A mobile trauma database with charge capture.
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.


CONCLUSIONS
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.
Moulton
Steve
S
Divisions of Surgery, Boston University School of Medicine, Boston, Massachsetts 02118, USA. smoulton@bu.edu
Myung
Dan
D
Chary
Aron
A
Chen
Joshua
J
Agarwal
Suresh
S
Emhoff
Tim
T
Burke
Peter
P
Hirsch
Erwin
E
D000066:Accounting / Q000379:methods*; D000328:Adult; D034201:Computers, Handheld; D039702:Current Procedural Terminology; D003628:Database Management Systems; D006801:Humans; D038801:International Classification of Diseases; D020407:Internet; D010350:Patient Credit and Collection; D019095:Point-of-Care Systems; D011216:Practice Management, Medical / Q000191:economics* / Q000458:organization & administration; D012042:Registries; D012984:Software; D014194:Traumatology / Q000191:economics* / Q000458:organization & administration