Instructions
You are a healthcare executive for a large hospital, serving as the Director of Health Information. There are
serious concerns regarding the competence of your healthcare staff. To address these concerns, you will
develop an action plan. Please complete each part of your action plan as indicated below.
Part Competency Assessed Instructions
1 Determine policies and procedures to monitor abuse or fraudulent trends
Evaluate at least three (3) types of abuse or fraud that may occur within a health information management department. Determine at least three (3) organizational policies and procedures that monitor such activities and critique the effectiveness of each policy/procedures.
2-Create and implement staff orientation and training programs
Based upon the identified trends of abuse or fraud, develop a staff orientation and training program for medical billing and coding employees. Design an outline of the program–constructing the learning activities involved. Your plan should indicate a leadership approach that you would use in the implementation of the program.
3-Evaluate initial and ongoing training programs
Develop a plan to evaluate the training program at “time of launch” and then at periodic times over the next two years. Appraise the effectiveness of our training program evaluation plan.
4 Facilitate the use of enterprise-wide information assets to support organizational strategies and objectives
Analyze the enterprise-wide information assets that you need to support organizational strategies and objectives. Differentiate at least three (3) assets and their role with ensuring quality healthcare. Please include the relationship of the asset to information management planning, enterprise information management, and/or master data/information management.
Expert Solution Preview
Introduction:
As a healthcare executive responsible for the Director of Health Information of a large hospital, it is essential to ensure that the healthcare staff is competent and adhering to the established policies and procedures. This answer will address each of the action plan parts, consisting of determining policies and procedures to monitor abuse or fraudulent trends, creating and implementing staff orientation and training programs, evaluating initial and ongoing training programs, and facilitating the use of enterprise-wide information assets to support organizational strategies and objectives.
1. Determine policies and procedures to monitor abuse or fraudulent trends
Abuse or fraud can occur within a health information management department and can have adverse effects, including financial losses and legal implications. To monitor such activities, at least three types of abuse or fraud should be evaluated, and at least three organizational policies and procedures should be implemented. The effectiveness of each policy and procedure should be critiqued to determine their effectiveness in detecting and preventing abuse or fraud.
2. Create and implement staff orientation and training programs
Based on the identified trends of abuse or fraud, a staff orientation and training program should be developed for medical billing and coding employees. The plan should outline learning activities involved in training the staff, and a leadership approach should be utilized in the implementation of the program. The focus should be on preventing abuse or fraud by ensuring that the staff is knowledgeable about detecting and reporting any suspicious activities.
3. Evaluate initial and ongoing training programs
To ensure that the training program is effective, a plan to evaluate the training program at the time of launch and at periodic times over the next two years should be developed. The effectiveness of the training program evaluation plan should be appraised to detect any shortcomings and identify areas that need improvement.
4. Facilitate the use of enterprise-wide information assets to support organizational strategies and objectives
To ensure that the healthcare organization’s strategies and objectives are supported, enterprise-wide information assets should be analyzed. At least three assets should be differentiated for their roles in ensuring quality healthcare while considering their relationship to information management planning, enterprise information management, and/or master data/information management. These assets should be incorporated into the organization’s information management strategy to promote transparency, accountability and to achieve desired outcomes.
