I. Problem Statement
Currently, medical services and other transactions at New Century Health Clinic
have to be repeatedly recorded because there is no system that automatically
updates all relevant records and files after a transaction is entered. Also, reports,
especially those related to billing and insurance claims, take a long time be
prepared.
This project aims to design a system for New Century that integrates the patient
appointments, medical services, patient records, and billing processes of the
clinic.
Users of the new system will be able to enter medical services transactions.
These services need to be entered only once and automatically, the corresponding
patient and insurance claims records are updated.
The system will be able to capture information regarding patient and household
profiles and history, provider profiles, list of medical procedures offered, and
insurance company records.
4. Generate statements, insurance claims, and other reports
New Century will be able to generate reports easily. These reports include the
Provider Report, Insurance Company Report, Claims Status Summary, and the
monthly statements that are sent out to patients.
A system notification will be integrated in the application that will flag scheduled
appointments based on the calendar tracking of regular patient’s history of
treatments. This will also produce a postcard as a reminder to patient and will be
sent via snail mail.
1. Appointments staff
The appointments clerk receives calls from patients who would like to set up an
appointment. She enters the daily appointment schedule of each provider.
Calling patients to remind them of their appointments is also the responsibility of
the appointments clerk.
2. Providers
The doctors, physical therapists, and nurses indicate the specific procedures or
treatments that were performed on patients. These procedures are the basis for the
patient charges.
Ensuring that patient records are updated and complete is the responsibility of the
patient records staff. He may also be in charge of maintaining the medical
services records, and the provider files.
5. Accounting staff
The accounting clerk uses information on patient payments and insurance claims
to come up with the total receivables and revenues of the clinic. He also
generates the provider reports.
V. Solution Strategy
2. Prototyping
4. Incremental Model
The New Century Health Clinic Information System project will use the
Waterfall strategy. The case has provided all the information and the project
members will use the case to determine all the system requirements. These
system requirements will be the basis for the design specifications. The other
strategies were not selected primarily because feedback from the customers is not
possible.
As mentioned, transactions need to be entered once only. All affected patient and
insurance claims records are updated automatically.
Reports can be generated by simply running the desired report program. Report
parameters can be entered so that the resulting report will only provide the
specific information needed.
This replaces the log book system New Century maintains to keep track of
appointments. The sharing and emailing of virtually any data needed by each
stakeholder is easily facilitated.
The developer will create the interface screens that satisfy the functional
specifications.
The QA analyst will review the data flow diagrams and screens' design and
expected flow. They are also expected to suggest improvements in the design.
X. Documents to be Prepared
a. http://www.scsite.com/sad5e/case
b. Software Engineering Student Manual. UP Information Technology Training
Center.