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Narrative

Description:
ISMG Hospital is a new medical center located in the Boulder, CO. ISMG Hospital needs to develop a system in order to track and organi e the in!ormation needed to run a newly "uilt hospital. ISMG Hospital has decided to implement an electronic system rather than a paper system in order to increase e!!iciency. #he system will allow them to $uickly evaluate the patient%s in!ormation, hospital in!ormation, and health insurance in!ormation. &urthermore, the system will allow them to input new patient in!ormation and health insurance in!ormation, and update the hospital in!ormation.

Scope:
#here are three main categories o! in!ormation !or the system patients, health insurance providers and hospital. #he patient%s in!ormation will "e inputted into the system as they visit the hospital or make appointments to visit the hospital. #he patients will need to include all o! the personal in!ormation that is re$uired "y the system ie address, phone num"er, gender. &urthermore, they will "e re$uired to enter their reason !or visiting the hospital. 'astly, the patient will need to indicate who their health insurance provider is. #he health insurance providers in!ormation will include the provider name, the employee assigned to the health insurance claim and whether or not they consider ISMG Hospital an in or out o! network hospital. #he in!ormation will also include the deducti"le amount that the patient is responsi"le !or. (ew health insurance providers can also "e inputted in the system as new patients are inputted into the system. #he hospital in!ormation will show the doctors, nurses and surgeons on sta!! and the !acilities availa"le !or the patients. )dditionally, the hospital in!ormation will include the patient%s procedure and the cost o! the procedure. Changes to the !acility assigned and the sta!! assigned to the patient will also "e allowed.

Work Flow:
) hospital employee will input the patient%s personal in!ormation, reason !or visiting and health insurance provider. I! health insurance provider is not already in the system they will have to input the new provider%s in!ormation. )dditionally, when a new patient is inputted into the system the associated sta!!, !acility and procedure will "e assigned. #hese items will "e decided "ased on the patient%s reason !or visiting ISMG Hospital. )!ter these items have "een inputted in!ormation regarding the "illing will "e updated "ased on the procedure needed. Once new health insurance in!ormation is provided "y the patient !urther in!ormation will need to "e o"tained regarding the health insurance provider. #he hospital employee will

input this additional in!ormation into the system in order to aid with "illing. #he additional in!ormation will include "illing in!ormation, employee assigned to the claim and whether or not ISMG Hospital is an in or out o! network hospital. #he in and out o! network in!ormation will determine the "illing amount. )dditionally, in!ormation regarding the deducti"le will "e o"tained and will determine the "illing amount !or the provider and patient. In!ormation regarding the sta!!, !acilities and procedures can "e updated "ased on the availa"ility and need !or the items. #he procedure that is assigned to the patient will determine the "illing amount. I! these items are changed the "illing !or the health insurance provider and patient will change. Billing to the health insurance provider will depend on the deducti"le and whether they consider ISMG Hospital in or out o! network hospital.

Business Rules:
*atients must include all personal in!ormation re$uired in system including the reason !or visiting. *atients may leave health insurance provider a null value i! they do not have a provider. #he dates o! the patients visit must "e included. *atient in!ormation can "e updated, deleted and inserted into the system. Health insurance provider in!ormation must include their name, "illing in!ormation and employee assigned to the health insurance claim. Health insurance providers are re$uired to input whether they consider hospital as an in+ network or out o! net+work provider. #his will change the "illing amount. Health insurance providers are re$uired to provide deducti"le in!ormation !or the patient. #his will a!!ect the "illing. Health insurance providers will indicate whether they are an HMO or **O. Health insurance in!ormation can "e inserted and updated, "ut not deleted. (urses must "e assigned to every patient. ,octor or surgeons can "e null values i! the patient is -ust visiting a nurse. ) ma-ority o! patients will have "oth a nurse and a doctor or surgeon assigned. ) !acility or room does not have to "e assigned to a patient and will accept null values. Some patients do not re$uire a room or !acility to complete their procedure.

#he procedure !or the patient must "e included. *rocedures can range !rom a simple physical to a complicated high risk surgery. Some procedures re$uire that either a doctor or surgeon "e assigned. .ach procedure will have a cost associated and will "e "illed to the health insurance provider. #he deducti"le will "e "illed to the patient. #he system will keep track whether the patient and health insurance has paid the "ill. #his item will "e updata"le. /pdates can "e made to the sta!!, !acility and procedure assigned to patients, "ut the sta!!, !acility and procedure in!ormation cannot "e inserted or deleted in the system.