Health Management Technology Free Subscription

	*Health Management Technology* is free to qualified professionals. Summary Description
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2.	For auditing purposes, please enter the high school you last attended: (Provide last school attended if high school does not apply.)

3.	Please select the category that best describes your title: (select only one)

General and Financial Management Information Management cont.

CEO, President, Executive Director, Administrator Other IT Personnel (please specify below)

CFO, Finance Director/Manager Network/MIS/Data Processing Director/Manager

CSO/Security Officer/Director Health Information Director/Manager

Planning Officer/Director Coding/DRG Director/Manager

Marketing Officer/Director Systems Administrator/Analyst/Network Specialist/Project Manager

COO, VP, Assistant Administrator Clinical Management

CCO, Compliance Director/Manager Chief of Staff/Medical Director/VP of Medical Affairs

CPO/Purchasing/Materials Management Director/Manager Chief of Pathology/Pathologist

Quality Officer/Director Chief of Radiology/Radiologist

Other Administrative Title (please specify below) Other Clinical Administration (please specify below)

Information Management Chief of Laboratory Services/Lab Administrator

CIO, VP of Information Systems, Tech Officer Chief of Pharmacy/Pharmacist

Chief of Medical Records/Medical Records Manager Chief/VP of Nursing Services/Asst Director/Case Manager

Director/Manager of Medical Informatics Other Title (please specify)

Director/Manager of Telecommunications/Call Center Director/Manager

4.	Please indicate type of Facility / Service / Firm: (select only one)

Hospital/Multi-Hospital System Managed Care Organization (HMO, PPO, Healthplans)

Integrated Delivery System/Health Network Insurance Company

University/Teaching Medical Center/Hospital Third Party Administrators (TPA)/Self-Insured Employer

Military/Government Medical Center/Hospital Pharmacy/Independent Lab

Clinical/Group Practice IT Consulting/Systems Integration

Physician Organization (IPA/PHO) Consulting Firm

Ambulatory Care Center VAR/Vendor of Systems

Long-Term/Sub Acute Care Facility/Nursing Home/Rehab Other (Please Specify)

Home Health Care Agency

5.	Number of physicians in your organization: (select only one)

More than 300 10 - 19

100 - 299 4 - 9

50 - 99 1 - 3

20 - 49 Not applicable

6.	Number of beds in your organization: (select only one)

over 1000 100 - 199

500 - 999 50 - 99

400 - 499 1 - 49

300 - 399 not applicable

200 - 299

7.	Annual budget for information technology products and services: (select only one)

$10 million + $1 - $1.999 million

$7 - $9.999 million $500,000 - $999,999

$5 - $6.999 million $100,000 - $499,999

$3 - $4.999 million under $100,000

$2 - $2.999 million

8.	For payers, the number of lives covered by your organization: (select only one)

10 million or more 250,000 - 500,000

5 - 10 million 100,000 - 250,000

2 - 5 million 50,000 - 100,000

1 - 2 million under 50,000

500,000 to 1 million not applicable

9.	Indicate the type of product & services you recommended, specified or approved for purchase: (select all that apply)

Hardware Software cont.

Disaster Recovery/Preparedness EMR/EHR

Mobile Workstations/POC Systems EDIS/OR/Perioperative Systems

Monitors/Displays Financial/Billing Systems

Printers/Copiers/Scanners Hospital/Healthcare Info Systems

Tablets/PDAs/Handhelds/Laptops Managed Care Systems

Services Materials Management/eProcurement

ASP/Internet/Intranet Services Medication Management/Drug Info Systems

Call Centers/Telecommunications Physician Practice Management

Software Radiology Systems/PACs/RIS/Diagnostic Imaging

Bar Coding/RFID/Tracking Systems Scheduling Systems

Claims - Coding, Processing Security/Authentication/Biometrics

Clinical Information Systems Voice Recognition/Transcription

Data Storage/Mining Wireless Applications

Decision Support: Clinical/Financial Workflow Automation

Document Management/Imaging Other (please specify)

Electronic Data Interchange (EDI)

None of the above

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