SOLUTION: Capella University Home Health Aides Database Discussion

Story: At-Home Health Aides Database
My organization, which provides at-home health care aides, has taken pride over the
years in being able to meet the needs of its customers. All of the new employees are
required to attend a 6-hour training session to learn the necessary information about
the organization. Because there are many different types of forms that we work with
in handling our customers’ orders, and various types of insurances are involved in
the transactions we conduct, it is imperative that all employees know the rules and
regulations. To generate the correct forms electronically, the user must select the
correct processing options when he or she is keying in an order. If the customer has
insurance, the entire order must be billed entirely to the insurance company. If the
customer does not have insurance, the bill must be sent to the customer for
payment. In addition, the person who is keying the order should not specify both
insurance and self-pay as payment options for a single order. If the customer has a
discount card, the amount of the discount should never be billed to the customer or
the insurance company.
Recently, some of the employees have been a bit relaxed in ensuring that all of the
rules were followed. Because of this, the system did not process some of the
insurance payments correctly, and the customers were sent bills for the medical
supplies that they ordered. In some cases, bills went to the customer, and
reimbursement requests were sent to the insurance company on record. A recent
audit that was conducted because of customer complaints found that over the last 9
months, approximately 20% of orders had some type of error when the order was
keyed in. The employees were aware of the rules, but because there are so many
rules to remember and numerous procedures to follow, some of the employees made
serious mistakes when entering orders. According to these employees, who were
questioned about the proper procedure, sometimes the order entry system led them
to believe that they were doing things correctly. In other cases, the employees
complained that they did not know how to use the order entry system correctly. In
fact, they stated that they were never asked about how much they understood about
the rules, procedures, policies or system. In all cases, the employees felt that there
had been a major breakdown in communication and, because of that, they should
not be held responsible for the errors.
The original database designers who planned the system did not effectively diagram
and document the system, so when another information technology (IT) company
was called in to discuss the issues that the company was having, there was no
system documentation available to provide to the company for review. The lack of
documentation cost the company money because the database designers had to
spend a considerable amount of additional time researching the current system and
determining the requirements.
Story: At-Home Health Aides Database
Moral of the Story
The documentation and verification of the rules of the procedure that an organization
abides by are put in place as a means of communicating the rules to employees and
also serve to assist database designers in gaining an understanding of the system
requirements of the organization. Consensus as to what the business rules are
should occur so that all end users have a common understanding. Systems
developers need to carefully document the system design using entity-relationship
data models, requirements documents, and system specifications documents so that
the system can be effectively maintained over time. It is important that all business
rules are written precisely, clearly, and in a simple form. The business rules must
assist in the identification of the entities, attributes, relationships, and constraints
that are needed in the system. Using a graphical data model can easily communicate
the schema.
When it comes to insurance reimbursements for medical supplies, the insurance
companies expect that all organizations that are processing claims will exercise due
diligence during the processing to avoid errors that could cost both companies
money. The customers will lose faith and trust in an organization that cannot
satisfactorily process insurance claims for the medical supplies that they need. If the
information system and related database allows mistakes to be made, that system
will cost the company money in the long run. It is important that the information
system be designed to enforce rules and to prevent the likelihood of errors occurring.
If the end user makes a mistake, the system should prompt the user to assist him or
her in making corrections. The integrity of the information that is stored in the
database is only as good as the process and design of the system that is used to
manage and store that information.

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