Final Review Flashcards
High speed broadband
high-speed internet access that is always on and faster than the traditional dial-up access
Intranet
a private network that uses internet software and TCP/IP protocols
Extranet
a corporate intranet connected to other intranets outside the corportation
Biometrics
the science that measures body characteristics; enables security devices to identify a user by these characteristics
Encryption
used to protect information from unauthorized users; involves encoding of messages
Bioinformatics
the application of information technology to biology
Medical informatics
the use of computers and computer technology in health care and its delivery
e-prescribing
the use of computers and software to enter prescriptions and send them to pharmacies electronically
HIPPA
-Health Insurance Portability and Accountability Act of 1996
-Guidelines to protect electronic medical records were developed by the Department of Health and Human Services by encouraging the use electronic record and facilitating the sharing of medical records among health care providers
HIPPA and Telemedicine
Email encrypted, facial recognition systems should allow the doctor to identify the patient on the network, digital identification cards should be used, and the computers and networks should be protected
AARA
American Recovery and Reinvestment Act 2009 by Obama. Includes financial incentives for adopting electronic health records
ONCHIT - Office of the National Coordinator for Health Information Technology
-2004 by Bush
-Mission is to “promote a national health Information and Technology infrastructure and oversee its development”
Administrative Applications
Office management, scheduling, and account tasks
Health informatics
Administrative applications, clinical applications, and special purpose application
Clinical applications
diagnosing and treating
Special purpose applications
research education pharmacy
telehealth
includes telemedicine and other health-related activities using telecommunications lines and computers, including education, research, public health, and administration of health services
Telemedicine
the delivery of healthcare over telecommunication lines
eHealth
the use of electronic means to transfer health information and resources
eHealth Exchange
is the infrastructure that allows communication among RHIOs
Electronic Health Records (EHRs)
Electronic record of patient information generated by one or more encounters in any care delivery setting
Electronic Medical Records (EMRs)
in a computerized office, the information that was gathered and entered onto a patient information form will then be entered into a computer into electronic records. This will form a patient’s medical record
Store-and-forward
technique in which the data to be sent are digitized, stored, and transmitted over a telecommunication network
Vidoeconfrencing
technologies for the reception and transmission of audio-video signals by users at different locations, for communication between people in real-time
HITECH Act
Health Information Technology for Economic and Clinical Health Act: part of the AARA, funds ONCHIT, and is designed to provide necessary assistance & technical support to providers, enable coordination & alignment within & among states, establish connectivity to the PH community in case of emergencies, & assures the workforce is properly trained and equipped to be meaningful users of EHRs
The _____ was signed into law on Feb 17, 2009, by Obama; it included billions of dollars for the expansion of health information technology. Through Medicare and Medicaid, monetary incentives would be offered to doctors and hospitals to adopt EHRs
American Recovery and Reinvestment Act (ARRA)
Which of the following are obstacles in the way of adopting electronic records?
cost
____ is the use of computers and software to enter prescriptions and send them to pharmacies electronically.
e-prescribing
Medical offices must use _____ billing to accommodate two or three insurers, who much be billed in a timely fashion before the patient is billed
bucket
_____ refers to the connection of people and diverse computer system
interoperability
___ use computers to solve biological problems.
bioinformatics
Administrative applications of computers include ____.
scheduling, coding, accounting
____ has the task of overseeing the adoption and meaningful use of EHRs, setting standards, and judging the impact.
ONCHIT
_____ refers to the use of computers to organize information in healthcare
medical informatics
what is the oldest form of telemedicine using computers and telecommunication equipment?
teleradiology
ICD-9
Abbreviation for international classification of disease, 9th revision, clinical modification. A reference in for reporting diagnoses code. No longer use - 14,025 diagnosis codes
ICD 10
Currently used system to classify and code diagnoses, symptoms, and procedures. It is more consistent with the rest of the world while providing more specific information per code
examples of ICD 10
-L89.624 - pressure ulcer left heel stage 4
-S88.119AA - partial traumatic amputation at level between knee and ankle, left lower leg initial encounter
CPT purpose
Describes medical service/tests/procedures completed. The data is collected and used on the EHR and data collected on public health issues
examples of CPT
-97001 - physical therapy evaluation
-97035 - ultrasounds
DRG (diagnosis related groups) purpose
hospital codes for payment
DRG examples
Heart Failure DRG 127
The ____ is a code used by private and government insurers to determine insurance reimbursement
DRG
______ informatics focuses on the use of technology to organize information in health care in order to improve health
clinical or medical
_____ informatics uses computer technology to support public health practice, research, and learning
public health
One important factor of clinical or medical informatics is the ____ of HIS, so that the results of one system are immediately available to the other.
integration
_____ has the tasks of overseeing the adoption and meaningful use of EHR, setting standards, and judging the impact
ONCHIT
The _____ is a longitudinal electronic record of patient health information generated by one or more encounters in any care delivery setting
EHR
The ____ belongs to one health care institution - a doctor’s office or hospital
EMR
ONCHIT was funded by the HITECH, part of the _____, signed into law in Feb 2009 by Obama
ARRA
Managed care plans and _____ may require that the provider get authorization before a procedure is performed
preferred provider organization (PPOs)
Regional cooperation was being fostered through the establishment of ____ in the US
Regional Health Information Organizations (RHIOs)
A _____ information system is concerned with the financial details of running a hospital
financial
_____ information systems are supposed to improve nursing by using computers to manage charting, staff scheduling, and the integration of clinical information
nursing
____ will permit the exchange of all medical information in the US?
eHealth exchange
____ information system manage patients in the radiology department, including scheduling appt, tracking film, and reporting results
radiology
PACS is a system associated with ____ information systems
radiology
____ application include the use of computer in office management accounting, scheduling, and planning
administrative
Medicare serves
people over the age of 65 and people with chronic renal disorders
Practices that submit electronic claims use a/an _____ a business that collects insurance claims from providers and send them to the correct insurance provider
clearing house
The insurance company’s response to paper claim includes an/a ____ which explains why certain services were covered and others were not
explanation of benefits (EOB)
The insurance company’s response to an electronic claim includes a/an ___ which explains why certain services were covered and others were not.
electronic remittance advice (ERA)
Telemedicine involves
linking of doctors and pts at a distance, transmission or radiologic images via telecommunication lines, and the transmission of pt data in any form
One technology used the tele radiology is called
store-and-forward
Before telemedicine can deliver high-quality medical services at a distance, _____.
a reliable broadband telecommunication network has to be in place and state licensing carriers have to be overcome.
the transmission of microscopic images over telecommunications lines is called _____
telepathy
Telemedicine projects in prisons have been found to ______.
improve health care, cut costs, and improve security
______ allows doctors and pts to consult in real time at a distance
interactive videoconferencing
Elderly, frail pts and pts in poor health are like than others to suffer from problematic injuries. ______ can increase access to specialists
telewound care
Telemedicine is used in some way in the treatment of _______
skin rashes
Remote medical consultations and exams were first tried
as soon as the telephone was invented
A remote house call by visiting nurse is an example of
telenurisng
______ technology is used to link electronic devices
bluetooth
The ____ program at Massachusetts general allows quick diagnosis and can determine if tPA should be used in treatment
telestroke
One of the most successful telemedicine programs links hospitalized premature infants with their parents at home. It is called ______
Baby CareLink
Many telemedicine programs have been found to be effective; however, ___ is not.
distance monitoring of problem pregnancies
In Vermont and Arizona, ____ projects link trauma surgeons’ homes with hospital emergency departments.
teletrauma
Mobile Health
-“use of mobile devices and global networks to deliver health services and info”
-tablets & smartphones using them for professional purposes: write prescriptions, look up info, look at EHR, or share info with pts.
Is telehealth over utilized or underutilized?
under because of reimbursement issues
What are basic telehealth licensure rules for clinicians?
Must be licensed in state they practice in and state their pt is in or the compact state agreement
How many states are in the medical licensure compact?
17 as of 2016
Examples of telehealth
telewound, telenursing, telepathology
What is the impact on the clinician is they do not adopt EHRs within timeframe?
they don’t get incentive money, Medicare and medicaid reimbursement deduced
CM-1500 Claim Form
Sec 1- carrier block, section contains the address of the insurance carrier & is located at the top of the form
Sec 2- Pt/insurance section contains info about the pt & the insured
Sec 3- Physician Supplier section
Restrictions of Medicare’s coverage of telehealth for beneficiaries
restricted by provider type and by location of pt also restricted to live
is telehealth right for everyone?
depends on many factors like older so it can’t run equipment, privacy issues, insurance coverage, cost of equipment
What is the widely-used telehealth and most reimbursable?
Teleradiology
What larger act is HITECH apart of?
AARA
What is the purpose of HITECH
increase EHRS
key elements of the HITECH act
money for EHRs, meaningful use, privacy regulation
What is meaningful use?
providers need to show they’re using certified EHR technology in ways that can be measured significantly in quality and in quantity
The purpose of meaningful use
The use of a certified EHR is a meaningful manner. The use of certified EHR technology for electronic exchange of health info to improve quality of HC. The use of certified EHR technology to submit clinical quality and other measures
How many phases in meaningful use?
3
Describe the licensure issues in telehealth
Clinician must know the laws/standards of practice in distant states and challenging when practicing in many states because states vary in rules
Privacy issues and strategies to protect pt privacy in telemedicine
HIPPA: encryption, recognition system more than one identifier, card
MIPS
Merit-based Incentive Payment Systems
What is MIPS
It’s a system for value-based reimbursement the Quality Payment Program (QPP) with the goal of promoting the ongoing improvement and innovation to clinical activities
Phases of meaningful use
- promotes basic EHR adoption and data gathering
- emphasizes care coordination and exchange of pt info
- improves HC outcomes
MIDAS stands for
medical identity protection software
What is MIDAS
Its the first and only solution to HC fraud that empowers you, the member, to monitor your Hc transactions and defend your medical identity
Pandemic
Disease that occurs over a wide geographic area and affects a very high proportion of the population
MRI (magnetic resonance imaging)
is the medical imaging technique used in radiology to form pictures of the anatomy and the physiological processes of the body. MRI scanners use strong magnetic fields, magnetic filed gradients, and radio waves to generate images of the organs in the body
fMRI (functional MRI)
A technique for revealing blood flow and, therefore, brain activity by comparing successive MRI scan. fMRI scans show brain function
PET scan (positron emission tomography)
A visual display of brain activity that detects where a radioactive form of glucose goes while the brain performs a given taask
Human Genome Project
An international collaborative effort to map and sequence the DNA of the entire human genome.
NMES (Neuromuscular electrical stimulation)
is a treatment for dysphagia - swallowing disorders. Uses a low-level electric current to activate muscles used for feeding and swallowing
TNES (transcutaneous electrical nerve stimulation)
is a back pain treatment that uses low voltage electric current to relieve pain. Typically done with a TENS unit, a small battery-operated device
Fludiotherapy
is a dry thermal physical agent that transfers its energy to soft tissues by forced convection. It is defined as: “A modality of dry heat that uses a suspended air stream with the properties of a liquid.”
Endodontics definition
is a dental specialty concerned with the study and treatment of the dental pulp
Periodontics
is the specialty of dentistry that studies supporting structure of teeth, as well as disease and conditions that affect them.
ADA (Americans with Disabilities Act)
The Americans with Disabilities Act of 1990 or ADA is a civil rights law that prohibits discrimination based on disability
Iontophoresis
is a process of transdermal drug delivery use of a voltage gradient on the skin. Molecules are transported across the stratum corneum by electrophoresis and electroosmosis and the electric filed can also increase the permeability of the skin.
Ultrasound
sound or other vibrations having an ultrasonic frequency, particularly as used in medical imaging.
Examples of endodontics
root canals
Gum disease is linked to
heart disease, stroke, cancers, premature delivery
Why is the dental field growing?
-dental health has improved over the last century. Many children don’t have many cavities
-each generation is more likely to keep their teeth so there is more of a need for dental care providers
Antibiotics resistance
the condition where certain bacteria no longer respond to antibiotics
Disease mapping
finding genetic cause of disease
Nanotechnology definition
science of bioengineering at the molecular level to produce new materials with new properties
Nanotechnology examples
include titanium dioxide and zinc oxide nanoparticles in sunscreen
Robotic surgery
Use of small surgical instruments attached to a computer and operated by the surgeon from a console several feet from the operating table
Examples of robotic surgery
hip replacement, kidney, coronary artery bypass
Endoluminal surgery
one form of minimally invasive robotic surgery is called endoluminal surgery. It doesn’t require incisions. It is also called natural orifice surgery
Stem cells
special human cells that have the ability to develop into many different cell types, from muscle cells to brain cells. In some cases, they also have the ability to repair damaged tissues
How are stem cells being used
Scientists have “grown” heart valves
-and converted adult skin into beating heart cells
Computerized Physician Order Entry (CPOE)
refers to the process of a medical professional entering and sending medication orders and treatment instructions electronically via a computer application instead of on paper charts
Conflict of interests in the FDA
-Drug companies pay fees to support the drug review process
-Members of FDA advisory panels have financial ties to big pharma
FDA
Monitor safety and efficacy of new medications
Pksis
products allowed healthcare personnel to avoid the manual recording of drugs dispensed or used by nurses and pharmacies based in a computerized and interconnected infrastructure, and allowed for the development of decentralized medication storages
When did the Human Genome Project begin?
1990
Purpose of Human Genome Project
Treatment can be gene therapy or drug development
What are smart cards?
A plastic credit card with a memory chip on it. It can open, access and update, all the essentials of a pt’s health records from a cloud-based host
Benefits of smart cards
-connect to multiple MRH
-can be used as a debit card as well
Counterfeit medications
it may be contaminated or contain the wrong or no active ingredient. They could have the right active ingredient but at the wrong dose. Counterfeit drugs are illegal and may be harmful to your health.
Epidemiology
distribution and determinants of health related conditions - control health problems in a population
Social inequality
distribution of wealth (any kind of social health has social inequity)
What-if Scenarios/simulations
like weather models for health or illness
Syndromic Surveillance
Unusual reports or patterns in symptoms prior to diagnosis - outbreak of diarrhea
computers can…
model and analyze past/current patterns and predict future trends
MRI’s can diagnose…
brain tumors, MS, detect cancers, orthopedic injuries
PET Scans use ______
radioisotopes that create images of the body in action
WAND
microprocessors senses the tissue density to ensure a steady injection of anesthetic
Visible Human Project
computerized library of human anatomy at the National Library of medicine. Started in 1986 using MRI and CT of cadavers that are available to anyone for use
Virtual Human Embryo
11 years to complete, 7000 human embryos lost in miscarriages stored by National Museum of Health and Medicine of the Armed Forces Institute of Pathology since 1880s.
CINAHL
group of four databases for nurses and 17 other allied health fields
