Electronic Health Records: An Audit and Internal Control Guide / Edition 1

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Electronic Health Records

An Audit and Internal Control Guide

With the use of electronic healthcare records (EHR) set totransform the healthcare industry, the use of informationtechnology in the maintenance of personal health records poses arange of issues and opportunities for every medical organization.Reflecting the U.S. government's goal of achieving widespreadadoption of interoperable electronic health records to improve thequality and efficiency of healthcare while maintaining the levelsof security and privacy that consumers expect, Electronic HealthRecords: An Audit and Internal Control Guide expertly walks readersthrough the elements required for an efficient, well-run healthcarerecord management system. This timely book details the audit toolsnecessary for continued internal controls regardless of the systemsimplemented.

Providing an application readers can adopt as a model, thisimportant book examines the infrastructure of electronic healthrecords and how government criteria will impact both private andpublic marketplaces. Clearly addressing how auditors, controllers,and healthcare providers can keep up with the market's aggressivemove towards an interoperable e-health world, without neglectingclinical and financial accountability in the delivery of healthcareservices, this invaluable resource:

  • Discusses several key market movements on standards, includingthose by various organizations that make important contributions toe-health initiatives
  • Reviews initiatives created by the Association of RecordsManagers and Administrators (ARMA)
  • Introduces the concept of data and a methodology to sort andidentify information
  • Covers the development of analytic tools and audit checklists toensure appropriate internal controls
  • Explores what the market is currently offering as well as acomparison on how vendors are contributing to the direction ofe-health developments and market conflicts
  • Provides a patient-focused perspective on the personal healthrecord

As e-health continues to develop and transform at a swift pace,auditors in the healthcare industry can expect today's environmentto be obsolete within the next ten years. Informed by the author'sexpertise and depth of knowledge in the area of auditing and IT inthe healthcare industry, Electronic Health Records: An Audit andInternal Control Guide thoughtfully prepares professionals to planand implement an effective EHR and internal controls system withinany clinical setting.

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Product Details

  • ISBN-13: 9780470258200
  • Publisher: Wiley
  • Publication date: 8/11/2008
  • Edition number: 1
  • Pages: 228
  • Product dimensions: 6.00 (w) x 9.10 (h) x 1.00 (d)

Meet the Author

Rebecca S. Busch, RN, MBA, CCM, CBM, CHS-III, CFE, FHFMA, is President and CEO of Medical Business Associates, Inc. (MBA), a consulting firm specializing in healthcare audits for employers, hospitals, and insurance companies. MBA has just released an electronic version of its PHR system, Portfolia, the most comprehensive tool in the market to help individuals manage their health care experience and mitigate medical and financial errors. She has over twenty years of progressive achievement in the healthcare management industry. She is a faculty member of the Association of Certified Fraud Examiners (ACFE), has published numerous articles, and is a frequent public speaker. Her firm can be found at www.mbanews.com.

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Table of Contents


About the Author.



Chapter 1. Market Background.


How is Electronic Information Created?

Information Technology Considerations.

How is Health Information Created?

Review of Primary HCC Market Players.



Third Party Vendors.


Review of HCC Secondary Market Players.

Major Initiative for E-Health.

Audit Implication Overview.

Chapter 2. Industry Application.

Public Uses.

Private Uses.

Information Continuum.

Market Standards and Initiatives.

Agency for Healthcare Research and Quality.

Health Level Seven.

Certification Commission for Healthcare InformationTechnology.

Department of Defense Records Management Program.

Association of Records Managers and Administrators.

Audit Implication Overview.

Chapter 3. Impact of E-Health on CaseManagement.

Financial Picture.

Hospital-Based FCM Application.

Background Information and Provider Perspective.

Problem: Getting Paid Correctly for Services Provided.


Additional Findings.


Consumer-Based FCM Application.

Market Problems: The Industry as It Operates Today.

Consumer FCM Model.

Healthcare Portfolio Application.

Virtual Case Management.

VCM Payer Model.

VCM Patient Model.

VCM Hospital Model.

VCM Physician Model.

VCM Allied Health Services.

VCM Nontraditional Health Services Model.

VCM Other Business Services Model.

Audit Implication Overview.

Chapter 4. Data in an E-Health Environment.

Data Library.

Data Intelligence.

New Data.

More New Data.

Processed Data.

Data Warehouse.

Audit Implication Overview.

Chapter 5. Algorithms.


Understanding Algorithms.

Data Elements.

Case Study.

Algorithm Selection

Auditor Implication Overview.

Chapter 6. Data-Driven Health Decisions in an E-HealthEnvironment.

Knowledge Models.

Primary Healthcare Continuum.

Secondary Healthcare Continuum.

Information Continuum.

Third-Party Vendor Knowledge Model.

Knowledge Models For White-Collar and Organized Crime.

Sample Identity Theft Case.

Medical Identity Theft.

Medical Identity Theft – Definition.

How Medical Identity Theft Occurs.

Damages To Primary Victims.

Medical Identity Theft From A Consumer Perspective.

When The Consumer Is Not Aware.

When The Consumer Is Involved.

When An Individual Wants Products Or Services.

Damages To Secondary Victims.

Medical Identity Theft From An Entity’s Perspective.

Auditor Considerations.

Sample Fraud Case.

Sample Pharmaceutical Fraud Case.

Audit Implication Overview.

Examples Of Worldwide Activity.

Chapter 7. Analytic Tools and Audit Checklists.

E-Health And Healthcare Business Processes.

Patient Business Process.

Problem #1: Financial Case Management Advocacy.

Problem #2: Clinical Case Management Advocacy.

Provider Business Process.

Problem #1: Lack Of Electronic Internal Controls.

Problem #2: Lack Of Internal Controls With User Identity.

Problem #3: Lack Of Internal Controls For Services Provided AndCharged.

Payer Business Process.

Problem #1: Use And Loss Of Health Information – HandlingSubcontracted Vendors.

Problem #2: Lack Of Insurance – Processing FraudulentClaims For Enrolled Beneficiaries.

Plan Sponsor Business Process.

Problem #1: Employee Working Environments.

Problem #2: Employer Increase In Healthcare Expenditures.

Third-Party Vendor Business Process.

Problem: Increase In Pharmaceutical Expenditures.

Audit Implication Overview.

Chapter 8. Electronic Health Records.

Current E-Health Offerings.

Market Evolution.

E-Health Content Standards.

E-Health Offering Vulnerabilities.

Audit Implication Overview.

Chapter 9. Healthcare Portfolio.

Health Infomediary Support.

PHR Attributes.

Future Considerations.

Major Market Activity.

Audit Implication Overview.

Chapter 10. Conclusions.

Market Overview.

Market Standards.

Market Conflicts.

Market Intelligence.

Market Audits.

Market Directions.

Consumer Response to PHRs.

Audit Implication Overview.


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