1. PrimeSUITE’s Practice Management and Electronic Health Record Software
chapter one
PrimeSUITE’s Practice
Management and
Electronic Health
Record Software

2. Learning Outcomes When you finish this chapter, you will be able to:
1.1 Describe practice management
applications.
1.2 List the advantages and disadvantages of
an electronic health record.
1.3 Describe EHR applications.

3. Learning Outcomes (cont)
When you finish this chapter, you will be able to:
1.4 Chart the flow of information from
registration through processing of the claim.
1.5 Use the help feature in PrimeSUITE.

4. Key Terms Application Care provider Clearinghouse Clinical information
Current Procedural Terminology (CPT)
Demographic information
Electronic claims submission
Electronic Health Record (EHR)
Electronic Medical Record (EMR)
Encounter form (Superbill)
International Classification of Diseases-10th revision, Clinical Modification/Procedure Coding System (ICD-10-CM/PCS)
Teaching notes:
At the end of the key terms slides, ask class to identify which ones they feel are most common and have a class discussion about why.
Move on to the lesser-known (or not mentioned) terms and stress to students why they are also important.
Ask whether they are aware of the change from ICD-9-CM to ICD-10-CM/PCS.

5. Key Terms (cont) Interoperability Master Patient (Person) Index
Point of care
Practice Management
Speech recognition
Teaching Notes: See notes on slide 4.

6. 1.1 Practice Management Applications
Practice Management (PM) Software
Computer programs that carry out administrative functions or operations
Electronic Health (Medical) Record (EHR/EMR)
Includes the clinical documentation of patient care
Learning Outcome 1.1 Describe practice management applications.
Teaching Notes:
Ensure students understand that there are software programs (such as PrimeSUITE) that contain both a practice management component and an electronic record.
Ask students why a combined program would be ideal. Would there be a situation in which standalone software might work better? Why or why not?
List various processes, functions, and tasks on whiteboard and ask students to define whether each would be part of PM or EHR.

7. Applications found in PM Software
Enter patients into a patient or master list
Schedule appointments
Assign ICD-10-CM diagnosis and CPT Procedure Codes
Complete a billing claim form
Send insurance claims to carriers
Learning Outcome 1.1 Describe practice management applications.
Teaching Notes:
Direct students to worktext pages 2-4 to discover all of the details under each PM process bulleted on slide (for example, the high-level process for completing billing forms).
Contrast “administrative” and “demographic” information (worktext, p. 3); provide or solicit examples of each.
Ask students to cite some benefits of filing claims electronically.
Instruct students that CMS-1500 forms are used for outpatient claims, UB-04 for hospital claims. Have them search for a sample of each on the Internet.
Ask if students understand what a carrier is.

8. 1.2 Why Adopt EHR Applications ?
Conversion to an EHR has been slow because of:
Security concerns (loss, theft, tampering)
High cost of implementation
Time involved for providers in learning how to implement, maintain, and use an electronic system
Loss of productivity by administrative and direct patient care staff during the learning phase
Learning Outcome 1.2 List the advantages and disadvantages of an electronic health record.
Teaching Notes:
Before revealing content on slides 8-10, ask class to brainstorm a list of potential concerns/advantages of EHRs. Check their list with the information presented on slides, and use information to generate a discussion.
Have students brainstorm whether paper records are more secure than electronic records. Why or why not?
Discuss concerns of rapid advances in technology – is that a positive or negative for adoption of an EHR?
Brainstorm any costs of paper records that will no longer be incurred once the EHR is installed.

9. Why Adopt EHR Applications (cont)
(slow conversion continued)
Sharing of information with other providers from a privacy viewpoint
Ability to communicate with other computer systems (interoperability)
Learning Outcome 1.2 List the advantages and disadvantages of an electronic health record.

10. Why Adopt EHR Applications ? (cont)
Advantages:
With today’s technology and proper policies, security need not be a concern.
Initial costs are high, but savings in supplies, space, staff, etc., plus the positive impact on patient care, all increase return on investment.
There is a high learning curve, but once learned, the benefits outweigh the disadvantages.
Learning Outcome 1.2 List the advantages and disadvantages of an electronic health record.
Teaching Notes: See notes on slide 8, and:
When covering sub-bullet #2, highlight specific examples of how patient care and ROI are positively effected by EHR adoption.
Ensure that the regulatory compliance issue is stressed! Students need to know about all of the regulations surrounding health records, and how EHRs assist in meeting those regulations; as the text continues, they will gain more in-depth knowledge of the regulations.
Discuss the idea of interoperability and how that improves patient care – this is a good place to discuss an EMR vs. an EHR.

11. Why Adopt EHR Applications ? (cont)
Advantages (cont):
Interoperability allows for sharing of information.
It is much easier to assure regulatory compliance.
Collection and use of incredible amounts of clinical data for use in medical research and epidemiology is made possible.
Learning Outcome 1.2 List the advantages and disadvantages of an electronic health record.
Teaching Notes: See notes on slide 9.

12. 1.3 EHR Applications Clinical documentation of the visit
Ability to ePrescribe medications
Exchange of clinical information between providers
Ability to access clinical trials, evidence-based medicine, and research
Mobile EHR applications
Point of care dictation of the progress notes, possibly using speech recognition technology
Learning Outcome 1.3 Describe EHR applications.
Teaching Notes:
Discuss with class which of the applications they believe is most:
beneficial
groundbreaking
timesaving
helpful for patient
helpful for staff
etc.
Were there any similarities in choices? Discuss why or why not.
If there was a variety of responses to each topic, use that information as a way to stress the comprehensiveness and multi-functionality of an electronic record – there is a LOT these EHRs can do!
Ask students: “When you are working as a healthcare professional, will you take advantage of the mobile functionalities of software such as PrimeSUITE? Why or why not?”

13. 1.4 Flow of Information from Registration through Claim Processing
An appointment is made.
Patient is “checked in” or registered.
Patient waits to be seen by the provider.
The patient is called back to an exam room.
Patient vital signs are taken, and questions are asked about why they are being seen and about their medical history.
Patient examination is completed.
A plan of care is provided.
Learning Outcome 1.4 Chart the flow of information from registration through processing of the claim.
Teaching Notes:
Put students into groups, and have each group create a flowchart of the information-gathering process.
Put the high-level topic headings for each piece of process on whiteboard or on pieces of paper, and have class list/brainstorm the individual tasks that would go under each heading, with reasons.
Print copies of the in-text flowcharts (pages 8-10) with the titles removed, and see if class (small groups?) can match each flowchart with its proper title; use results as springboard for discussion.

14. Flow of Information from Registration through Claim Processing (cont)
Patient check-out and billing procedures begin:
Create/file follow up on insurance claims
Claims processing edits
Claims status/clearinghouse reports
Claims maintenance
Receive insurance Explanation of Benefits (EOB); post payments
Insurance transactions
View accounts/generate statements
Learning Outcome 1.4 Chart the flow of information from registration through processing of the claim.
Teaching Notes: See notes on slide 12.

15. Flow of Information from Registration through Claim Processing (cont)
If diagnostic procedures such as x-rays or laboratory tests were ordered, clinical documentation steps may be repeated:
Receive results from lab/hospital
Document import results
Authenticate results/execute follow-up instructions
Track orders
Notify patients of results
Document follow-up
Learning Outcome 1.4 Chart the flow of information from registration through processing of the claim.
Teaching Notes:
See notes on slide 12.
Stress that the content on this slide is not always done; it is only repeated if necessary based on new or updated medical information.

16. 1.5 Use of the Help Feature
“Help” functions are standard in most software applications. PrimeSUITE is no different.
PrimeSUITE “Help” can be accessed through any screen.
Learning Outcome 1.5 Use the help feature in PrimeSUITE.
Teaching Notes:
Poll students on their interactions with a software Help feature in the past. What were their experiences? Did they like it? For those who do not like to use help features or do not use them…why not?
Ask class what they feel the advantages of using the Help feature in PrimeSUITE might be (can “do things themselves” without asking for help; eliminates the need to memorize where everything is located…)
Use responses as a segue into the next slide.

17. Use of the Help Feature (cont)
When you click on “Help,” access to the entire user’s guide is available.
It can be searched by topic.
It can be searched by the index or glossary.
The important thing about “Help” is that it is there for just that, to help you learn PrimeSUITE and to assist you when you are unsure of the steps you need to complete.
Learning Outcome 1.5 Use the help feature in PrimeSUITE.
Teaching Notes:
Remind students of their responses to the “advantages” question on last slide and see if they match up.
List some examples of when Help might be needed, and see if students would use the topic or index search function.

18. Summary Practice management applications
Master Patient Index/Patient List
Scheduling appointments
Assign ICD-9-CM and CPT codes
Complete billing claim form
Send insurance claims to carriers
Advantages and disadvantages of an electronic health record
Teaching Notes:
Before going through the chapter summary, ask students to write down 2 things:
1-2 biggest takeaways from Chapter 1
1-2 outstanding questions/challenges from Chapter 1
Encourage students to keep this list and add to it after each subsequent chapter (to compile a list of their personal key points and to see if their questions get answered).

19. Summary (cont) EHR Applications include: Clinical documentation
Electronic prescribing
Exchange of clinical information
Research evidence-based medicine, pharmaceutical research, clinical and financial benchmarking studies
Speech recognition
Teaching Notes: See notes on slide 17.

20. Summary (cont)
Flow of information from registration through processing of the claim
Appointment scheduling
Front desk check-in
Patient taken to examining room
Provider meets with the patient
Patient checked out
Business office/billing completed
Follow-up on test results
The “Help” feature in PrimeSUITE
Teaching Notes: See notes on slide 17.