HCM 435- Section 5 Flashcards
Major types of healthcare information
Internal and External
Internal information
Created internally by healthcare organization. Can be financial, clinical or aggregate.
External Information
3rd party payer; Medicare/aid; Insurance companies; billing i.e.. Insurance claims; copies of insurance cards
Financial Internal Healthcare Information
3rd party payer; Medicare/aid; Insurance companies; billing i.e.. Insurance claims; copies of insurance cards
Clinical Internal Healthcare Information
Patient information directly related to care/a part of medical record i.e.. Physician’s orders; history and physical; lab reports
Aggregate Internal Healthcare Information
Reports that combine one or more types of information. Example: AD HOC Reports; Medicare cost reports; health care statistics)
External Healthcare Information
Created outside the healthcare organization. Can be comparative, expert or knowledge based, or competitive.
Comparative External Healthcare Information
combines internal and external information to aid organization in evaluation performance (ex. Balanced scorecards; health care data sets (HEDIS by NCQA); CMS
Expert or Knowledge Based External Healthcare Information
Clinical/scientific/management print literature i.e.. Professional Journals; Push technology; Online databases
Competitive External Healthcare Information
Market Analysis
Identify problems associated with poor quality health care data.
o Patient care; communication among providers/patients; documentation; reimbursement; outcomes assessment; research;
o Medical record institute cites with- patient/public safety; continuity of care; economics; clinical research/outcomes; can post a problem when a medical record is evidence in court
HIPAA
HIPAA emphasizes privacy for the right to limit access to healthcare information and confidentially that information will only be used or its intended purpose and relies on trust
Protected health information
any information created by provider for health care purposes related to an individual
The component of the HIPAA Privacy Rule that specifies that entities that improperly handle PHI can be charged under criminal law and punished and are subject to civil recourse is know as:
accountability
What was the first comprehensive federal regulation that offers specific protection to private health care information?
The HIPAA Privacy Rule
