Computerized system for tracking, managing and analyzing hospital privileges through the use of specifically researched content in conjunction with icd, cpt or other codes

A computerized system for tracking, managing and analyzing hospital/facility privileges, comprising:

• privilege information stored on a computer readable medium identifying a comprehensive list of privileges for each medical specialty performed at a hospital/facility, each said privilege being individually assignable to individual healthcare workers;
• billing code information stored on the computer readable medium, said billing code information including a comprehensive list of medical billing codes, each said medical billing code being assignable to one or more individual ones of said privileges;
• relational information stored on the computer readable medium keeping track of medical procedures performed by said individual healthcare workers and appropriate one(s) of said medical billing codes reflective of each said medical procedure;
• and
• a privileging computer for generating a privilege determination for the individual healthcare workers using said privilege information, said billing code information, and said relational information,
• wherein each privilege within each medical specialty:
• contains a description of the basic education a healthcare worker is required to have for said privilege;
• describes a list of procedures that are included in the healthcare worker's basic education;
• describes a list of special procedures that require training or other limitations on performing of such special procedures, including:
• additional educational requirements to perform each said special procedure;
• a description of each said special procedure;
• a performance level required to grant or renew each said special privilege to a particular one of said healthcare workers;
• and
• approval from an authorized medical entity within the hospital/facility,
• wherein each of the privileges for each medical specialty is matched to one or more of said medical billing codes related to each said privilege to measure the performance level of each said privilege,
• wherein the computerized system analyzes and updates individual healthcare worker performance level or privileging requirements by use of said relational information containing medical billing codes reflective of said performed medical procedures to assess whether individual ones of said healthcare workers have reached the performance level required to be granted or have renewed one or more of said special privileges.

A database stored on a computer readable medium and adapted for use with a computerized medical privileging system, said database comprising:

• privilege information stored on a computer readable medium identifying a comprehensive list of privileges for each medical specialty performed at a hospital/facility, each said privilege being individually assignable to individual healthcare workers;
• billing code information stored on the computer readable medium, said billing code information including a comprehensive list of medical billing codes, each said medical billing code being assignable to one or more individual ones of said privileges;
• and
• relational information stored on the computer readable medium keeping track of medical procedures performed by said individual healthcare workers and appropriate one(s) of said medical billing codes reflective of each said medical procedure,
• wherein each privilege within each medical specialty:
• contains a description of the basic education a healthcare worker is required to have for said privilege;
• describes a list of procedures that are included in the healthcare worker's basic education;
• describes a list of special procedures that require training or other limitations on performing of such special procedures, including:
• additional educational requirements to perform each said special procedure;
• a description of each said special procedure;
• a performance level required to grant or renew each said special privilege to a particular one of said healthcare workers;
• and
• approval from an authorized medical entity within the hospital/facility,
• wherein each of the privileges for each medical specialty is matched to one or more of said medical billing codes related to each said privilege to measure the performance level of each said privilege to be used in assessing whether individual ones of said healthcare workers have reached the performance level required to be granted or have renewed one or more of said special privileges.