Document Detail

A mobile trauma database with charge capture.
MedLine Citation:
PMID:  16385275     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Charge capture plays an important role in every surgical practice. We have developed and merged a custom mobile database (DB) system with our trauma registry (TRACS), to better understand our billing methods, revenue generators, and areas for improved revenue capture. METHODS: The mobile database runs on handheld devices using the Windows Compact Edition platform. The front end was written in C# and the back end is SQL. The mobile database operates as a thick client; it includes active and inactive patient lists, billing screens, hot pick lists, and Current Procedural Terminology and International Classification of Diseases, Ninth Revision code sets. Microsoft Information Internet Server provides secure data transaction services between the back ends stored on each device. Traditional, hand written billing information for three of five adult trauma surgeons was averaged over a 5-month period. Electronic billing information was then collected over a 3-month period using handheld devices and the subject software application. One surgeon used the software for all 3 months, and two surgeons used it for the latter 2 months of the electronic data collection period. This electronic billing information was combined with TRACS data to determine the clinical characteristics of the trauma patients who were and were not captured using the mobile database. RESULTS: Total charges increased by 135%, 148%, and 228% for each of the three trauma surgeons who used the mobile DB application. The majority of additional charges were for evaluation and management services. Patients who were captured and billed at the point of care using the mobile DB had higher Injury Severity Scores, were more likely to undergo an operative procedure, and had longer lengths of stay compared with those who were not captured. CONCLUSION: Total charges more than doubled using a mobile database to bill at the point of care. A subsequent comparison of TRACS data with billing information revealed a large amount of uncaptured patient revenue. Greater familiarity and broader use of mobile database technology holds the potential for even greater revenue capture.
Steve Moulton; Dan Myung; Aron Chary; Joshua Chen; Suresh Agarwal; Tim Emhoff; Peter Burke; Erwin Hirsch
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of trauma     Volume:  59     ISSN:  0022-5282     ISO Abbreviation:  J Trauma     Publication Date:  2005 Nov 
Date Detail:
Created Date:  2005-12-30     Completed Date:  2006-02-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376373     Medline TA:  J Trauma     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1042-7     Citation Subset:  AIM; IM    
Divisions of Surgery, Boston University School of Medicine, Boston, Massachsetts 02118, USA.
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MeSH Terms
Accounting / methods*
Computers, Handheld*
Current Procedural Terminology
Database Management Systems*
International Classification of Diseases
Patient Credit and Collection
Point-of-Care Systems
Practice Management, Medical / economics*,  organization & administration
Traumatology / economics*,  organization & administration

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