Abstract
Hospitals around the globe face a profitability crisis that ultimately threatens the quality of healthcare provided to patients. While a variety of factors have been attributed to this profitability crisis, key internal causes include the failure of process design and the healthcare technology solution to keep up with changing demand, environmental and governmental regulations, and lack of integration of disparate systems. This paper examines these issues with regard to ambulatory payment classification (APC) – the scheme that drives hospital billing systems – and an integrated technology solution. Two scenarios are provided illustrating a non-integrated/manual hospital and an integrated process and information system. Learning points, process flowcharts, and real-world examples are used to demonstrate potential gains from the integrated technology solution.
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