1. © Richard Welke 2002 CIS 4120: Define/Innovate BP’s Richard Welke Director, CEPRIN Professor, CIS Robinson College of Business Georgia State University Atlanta, GA AH-2 Instructor’s Solution: Physician’s Office Patient Processing

2. CIS 4120 Session 2: AH-2 Solution © Richard Welke 2008-12 Starting point 2

3. CIS 4120 Session 2: AH-2 Solution © Richard Welke 2008-12 Slightly redone process diagram 3 Two “pools”

4. CIS 4120 Session 2: AH-2 Solution © Richard Welke 2008-12 Teasing out the services 4

5. CIS 4120 Session 2: AH-2 Solution © Richard Welke 2008-12 Service 1: Patient scheduling Service name: Request-to-Appointment Client: Patient PTBS: Secure acceptable doctor appointment Value metrics (those relevant to the client) Effort to secure appointment (t[secured appt]- t[start]) Convenience of appointment (# iterations to secure) Process steps: As shown in diagram for lane labeled scheduling Process metrics (those relevant to process owner) Resources consumed (Aver[time x $cost of scheduler]) Compactness of schedule (# of non-scheduled time slots/week) # of missed appointments (potential indicator of scheduling quality) 5

6. CIS 4120 Session 2: AH-2 Solution © Richard Welke 2008-12 Service 2: Information processing Service name: Arrive-to-Resolve Client: Patient (or possibly doctor) PTBS: Obtain treatment at acceptable cost Value metrics: Amount of duplicate information asked (count) Ratio of total billing cost to out-of-pocket cost ($’s) Treatment satisfaction (Likert scale) Process steps: As shown in diagram lane labeled “Scheduling” Process metrics: Resources consumed (Aver[time x $cost of processor]) Total billed to amount recovered from all sources A/R age (average A/R days) Patient data accuracy and rework (#errors) 6

7. CIS 4120 Session 2: AH-2 Solution © Richard Welke 2008-12 Service 3: Insurance processing Service name: Request-to-Reimbursement Client: Doctor (or their agent in info processing) PTBS: Validate policy and receive payment Value metrics: Timely validation (time-to-validate: mins) Accuracy of response (# of Type-1 and Type-2 errors) Acceptance of insurance billing (# of changes, difference between billed and received $’s) Time to pay (time between initiation and receipt) Process steps: Initiation shown in diagram External service  actual steps not known (SLA) Process metrics (probable): Resources consumed Total paid for service A/P age (average A/P in days) Patient data accuracy and rework (# errors) 7