This invention concerns a system and user interface for monitoring resource usage (e.g., of a medical device such as an MR imaging unit) and for determining cost and profitability of the resource.
In order to optimize acquisition, deployment and usage of resources such as a medical device in a hospital, for example, it is necessary to accurately determine the true profit or loss attributable to a particular resource. This requires the accurate determination of the total costs and revenue attributable to an individual resource over a particular time duration. It is also desirable to be able to determine this information on a substantially immediate and real time basis to enable an accurate, current profit or loss determination to be made for a particular medical device upon user request. Accurate cost, revenue and profitability (or loss) information for a particular medical device facilitates device management and maximizing revenue, minimizing cost and optimizing profit of the medical device. The information also enables inventory management and identification of medical devices that are underused or overused as well as identification of the need for an additional device or a redundant device that may be eliminated.
There are a number of problems involved in accurately determining cost, revenue and profitability (or loss) information for a particular medical device or other resource at a particular time. Specifically, asset depreciation, cost, revenue and other relevant information may be inaccessible, or retained in remote different computer systems. Further, resource cost and revenue information may be subject to assessment or determinations made by third parties involving additional different computer systems and communications that delay determination of accurate cost and revenue data. Existing systems in supply chain management, product pricing and marketing and service payment reimbursement, for example, are concerned with optimization of cost but fail to determine true costs, payments, revenues and profitability. A system according to invention principles addresses the identified deficiencies and associated problems
A system employs an on-line analytical processing (OLAP) compatible database to support creation of fact and dimensional tables including information automatically and seamlessly derived from, a hospital revenue management system (e.g. a Clinical and Financial Information System), an expense system (e.g. Ariba compatible system) and a medical device inventory management system. A system for determining characteristics of resource usage (such as actual, cost, revenue and profit or loss), includes an acquisition processor for automatically acquiring data representing information. The acquired information includes revenue received for a particular usage of a particular resource by a particular patient, operating cost of maintaining the resource, and an acquisition cost of the resource. A data analyzer processes the acquired information to determine a profit or loss attributable to the resource. A communication processor communicates a message to a remote unit indicating the profit or loss in response to user command.
The inventors have advantageously recognized that medical device (and other resource) utilization characteristics may be accurately determined by a system that integrates and configures particular information systems. In a hospital, for example, the system advantageously integrates device management related systems with a hospital revenue management system and enables determination of utilization characteristics including accurate cost, revenue and profitability of a particular medical device (e.g., a magnetic resonance (MR), X-ray, computerized tomography (CT) scan or other imaging device). The determination of accurate revenue and cost data for usage of a particular medical device is impeded by the fact that data required to determine an individual cost or revenue figure may be located within multiple different processing systems. Further, these different processing systems may be incompatible and may contain required cost or revenue information in different record formats accessible using different parameters. The data also may be derived at different times and may be available after varying periods of time delay.
The system performs cost optimization by determining final reimbursement amounts received from an insurance company and other payers for services performed for a patient using a medical device (or other resource). A final revenue payment made in reimbursement for a specific service rendered to a particular patient using a medical device typically depends on the terms of a particular contract existing between an insurance company and a health care provider. Medical insurance contract terms vary for different patients since patients participate in different health care plans with different insurance companies. Hospital revenue management systems (e.g. Clinical Information systems and Financial systems) store contract information. Hospital revenue management systems also process financial transactions including claims between a health care provider and an insurance company. The system interfaces with Hospital revenue management systems, clinical and inventory information systems for automatically acquiring information and determining true cost of a medical device and payments received for a medical device for individual services performed for patients. For this purpose, the system automatically accesses accounts in a Hospital revenue management system and other financial systems of a healthcare provider.
The system employs the automatically acquired current, accurate information to determine optimized utilization characteristics of a medical device such as true cost, revenue and profitability of a medical device in a predetermined time period or for a particular instance of use. These characteristics enable a user to optimize how and when a medical device is deployed, as well as how the device is used, including the frequency of its use and the type of services it is used to provide. The system loads current, accurate data derived from, a hospital revenue management system (such as payments received for services rendered on imaging modalities) and from an expense system (such as depreciation of capital expenditures for imaging modalities) and also from a financial system (such as operational expenses for imaging modalities). The system advantageously automates determination of optimized utilization characteristics through its integration with a hospital revenue management system providing accurate and up-to-date device costs.
The system creates fact tables and dimensional tables supporting online analytical processing and organization of data in a cubic structure, for example. This structure facilitates search and search refinement (e.g., drilling down, and slice and dice type search) for the purpose of profitability analysis. In order to make an accurate business decision in a hospital, for example, the system advantageously creates and builds fact and dimensional tables using information stored in, a hospital revenue management system, an expense system (financial system) and inventory management system. The system employs a module that extracts information from online transactional databases or copies thereof and transfers and modifies the data using analysis algorithms to create fact tables and dimensional tables in an online analytical processing database (OLAP database).
An executable application comprises code or machine readable instruction for implementing predetermined functions including those of an operating system, healthcare information system or other information processing system, for example, in response to user command or input. A processor as used herein is a device and/or set of machine-readable instructions for performing tasks. A processor comprises any one or combination of, hardware, firmware, and/or software. A processor acts upon information by manipulating, analyzing, modifying, converting or transmitting information for use by an executable procedure or an information device, and/or by routing the information to an output device. A processor may use or comprise the capabilities of a controller or microprocessor, for example. A data analyzer comprises a processor for processing data by performing combinatorial, algebraic, logical and other analysis functions including financial accounting functions. A database is one or more centralized data repository or multiple distributed data repositories, storing records and associated data supporting data search, location and extraction.
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Clinical and financial information database 70 (comprising a hospital revenue management system, for example) maintains records that track services rendered to a patient including date and time stamps identifying time and date of medical device usage in providing a particular service and a current status of reimbursement and payment for the particular service. Financial ledger system database 75 (such as an SAP, or Peoplesoft compatible system, for example) stores summarized ledger data. Expense system database 80 maintains records that track expense information. The expense information identifies, purchase cost and date of purchase of specific items of a medical device inventory, medical device service and operational fees and costs as well as capital (purchase) cost depreciation for individual medical devices.
Extraction module (ETL) 10 automatically acquires data from tables stored in inventory database 60, clinical and financial information database 70, financial ledger database 75, and expense system database 80. Module 10 automatically collates, transforms and communicates acquired data for storage in OLAP database 20 and creates fact tables 30 and dimension tables 40. Module 10 employs analysis algorithms 50 in modifying and processing data acquired from databases 60-80 for transfer to OLAP database 20. Analysis algorithms 50 also create fact tables 30 and dimensional tables 40 in online analytical processing database 20. Module 10 employs analysis and visualization applications (such as Cognos and Microsoft Analysis applications) to generate cubes 90 comprising data representing organized, structured information for display to a user in a display image. The cubic structured information includes device inventory, time period, medical procedure and medical condition identification and selection information, for example. This facilitates user selection of search criteria for implementing a search to provide medical device profitability related characteristics sorted by particular device, medical procedure, patient medical condition and other parameters. As a result data cubes 90, presented to a user in a display image, facilitate user initiated data mining, and hierarchical search and analysis. Cognos visualizer applications create sophisticated visual reports and display multiple measures simultaneously to communicate complex business data quickly and intuitively. Similarly, Microsoft Analysis applications provide data analysis supporting on-line analytical processing of data in fact tables 30 and dimension tables 40 to support data mining of database 20.
The received revenue for an individual particular usage of the particular medical device by the particular patient comprises an actual reimbursement sum received from an organization for the particular usage in response to a reimbursement claim for reimbursement made to the organization. Module 10 accumulates received revenue data for usage of a particular medical device by multiple different patients for individual episodes of use of the medical device in response to reimbursement claims made to a multiple different organizations. The operating cost of maintaining the medical device includes at least one of, (a) a cost of services to maintain the medical device, (b) a cost of parts to maintain the medical device and (c) a cost attributed to associated overhead expenses for maintaining the medical device.
In step 708 module 10 combines the operating cost and the acquisition cost and the resource revenue to provide a profit or loss value attributable to the particular medical device. Module 10 subtracts the operating cost and the acquisition cost from the medical device revenue to provide the profit or loss attributable to the medical device, for example. In other embodiments, module 10 combines the operating cost and the acquisition cost and the resource revenue using other data in a more complex manner (as known) to account for depreciation of acquisition (capital) cost, taxation, lease or rental arrangements, deferral of cost, deferral of revenue, loan repayments and other factors in order to provide a profit or loss value attributable to the particular medical device. In response to user command unit IQ, in step 713, communicates a message to a remote unit indicating the profit or loss value determined in step 708 and stores the value in step 717. The process of
The system and processes presented in
This is a non-provisional application of provisional applications Ser. No. 60/566,564 by A. Monitzer et al. filed Apr. 29, 2004.
Number | Date | Country | |
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60566564 | Apr 2004 | US |