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S. Department of Health and Human Services, 2011). Furthermore, subpart C explains the privileges and the protections of confidentiality that is attached to the patient's record along with much exception (U.S. Department of Health and Human Services, 2011).
The penalty for anyone who breaks confidentiality is imperative. In "November, 23, 2009" was increased to $11,000 (U.S. Department of Health and Human Services, 2011). This goes for anyone in the medical field or has access to this information. A person has to follow HIPAA precisely or face a huge fine. If one thought of this ahead of time, whether or not they own a business, then no issues would arise legally. However, sometimes this does occur, especially for those who want to harm another person, yet in the medical field the goal is not to do this to any individual, regardless, otherwise he or she could face losing their license in…
U.S. Department of Health and Human Services Civil Rights. (2011). Your health information privacy rights. Retrieved May 3, 2011, from U.S. Department of Health and Human
Services Civil Rights:
U.S. Department of Health and Human Services. (2011). Health information privacy. Retrieved May 3, 2011, from U.S. Department of Health and Human Services:
While there are some differences according to jurisdiction, in general, if the defense is allowed by the judge to go to the jury.
The term illness of the mind is solely a legal notion. In the case of Bratty v. Attorney-General (Northern Ireland) (1963), Lord Denning declared that the foremost mental illnesses, which the doctors identify as psychoses, like schizophrenia, are plainly illnesses of the mind. Whether or not drug-associated psychosis will be considered to qualify as an illness of the mind will essentially depends on the division amid a fault of cause resulting from an underlying condition and a fault of cause caused by something external.
There is justifiable societal concern about the links between violence and illicit substance use. Such concern finds a focal point at the debate around the boundaries for the insanity defense where drug-associated psychoses are involved. This article outlined three potential approaches that…
Health Care Law
Read: Compliance needs a shrewd strategic plan
Discuss the reasons why healthcare organizations should include a compliance program into their strategic planning?
In short, the Cerrato story linked above discusses and makes clear, more or less, that it is a non-optional part of doing business in the healthcare business and sphere. He noted that healthcare providers must comply with "a long list of healthcare-related laws and regulations" and that it remains "a major challenge for provider organizations around the country" (Cerrato, 2013). Just a short list of reasons why compliance should be a focal point within the broader strategic planning sphere for healthcare organizations is because doing otherwise can open a company to civil liability, can open up a company to agency sanction, can open up a company to criminal charges (in extreme cases), can lead to a degradation or failure to improve patient…
Informed consent signifies one of the protections in studies on mental illness. Consent is a procedure that permits for the free choice by a knowledgeable and competent person to or not to partake in investigative procedures. Capacity for consent is not a stationary experience. It can transform with the circumstance of the person. The theory of informed consent was established on two distinctive legal philosophies. Every patient has the right to figure out what will or will not be completed on them and in regards to a fiduciary character of the patient physician affiliation it has to be articulated with the main purpose of endorsing individual self-rule while endorsing balanced decision formulation.
This article was very easy to read and attempted to break the subject matter down into everyday language in order to maintain clarity. It gave a very good overview of psychiatric drug testing on children and how…
Malhotra, Savita and B.N., Subodh. (2009). Informed consent & ethical issues in paediatric psychopharmacology. Indian Journal of Medical Research, 129(1), p.19-32.
This allows for the maintenance of a Network price list, as stipulated in the Physician's version of this clause while still tying price (as well as incorporating the discounts) to standard physician charges, as stipulated by the Network. The Physician's current version of the compensation clause is untenable, however, as it limits the freedom of market forces to have their effect on price, which is unfair to the network and will most likely create higher costs to the network and its clients thus eliminating benefits to clients.
Again, the terms of the Physician's version are unacceptable to the Network as it will eliminate any benefit to clients. The affiliation of hospitals with the Network is a possible point of negotiation as long as other hospital services are not charged to the Network.
The Network's indemnity clause creates fair and equal liability, ensuring that physicians and only physicians will be liable…
Petersen, L.; Woodard, L.; Urech, T.; Daw, C. & Sookana, S. (2006). Does Pay-for-Performance Improve the Quality of Health Care? Annals of internal medicine 145(4), pp. 265-72.
Laws invariably impact scope of care and scope of practice. Many scope of care-related laws are designed to protect the interest of patients and/or consumers. Similar to jurisdiction debates in law enforcement, scope of care issues in healthcare highlight the ways each professional dimension or area of specialization is bounded by "turf battles," even when those battles may adversely impact quality of care (National Council of State Boards of Nursing, 2009). Complicating the matter are recent developments in healthcare law, which constrain unethical practices but which might also inadvertently impinge upon legitimate healthcare work. Scope of practice changes should ideally reflect evidence-based practice.
Often the primary beneficiary of scope of care laws are institutions, which avoid needless lawsuits. Primary care services that change as the result of scope of practice legal changes may have positive economic impacts on healthcare institutions. On the other hand, laws that unnecessarily prevent quality of…
National Council of State Boards of Nursing (2009). Changes in healthcare professions' scope of practice. Retrieved online: https://www.ncsbn.org/ScopeofPractice_09.pdf
Panagala, S.V. & Jansen, D.J. (2014). TRICARE and VA health care. CRS Report for Congress. Feb 11, 2014.
Third Party Patient
The Doctrine of Apparent Agency
June, a 34-year-old divorced woman diagnosed with severe anorexia, is hospitalized. Her doctors feel she may need to be placed on a feeding tube soon to save her life. Initially June agreed to the feeding tube. However, in the evening (before the tube has been placed), she became combative, disoriented, and refused to have the feeding tube placed. Her mother and father insisted that the feeding tube be inserted despite her refusal to allow it. Her ex-husband wishes to uphold June's decision. The hospital administrators seek risk management for legal counsel.
Explain how the Patient Bill of ights applies to this situation.
The Patient Bill of ights articulates U.S. federal law on the doctor-patient relationship, and is consistent with laws on informed consent where licensed professional practice respective to patient well being is in order. Confidentiality of patient record is perhaps…
Bullough, B. ed. The Law and the expanding nursing role. New York, NY: Appleton-Century-Crofts, 1980.
Callahan, Joan, ed. Ethical Issues in Profesional Life. Oxford: Oxford University Press, 1988.
Patient Bill of Rights (2010). NIH. Retrieved from: http://www.cc.nih.gov/participate/patientinfo/legal/bill_of_rights.shtml
How is shared decision-making different from informed consent? (2010) American Cancer Society. Retrieved from: http://www.cancer.org/Treatment/FindingandPayingforTreatment/UnderstandingFinancialandLegalMatters/InformedConsent/informed-consent-shared-decision-making
The CW 70.41.250 is a law that provides cost disclosure to health care providers. It is a state law that offers some control over the spiraling expenses of health care by creating transparency within hospital and medical bills (Wash. State, 2016). Made to ensure health care providers provide only necessary services and reduce inflationary rates, CW 70.41.250 also gives the option for a health care provider or physician to inform patients of such expenses to further increase transparency and perhaps fuel a more communicative provider-patient relationship.
A hospital's chief executive officer licensed under this chapter as well as superintendents of state hospitals must maintain and establish a procedure for releasing to health care providers and physicians that have admitting privileges the expenses of all ordered health care services for their patients. This includes copies of hospital charges if they make orders for inpatient/outpatient services. The health care provider…
Adler, R. (1992). Overview of the Washington Health Care Information Act: Rights and Duties of Provider and Patient - Adler Giersch PS. Adler Giersch PS. Retrieved 7 April 2016, from http://www.adlergiersch.com/overview-of-the-washington-health-care-information-act-rights-and-duties-of-provider-and-patient/
ASPE,. (2015). Standards for Privacy of Individually Identifiable Health Information. ASPE. Retrieved 7 April 2016, from https://aspe.hhs.gov/basic-report/standards-privacy-individually-identifiable-health-information
Grass, J. (2013). The Impact of Obamacare on Financial Disclosure Laws for Nonprofit Hospitals: Some Say They Don't Go Far Enough, 3(5). Retrieved from http://www.americanbar.org/publications/gpsolo_ereport/2013/december_2013/impact_obamacare_financial_disclosure_laws_nonprofit_hospitals.html
U.S. Dept of State,. (2016). The Privacy Act: U.S. Department of State - Freedom of Information Act. Foia.state.gov. Retrieved 7 April 2016, from https://foia.state.gov/Learn/PrivacyAct.aspx
rights EMTALA grants, to whom, when, and in what setting.
EMTALA is short for the Emergency Medical Treatment and Active Labor Act. It was part of the larger Consolidated Omnibus Budget econciliation Act of 1986, which is commonly referred to as COBA. The EMTALA legislation governs how and when a patient may be refused treatment and/or when they may be transferred from one hospital to another while in an unstable condition. The "avowed purpose" of EMTALA prevents "hospitals from rejecting patients, refusing to treat them, or transferring them to 'charity hospitals' or 'county hospitals' because they are unable to pay or are covered under the Medicare or Medicaid programs" (EMTALA, 2015). Basically, it protects patients that are near-death or are otherwise in medical distress from being sent off to another hospital due to concerns about payment for services rendered. In other words, it prevents a hospital from treating patients based…
Berkeley. (2015). Similarities and differences. Evolution.berkeley.edu. Retrieved 21 June 2015, from http://evolution.berkeley.edu/evolibrary/article/similarity_ms_01
EMTALA. (2015). FAQ on EMTALA. Emtala.com. Retrieved 21 June 2015, from http://www.emtala.com/faq.htm
HHS. (2015). The Belmont Report | HHS.gov. HHS.gov. Retrieved 21 June 2015, from http://www.hhs.gov /ohrp/humansubjects/guidance/belmont.html
ABC Hospital Incident Report
Follow Up Requested: Yes? Nox
What happened? Time: 5 PM Date: 8 Feb 2015 Location: Treatment Room
ABC Hospital has been always known for upholding the highest of ethical and moral standards since my time being employed as a nurse in this organization. The code itself is based on the Hippocratic Oath which directs and aligns the clinical practices of this organization with directed set of principles based on the ancient teachings of Hippocrates, the first Western Healer. The code suggests that patients are to receive our best efforts as healers, leaving no reasonable excuse for failure. Patients are treated as real people with real problems and the need to ensure their protection and safety is no doubt a primary concern.
The code of conduct here at ABC appears to have been violated with the recent problems with MS. Patient X and here misdiagnosis…
Purdue Pharma's Role in the Opioid Crisis
The court case of US v. Purdue Pharma is a case that focuses on the Anti-Kickback Statute, which holds it a felony for an entity to accept kickbacks for providing services or items that are reimbursable by a federal program (Baird, 2021). Part of the problem with this case and others like it is that not everyone agrees on what constitutes a kickback. For example, Illiparambil (2020) writes in the Brookly Law Review that pharmaceutical “donations” should not be viewed as kickbacks—even though prosecutors could and have made the case that they act as such. However, kickback laws have been in existence for decades, the first going all the way back to 1931 (Raspanti, Roberts & Bosick, 2017). Today, the Anti-Kickback Statute has led to prosecutions and settlements with pharmaceutical companies like Purdue Pharma for over half a billion dollars (Kraschel &…
Baird, J. (2021). Recent federal case—Medicare AntiKickback Statute. Retrieved from https://medtrade.com/news/billing-reimbursement/Recent-Federal-Cases-Medicare-Anti-Kickback-Statute/
Gore, A. (2020). Exposing the Middlemen in Rising Drug Costs: Modifying Safe Harbor Protections for Pharmacy Benefit Manager Rebates Under Federal Anti-Kickback Statutes. Or. L. Rev., 98, 297.
Illiparambil, T. (2019). Pharmaceutical Philanthropy Or Resisting Regulations?: Why Pharmaceutical Donations Do Not Violate the Anti-Kickback Statute. Brook. L. Rev., 85, 571.
Kraschel, K., & Curfman, G. (2019). Patient Assistance Programs and Anti-Kickback Laws. Jama, 322(5), 405-406.
Raspanti, M. S., Roberts, D. E., & Bosick, P. G. A. (2017). A Practitioner’s Primer on the History and Use of the Federal Anti-Kickback Statute. Retrieved from https://www.falseclaimsact.com/wp-content/uploads/2018/02/MSR-DER-A-Practitioners-Primer-on-History-and-Use-of-Federal-Anti-kickback-Statute.pdf
Rios, K. S. (2019). Combatting the Opioid Epidemic in Texas by Holding Big Pharma Manufacturers Liable. . Mary's LJ, 50, 1353.
Health Care: The Next Twelve Months
Over the next twelve months, there will be many changes to health care in the United States. The largest and most ambitious goal is to provide the majority of Americans with health insurance (Blendon & Benson, 2010). However, there will be a presidential election and a Supreme Court ruling, which means that 2012 could be the year that determines whether the health care law moves forward or whether it is shut down. It could also go forward in part, after having large pieces of it removed, and it could go forward with some fundamental changes. How the elections go will greatly affect the law - unless, of course, the Supreme Court strikes the law down before the elections arrive. It seems like that the Supreme Court will rule on the individual mandate from a constitutional standpoint, and that could lead to some of the…
Blendon R.J., Benson J.M. (2010). Public opinion at the time of the vote on health care reform. New England Journal of Medicine, 362 (16): e55.
Elmendorf, D.W. (2010). Additional information on the effect of the Patient Protection and Affordable Care Act on the Hospital Insurance Trust Fund. Congressional Budget Office.
Peterson, C.L. & Chaikind, H. (2010), Summary of small business health insurance tax credit under PPACA. Congressional Research Service.
Health Care Past, Current, And Future
The health of any nation should be a top priority for leaders and elected political representatives, but in the United States it took several centuries for the nation to begin to come to terms with providing health care for its citizens. This paper covers the gradual implementation of health care services and doctor training facilities in the U.S., and also covers the recent attempt by President Barack Obama to reform a chaotic, poor-functional and expensive health care system. Thesis: It is a scandal of massive proportions that a well-functioning, citizen-friendly universal health care system cannot be instituted in America, the world's most democratic superpower. Until the divisive and toxic political climate can be reformed, there is no chance of major reforms -- or for universal health care coverage -- in these United States.
Past Health Care Services -- Early America
Health care in colonial…
Daly, John. (2005). Professional Nursing: Concepts, Issues, and Challenges. New York:
Springer Publishing Company.
Gorsky, Martin. (2010). Good Health for America? History Today, 60(2), 1-6.
McCarthy, Robert L., and Schafermeyer, Kenneth W. (2007). Introduction to Health Care
Health Policies Medicare
hen everyone in our country finally starts to reach the age of 65 years of age or older, then every person will become eligible for Medicare. It is clear that there are some elderly that are having minimum health concerns while others recurrently are dealing with medical issues for which they will have to seek out treatment by the doctor. However, research is starting to display that there are at least five top conditions that are enhancing on medical and drug spending. It is obvious that Heart disease circumstances are the number one medical issue that the those that are considered elderly are facing and that is becoming very costly to them. Most are unaware that the second one is the disease cancer and it could be internal or external for various elderly patients. Other issues such as joint ailments a lot of the times can cost…
Wenzlow, Audra T., et al. "Effects of a Discharge Planning Program on Medicaid Coverage of State Prisoners with Serious Mental Illness." Psychiatric Services 62.1 (2011): 73-8.
Sommers, Benjamin D. "Loss of Health Insurance among Non-Elderly Adults in Medicaid." Journal of General Internal Medicine 24.1 (2009): 1-7.
Verdier, James, and Allison Barrett. "How Medicaid Agencies Administer Mental Health Services: Results from a 50-State Survey." Psychiatric Services 59.10 (2008): 1203-6.
Harman, Jeffrey S., Allyson G. Hall, and Jianyi Zhang. "Changes in Health Care use and Costs After a Break in Medicaid Coverage among Persons with Depression." Psychiatric Services 58.1 (2007): 49-54.
health care debate that has been going in the United States. It discusses the Obama Care Act and how it impacts the society. Functionalist perspectives and theories are utilized in analyzing the situation and what outcomes are expected. The major themes and concepts of the functionalist theory are discussed in detail.
The Health Care reform proposed by the Obama Administration has long been the area of debate in America and in countries all over the world. The Patient Protection and Affordable Care Act go on to cut down the number of people who are not insured. It requires small businesses to provide medical insurance to all the people working in the business. The employers are obliged to provide a good quality medical insurance. Failure of the small business to provide a good health care system will result in a penalty for any employee that goes uninsured. This act applies to…
Berkman, L. et al. (2000) from social integration to health: Durkheim in the new millennium. Social Science & Medicine 51 (2000), 51 p.843-857.
Gerhardt, U. (1979) The Parsonian paradigm and the identity of medical sociology. The Sociological Review, 27 (2), p.229-251.
Napsha, J. (2011) Small Business Owners Fret over Health Care Law's Fallout . Tribune-Review/Pittsburgh Tribune-Review, 24th March.
Unknown. (2012) Supreme Court Ruling Dooms Small Business; Obamacare Increases Taxes and Red Tape Burden . The Washington Times, 29th June.
Strategic human resource management:
Applications in a healthcare organization
It has been said that one of the great ironies of healthcare is that despite the fact it is an industry where the 'human' dimension is so important, the H department is often one of the most-overlooked aspects of healthcare organizations. "There is arguably no other labor-intensive industry that is so reliant upon a highly skilled, highly educated, high-cost, and high-in-demand workforce that literally makes life-or-death decisions every day. And yet, in many hospitals and health systems H remains an afterthought in the C-suite" (Commins 2013:1). However, the need for change is constant, and many organizations are finding they must 'adapt or die,' given the new realities they are facing. "by the federal healthcare law, the inevitable and growing shortages of skilled healthcare professionals, and the newfound and measurable importance of patient satisfaction scores for reimbursements will prompt…
Commins, J. (2013). Ready or not healthcare HR is going strategic. Health Leaders Media.
Retrieved from: http://www.healthleadersmedia.com/content/HR-266470/Ready-or-Not-Healthcare-HR-is-Going-Strategic
Kabene, S. (et al. 2006). The importance of human resources management in health care: A
global context. Human Resources Health, 4: 20. Retrieved from:
The Affordable Care Act works on the premise that all Americans should have access to health care insurance. Because this is provided through insurance companies, the system is only enforceable under certain conditions. One of the key tenets of health care reform is the idea that those with pre-existing conditions cannot be denied insurance coverage. This group of people has long had problems getting insurance, and insurance companies spend tens of millions to invent pre-existing conditions that would then be used to deny coverage. Even insurance commissioners have been known to take offensive and absurd stances on pre-existing conditions, arguing that insurance companies should not have to take customers with such conditions because the person is to blame for their pre-existing condition (Ferguson, 2013). With attitudes like this from people connected to the insurance industry, the only way that the Obama Administration was going to achieve universal health care…
Ferguson, D. (2013). Georgia insurance commissioner: It's your fault if you have a pre-existing commission. Raw Story Retrieved December 6, 2013 from http://www.rawstory.com/rs/2013/12/05/georgia-insurance-commissioner-its-your-fault-if-you-have-a-pre-existing-condition/
Klein, E. (2012). Unpopular mandate. The New Yorker. Retrieved December 6, 2013 from http://www.newyorker.com/reporting/2012/06/25/120625fa_fact_klein
Kliff, S. (2013). Washington State provides case study on effects of health care reform. Washington Post. Retrieved December 6, 2013 from http://articles.washingtonpost.com/2012-06-16/national/35461636_1_individual-mandate-health-insurance-insurance-reforms
AARP. (2013). For people 65+. American Association of Retired People. Retrieved December 6, 2013 from http://www.aarp.org/content/dam/aarp/health/healthcare_reform/2013-07/aca-factsheet-for-65-aarp.pdf
4 million young people); e) Americans that are uninsured and that have "preexisting conditions" can as of now get insurance through the "Pre-Existing Condition Insurance Program" (PCIP); f) 46 states are using Affordable Care Act resources to "crack down on unreasonable premium increases" (hite House).
There are additional benefits that result from the Affordable Care Act will come into play in 2014, according to the hite House. Those include a new competitive insurance marketplace that will be established. In that new marketplace will be state-run health insurance exchanges where "million of Americans and small businesses will be able to purchase affordable coverage" and have the same healthcare choices as "Members of Congress," the hite House explains.
As to the federal fiscal benefits from the Affordable Care Act, the Government Accountability Office (GAO) reports that healthcare reform can reduce the national debt / deficit by $145 billion by 2019 and by…
Lampert, Jacqueline Garry. (2009). The Need for Health Care Reform by the Numbers. The Democratic Policy Committee. Retrieved March 29, 2011, from http://www.dpc.senate.gov/dpcdocpr.cfm?doc_name=fs-111-1-90 .
Obama, Barack. (2009). Why We Need Health Care Reform. The New York Times. Retrieved March 29, 2011, from http://www.nytimes.com .
Singletary, Michelle. (2011). Denied insurance under new health-care law? File an appeal, the GAO says. The Washington Post. Retrieved March 30, 2011, from http://www.washingtonpost.com .
The White House. (2011). Health Reform in Action / the Affordable Care Act. Retrieved March
Quality improvement within a healthcare firm is very important. Health care laws are continually changing and required a diverse and varied array of skillsets. One of which is a high standard for patient care. Antiquated systems, a higher insured population, and new regulations all impede the quality improvement process. Therefore, it is necessary to form a dedicated team of professionals who focus solely on the quality improvement issue. The selection of this subcommittee is vital in regards to the actual success of such a program. As a result, the process of identifying and onboarding subcommittee team members can become a complicated process.
Identify some of the risks associated with working with interdisciplinary teams and how you plan to address them.
Interdisciplinary teams can cause risks, particularly as it relates to quality of care. The most obvious is a lack of emotional intelligence and cultural awareness. The insured population is now…
1. Juran, Joseph M. and Joseph A. De Feo, "Juran's Quality Handbook," 2010, ISBN 978-0-07-162973-7
2. Rose, Kenneth H. (July 2005). Project Quality Management: Why, What and How. Fort Lauderdale, Florida: J. Ross Publishing. p. 41. ISBN 1-932159-48-7.
3. Paul H. Selden (December 1998). "Sales Process Engineering: An Emerging Quality Application." Quality Progress: 59-63.
4. Thareja P (2008), "Total Quality Organization Thru' People, Each one is Capable," FOUNDRY, Vol. XX, No. 4, Aug 2008
The subject of healthcare reform set the country ablaze last year, proving to be one of the most contentious issues that has swept through American political discourse in recent decades. One reason that healthcare reform might have proven to be such a contentious issue -- bringing out the worst and shrillest elements of the American public -- was that healthcare is one of the most important issues in the lives of many and even most Americans (Christensen and Jason, 2009).
All of us will face serious illness at some point in our lives, whether our own or that of a loved one. The fact that so many Americans do not have any healthcare at all or have very limited access to healthcare makes the issue a personal one, and this alone should have made it central to the public discourse. However, while the above was no doubt the…
Christensen, Clayton and Jason, Grossman. The Innovator's Prescription, New York: McGraw Hill, 2009.
Mahar, Maggie. Money-Driven Medicine: The Real Reason Health Care Costs So Much. New York:Harper/Collins, 2006.
Reid, T.R. The Healing of America: A Global Quest for Better, Cheaper and Fairer Health Care. New York: Penquin Books, 2009.
ABC/123 Version X
Institutional Policy Analysis
Summary of the Policy (in your own words)
Explain if the policy is effective and provide a rationale
Describe the financial outcomes of the policy
Provide examples of policy violations
APNs' ability to practice is determined on a state-by-state basis, there is no specific policy in regards to practice scope (Kleinpell et al. 2014).
Given that nurses are credentialed on a state versus a federal basis and the healthcare system is largely regulated by the states versus federal policy, this seems inevitable in terms of how healthcare laws in the U.S. are structured.
Healthcare costs increase due to a failure to take full advantage of APN's expanded yet lower-cost care alternatives.
APN's roles in institutional leadership are not defined or restricted according to federal policy (Hain & Fleck 2014)
States are allowed to set regulations regarding the scope of…
Bakanas, E. (2013). Resistance to changing roles in the medical team Virtual Mentor. 15 (6): 498-503. Retrieved from: http://journalofethics.ama-assn.org/2013/06/ecas2-1306.html
Hain, D., Fleck, L., (2014). Barriers to Nurse Practitioner practice that impact healthcare redesign. OJIN: The Online Journal of Issues in Nursing, 19 (2)2. Retrieved from: http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-19-2014/No2-May-2014/Barriers-to-NP-Practice.html
Kleinpell, R., Scanlon, A., Hibbert, D., Ganz, F., East, L., Fraser, D., Wong, F., Beauchesne, M., (2014). Addressing issues impacting Advanced Nursing Practice Worldwide. OJIN: The Online Journal of Issues in Nursing, 19 (2) 5.
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HEALTHCAE & INFOMATION TECHNOLOGY
The state of healthcare in the United States is very much influenced and improved through the increased use of technology solutions. Whether it be the use of tablets, laptops, electronic healthcare records and some others, the use of technology has become more and more pervasive as the years and decades roll on. However, not everyone is sold on technology being a saving grace and those same people often think that technology solutions being added to healthcare actually do not help or that they make things worse rather than make them better. However, there is a cacophony of evidence that suggests and proves that electronic healthcare records, electronic administration and the use of information technology in a strategic and adept fashion actually makes things better over the long haul. This is true for patients, administrators, healthcare professionals and the wider network of providers that are typically also…
Bloomfield, G.S., Hogan, J.W., Keter, A., Holland, T.L., Sang, E., Kimaiyo, S., & Velazquez, E.J. (2014). Blood pressure level impacts risk of death among HIV
seropositive adults in Kenya: a retrospective analysis of electronic health records. BMC Infectious Diseases, 14(1), 1-20. doi:10.1186/1471-2334-14-284
Campbell, M. (2010). Technology in Healthcare: The Wave of the Future.
Ahdbonline.com. Retrieved 24 April 2015, from http://www.ahdbonline.com/issues/2008/may-2008-vol-1-no-4/350-article-350
Healthcare Administration: Culture, Accounting, And Ethical Issues
The causes of prejudice
Prejudice is described as the generalization of a group of people, based on negative attitudes that stem from stereotypes and non-factual beliefs. Although the reasons for prejudice may vary, Samovar, Porter and McDaniel (2009) explain three major motivations: societal pressures, social identities and scapegoating. Societal sources refer to rules and regulations that may be put in place in a given society to maintain one group's dominance over others. Social identities, on the other hand, are people's connection to their cultures and beliefs. Any groups that are deemed a threat to this connection are treated as enemies and are often at the receiving end of prejudice. Sometimes, different groups, such as gays and African-Americans are used as scapegoats to express anger and discontentment over various issues in society (Samovar, Porter and McDaniel, 2009). This allows one group to…
Kazmier, J.L. (2008). Introduction to Healthcare Law. Clifton Park, New York: Cengage Learning
Samovar, L.A., Porter, R.E. & McDaniel, E.R. (2009). Communication between Cultures (7th Ed.). South-Western: Cengage Learning
Warren, C.S., Reeve, J.M. & Duchac, J.E. (2013). Financial Accounting (13th Ed.) South- Western: Cengage Learning
In the wake on new and very contentious health care reform, many firms have undergone extensive transformations. These transformations have been predicated on both cost control and quality management. In particular quality management has had a profound impact on the underlying business operations of many health care firms. For one, firms are now finding methods in which to enhance the overall patient experience while also mitigating potential loses due to negligent means. The focus on quality management has also made firms more efficient in regards to the overall delivery of service. In particular, my firm has done extensive work with reducing elderly accidents within the facility. This quality management initiative has not only reduced costs associated with accidents, but it also has enhanced the trust and patient experience of all stakeholders within the firm (Kelly, 2011).
Identify the milestone you chose in the history of quality improvement in…
1) Draper, Elaine, Joseph LaDou, and Dan J. Tennenhouse. 2011. "Occupational Health Nursing and the Quest for Professional Authority," New Solutions 21, 47 -- 81
2) Kohn, L.T., Corrigan, J.M., & Donaldson, M.S. (Eds). (2000). To err is human: Building a safer health system. Washington, D.C.: National Academy Press.
3) Kelly, D.L. (2011). Applying quality management in healthcare: A systems approach (3rd ed.). Chicago, IL: Health Administration Press
4) Lucia, Patricia R.; Otto, Tammy E.; Palmier, Patrick A. (2009). "Chapter 1
Health and Legislative Issues
All Americans have the desire of having a healthcare system which is capable of delivering world-class security together with financial security. The system in place should always be accessible and one that impacts the economy positively. Successful healthcare reforms will lead to a maximization of the choices available for consumers put a restrain to the ever increasing medical care costs and make healthcare accessible to more and more Americans. There are a number of organizations that have consistently urged the president and congress on building on the existing systems which strengths in order to achieve health reform solutions that are workable in a bipartisan manner. However, there are some healthcare legislative issues that come up and have effects on various stakeholders such as legislators, consumers and other healthcare professionals. This paper will look at one of the current health legislative issues, who is affected most by…
Mears, B.(2012). Health care's big four issues: What the justices are tackling. Retrieved March 12, 2014 from http://www.cnn.com/2012/06/17/politics/health-care-issues/
ANA.(2010). Nursing Beyond Borders: Access to Health Care for Documented and Undocumented Immigrants Living in the U.S. Retrieved March 12, 2014 from http://www.nursingworld.org/MainMenuCategories/Policy-Advocacy/Positions-and-Resolutions/Issue-Briefs/Access-to-care-for-immigrants.pdf
Goodman, J., (2012). The Impact of the Patient Protection and Affordable Care Act on Job Creators and the Economy. Retrieved March 12, 2014 from http://www.independent.org/issues/article.asp?id=3385
American College of Emergency Physicians, (2013). The Ethics of Health Care Reform: Issues in Emergency - Medicine - An Information Paper. Retrieved March 12, 2014 from http://www.acep.org/Content.aspx?id=80871
Realistically this compliance and assistance should be sought and used before, during and after negotiations with other health care organizations with which this organization might merge or enter a joint venture. Furthermore, the proposed contract itself should be passed by the FTC's Office of the General Counsel or its designee for approval before final ratification of the contract.
In order to merge and operate in a joint venture acceptable to the FTC, the organization must be mindful of Title 15 of the U.S. Code, specifically Section 7 of the Clayton Act, 15 U.S.C. § 18, Sections 1 and 2 of the Sherman Act, 15 U.S.C. § 1, 2, and Section 5 of the Federal Trade Commission Act. In addition, due to the FTC's recent special interest in the mergers/joint ventures of health care organizations, particularly but not solely in connection with price fixing, the organization should assume that…
Prejudice and ethical/leadership issues with healthcare are nothing new but the fight to keep those standards and ethics on an even keel and prevent racism, bigotry and predudice of any sort including based on class, money, political ideology, nationalism, and so forth should be stomped out and eviscerated whenever it can be. People are people and should treated with dignity and respect regardless of their race, gender, beliefs and so forth. Even convicted murderers and rapists should not be treated disdain due to their actions because doing otherwise lowers the ethics and standards of the healthcare community that can and should still apply at all times.
Callahan, M. (2008). Healthcare providers constricted by financial, legislative, and regulatory issues. The Journal of Medical Practice Management: MPM, 24(3),
Cobaugh, D., Angner, E., Kiefe, C., ay, M., Lacivita, C., Weissman, N., & ... Allison, J.
(2008). Effect of racial differences…
Callahan, M. (2008). Healthcare providers constricted by financial, legislative, and regulatory issues. The Journal of Medical Practice Management: MPM, 24(3),
Cobaugh, D., Angner, E., Kiefe, C., Ray, M., Lacivita, C., Weissman, N., & ... Allison, J.
(2008). Effect of racial differences on ability to afford prescription medications.
Health Care Reimbursement and Billing
Both Mrs. Zwick and Mr. Davis face significant issues in the presented scenarios. Mrs. Zwick has multiple considerations under Medicare Parts A, B and D, in addition to her hospital-acquired urinary tract infection. Meanwhile, Mr. Davis must address the severe time constraints and costs of COBRA in light of his job termination. These two scenarios underscore current difficulties and complexities of current health care in the United States.
Discussion of Mrs. Zwick's coverage under Medicare Parts A, B and C
Medicare Part A (often called "hospital insurance") (U.S. Department of Health and Human Services, 2011, p. 15) assists in covering inpatient hospitalization and skilled nursing facilities, hospice and home health care (U.S. Department of Health and Human Services, 2011, p. 14). There is usually no monthly premium if you and/or your spouse paid Medicare taxes while employed (U.S. Department of Health and Human Services, 2011,…
Ethical implications of Mrs. Zwick's incurring costs related to her hospital-acquired condition are applicable despite the rehabilitation facility's exemption from POA/HAC Medicare laws. Having no first-hand knowledge of the cause of the urinary tract infection, no clear indication that I work at the rehabilitation facility and neither the privilege nor the duty of diagnosis, it would be unethical for me to tell Mrs. Zwick about my suspicions. Rather, a nurse is required to maintain his/her professional boundaries (American Nurses Association, 2001, p. 6). Simultaneously, a nurse is supposed to assure "responsible disclosure of errors" to patients and act to stop bad practices and promote best practices (American Nurses Association, 2001, p. 6). Consequently, a nurse in my position faces a dilemma: lack of personal knowledge and authority vs. my concern for the patient's well-being and constant improvement of the profession. In the face of this dilemma, I would: contact the rehabilitation facility's newly-hired nurse and advise/remind him/her of the duty to report to the appropriate supervisor and responsible disclosure to Mrs. Zwick; contact Mrs. Zwick's personal physician and explain the entire situation; direct Mrs. Zwick to discuss her health issues with her personal physician, who can review, diagnose and discuss the ramifications of her medical records, including but not limited to the urinary tract infection (American Nurses Association, 2001, p. 7). The desired outcomes would be: the rehabilitation center's absorption of Mrs. Zwick's costs related to her hospital-acquired infection through pressure exerted by its own nursing staff and Mrs. Zwick's personal physician; Mrs. Zwick's awareness of the true cause of her infection by health care providers who are directly responsible and capable.
Explain how the COBRA will allow Mr. Davis to continue his insurance coverage while he is out of work.
Due to Mr. Davis' termination from an employer of more than 20 employees, he can obtain coverage for himself, his spouse and his dependent children for up to 18 months (U.S. Department of Labor, 2012). In addition, due to his chronic cycle cell anemia, he may be entitled to an additional 11 months' extension for disability (U.S. Department of Labor, 2012). His employer is required to give a qualifying event notice to COBRA; then, COBRA sends a notice of the right to elect to continue coverage and an explanation of the steps that must be taken to continue coverage; Mr. Davis, his spouse and either or both of them in behalf of dependent children may elect for continuation of coverage
The experiences of seniors within the healthcare delivery system will alter how all Americans view healthcare. The healthcare delivery systems and overall organizational structure in the United States has been slow to adjust but that rest of the world is currently in flux that will migrate into our system. Technological advances in communication have made telehealth and telemedicine vialbel solutions to our outdated healthcare industry orgainzational structre. While these types of advances are only in their infancy, "...there seemed to be broad acceptance that telehealth and telemedicine had provided positive benefits to the worlds healthcare delivery system." (Telehealth Applications) Our technoloically challenged seniors have actually discovered the trend within the healthcare system and telehealth and telemedicine seems to be an advance that will find worldwide support so we as a nation will be reqquired to jump on the bandwagon.
In conclusion, this article review focused on new Healthcare Delivery Systems…
Farnsworth, Chris. "The Truth About Fraud" Washington Monthly 01 May 1997.
Joshua-Amadi, Mabel. "Recommendations: A Study in Motivation: Recruitment and Retention in the NHS" Nursing Management. February (2003).
Soloye, Daniel J. "Privacy and Power: Computer Databases and Metaphors for Information Privacy" Stanford Law Review July (2001).
Telehealth Applications. (2004) "Current Telehealth Applications" Retrieved October 26, 2004, at http://www.startegis.com/epic/internet/inict-tic.nsf/PrintableE/it07545e.html
(Menzel, 1990, p. 3) Fisher, Berwick, & Davis alude to the idea of integration in health care, with providers linking as well as creating networks of electronic medical records and other cost improvement tactics.
The United States and other nations over the last twenty or so years, have begun a sweeping change in health care delivery, regarding the manner in which health information is input, stored and accessed. Computer use in the medical industry has greatly increased over the last thirty years the culmination of this is fully networked electronic medical record keeping. (Berner, Detmer, & Simborg, 2005, p. 3) the electronic medical record trend began in the largest institutions first, as hospitals and large care organizations attempted to reduce waste and improve patient care, while the adoption has been much slower among physician's practices and smaller medical institutions. (Hillestad, et al., 2005, pp. 1103-1104) Prior to this time medical…
Resources, and Utilization
Healthcare Legal Issues
Discuss the impact Federalism has on the regulation of health care delivery; how do the different sources of law as they related to the federal and state governments matter, if at all?
In general, federal regulation of health care delivery would be much more appropriate and efficient than state or local law, at least in so far as major aspects of health care delivery are concerned. That is because state laws vary considerably; that makes it impossible to establish a consistent or uniform standard of health care delivery across state lines. Certainly, there are aspects of health care that are appropriate to regulate at the state or even the local level, but there are others that would be much better to regulate on a national or federal level.
One of the best examples of an aspect of health care delivery that should be regulated federally are elements…
Reid, T. (2009). The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care. New York: Penguin Group.
Integrity is a major issue for healthcare organizations because there are many avenues for fraud, and for people to demonstrate a lack of ethics. The problem is that the temptation is sometimes too great and despite the fact that there are laws in place to guard against these practices unethical behavior takes place anyway. The government, which supplies a lot of the money which goes for treatments through Medicare and Medicaid, has structured certain laws to make sure that the practices of healthcare organizations are ethical, but billions of dollars in fines are still doled out every year. The big drug companies complain of arcane and hard to decipher legalese, but the fact is that although they realize the issue and the penalty they continue to subvert the law. This paper looks at qui tam statutes and cases, Medicare and Medicaid admissions criteria, installing a corporate integrity program, and…
American Speech-Language-Hearing Association (ASLHA). (2010). Summary of self- referral and anti-kickback regulations. Retrieved from http://www.asha.org/practice/reimbursement/medicare/regulations_sum.htm
Hanford, J.T. (2001). Regulation of the healthcare professions. Ethics & Medicine, 17(3), 188-190.
Louthian Law Firm. (2012). Healthcare fraud qui tam whistleblower protection lawsuits.
Mattie, A. & Ben-Chitrit, R. (2009) The federal False Claims Act and qui tam actions: What every healthcare manager should know. Journal of Legal, Ethical and Regulatory Issues, 12(2), 49-65.
Healthcare in the United States: Where We Have Been, Where We Are Going
The current healthcare crisis in America is not one that happened over night. It is one that has been building for more than a quarter century. There was a time in America when healthcare was a stellar institution: research, cures, technological advances, and treatments. The focus of healthcare was maintaining and improving the quality of life. Then, during the early 1980s, managed care became an entity between the physician, the patient, and the healthcare provider of hospital services. It began subtly, but has, today, become one of the most aggressive and successful business ventures of our time; and it has been the unmaking of a once stellar and progressive American institution.
Managed care is a "distinctly American" product (Birenbaum, 1997). It was legislation introduced by the Nixon Administration with the intent to regulate healthcare and to maintain…
Bernstein, A.B., Hing, E., Moss, A.J., Allen, K., Siller, A., and Tiggle, R. (2003). Health Care in America: Trends in Utilization. Hyattsville, MD: National Center for Health Statistics.
Birenbaum, A. (2002). Wounded Profession: American Medicine Enters the Age of Managed Care. Westport, CT: Praeger.
Birenbaum, A. (1997). Managed Care: Made in America. Westport, CT: Praeger.
Committee on Health Care Access and Economics Task Force on Mental Health (2009). Improving Mental Health Services in Primary Care: Reducing Administrative and Financial Barriers to Access and Collaboration. The Official Journal of the American Academy of Pediatrics, March, 30, 2009, pp. 1248-1251.
While it may not be just to hold an organization liable, absolutely, for every instance of employee negligence, there is a rationale for imposing such liability in many cases. For example, many types of industries entail potential danger to others that are inherent to the industry.
Individual workers are not likely to be capable of compensating victims of their negligence, but the employer benefits and profits financially by engaging in the particular industry. Therefore, the employer should not necessarily escape liability for compensating all harm caused by their activities, regardless of fault in particular instances.
10.A nurse is responsible for making an inquiry if there is uncertainty about the accuracy of a physician's medication order in a patient's record. Explain the process a nurse should use to evaluate whether or not to make an inquiry into the accuracy of the physician's medication order.
Like other highly trained professionals, experienced nurses…
Abrams, N., Buckner, M.D. (1989) Medical Ethics: A Clinical Textbook and Reference for the Health Care Professionals. Cambridge, MA: MIT Press
Caplan, a.L., Engelhardt, H.T., McCartney, J.J. Eds. (1981) Concepts of Health and Disease: Interdisciplinary Perspectives. Reading, MA: Addison-Wesley
Starr, P. (1984) the Social Transformation of American Medicine.
New York: Basic Books
On the contrary, a comprehensive medical care solution that tackles the main issues driving up health care costs in America is possible. The main problem experienced by the average American is that health insurance premiums are cost prohibitive for the middle-class, but being uninsured can bankrupt a family forced to deal with even a minor catastrophic illness. Therefore, a national health insurance program has to be part of the solution. However, one cannot overlook the role that unpaid medical bills and exorbitant malpractice premiums also play in the modern healthcare crises. As a result, the solution must include a way to reduce malpractice premiums through tort reform, and a way to reduce the percentage of medical bills that go unpaid. The proposed three-prong approach would tackle all of those issues, without forcing any unwilling person to participate in a nationalized healthcare program.
American Tort Reform Association. "Medical Liability…
American Tort Reform Association. "Medical Liability Reform." ATRA Issues. 2007.
American Tort Reform Association. 6 Nov. 2008 http://www.atra.org/show/7338.
Kershaw-Staley, Tracy. "Miami Valley Hospital Files Lawsuit Over Unpaid Medical Bills."
Dayton Business Journal. 2008. Dayton Business Journal. 6 Nov. 2008 http://dayton.bizjournals.com/dayton/stories/2008/01/07/story5.html .
A patchwork of laws provided narrow privacy protections for selected health data and certain keepers of that data." (Administrative Simplification in the Health Care Industry) Therefore, new technologies such as relational databases have simplified the data gathering and maintenance processes of all types of healthcare related data like the physician information process. It is not unheard of today for healthcare and insurance providers matching or 'sinking data' on a monthly or quarterly basis because of the availability of better communication capabilities as well as compatible database comparison processes.
Even the doctors themselves have access to providers' systems and databases today. Through automatic telephone systems, business to business Internet portals, and tape or disk delivery processes, all of a physician's personal, office and patient information can be updated easily. In many cases, the entire process including security and confirmation is a completely hands free operation. In other words, without human intervention,…
Administrative Simplification in the Health Care Industry. Ed. HIPAA. Health and Human Services. 23 Oct. 2004 http://www.hipaa.com/.
HMO Patients Can Contact Their Doctors Electronically as Blue Shield of California Expands Online Communication Services. Ed. Unknown. October 29, 2003. Relay Health. 23 Oct. 2004 http://www.relayhealth.com/rh/general/news/newsRecent/news49.aspx .
Hoffer, Prescott, and McFadden. Modern Database Management. 7th ed. Add City: Add Publisher, Add Year.
When considering the ever-changing and highly competitive economic landscape of the modern world; governments, businesses and institutions must remain diligent in their care and compassion for their citizens and staff members. With the current exponential growth and advancement of technology and the computerization of business and learning, voters, workers and consumers have become much more connected to the organizations they patronize (Kurzweil). Accordingly, these important groups are faced with the continuous task of finding new ways to understand and subsequently accommodate the needs of their followers, while simultaneously securing lucrative business models and job environments. One of the most important needs presented in all demographics is reliable healthcare. Thus, with the inelasticity in the demand for healthcare, countries need to determine an applicable system, whereby citizens can have access to the medical services they will inevitably need. Collective access to healthcare represents the main problem in field of…
Blumenschein, K. And M. Johannesson. "Economic Evaluation in Healthcare. A Brief History and Future Directions." Journal of Pharmacoeconomics 10.2 (1996): 114-122.
Cox, Malcolm, et al. "Health Care Economics, Financing, Organization and Delivery." Family Medicine January 2004: 20-30.
Hamburger, Tom and Kim Geiger. "Healthcare Insurers Get Upper Hand." The Los Angeles Times 24 August 2009.
Jeremiah Hurley. "An Overview of the Normative Economics of the Health Sector." Journal of Health Economics 1.1 (2000): 55-118.
Healthcare spending by the New York State persistently surpasses its earnings. That difference continues to be expanding and is also anticipated to broaden unless of course there happen to be severe, continuous modifications in spending budget actions. Lieutenant Governor ichard avitch, in "A 5-Year Strategy to Deal with the State of New York's Spending budget Deficit" released during March 2010, approximated this structural disproportion within the state's spending budget to become no less than $13 billion. The structural inequality isn't simply the consequence of the economic downturn that started during 2007, and a commonly strengthening economic climate is not going to get rid of it.
To help the State of New York in providing the solutions and dedication to quality that its residents rely on, structural modifications are needed. The aim of this paper is actually to summarize one particular realignment - solving an outright inequity involving the state as…
California Public Employees' Retirement System, "Facts at a Glance: Health," September 2010, http://www.calpers.ca.gov/eip-docs/about/facts/health.pdf .
Citizens Budget Commission, Out of Balance: A Comparison of Public and Private Employee Health Benefits in New York City, December 2009, http://www.cbcny.org/sites/default/files/REPORT_Survey_12162009.pdf .
City of New York Office of Labor Relations, "New York City Summary Program Description, Health Benefit Program," 2010, http://www.nyc.gov/html/olr/downloads/pdf/healthb/full_spd.pdf.
Government Finance Officers Association, "Recommended Practices, Health Care Cost Containment 2004," http://www.gfoa.org/downloads/corbaHealthCareCostContainment.pdf .
ecause unions retain the exclusive right to negotiate on behalf of its members, the individual worker may have little recourse to easily address incompetent leadership.
The Disadvantages of Unionized Labor for Healthcare Employers:
The primary disadvantages of unionized labor for healthcare employers correspond to the relative loss of control over issues and workplace elements commonly transferred to workers (through their unions), which accounts for the traditional resistance with which many employers responded to unionization attempts. On the one hand, unionized workforces are able to secure better pay and benefits from employers than would have been available to workers without union representation; likewise, employers must cede control over many aspects of operational and personnel decisions traditionally within administrative control.
On the other hand, particularly in light of the beneficial effect that unionized nursing has had on the quality of patient care and reduction in patient mortality, it is difficult to conceive…
Daft, R. (2005) Management (7th ed.) Mason: Thomson South Western.
Nevins, J., Commager, H. (1992) a Pocket History of the United States.
New York: Pocket Books
Seago, J., Ash, M. (2002)
On the other hand, the industry will most likely insist on the service quality segment rather than on the price transparency. A constant improvement of the services provided within the healthcare facility will not only produce the appropriate competition on the market, but it will also provide the incentives for the other healthcare organizations, thus rising overall quality levels in the market. This will rather change the way hospitals price their services rather than price transparency.
Nevertheless, price transparency will change ridiculous situations in which the client is charged $35,000 to change a battery in a pacemaker. It will drive such prices lower, encouraging price competition.
1. A Call for Transparency in Healthcare Cost and Quality. On the Internet at http://blogs.msdn.com/healthblog/archive/2006/05/16/599064.aspx.Last retrieved on June 30, 2007
2. Feld, Stanley. What Is Real Price Transparency? Medicine: Healthcare System. May 2007. On the Internet at http://stanleyfeldmdmace.typepad.com/repairing_the_healthcare_/2007/05/what_is_real_pr.html.Last retrieved on June 30, 2007…
1. A Call for Transparency in Healthcare Cost and Quality. On the Internet at http://blogs.msdn.com/healthblog/archive/2006/05/16/599064.aspx.Last retrieved on June 30, 2007
2. Feld, Stanley. What Is Real Price Transparency? Medicine: Healthcare System. May 2007. On the Internet at http://stanleyfeldmdmace.typepad.com/repairing_the_healthcare_/2007/05/what_is_real_pr.html.Last retrieved on June 30, 2007
Call for Transparency in Healthcare Cost and Quality. On the Internet at
Health Care ight or Privilege
Health Care ight Privilege
Whether health care is a right or a privilege is one of the most intensely debated social questions of the modern era, but phrasing it in this binary way of one or the other masks a deeper problem that is far more complex. The specific issue at hand is the rationing of scarce medical resources. If there were unlimited resources where everyone could achieve the maximum health all the time, we would not have to ask the question, but this is clearly not the case. Glannon argues this requires a theory of "distributive justice" (2005, p. 144), and outlines the four main theories that have emerged from the modern discussion, which are Utilitarian / consequentialist, Libertarian, Communitarian and Egalitarian.
Utilitarian, consequentialist theory is often invoked toward a solution of who deserves health care when there is not enough for everyone, and…
Brownstein, B. (1980). Pareto optimality, external benefits and public goods: a subjectivist approach. The Journal of Libertarian Studies, IV (1), 93-106. Retrieved from mises.org/journals/jls/4_1/4_1_6.pdf
Gensler, H. (1998). Ethics: a contemporary introduction. New York: Routledge.
Glannon, W. (2005). Biomedical ethics. New York: Oxford University Press.
Hare, R. (1963). Freedom and reason. London: Oxford University Press.
Health Care Situation: Medical Error Due to Doctors' Bad Handwriting
Identify a health care news situation that affects a health care organization such as a hospital, clinic or insurance company.
I have identified the following health care news situation as the topic of my paper: "Poor Handwriting of Doctors and its implied risks for the Patient, Hospital and Medical Malpractice Insurance." Poor handwriting of physicians resulting in poor legibility of entries into patients' medical records carries very dramatic risks for all above-mentioned interest bearers. It can result in severe health danger for the patient and - in extreme situations - even cause a patient's death. Doctors' bad penmanship has long been seen a problem within organized medicine and the patient safety movement. Three American Medical Association (AMA) policies dating back to 1992, urge doctors to "improve the legibility of handwritten orders for medications" and review all orders for accuracy and…
Berwick, Donald M. & Winickoff, David E. (1996). The truth about doctors' handwriting: a prospective study. BMJ Vol. 313 (21-28 December 1996). 1657-1658. www.bmj.com/content/313/7072/1657.full, accessed 21 August 2011.
Bruner, Anne & Kasdan, Morton.L. Handwriting Errors: Harmful, Wasteful and Preventable.
1-4. www.kyma.org/uploads/file/.../Harmful_wasteful_and_preventable.pdfSimilar, accessed 22 August 2011.
Gallant, Al. (22 November 2009). For a secure electronic health record implementation, user authentication is key. 1-2). searchhealthit.techtarget.com/.../User-authentication-is-critical-for-pl.., accessed 24 August 2011.
The American Public Health Association (APHA) is founded. This organization is concerned with the social and economic aspects of health problems.
The National Quarantine Act is signed into law. This legislation is designed to prevent entry into the country of persons with communicable diseases.
1899 the National Hospital Superintendent's Association is created. It later becomes the American Hospital Association.
Patel & ushefsky, 1995, p. xvii)
The seeds of health care legislation and centralization began before 1875 but began to take hold as the most accepted manner in which to ensure safe and scientifically founded health care for many and to begin to ensure that diseases that commonly plagued a newly urbanized and highly stressful environment of mass immigration could be dealt with, in a more centralized and practical manner. Founded earlier in 1847, the American Medical Association began to have a concrete and centralized role in the health care decisions…
Healthcare in Sweden
The healthcare system in Sweden is used as one of the model systems in the world. hen Johan Hjertoqvist from the Timbro Policy Group spoke before the Montreal Economic Institute in 2002, he said, "...you refuse to accept the consumer as an equal partner, you still look upon the client, the patient, as an inferior partner in the relation" and "you deny the need for good working condition when it comes to the staff, etc." (http://www.iedm.org/conference5_en.html).Moreover, he stressed the need to move interests and priorities away from the processes and production organization to "the quality of the outcome for the consumer" (http://www.iedm.org/conference5_en.html).Quality seems to be synonymous with healthcare in Sweden.
Two important characteristics of the Swedish healthcare system are that it is "decentralized and it is run on democratic principles" (http://www.si.se/docs/infosweden/engelska/fs76.pdf).All residents of Sweden are covered by the national health insurance system which covers medical care, pharmaceuticals,…
Fact Sheets on Sweden: The Health Care System in Sweden. Swedish Institute. May 1999. http://www.si.se/docs/infosweden/engelska/fs76.pdf .(accessed 06-27-2003).
Gennser, Margit. "Sweden's Health Care System." http://oldfraser.lexi.net/publications/books/health_reform/sweden.html.
A accessed 06-27-2003).
Hadenius, Stig; Lindgren, Ann. "Sweden: On Sweden Health care." Countries of the World. January 01, 1991.
In the case of pill mills, participating physicians and pharmacists bill insurance companies or Medicare for prescription drugs, allowing participating beneficiaries to resell those drugs to criminal middlemen. The pharmacy then repurchases the drugs at a lower cost. According to the USGAO, any misuse of beneficiary identification information is a felony.
Criminals may also steal beneficiary information by creating drop boxes. The drop box scheme involves establishing a phony health care company in order to obtain insurance or Medicare payments. Like the drop box scheme, the pill mill scheme, and the rent-a-patient scheme, third-party billing also involves felony acts. Illegally obtaining beneficiary identification numbers, a criminal can use third-party billing agents to receive insurance payouts. The third-party billing company may not even be aware of the scheme. In other cases, the third-party billing company is a part of the scheme, defrauding by tacking on fraudulent claims to legitimate ones and…
Cornell University Law School. "Health Care Fraud." Retrieved Aug 7, 2008 from http://topics.law.cornell.edu/wex/healthcare_fraud
United States General Accounting Office (USGAO). "Health Care Fraud." Retrieved Aug 7, 2008 from http://18.104.22.168/search?q=cache:NcKXTYWPgDEJ:www.gao.gov/new.items/os00015t.pdf+health+care+fraud&hl=en&ct=clnk&cd=5&gl=us&client=firefox-a
Contracts with doctors often contain a clause which doesn't allow the doctors to discuss
Health care 7 with their patients financial incentives to deny treatment or about treatments not covered by the plan (Glazer, 1996). This has caused many consumers, especially those with chronic illnesses, to form organizations with the American Medical Association and physician specialty groups to promote legislation forbidding "gag rules" (Glazer, 1996). One group, Citizen Action, has 3 million members and "has been lobbying in state legislatures for laws that would require plans to disclose how they pay their doctors; give patients the right to choose specialists outside the plan; and provide appeals for patients who get turned down for expensive treatments" (Glazer, 1996).
The doctor-patient relationship is also affected if a patient must switch to a new doctor under managed care. Having a longterm relationship with a primary doctor is important because he or she is…
Bennett Clark, Jane (1996, July). What you should ask your HMO.
Kiplinger's Personal Finance Magazine. pp. 92-93.
Glazer, Sarah (1996, April 12). Managed Care. CQ Researcher, 6,
Koop, C. Everett (1996, Fall). Manage with care. Time. pp. 69.
As a result, millions of Americans remain unable to bear the heavy financial toll of medical expenses. Indeed, the problem of a lack of insurance for many is related to the problem of the cost of healthcare. So confirms the article by Consumer Reports (CR) (2008), which finds that "health-insurance premiums have grown faster than inflation or workers' earnings over the past decade, in parallel with the equally rapid rise in overall health costs. Industry spending on administrative and marketing costs, plus profits, consumes 12% of private-insurance premiums." (CR, 1) This reiterates the case that the undue imposition of costs by the healthcare industry -- a reflection of a free-market industry with little to no regulatory oversight -- has negatively impacted the accessibility and quality of healthcare for many of the poorest users.
Moreover, these users are most vulnerable to the long-term economic damages provoked by unexpected healthcare costs. So…
Bureau of Labor Education (BLE). (2001). The U.S. Health Care System: Best in the World, or Just the Most Expensive? The University of Maine.
Childress, M. (2010). Poverty is on the Upswing, but Metric is Out of Date. The Washington Independent.
Cockerham, W.C. (2004). Medical Sociology and Sociological Theory. The Backwell Companion to Medical Sociology.
Consumer Reports (CR). (2008). High Health Care Costs. Consumer Reports Health.org.
the Allied health care staffing agency is a staffing agency that focuses on the niche of the nursing jobs within the healthcare industry in Chicago
The Allied healthcare staffing agency works to recruit registered nurses belonging to all medical Specialties, Practical Nurses that are licensed also called LPNs, Nursing Assistants that are certified also called CNAs and Specialists from the allied health sciences. These professionals would be hired both from the area of the metro city as well as the suburbs and placed within the hospitals, the neighborhood medical centers, Adult care facilities, clinics, and rehabilitation centers.
The mission of the Allied Healthcare Staffing Agency is to provide the best opportunities of employment both to its collaborators which are the local healthcare organizations as well as serving the entire nursing community to provide amply amount of job opportunities to choose from in a time when the turnover of…
Bureau, U.C. (2000). Census 2000 Demographic Profile Highlights:. chicago illinois, fact sheet .
commerce, U. d. (2010). bear facts, state illinois. bureau of economic analysis .
directory, a. h. (2010). free stats & national stats. Retrieved september 7, 2011, from american hospital directory: www.ahd.com
Lindberg, R.C. (1991). To Serve and Collect: Chicago Politics and Police Corruption from the Lager Beer Riot to the Summerdale Scandal. chicago: praeger publications.
The relationship between the doctor and a possible patient is established when the physician asks the person for the first time as how he could be of possible help. This direct and simple enquiry is the beginning of the trust of the patient that has to be put in the physician for any treatment to proceed. The patient is in need of help at that time, and has to trust the professional for getting the help and the patients want to do it. They need a person to take care of them during their period of suffering from illness. This relationship between the patient and the physician in the financial sphere also involves the same amount of reliance, confidence and trust, as otherwise, not treatment can be undertaken. This makes it essential that the physicians clearly mention to the patients when there is any conflict of interest in…
"Changes in Health Care Financing and Organization: Deriving Best Practice Models for the U.S. Health Care Safety Net: A Cross-State Meta Analysis of Finance, Organization and Outcomes" Retrieved from http://22.214.171.124/search?q=cache:h3F83ojarhYJ:depts.washington.edu/eprc/areas/proposalnarrative%2520web.pdf+Changes+in+Health+Care+Financing+and+Organization+& ; hl=en Accessed on 7 June, 2005
'Health Administration Press" (March/April 2003) Journal of Health Care Management.
Volume 48, Number 2. Retrieved from http://126.96.36.199/search?q=cache:p36ZB3H0T4AJ:www.ache.org/pubs/jhm482.cfm+healthcare+finance+relationship+centered& ; hl=en Accessed on 7 June, 2005
"The Core Program: Trust and the Patient -- Professional Relationship" (September, 2000) The
In the current era of managed care in medicine, physicians and other healthcare providers and institutions have been under tremendous pressure to reduce costs. In that regard, avoiding unnecessary hospitalization is one of the most important goals of lowering the costs of healthcare delivery (Stanhope & Lancaster, 2004). Toward that end, diverse strategies have evolved to provide as many healthcare services as possible on an ambulatory basis.
Hospitals and insurance companies now encourage patients to participate in preventative medicine and routine testing intended to lower the costs associated with hospitalization over the long-term. The strategy is simply to reduce the incidence of serious illnesses, particularly those that typically develop over many years and which are capable of prevention through behavior modification and early detection through diagnostic testing (Stanhope & Lancaster, 2004).
Because state and federal governments must absorb much of the costs of uncompensated medical services, the many administrative agencies…
References Stanhope, M., Lancaster, J. (2004) Community and Public Health Nursing (6th ed.) St. Louis: Mosby.
ef: The Health Care bill signed by Andrew M. Cuomo -- Governor for Treatment of Autism Spectrum Disorder
I wish to state that the legislation must have come in earlier than this. Autism is a condition that requires medication and care for children and the legislation passed by the Governor Albany, NY on November 1, 2011 requires that the treatment of Autism Spectrum Disorder be brought under the health care coverage. This is a laudable step in New York and it will be a blessing to such families with autistic children to afford the expensive health care costs. The law now makes it mandatory for the health insurance companies to provide coverage for treatment of autism spectrum disorders, and the companies however may resort to 'deductibles, co-pays, and coinsurance consistent with those imposed on other benefits.' (Cuomo, 2011)
Discussing the law Governor Andrew M. Cuomo said that the…
Cuomo, Andrew M. (2011) "Governor Cuomo Signs Law to Expand Health Care
Coverage for Treatment of Autism Spectrum Disorder"
Retrieved 12 November 2011 from http://www.governor.ny.gov/press/1112011Spectrum%20Disorder
National Conference of State Legislatures. (2011) "Insurance coverage for Autism"
In 2004, a Ten-Year Plan to Strengthen Health Care was announced, primarily intended to improve access to medical services, decrease wait times, and update medical equipment and ensure accurate reporting and enhance public health promotion and prevention programs. Shortly thereafter, the Canadian Supreme Court affirmed the nation's health care philosophy and the immediate need to implement further improvements envisioned by the ambitious 2004 plan in striking down a Quebec law that had prohibited private medical insurance for covered services:
The evidence in this case shows that delays in the public health care system are widespread and that in some serious cases, patients die as a result of waiting lists for public health care...In sum, the prohibition on obtaining private health insurance is not constitutional where the public system fails to deliver reasonable services."
According to legal experts, the decision could "open the door to a wave of lawsuits challenging the…
Canadian Medical Association Journal.
1939 September; 41(3):
Chaoulli v. Quebec: Judgments of the Supreme Court of Canada Accessed, September 2, 2007, at http://scc.lexum.umontreal.ca/en/index.html
Kraus, C. (2005) Canada's Supreme Court Chips Away at National Health Care.
Health Care -- Regulatory Scheme and Licensure Requirements -- Operating a Health Care Organization
California's licensing process for health care organizations is governed by the State's Health and Safety Code, with responsibility for licensing, licensing, inspecting, regulating and/or certifying shouldered by State and Federal agencies. In a straightforward yet rigorous process aided by online application packets and checklists, these agencies are intent on ensuring compliance with State and Federal laws and regulations.
The process for becoming licensed to operate as a health care organization in California is governed by §1200 -- 1209 of the California Health and Safety Code (California State Legislature, 2003). These code sections broadly deem the term "clinic" or "primary care clinic" to mean an "organized outpatient health facility," whether a community clinic, free clinic, specialty clinic or clinic corporation required to be licensed (California State Legislature, 2003). The requirements and processes outlined in these code sections…
Defined as the philosophical study of right and wrong action, Ethics is a predominant subject of concern in nursing (Michael Dahnke, 2006). Being presented with various situations, the ethical and cultural problems are a serious concern faced by the nursing and healthcare staff which needs to be catered to day in and out. There is no time tested methodology that can be applied here, since the every patient is different, with a different background history, therefore the ethical and cultural implications of each decision would also vary.
Importance of Ethical Theory to Nursing
Defining what is right and wrong is a very subjective approach and even that can change from scenario to scenario. Therefore it is important to have some form of umbrella under which the functioning of nurses takes place. It is under this rationale that the importance of ethical theory emerges in front of us.
DuAnne Foster Edwards, R.M. (1999, Feburary). The Synergy Model: Linking Patient Needs to Nurse Competencies. Retrieved September 30th, 2011, from American Association of Critical Care Nurses: http://www.aacn.org:88/wd/certifications/content/synpract2.pcms?pid=1&menu=
Green, D.B. (2001, July). Medical Ethics. Retrieved September 30th, 2011, from Priory.com: http://priory.com/ethics.htm
Michael Dahnke, H.D. (2006). Defining Ethics and Applying the Theories. In P.M. Vicki D. Lachman, Applied Ethics in Nursing (p. 3). New York: Springer.
Samar Noureddine RN, M. (2001). Development of the ethical dimension in nursing theory. International Journal of Nursing Practice, 2-7.
If the area wage index is greater than 1, the labor share equals 69.7%. The law requires the labor share to equal 62% if the area wage index is less than 1.0.
2) the wage adjusted labor share is added to the non-labor share of the standardized amount.
3) the wage adjusted standardized amount is multiplied by a relative weight for the DG. The relative weight is specific to each of 746 DG's (for fiscal year [FY] 2009) and represents the relative average cost of a beneficiary in one DG compared to another.
4) if applicable, additional amounts will be added to the IPPS payment for hospitals engaged in teaching medical residents, hospitals that treat a disproportionate share of low income patients, and for high cost outlier cases" (Acute Inpatient Prospective Payment System, 2009).
Physician services include office visits, surgical procedures, and other diagnostic services. These services are usually performed…
Acute Inpatient Prospective Payment System. (2009). Retrieved April 2, 2009, from Centers
for Medicare and Medicade Service Web site:
Physician Services Payment System. (2008). Retrieve April 3, 2009, from MedPac Web site:
Access and Availability
The biggest problem in terms of access to healthcare is in rural areas. Our investigation found that there are very few if any rural clinics or healthcare facilities.
Access to healthcare is also limited to those that can afford insurance or qualify for Medicare or Medicaid. The unemployed and the poor are at a major disadvantage when it comes to gaining access to healthcare. The location of healthcare facilities is limited to the larger municipalities.
The entity that is responsible for the healthcare system is the United States Government. In addition, Puerto ico has a governor and a cabinet in place to ensure that the appropriate laws are carried out. The entity that makes laws concerning healthcare is outside of the country but the entity that enforces these laws is inside the country. Services are evaluated by state run entities and agencies of the United States…
The World Factbook -- Puerto Rico. Retrieved November 8, 2004 from; http://www.cia.gov/cia/publications/factbook/geos/rq.html#People
Puerto Rico: Estimated Number of Persons Living with AIDS at the End of 2002. Retrieved November 8, 2004 from; http://www.statehealthfacts.kff.org/cgi-bin/healthfacts.cgi?action=profile&area=Puerto+Rico&category=HIV%2fAIDS&subcategory=Persons+Living+with+AIDS&topic=All+Ages
HIV / AIDS Among Hispanics. Retrieved November 8, 2004 from; http://www.cdc.gov/hiv/PUBS/Facts/hispanic.pdf
Puerto Rico: Total Number of Adults with Diagnosed Diabetes, 2002. Retrieved November 8, 2004 from;
Stated to be barriers in the current environment and responsible for the reporting that is inadequate in relation to medical errors are:
Lack of a common understanding about errors among health care professionals
Physicians generally think of errors as individual that resulted from patient morbidity or mortality.
Physicians report errors in medical records that have in turn been ignored by researchers.
Interestingly errors in medication occur in almost 1 of every 5 doses provided to patients in hospitals. It was stated by Kaushal, et al., (2001) that "the rate of medication errors per 100 admission was 55 in pediatric inpatients. Using their figure, we estimated that the sensitivity of using a keyword search on explicit error reports to detect medication errors in inpatients is about 0.7%. They also reported the 37.4% of medication errors were caused by wrong dose or frequency, which is not far away from our result of…
Discussion Paper on Adverse Event and Error Reporting In Healthcare: Institute for Safe Medication Practices Jan 24, 2000
Patient Safety/Medical Errors Online at the Premiere Inc. page located at: http://www.premierinc.com/all/safety/resources/patient_safety/downloads/patient_safety_policy_position_2001.doc
Medstat / Shortell, S. Assessing the Impact of Continuous Quality Improvement on Clinical Practice: What It Will Take to Accelerate Progress.
Health Policy Monitor (2001) A Publication of the Council of State Governments Vol. 6, No. 1 Winter/Spring 2001 PO18-0101
The research thus concludes the essence of having quality and effective legislation addressing the aspects of overall oral health of the people.
Additionally, the Canadian Dental Association also relates several issues of the overall body health to the oral health of the individual. In view of the article on the relation "oral health -- good life," the article gives information on the essence of good oral health, indicating some of the illnesses of ill oral health (Chattopadhyay, 2011). In this article, the relation between the ill oral health and the overall health of the body is that the mouth is the ingress to the body. Therefore, an individual with ill oral health is at the highest risk of having infection that affects the whole body system severely. According to this article, it emphasizes the need for dentists-patient relation as the dentists is the only person with the skill, expertise and…
Chattopadhyay, a. (2011). Oral health epidemiology: Principles and practice. Sudbury, Mass:
Jones and Bartlett Publishers.
Ramseier, C.A., & Suvan, J.E. (2010). Health behavior change in the dental practice. Ames,
Health Care -- Lean Philosophy on Cost Reduction and Quality Improvement
Lean Philosophy is initially traced back to Henry Ford's innovative assembly line, revolutionizing manufacturing while failing to provide true variety. Building on Ford's concepts Toyota management established a Lean Philosophy in the 1930's and 1940's that focused on production flow and waste elimination, resulting in rapid, low cost and high quality processes, along with simpler and more accurate management. These concepts were further elucidated by authors including James omack, who established the Lean Enterprise Institute in 1997.
The essential elements of Lean Philosophy are 5 principles including: defining the value sought by the customer; specifying the value stream of the product satisfying that value while challenging wasted steps; making a continuous flow of product through refined steps; creating "pull" (essentially meaning "customer demand/expectation") from step-to-step for continuous flow wherever possible; continually improve and refine the process to cut the…
Berk & Associates. (2011). Idea: Lean government. Seattle, WA: Washington State Auditor's Office.
Jimmerson, C. (2010). Value stream mapping for healthcare made easy. New York, NY: Productivity Press.
Lean Enterprise Institute. (2009). 5S - Visual workplace. Retrieved October 5, 2012 from www.lean.org Web site: http://www.lean.org/Workshops/WorkshopDescription.cfm?WorkshopId=39
Lean Enterprise Institute. (2009). Lean timeline. Retrieved October 5, 2012 from www.lean.org Web site: http://www.lean.org/WhatsLean/Timeline.cfm
Figure 1 portrays the state of Maryland, the location for the focus of this DR.
Figure 1: Map of Maryland, the State (Google Maps, 2009)
1.3 Study Structure
Organization of the Study
The following five chapters constitute the body of Chapter I: Introduction
Chapter II: Review of the Literature
Chapter III: Methods and Results
Chapter IV: Chapter V: Conclusions, Recommendations, and Implications
Chapter I: Introduction
During Chapter I, the researcher presents this study's focus, as it relates to the background of the study's focus, the area of study, the four research questions, the significance of the study, and the research methodology the researcher utilized to complete this study.
Chapter II: Review of the Literature in Chapter II, the researcher explores information accessed from researched Web sites; articles; books; newspaper excerpts; etc., relevant to considerations of the disparity in access to health care services between rural and urban residence in Maryland…
Potter, S. (2002) Doing Postgraduate Research. London: Sage.
Qualitative research: Approaches, methods, and rigour, (2008, Nov. 7). Microsoft PowerPoint Qualitative Research AdvC08 RS.PPT. Retrieved March 10, 2009 from www.unimaas.nl/bestand.asp?id=11629
Wolvovsky, Jay. (2008). Health disparities: Impact on Business and Economics Summit. Maryland's healthcare at a glance. The Heart of Community Health Baltimore Medical Syste. Retrieved March 10, 2009 at http://dhmh.maryland.gov/hd/pdf/2008/oct08/Jay_Wolvovsky.pdf