Hospitals Business Information Model

Hospitals generate patient, clinical, and financial data that doesn't reduce to a simple customer-and-order model. This Business Information Model maps the sector's core data entities — foundational, transactional, and informational — and the relationships between them, delivered as an editable Word document.

Why "Patient" Isn't the Whole Story

A hospital's data model breaks the moment "Patient" is treated as the entity clinical and financial data attaches to — it isn't. Diagnoses, procedures, and charges belong to a specific Encounter (an ED visit, an inpatient stay, an outpatient appointment), and one Patient accumulates many Encounters over years, so patient identity has to be resolved and matched across registrations that may carry typos, maiden names, or duplicate MRNs — a probabilistic entity-resolution problem most generic customer models never have to solve. "Provider" is really several roles, not one: the attending, ordering, referring, and rendering physician on a single encounter are often different people, and many physicians hold admitting privileges as independent medical staff rather than being hospital employees, so Provider-to-Facility is a credentialing relationship, not an employment record. A patient's physical Location also isn't a static field — it's a time series of bed and unit transfers across a single stay, and that transfer history is exactly what utilization review and capacity planning depend on. And Diagnosis and Procedure codes attach to an Encounter in a many-to-many relationship, each mapped to specific charges, that a flat "order" entity can't represent.

What's Inside

• Foundational entities — Patient, Provider, Facility/Unit, Payer, Diagnosis/Procedure Code
• Transactional entities — Encounter, Order, Charge, Claim, Bed/Unit Transfer
• Informational entities — Length of Stay, Readmission Rate, Case Mix Index, Quality Measure Reporting
• Entity relationships across the model
• Delivered as an editable Word document

How Teams Use It

• Scope master data management for patient identity (MPI) and provider credentialing data
• Reference model for EHR, revenue cycle, or claims system integration
• Baseline for data warehouse design supporting quality and utilization reporting
• Shared vocabulary between clinical, financial, and IT teams during system consolidation

Who It's For

Data architects, business architects, and IT leaders at hospitals and health systems who need patient identity, provider credentialing, and encounter data modeled accurately, not assembled from a generic customer template.