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HIT Flashcards

0
Q

What are the 5 National Priorities for MU.

A
  1. Improve quality, safety, and efficacy of care while reducing health disparities
  2. Engage patients/families in their care
  3. Promote public/population health.
  4. Improve care coordination.
  5. Promote the privacy and security of EHR
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1
Q

CQM

A

Clinical Quality Measure

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2
Q

HIPAA

A

Health Insurance Portability and Accountability (1996)

Requires payors and Medicare to comply with EDI standards.

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3
Q

HITECH

A

Health information technology for economic and clinical health

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4
Q

ONC

A

Office of national coordinator for health information technology

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5
Q

What is the HITECH act?

A

2009 law signed under ARRA which created MU

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6
Q

What is Pay for Performance? (P4P) (Value-Based Purchasing)

A

A payment model that rewards healthcare providers for better health outcomes.

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7
Q

what are categories of care?

A

they align with the 5 national priorities

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8
Q

what does INTEROPERABILITY refer to?

A

Using technology to exchange key pieces of health information securely with a goal of obtaining the right information in the right context.

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9
Q

what are the ONC defined framework for a set of building blocks that support system interoperability?

A 
vocabulary and code sets
content structure
transport
security
services
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10
Q

CCHIT

A

certified commission for health information technology - independent, non profit with a public mission of accelerating the adoption of robust, interoperable HIT

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11
Q

Define MU

A

A qualification to receive federal funding for HIT (emr)

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12
Q

2015

A

Last year of eligibility to achieve MU incentives.

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13
Q

CAH

A

Critical Access Hospital

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14
Q

MU 2 - How long to meet requirements.

A

2 full years

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15
Q

Eligible hospitals vs Eligible professionals in schedule?

A

EPs = Calendar year

Hospitals and CAH = federal fiscal year

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16
Q

MU General requirements

A

Menu set + Core set of objectives specific to EPs or hospitals and CAHs

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17
Q

CMS MU specification sheet

A

Single sheet per objective:

  • Meeting the measure for each objective
  • How to calculate the numerator and denominator for each objective
  • How to qualify for an exclusion to an objective
  • In-depth definitions of terms that clarify objective requirements
  • Requirements for attesting to each measure
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18
Q

CQM requirements for EPs

A

Eligible professionals must report on 6 total clinical quality measures:

3 required core measures (or 3 alternate core measures) and
3 additional measures (selected from a set of 38 clinical quality measures).

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19
Q

what are the financing and insurance mechanisms for US healthcare?

A

Private: Employer-based or Privately purchased insurance
Public: Government Programs
1. State Employees
2. MC (elderly and certain disabled)
3. Medicaid and CHIP (indigent poor/children)

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20
Q

NHI (national health insurance) example

A

Canada, Great Britain

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21
Q

NHI Description

A

Government finances through taxes but care is rendered by private providers.

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22
Q

Socialized Health Insurance Examples

A

Germany, Israel, and Japan

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23
Q

Socialized Health Insurance description

A

Financed through government-mandated employer/employee contributions and delivered by private providers.

Government has overall control.

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24
Q

What is an HIE

A

a network that shares EHRs across a community

25
Q

What are the benefits of an HIE?

A
  1. Reduce duplicate test orders.
  2. Avoid adverse drug interactions.
  3. Reduce time spent looking for records.
26
Q

4 data types of an HIE

A
  1. Lab results
  2. Meds data
  3. Allergy data
  4. ED discharge summaries
27
Q

HIE Main Standards

A 
HL7
SNOMED
ICD9/10
CPT
LOINC
RXNorm
28
Q

what does PACS stand for?

A

Picture Archiving and Communication System

29
Q

What does PACS do?

A

$$$$$
Stores images from different modalities, indexes them for fast retrieval, has its own db plus metadata, and allows for transfer of images to different network locations. Multiple site/Simultaneous access.

30
Q

Example of an analog imaging modality

A

plain film/fluroscopy/ultrasound/angiography

31
Q

Example of digital imaging modality

A

MRI/CT

32
Q

CT xray

A

digital, sliced xray images like a loaf of bread, shows structure only

33
Q

Xray

A

Short, tight wavelength, one slice image

34
Q

PET

A

Positron emission Tomography - uses gamma rays

measures body functions like metabolism of an organ, blood flow, O2 use

35
Q

MRI

A

Uses magnets, radiowaves, and computer. no radiation.

36
Q

DICOM

A

Digital Imaging and Communications in Medicine

37
Q

EDI

A

Electronic Data Interchange

38
Q

HIPAA 5010

A

New standard set around a billing transaction foundational to ICD-10 coding standards.

39
Q

Mapping ratio of ICD9 to ICD-10

A

One ICD-9 code can map to 100 ICD-10 codes.

40
Q

ICD-10 Code structure

A

Category - Etiology - Extension Code

41
Q

What is E&M?

A

Evaluation and Management

42
Q

How many levels of E & M are there?

A

4

43
Q

What are the 3 components of an E & M code?

A
  1. History
  2. Examination
  3. MDM
44
Q

NCQA

A

National Committee for Quality Assurance

45
Q

HEDIS

A

Healthplan Employer Data and Information Set

46
Q

What does HEDIS do?

A

71 measures comparing the quality of care between different health plans.

47
Q

How does an INTERFACED SYSTEM work?

A

Separate software and databases linked to a computer network and exchange information with other HC Systems. Can be from different vendors.

48
Q

How does an INTEGRATED SYSTEM work?

A

Shared common database. Same Vendor.

49
Q

RAC

A

Recovery Audit Contractors

50
Q

What is the purpose of an AGING REPORT?

A

To monitor Accounts Receivable.

51
Q

PCE

A

Partially Compensable Event

52
Q

What is PCMH stand for?

A

Patient-Centered Medical Home

52
Q

What is a PCMH?

A

A patient-centered medical home is a way of organizing primary care to emphasize care coordination.

52
Q

What does NCQA do?

A

This private, not-for-profit organization provides programs and services to improve care quality through quality standards and performance measures.

52
Q

How is NCQAs performance measured?

A

Statistics that track quality of care as delivered by the nation’s health plans.

52
Q

What is the MEDICARE PAYMENT ADVISORY COMMITTEE?

A

A group of experts that advise Congress.

52
Q

What drove many of the recent doctor-hospital mergers?

A

Medicare’s disparate pay policies.

52
Q

What is VBR?

A

Value-Based Reimbursement.

53
Q

What is Wellcentive’s population health management technology?

A
  • Cloud-based, scalable, customizable technology and services.
  • For providers, health organizations, and payers
  • To help measure and report performance toward VBR (value-based reimbursement).
54
Q

In Value-Based Payment, what does VALUE equal?

A

Value = Quality/Cost

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