Jentayu Medical Centre (JMC) offers a holistic approach to healthcare and one of the largest hospitals in Malaysia. JMC is interested in a new information system to support its business information and management needs. The new system would replace a mix of paper-based and fragmented computer systems. Dr. Hazlina had previously asked you to work with her to help a group of people (steering committee) develop an information system that will support current operations and future growth. You explored the possibility of a business support system for the scheduling, billing, accounting and payroll functions.

Based on your preliminary investigation, you recommended a detailed analysis of four key areas: patient scheduling, billing and account receivable, and payroll. Because these areas are highly interactive, you suggested that an integrated system would provide the greatest benefits. Dr. Hazlina and the partners agreed, but they also expressed interest in a medical practice support system and asked whether the business support system could be expanded. After research and analysis, you concluded that medical practice support system should be a separate system to be considered in JMC’s long term strategic plans. Because future integration would be very important, the business support system design should be compatible with a future medical practice support system.

You began the systems analysis phase by conducting interviews, reviewing existing reports, and observing office operations. JMC medical team performed services and medical procedures, which are coded according to the Malaysia Medical Association’s Current Procedure Terminology (CPT). CPT codes consist of five numeric digits and a two-digit suffix, and most insurance payers require the codes to be included with billing information.

The new system must be able to handle the new ICD-10 procedure coding system, which will be required by the Centers for Medicare & Medicaid Services (CMS) beginning October 1, 2014. ICD-10 codes consist of seven alphanumeric characters, which can be electronically transmitted and received. JMC’s information system must interface with health insurance providers registered in Malaysia. The new system represents an opportunity for significant cost saving for JMC, and more convenience for patients, who will be able to go online to update medical information, schedule appointments, and request medical records.

During your fact-finding, you learned that the clinic requires various reports, as follows:

• Daily appointment list for each doctor. The list shows all scheduled appointment times, patient names, and services to be performed, including the procedure code and description.
• Daily report call list, which shows the patients who are to be reminded of their next day’s appointments. The call list includes the patient name, telephone number, appointment time, and provider name.
• Weekly doctor report that lists each of the doctors and the weekly charges generated, plus a month-to-date (MTD) and a year-to-date (YTD) summary as well as profit distribution data for the partners.
• Monthly patient statement, which includes the statement date, head of household name and address, previous month’s balance, total household charges MTD, total payments MTD, and the current balance. The bottom section of the statement shows activity for the month in date order. For each service performed, a line shows the patient’s name, the service date, the procedure code and description, and the charge. The statement also shows the date and amount of all payments and insurance claims. When an insurance payment is received, the source and amount are noted on the form. If the claim is denied or only partially paid, a code is used to explain the reason. A running balance appears at the far right of each activity line.
• Weekly Insurance Company Report.
• Monthly Claim Status Summary.

In addition to these reports, the office staff would like automated e-mail and text messaging capability for sending reminders to patients when it is time to schedule an appointment. Data also needs to be maintained on employers who participate in employee wellness programs. This information can be used for marketing purposes throughout the year. Finally, the new system needs to track employee schedules, attendance, vacation time, and paid time off.

Now you are ready to organize the facts and prepare a system requirements document that represents a logical model of the proposed system.

Required:

1. Create Entity-Relationship Diagram (ERD) for JMC new system.
2. Normalize your design for all tables to ensure they are 3NF (normal form).