges are within an organization-defined percentage of the DRG expected reimbursement amount
• Patients whose LOS is an organization-specified number of days before/after their DRG standard length of stay
• Patients whose DRG or diagnosis has changed in the previous user-specified number of days
• Patients with a particular DRG status
• Transmit UB 92 CPT charge master codes from the Revenue Cycle product to the Abstracting functionality.

The functionality includes the ability to create a Final DRG Delinquency Register that identifies discharged patients lacking a final DRG assignment. Test case grouper features allow users to test cases without using actual patient abstracts.

Utilization Reports
Case Managers perform patient-specific utilization reviews such as quality management and risk management. Reviewers have the ability to:
• Collect patient-specific data for pre-admission, concurrent, and retrospective reviews
• View diagnoses and insurances
• Create specific criteria indicators such as severity of illness and appropriateness of admission
• Generate letters and messages based upon review outcomes
• Generate statistical reports which analyze utilization review data
• Create worksheets and collection forms for patient data
• Create organization-defined worklists specifically for utilization review.

Customer-Defined Screens
Users may create and customize their own screens to collect information. If desired, these screens can be set up in the Registration functionality to pass information captured on these screens to the patient abstract.

Encoding Capabilities
The Abstracting functionality contains coding and grouping functionality through the use of HCFA tables. Sites have the option to connect to other vendor software. Features include:
• Ability to pass MEDITECH patient identifying information to other vendor encoder
• Ability for MEDITECH to receive other vendor’s coding date for automatic inclusion into the patient's abstract profile
• A choice of third-party encoding software that is HL7 compliant including 3M, Codemaster, and Medicus.

MEDITECH receives the following Ambulatory Patient Group (APG) information for the patient:
• CPT codes with APG information attached to them
• All APG assignments with associated APCs, cost weights, and APC percentage values
• Summary APG assignment
• Total charges, outlier dollar value, APG weight and expected reimbursements for the summary APG.

On-Line Patient Abstracts
The functionality makes it easy to create, view, and maintain both inpatient and outpatient abstracts on-line. The application pulls selected information on a particular patient from the Registration application to minimize data entry and allow for historical reporting. The system allows users to:
• Easily create abstracts from information passed from the Registration application
• Display, edit, and finalize abstracts for statistical compilation and tape creation, if applicable
• File data automatically
• Develop user-defined reports
• Print forms such as the Attestation Statement, UR Utilization Worksheet, and Patient Abstract form.

Abstract Reports
Abstract reporting options ensure that abstracts are completed as soon as possible. Unfinalized abstracts are included in statistical reports to provide more accurate reporting. Users may create reports such as:
• Incomplete Abstracts List to note those patients whose abstracts are not final
• Expired Patients Report to list those patients who passed away during a user-specified time period
• Case Mix Indexing
• A listing of all patients involved in a particular special study which the institution is conducting
• Report the top 10 diagnoses and procedures, including rank and patient counts.

Project Screens and Special Studies Routines
A group of user-defined project screens included in the functionality enable the organization's staff to establish its own data collection screens for collecting information such as quality assurance, risk management, infection control, and utilization review data. Users can:
• Flag special studies
• Collect and report on an unlimited number of user-defined queries and responses
• Assign an unlimited number of projects to a patient abstract as appropriate
• Use the report writer to report on projected data
• Limit user access to appropriate projects
• Enter the diagnosis and procedures, as well as finalize the abstract, on one screen.

Optional Features
The functionality allows organizations to incorporate a variety of optional features and routines, including the use of abstract tapes (UIS, PAS, and various other state tapes).

For more information about us, contact a MEDITECH Marketing Representative.

MEDITECH
Medical Information Technology, Inc.
MEDITECH Circle
Westwood, MA 02090
781-821-3000
www.meditech.com