ISPR: An Information System for Physicians Resources

Mudasser Fraz Wyne; Gregory Stuart Rogers; Preston Jay Mendoza

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Conference: 2012 ASEE Annual Conference & Exposition
Location: San Antonio, Texas
Publication Date: June 10, 2012
Start Date: June 10, 2012
End Date: June 13, 2012
ISSN: 2153-5965
Conference Session: Information and Network Security
Tagged Division: Computing & Information Technology
Page Count: 12
Page Numbers: 25.865.1 - 25.865.12
DOI: 10.18260/1-2--21622
Permanent URL: https://strategy.asee.org/21622
Download Count: 431

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Paper Authors

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Mudasser Fraz Wyne National University

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Mudasser Fraz Wyne is currently serving as a professor of computer science and Chair of Department of Computer Science, Information, and Media Systems at the School of Engineering, Technology, and Media, National University, San Diego, Calif., USA. He is a lead faculty member for the B.S. in information systems and previously for M.Sc. in database administration and M.Sc. in computer science programs. Wyne has a Ph.D. in computer science, a M.Sc. in engineering, and a B.Sc., in electrical engineering. He has been in academics for 20+ years and supervised more than 50 graduate and undergraduate projects. Wyne has been with the ABET USA for more than 10 years and is currently serving as a Commissioner for Computing Accreditation Commission (CAC) of ABET. In addition, he is a Guest Editor for a journal, Associate Editor, and is serving on editorial boards for four international journals. He has also served as Chair and Co-chair of numerous conferences, workshops, tracks, and panels, in addition to serving on the program committee for more than 60 international conferences. Wyne has given invited talks on numerous occasions and published a number of articles in peer-reviewed international journals and peer-reviewed international conferences.

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Gregory Stuart Rogers

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Preston Jay Mendoza National University

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Business, graphic arts, politics, music, and computer technology have always been Preston Jay Mendoza's main interests. His undergraduate years have been a long filtration of those many interests, which ultimately led him to enroll in the Computer Information Systems program at National University. From this program, he further enhanced his business and computer skills in project management and data management systems. These skills were used to develop the capstone project, which includes the corresponding paper.

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Abstract

ISPR: An Information System for Physicians Resources ABSTRACTThe information system detailed in this paper was designed and developed for PhysicianPartners. Scripps Mercy Physician Partners is a physician business organization and medicalgroup with a 6-year track record of helping our 600+ members increase the viability of theirprivate practices. Their goal is to provide member physicians with an organization thatimproves fee-for-service contract reimbursement and offers the cost benefits of a large group,while respecting the independence of each physician practice. Physician Partners has developedselect strategic business partnerships that offer physician practices opportunities to decreaseoverhead costs and access new revenue-producing services.Physician Partner approached School of Engineering, Technology and Media at NationalUniversity with a request to update its existing physician information system based on MicrosoftAccess on a PC to a more advanced, scalable and extensible, distributed database which cansupport concurrent use, high numbers of records and potential web based secure access. Thecurrent data system used information from both the physicians and the insurance carriers toproduce a series of Current Procedural Terminology (CPT) codes and associated billing rates forthose codes as to what a physician may charge a patient for a particular procedure based on thepatient’s medical insurance carrier. CPT (Current Procedural Terminology) codes are numbersassigned to every task and service a medical practitioner may provide to a patient includingmedical, surgical and diagnostic services. These codes are then used by insurers to determine theamount of reimbursement that a practitioner will receive by an insurer. Since everyone uses thesame codes to mean the same thing, they ensure uniformity. It should be noted; however, thatuniformity in understanding what the service is, and the amount different practitioners getreimbursed will not necessarily be the same. The estimated systems size at present isapproximately 12000 records with growth. A typical set of records for a physician may holddetails on: Physician name and contact information, Medical Specialty, Board certifications andlicensure information, Board certifications expiration dates, Physician Schools attended,Physician License details, Specific billing information and a list of CPT codes detailing theprocedures that physician performs.The new proposed ISPR system support the current system functionality to existing levels ofservice, more scalable in terms of time, data, location and users, i.e. a higher number of records,and further increases, plus a higher number of concurrent users if so required, a normalized,extensible SQL compliant data model that can be extended as more detail to the informationrecords may be required, able to generate or provide the relevant data to support the generationof reports for Insurance companies, generate or provide the relevant data to support thegeneration of reports in a more flexible and open way such that end users have the ability tofurther tailor the reports before dissemination to relevant end user groups, an SQL baseddatabase which allows the traceable evolution of both the schema and the content data. Somelight transactional semantics introduced to the system to be able to trace and follow changes tothe database over time and secure the data at multiple levels at the user, database, OS andnetwork levels.

Citation
Format

Wyne, M. F., & Rogers, G. S., & Mendoza, P. J. (2012, June), ISPR: An Information System for Physicians Resources Paper presented at 2012 ASEE Annual Conference & Exposition, San Antonio, Texas. 10.18260/1-2--21622

TY  - CPAPER
AB  -              ISPR: An Information System for Physicians Resources                                        ABSTRACTThe information system detailed in this paper was designed and developed for PhysicianPartners. Scripps Mercy Physician Partners is a physician business organization and medicalgroup with a 6-year track record of helping our 600+ members increase the viability of theirprivate practices. Their goal is to provide member physicians with an organization thatimproves fee-for-service contract reimbursement and offers the cost benefits of a large group,while respecting the independence of each physician practice. Physician Partners has developedselect strategic business partnerships that offer physician practices opportunities to decreaseoverhead costs and access new revenue-producing services.Physician Partner approached School of Engineering, Technology and Media at NationalUniversity with a request to update its existing physician information system based on MicrosoftAccess on a PC to a more advanced, scalable and extensible, distributed database which cansupport concurrent use, high numbers of records and potential web based secure access. Thecurrent data system used information from both the physicians and the insurance carriers toproduce a series of Current Procedural Terminology (CPT) codes and associated billing rates forthose codes as to what a physician may charge a patient for a particular procedure based on thepatient’s medical insurance carrier. CPT (Current Procedural Terminology) codes are numbersassigned to every task and service a medical practitioner may provide to a patient includingmedical, surgical and diagnostic services. These codes are then used by insurers to determine theamount of reimbursement that a practitioner will receive by an insurer. Since everyone uses thesame codes to mean the same thing, they ensure uniformity. It should be noted; however, thatuniformity in understanding what the service is, and the amount different practitioners getreimbursed will not necessarily be the same. The estimated systems size at present isapproximately 12000 records with growth. A typical set of records for a physician may holddetails on: Physician name and contact information, Medical Specialty, Board certifications andlicensure information, Board certifications expiration dates, Physician Schools attended,Physician License details, Specific billing information and a list of CPT codes detailing theprocedures that physician performs.The new proposed ISPR system support the current system functionality to existing levels ofservice, more scalable in terms of time, data, location and users, i.e. a higher number of records,and further increases, plus a higher number of concurrent users if so required, a normalized,extensible SQL compliant data model that can be extended as more detail to the informationrecords may be required, able to generate or provide the relevant data to support the generationof reports for Insurance companies, generate or provide the relevant data to support thegeneration of reports in a more flexible and open way such that end users have the ability tofurther tailor the reports before dissemination to relevant end user groups, an SQL baseddatabase which allows the traceable evolution of both the schema and the content data. Somelight transactional semantics introduced to the system to be able to trace and follow changes tothe database over time and secure the data at multiple levels at the user, database, OS andnetwork levels.
AU  - Mudasser Fraz Wyne
AU  - Gregory Stuart Rogers
AU  - Preston Jay Mendoza
CY  - San Antonio, Texas
DA  - 2012/06/10
PB  - ASEE Conferences
TI  - ISPR: An Information System for Physicians Resources
UR  - https://strategy.asee.org/21622
DO  - 10.18260/1-2--21622
ER  -