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In what seems like only a few short years, financial information systems (FIS) have evolved from simple, back-office support systems into fully integrated solutions that can handle everything from payroll to accounts receivable and revenue cycle management. But such increased functionality would not be possible without the ability to combine disparate databases into a single source of financial information that can be mined at multiple levels.

The importance of data mining quickly became apparent to corporate executives at Scripps Health in San Diego, who had been working with six separate databases before upgrading to a newer version of Sunrise Access Manager/Patient Financial Manager from Boca Raton, Fla.-based Eclipsys Corp. Scripps Health currently operates five acute care facilities totaling nearly 1,400 beds, two medical groups with 14 outpatient clinics, a home health agency and a health plan.

Today, yearly revenues average $1.35 billion, which is a big turnaround from a few years ago when Scripps Health posted operating losses in 2000 and 2001 totaling approximately $26 million and $22 million and respectively.

In an effort to bolster their bottom line, Scripps Health devised a number of key strategies, not the least of which was drastically changing their methods of billing and reimbursement. "A couple of years ago we moved away from capitated risk to fee-for-service risk," says David Cohn, vice president of patient financial services. Additionally, since each hospital had been running its own Eclipsys FIS, the organization made the decision to upgrade these 13-year-old systems by installing an enterprisewide FIS.

With the HIPAA deadline looming, Scripps Health had only six months to install and test the new system. In July 2003, they rolled out version 11.3, which was not only HIPAA-compliant, but was also the vendor's "multientity" product. This enabled the organization to merge multiple databases into one central database that now resides on the mainframe. "Prior to that, each hospital was operating in its own silo," says Cohn.

That presented problems of both access and efficiency, says Paula Pochodowicz, senior support analyst for information services. "Patient registration lives at the corporate level, but then there is an entity level." In the single-silo version, the user had to login to one entity, then logout before logging in to another facility's database.

# posted by Medical Information : 4:06 AM