Ch 1 - Technology in Care Delivery Flashcards
Informatics
Application of information technology
Medical Informatics
“Interdisciplinary science of acquisition, maintenance, retrieval, and application of biomedical knowledge and information to improve pt care, medical info, and health science research”
Who is needed to develop an EMR system?
Clinical professionals
What kind of data needs to be collected into an EMR?
Anything and everything
How do we measure safety, efficacy, and reliability?
Once we crunch all numbers together, we will know if there is a safety issue in the EMR, how fast can we correct it
How do we determine responsibility for errors?
Who put info into the chart
Administrative Applications
Office management use - scheduling, account and billing
Clinical Applications
Anything to do with direct pt care - includes diagnosis, monitoring, and treatments
EHR
Belongs to a single pt and is the info from one or more encounters, test results, vital signs, demographics, etc (Pt portal/MySanfordChart)
EMR
Belongs to a single health care institution and is where the pt info is entered into a system and managed (EMR = medical professionals)
Interoperability
Computer systems and programs that can communicate and transfer data between systems (where it doesn’t work, like D2L and Pages)
Health Information Technology (HIT)
EMR and computer information systems
What would complete interoperability look like?
Would be great if all systems could talk to each other but there are glitches
Problems & Challenges w/ EMRs
Costs, accuracy, reliability, workflow, system automation & defaults, distracting, privacy, complex interfaces, shortcuts in charting
EMR for the win!
Reduce errors, handwriting is hard to read, default alerts and thresholds, data support systems, smart sets, clinical care picture, pt access, tracking care, continuation of care, screenings & preventative care
Foundational Interoperability
One EHR system can receive data from another system but doesn’t need to be able to interpret it
Structural Interoperability
Data can be exchanged between information technology systems and interpersonal at the data field level
Semantic Interoperability
Where two or more systems can exchange information, and the exchanged information can be used
CMS
Center for Medicare and Medicaid
ONC
Office of the National Coordinator for Health Information
1996 - HIPAA
Privacy and security to individual records and insurance portability
2004 - ONCHIT
Bush Admin - declared 2004-2014 “The decade of HIT” aimed promote and oversee to development of national health information tech infrastructure, adoption, and meaningful use of EHR
2009 - ARRA
The American Recovery and Reinvestment Act - Obama Admin - promotes the expansion of HIT even further and offered monetary incentives through Medicare and Medicaid for HC systems to adopt EHR’s
2009 - HITECH
Provision of ARRA and increases penalties for violating HIPAA (fined)
2010 - ACA
Affordable Care Act - goal was to make health insurances accessible and affordable, expand Medicaid, and support methods to lower the cost of HC
Meaningful use of EHR’s
providers need to show they are using the EHR tech in ways that can be measured significantly in quantity and quality - it all has to have purpose and can be measured
ACA in a nutshell
Signed into effect in 2010, individual mandate repealed in 2017 but some provisions of original act in place
HIE
Health Insurance Exchange - marketplace to purchase insurance
Biometrics
Uses body parts to identify user (retina, finger) like in the movies
Encryption
Data is scrambles as it passes through the internet
Office Management
Ordering supplies, staff scheduling, budget analysis etc…
Scheduling
staff, pts, outreach clinics, procedures, therapies, out-pt services
Accouting
Payment collection, billing, insurance coding, payment processing
Personal Health Records (PHR)
electronic form of individuals health info, available on an Web enabled device, used in emergency situations to communicate important info, routine dr visits, pt owns records & controls the use & access to it
Meaningful Use of PHR
Defined by ONCHIT in meeting criteria in stages
Quality Based Repayment Programs
includes protected health info, e-perescribing, pt electronic access, pt engagement, health info exchange, & public health & clinical data registry reporting
CHIP
Children’s Health Insurance for those who don’t qualify for Medicaid
ADE
EHR’s try to improve pt’s outcome by decreasing Adverse Drug Events
RHIO
Regional Health Information Organizations (regional shared data)
NHIN
(National Health Information Network) communication between regions
FIS
Financial Information System
CIS
Clinical Information System
PIS
Pharmacy Information System
RIS
Radiology Information System
LIS
Laboratory Information System
NIS
Nursing Information System
PACS
Picture Archiving and Communication System
DRG
Diagnosis-related group - related to one primary diagnosis that gives the encounter a relative weight and/or classification. This formula determines reimbursement amounts for that particular encounter. Excess cost is absorbed by hospital. A DRG payment covers all anticipated charges associated with an inpatient stay from admission to discharge.
ICD
International Classification of Disease
Charges, payments, and adjustments
all types of transactions to an account
Guarantor
persons responsible for the payment (pt or third party)
Schedule of Benefits
List of services that carrier will cover
Deductible
Amount of pt is required to pay before insurance kicks in
Co-payment
part of each charge that pt is responsible for
Medicaid
federal state funded based on need
Medicare
65+, ESRD