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IMPLANTING AN ELECTONIC HEALTH ECOD CHIP INTO U.S. CITIZENS
The purpose assignment investigate safeguards apply ethical principles health care technology.
Imagine having all your medical records with you at all times, thus reducing the issues that arise of patient safety and identification when one visits a health facility. With the use of an Electronic Health ecord (EH), this would become a reality for every U.S. Citizen. The EH is a collection of a patient's health information that is acquired over several visits to a health facility. It has all the patients' progress notes, medications, problems, laboratory data, past medical history and radiology reports. For this to be achieved, one would need to be implanted with a chip or a adio Frequency Identification Device (FID) that would contain their health information. When one visits a health facility, the health care providers would scan the chip and all the patient's health information…
Haifley, K.A., & Hecht, S. (2012). Functionality of implanted microchips following magnetic resonance imaging. [Article]. Journal of the American Veterinary Medical Association, 240(5), 577-579.
Levi, M., & Wall, D.S. (2004). Technologies, Security, and Privacy in the Post-9/11 European Information Society. Journal of Law and Society, 31(2), 194-220.
Nisbet, N. (2004). Resisting Surveillance: Identity and Implantable Microchips. Leonardo, 37(3), 211-214.
Peslak, A.R. (2005). An Ethical Exploration of Privacy and Radio Frequency Identification. Journal of Business Ethics, 59(4), 327-345.
New Electronic Health ecords System
Nurse Facilitator preparing a team on implementation of new electronic health records system
Electronic health record systems are a compilation of health information details of the individual patients stored in digital systems (Greenhalgh, 2005). The records are shared across the different health care institutions. The sharing of this information occurs via the network connections, where the internet facilitates this connection.
An electronic health system includes information of patients, such as the identity and contact information of the patient (Greenhalgh, 2005). The system contains details about the patients visiting the healthcare facilities, whether a patient has allergies or any conditions. Information of the insurance of the person and general family health history, the immunization status, a list of medications administered, records of being hospitalized and information of any surgeries performed on the individual.
The health of our population is a very crucial area of success to…
Greenhalgh, T. (2005). Diffusion of innovations in health service organisations: A systematic literature review. Malden, Mass: Blackwell.
Lehmann, H.P. (2006). Aspects of electronic health record systems. New York: Springer.
Rogers, E.M. (2003). Diffusion of innovations (5th ed.). New York, NY: Free Press.
Electronic Health ecord (EH)
Bearing the everyday evolution of the technology used in hospitals and the Healthcare sector in general, there is need to understand the concept of EH. This paper undertakes to divulge what EH is, the components, the advantages that it brings to the Healthcare department in general as well as the complications or loopholes that may come with it and suggestions on how this system can be used safely without exposing the patients to undue dangers and exposure of private details.
The Electronic Health ecord (EH) can be referred to as a longitudinal electronic record about the health of patients that is gathered by the number of turns that the patient visits a healthcare facility. The information that is included in the EH is vital pieces of information that can help in the handling of the patient in any part of the state. The information include medications,…
Conrad Artio, (2011). Advantages of Electronic Health Record System. Retrieved November 23,
2011 from http://ezinearticles.com/?Advantages-of-Electronic-Health-Record-System&id=2720601
Dick, Richard S., Steen, Elaine B. And Detmer, Don E. (2011). The Computer-Based Patient
Record: An Essential Technology for Health Care, Revised Edition. Retrieved November 22, 2011 from http://books.nap.edu/books/0309055326/html/index.html . (Pp67).
Predicting the Future of Medical Health ecords
Predict the form and function of medical health records in 2030 (provide specific example to support your response).
With the advent of digital databases used to store vast amounts of medical information, health histories, and vital statistics for millions of patients across America, a concept known on the local level as electronic medical recordkeeping (EM), and collectively forming the electronic health record (EH), the delivery of healthcare services has undergone a rapid transformation during the last two decades. The traditional clipboard and paper chart carried by physicians and nurses, which held an often indecipherable maze of pencil-etched recordings made throughout a patient's stay, has since been replaced in many modern healthcare facilities by the iPad and other handheld computer tablet devices. Banks of unwieldy filing cabinets, each storing hundreds of individual patient files, have vanished in the private practices and doctor's offices of…
Ford, E.W., Menachemi, N., & Phillips, M.T. (2006). Predicting the adoption of electronic health records by physicians: When will health care be paperless?. Journal of the American Medical Informatics Association, 13(1), 106-112. Retrieved from http://jamia.bmj.com/content/13/1/106.abstract
Wall, P.T., Kudtarkar, P., Fusaro, V.A., & Pivoravov, R. (2010). Cloud computing for comparative genomics. BMC Bioinformatics, 11(259), Retrieved from http://www.biomedcentral.com/1471-2105/11/259
Clinical Documentation and the Health Record:
The adoption of computerized records is seen as the most appropriate means of improving the quality of care while decreasing health care costs. However, the main concern is on how to design the most suitable and effective electronic health records that improves the workflow of clinicians. hile clinical documentation is integral in electronic health records and accounts for a considerable portion of physicians' time, its practices have largely been dominated with legal and billing requirements. Through the effective implementation of electronic clinical documentation, it will be possible to not only lessen the rate of medication errors but it will also help in achievement of other benefits. This method of documentation has been characterized with various concerns including whether it can be leveraged to enhance the quality of care without negative impacts on the efficiency of clinicians.
Electronic Health Records can help in lessening diagnostic…
Schiff, Gordon D., and David W. Bates. "Can Electronic Clinical Documentation Help Prevent Diagnostic Errors?" The New England Journal of Medicine 362 (2010): 1066-069. NEJM.org. NEJM.org, 25 Mar. 2010. Web. 11 Feb. 2012. .
The relevance of electronic health records (EHRs) cannot be overstated when it comes to the enhancement of better and safer care for patients. This is more so the case given that they enable quick access to the records of patients, as well as enhance the safe and secure sharing of medical data. However, it is important to note that the efficient implementation of EHRs could be hindered by a number of challenges. It would be prudent to highlight some of the said challenges, based on my experiences with implementing EHRs, and to develop suggestions on how the challenges could be addressed.
One of the key challenges in the implementation of electronic health records is cost. In essence, health information technology is in most cases costly not only in implementation, but also in usage. For instance, some of the key cost centers with regard to EHRs include, but they are not…
However, because they make billing more efficient, the majority of large urban practice groups and hospitals have already made the switch to electronic records, according to Michael R. Costa, attorney and associate at Greenberg Traurig, LLP, in oston, Mass. However, he adds, most of these organizations maintain warehouses where they store paper records that have been transcribed to electronic form. "There is resistance from some about going to a completely electronic format because there are still some questions about privacy," Costa says. "There is definitely still a place for paper-based medical records, but the focus from now on will be on making sure that information can be adequately secured" (Fiske).
Frederick Geilfuss, partner in the health law department of Foley & Lardner, in Milwaukee, Wis. says that while many larger providers have already begun the shift, he has not encountered any institutions that have made a complete transition -- an…
Ball, Marion, Carla Smith and Richard Bakalar. "Personal Health Records: Empowering Consumers." Journal of Healthcare Information Management (2007): 76-83.
Brenner, Bill. "Secure Electronic Medical Records: Fact or Fiction?" 3 March 2009. The Standard. 10 April 2009 .
Bright, Beckey. "Benefits of Electronic Health Records." 29 November 2007. The Wall Street Journal. 10 April 2009 http://hfs.illinois.gov/assets/ilhie_112907.pdf
Byers, Jay. "Medical Records Scanning: Convert your paper-based patient records into electronic records." December 2008. EMR Services of Canada. 9 April 2009 .
Electronic Health ecords (EH)
Description: The legislation
Over the past fifty years, Electronic Health ecords or EHs have quickly transformed just like all other technologies in computing. The pace of these transformations has seen more acceleration since the promulgation of the Health Information Technology for Economic and Health Act, or HITECH, in January 2009. This was a $30 billion attempt to transform the delivery of healthcare in the United States through greater application of EH technology. EH incentive program stipulations, and insistence on meaningful use, have largely assisted in creating more homogeneity in the primary functions of EH. This uniformity of design has been spreading across systems much more rapidly than could otherwise have been envisaged. However, technological advancements do not solely determine the direction of innovations in EH. The pace and type of change is impacted by other factors such as "Accountable Care" programs and organizations, business drivers and…
Freymann Fontenot, S. (2013). The Affordable Care Act and Electronic Health Care Records: Does today's technology support the vision of a paperless health care system? Physician Executive, 39(6), 72-76.
Friedman, D., Parrish, R., & Ross, D. (2013). Electronic Health Records and U.S. Public Health: Current Realities and Future Promise. American Journal of Public Health, 103(9), 1560-1567.
HealthIT.gov. (2014, September 25). Health IT Legislation and Regulations. Retrieved June 2, 2015, from http://www.healthit.gov/policy-researchers-implementers/health-it-legislation-and-regulations
Menachemi, N., & Collum, T.H. (2011). Benefits and drawbacks of electronic health record systems. Risk Management and Healthcare Policy, 4, 47 -- 55. doi:10.2147/RMHP.S12985
Electronic Health ecords
Adoption of electronic health records, commonly referred to as EH in short, provides a significant chance for secondary application of clinical data for clinical research purposes. For instance, because individual genetic variants do not have a strong correlation to complicated illnesses, the need for genome-wide associations studies increases if significant results are to be realized (Kohli & Tan, 2016). This paper conducts HE evaluation through four measures linked to HE on care quality, optimization of software and the work flow designs.
The ole of EH
EH systems are support tools for clinicians and have the potential to decrease the strain that the clinician is often subjected to in terms of memorizing and cognition. They also have the advantage of efficiency. They enhance the effectiveness of care and improve coordination. Patient centered equitable and timely provision of quality healthcare requires tools that can help to organize and provide…
Armijo, D., Mcdonnell, C. & Werner, K. (2009). Electronic Health Record Usability: Evaluation and Use Case Framework. AHRQ Publication No. 09(10)-0091-1-EF. Rockville, MD: Agency for Healthcare Research and Quality.
Cresswell, K. M., Worth, A., & Sheikh, A. (2010). Actor-network theory and its role in understanding the implementation of information technology developments in healthcare. BMC Medical Informatics & Decision-Making, 10(1), 67-77. doi:10.1186/1472-6947-10-67
Herndon, J. H., Hwang, R., & Bozic, K. H. (2007). Healthcare technology and technology assessment. European Spine Journal, 16(8), 1293 -- 1302. Doi.10.1007/s00586-007-0369-z
Kohli, R., & Tan, S. S. (2016). ELECTRONIC HEALTH RECORDS: HOW CAN IS RESEARCHERS CONTRIBUTE TO TRANSFORMING HEALTHCARE? MIS Quarterly, 40(3), 553-574.
electronic health record-Keeping (EHs)
According to Jensen, Jensen & Brunak (2012)'s article entitled "Mining electronic health records: Towards better research applications and clinical care," scientists have a potentially invaluable source of information at their fingertips that can improve human health -- the data yielding by analyzing the electronic records of patients. "Mining of electronic health records (EHs) has the potential for establishing new patient-stratification principles and for revealing unknown disease correlation" (Jensen, Jensen & Brunak 2012). One of the most common complaints about clinical trials is their limited nature: their accuracy may be compromised by relatively small numbers, limited demographic profiles of participants, and the difficulties of longitudinal analysis, all of which EHs can potentially remedy.
The downside of using EHs is that it involves using "scattered" and "heterogeneous" data not specifically designed for the purposes of research (Jensen, Jensen & Brunak 2012). Still, using such information is still vitally…
Gardner, Elizabeth. (2013). The healthcare approach to big data. Health Data Management, 21
Jensen, Peter B., Jensen, Peter & Brunak, Soren. (2012). Mining electronic health records:
Towards better research applications and clinical care. Nature Reviews Genetics, 13, 395-
EH Assessment and Evaluation to Support Healthcare Outcome Objectives
The outcome-related goals that the tertiary care hospital seeks to achieve include the following: 1) Strengthen adult admissions screening at intake for pain, depression, and adverse health behaviors such as smoking, excess alcohol intake, and body mass index (BMI) greater than 30; 2) implement comprehensive geriatric assessment for all adults 65 years of age and over who are hospitalized for more than seven days or readmitted within less than three days following discharge; and 3) promote care team performance. The electronic health record (EH) is the default system for adult admissions, and it includes documentation standards and structures such as SOAP and checklists. Hospital staff are provided periodic guidelines through educational venues or through referral to the electronic policy and procedure manual. Given this information, the data elements that should be included in the EH assessment and evaluation screens are as…
Lowry, S.Z., Quinn, M.T., Ramaiah, M., Schumacher, Gibbons, M.C., Patterson, E.S., North, R., Zhang, J., and Abbott, P. (2012, February 21). NISTIR 7804: Technical evaluation, testing and evaluation of the usability of electronic health records. Retrieved from http://www.emrandhipaa.com/emr-and-hipaa/2013/10/22/turf-an-ehr-usability-assessment-tool/
large number of changes in the healthcare industry, largely due to globalization and technological improvements. Much of the change has been the result of the cost of healthcare and its continual rise. For example, in 1990 the average cost of care per person was $2,800, in 2000 it was $4,700 and then in 2010 close to $8,000. One way to reduce these costs and improve efficiency is to allow healthcare professionals to spend more time with their patients rather than filling out redundant paperwork, to increase information accuracy, and to provide a way for medical professionals in Emergency Rooms or other health care facilities to have access to critical patient information. his can be accomplished through the use of Electronic Medical Record Systems, or ERM systems.
Diabetes is a group of metabolic diseases that surround the body's ability to produce and use sugars and efficiently process those sugars. Globally, there…
The conclusions reached seemed robust and showed that the use of EHRs, particularly in the primary care system improves both the process of care and outcomes. This suggests that organizations should immediately implement EHR systems so that decision support, patient care, timing of appointments and efficiency of recording of data and tracking medications and treatment options is actually far more efficient in both monetary and patient centered outcomes. Certainly, room for improvement exists, and as EHRs become more sophisticated, it stands to reason that efficiencies, outcomes and improvements in decision support will also become expected by stakeholders.
Herrin, J., et al. (2012). The Effectiveness of Implementing and Electronic Health Record on Diabetes Care and Outcomes. Health Services Research, 47(4), 1522-40. doi:10.1111/j.l475-6773-2011-01370.x
Adoption Of the EH Technology Systems
In a contemporary health environment, nurses have long been using the computer technology to achieve the health outcomes such as the laboratory tests, however, the EH (electronic health records) has become a revolutionary innovative technology for the enhancement of the healthcare system. It is very critical for nurses to understand their roles as an agent of changes and influence other to change the tradition way of doing things. My role as a nursing facilitator of a small hospital in New York is to prepare the implementation plan of a new EH system for the hospital. While the decision has been finalized for the implementation of the EH, nevertheless, there is still a resistance from the nurses of the hospital.
The objective of this paper is to use the five qualities of the oger (2003) model for the implementation of the new system.
Evans, S. & Stemple, C. (2008). Electronic Health Records and the Value of Health IT. Journal of Managed Care Pharmacy JMCP. 14 (6):S16-S18.
Lee, T. (2004). Nurses' adoption of technology: Application of Rogers' Innovation-diffusion Model. Applied Nursing Research. 17(4): 231-238.
Rogers, E. M. (2003). Diffusion of innovations (5th ed.). New York, NY: Free Press.
Electronic Medical ecords (E-SIHI) in King Khalid University Hospital on Patient Safety
The objective of this study is to demonstrate the impact of e-SIHI (Electronic Medical ecords) on patients with regards to their security and safety. The King Khalid University Hospital has implemented the e-SIHI since May 2015 for all departments. Two weeks after the implementation, QMD (Quality Management Department) conducted an audit to measure a compliance for the system and ascertain whether the e-SIHI can improve health and safety of patients. However, the QMD found that there are many areas requiring improvement in the system. The paper discusses the methodology used to evaluate the system to ascertain whether e-SIHI is beneficial to the patient.
The research methodology reveals research design discussing the method of data collection, sample population, sample size, and project tool.
Study Design: The team audits the e-SIHI using a checklist to verify whether the…
AlAswad, A.M. (2015). Issues Concerning the Adoption and Usage of Electronic Medical Records in Ministry of Health Hospitals in Saudi Arabia. School of Health and Related Research (ScHARR) the University of Sheffield.
Bowman, S. (2013). Impact of Electronic Health Record Systems on Information Integrity: Quality and Safety Implications. Perspectives in Health Information Management, 10.
Jang, J., Yu, S. H., Kim, C., Moon, Y. et al. (2013). "The effects of an electronic medical record on the completeness of documentation in the anesthesia record, International journal of medical informatics, 82(8):702-707.
Kazley, A. S. & Ozcan, Y. A. (2009). Electronic medical record use and efficiency: A DEA and windows analysis of hospitals, Socio-economic planning sciences, 43(3): 209-216.
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.
Health Care continues to undergo fundamental change. Legislation such as the affordable care act has created a much higher percentage of insured citizens. Patent legislation is now allowing for much more competition for popular drugs. Generic drugs in particularly which are cheaper for consumers and much more profitable for producers are now eroding the market share of popular products. Even the use of cloud computing is changing the way care is administered within a facility. Even with these innovations, facilities still struggle with bloated cost structures, inefficient behavior, and lack of staffing. MGH is not different in this regard. It suffers from a large influx of patients with the inability to provide timely care. Below is a description of the issues combined with possible real world solutions.
Describe the current process and identify the specific areas that slow the process.
The current process has is inadequate primarily due to staffing…
1) Roukema, J.; Los, RK; Bleeker, SE; Van Ginneken, AM; Van Der Lei, J; Moll, HA (2006). "Paper vs. Computer: Feasibility of an Electronic Medical Record in General Pediatrics." Pediatrics 117 (1): 15-21
" (2004, p.159) Activities have included:
(1) Development and promotion of industry-wide standards;
(2) Funding of research for investigation of the impact of IT on quality;
(3) Provision of incentives that provide encouragement of investment in IT;
(4) Giving grants to investors in IT; and (5) Development of strategies to improve the flow of information across providers. (Report to Congress, June, 2004, p.159)
Stated additionally in the Report to Congress is that there are multiple functions that must be considered when purchase IT and hundreds of applications that various vendors offer. The various IT applications are stated to be within three categories including those of:
(1) Administrative and financial systems that facilitate billing, accounting and other administrative tasks;
(2) Clinical systems that facilitate or provide input into the care process; and (3) Infrastructure that supports both the administrative and clinical applications. (Report to Congress, June 2004, p.160)
The work published…
BC Medical Association. Getting IT Right: Patient Centered Information Technology [discussion paper]. Vancouver: BCMA. 2004:39-40.
Blum E. Paperless medical record not all it's cracked up to be AMNews; 17 February 2003. Online available at: www.ama-assn.org/sci-pubs/amnews/pick_03/bica0217.htm
Brookstone A, Braziller C. Engaging physicians in the use of electronic medical records. Electronic Healthcare 2003;2:23-27.
Brookstone, Alan. 2004. Electronic Medical Records: Creating the Environment for Change. BCMJ, Vol. 46, No. 5 June 2004. Online available at: http://www.bcmj.org/electronic-medical-records-creating-environment-change
overwhelming connections between healthcare costs and the macroeconomic performance of the U.S. economy. The impact of healthcare industry on the macroeconomic performance is evident from the fact that in 2009 healthcare expenditure of the U.S. was 18% of the gross domestic product (GDP) of the country. It was also estimated that should the healthcare costs continue to grow at historical rates, 34% of the U.S. GDP will compose of healthcare spending by 2040 (Whitehouse, 2009). The major sources of funding the healthcare costs are the Federal, State, and local governments of the U.S. Medicare is a healthcare program that subsidizes healthcare for citizens above 65 years of age. Medicaid subsidizes healthcare delivery for people below a certain income level. Approximately 50% of the healthcare expenditure is bore by governments at the federal, state and local level. It is also estimated that Medicare and Medicaid spending of Federal and State governments…
CMS. (2013, Nov). National Health Expenditure Projections 2012-2022. Centers for Medicare & Medicaid Services. Retrieved from: http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/NationalHealthAccountsProjected.html
Kolstad, J.T., & Kowalski, A.E. (2012). Mandate-based health reform and the labor market: Evidence from the Massachusetts reform (No. w17933). National Bureau of Economic Research.
The Whitehouse. (2009). Deficit-Reducing Health Care Reform. The Whitehouse. Retrieved from: http://www.whitehouse.gov/economy/reform/deficit-reducing-health-care-reform
CBO. (2011, March). The Economic Case for the Health Care Reform. Congressional Budget Office: Executive Office of the President Council of Economic Advisers. Retrieved from: http://www.cbo.gov/publication/22077
Nursing Health Care Informatics
"…At the beginning of the 21st century, nursing informatics has become a part of our professional activities…[and has] advanced the field of nursing by bridging the gap from nursing as an art to nursing as a science…" (Saba, 2001, 177).
Nursing Health Care informatics relate to and address technology and other cutting edge issues of great interest in the healthcare field. According to the AMIA, Nursing Informatics is the "…science and practice (that) integrates nursing, its information and knowledge, with management of information and communication technologies to promote the health of people, families, and communities worldwide." New and relevant knowledge presented in the genre of informatics helps to empower nurses and other healthcare practitioners to deliver the most effective patient-center care possible. This paper presents several informatics in the belief that applying healthcare technologies and practices that are genuinely progressive and helpful to today's nurse is…
AMIA (2009) Working Group Nursing Informatics. Retrieved March 9, 2014, from http://www.amia.org .
An, J.Y., Hayman, L.L., Panniers, T., and Carty, B. (2007). Theory Development in Nursing
And Healthcare Informatics. A Model explaining and Predicting Information and Communication Technology Acceptance by Healthcare Consumers. Advances in Nursing Science, 30(3), E37-E49.
Cipriano, P.F. (2011). The Future of Nursing and Health IT. Nursing Economics, 29(5).
The healthcare industry has widely adopted IT solutions in the development and maintenance of information systems for this sector. These information system applications will go a long way in boosting medical care goals by reducing costs significantly, increasing efficiency in the process and achieving a zero error. With this, client satisfaction will be realized. At the core of this is the electronic medical records (EHR) which is representative of all the health information of an individual that is available in a database and can be shared across healthcare service providers (Rouse, 2016). Also integral to this system are two components; mobile health (mHealth) and telehealth (telemedicine). Though the two are interconnected, they have a slight difference. Telehealth includes home monitoring of health conditions through desktops, laptops and other online material (Terry, 2016), while mobile health is restricted to mobile devices.
Considering the impact of electronic medical records (EHR), it is…
Medicare Health Care eform
The Medicare is an American health program that is administered by the federal government and serves as a health insurance for people aged 65 years and above. The Medicare is also designed for people with disabilities and people diagnosed with the renal disease. (Davis, Cathy, & Stuart, 2013). The Medicare is currently being funded by the premiums, payroll tax, surtax from general revenue. In 2015, over 55 million American enrolled for the Medicare services where 46 million people are people aged 65 years and above and 9 million are young people. On the average, Medicare covers half of the health costs and the enrollees are to cover the remaining costs through a separate insurance, supplemental insurance, or out-of-pocket. Since the inception of the Medicare, the cost of funding the program continues to increase, and the rising costs of funding are becoming unbearable both for the current…
Blum, J. (2011). Improving Quality, Lowering Costs: The Role of Health Care Delivery System. Center for Medicare Management.
Davis, K. Cathy, S. & Stuart, G. (2013). Medicare Essential: An Option to Promote Better
Care and Curb Spending Growth, Health Affairs 32, no. 5: 901 -- 9.
Golberstein, E. Kayo, W. Yulei, H. et al. (2013). Supplemental Coverage Associated with More Rapid Spending Growth for Medicare Beneficiaries, Health Affairs, 32, no. 5. 873 -- 81.
Patient portals, electronic medical records, and personal monitoring devices are three of the most revolutionary technologies in the healthcare sector. Each of these technologies presents patients with the potential to empower themselves, taking control of their own healthcare outcomes, and taking part in their overall healthcare goals. These technologies also streamline healthcare administration and minimize medication and billing errors. However, each of these technologies is also constrained by a range of issues related to accessibility, with potent socioeconomic class disparities evident. Security and standardization of healthcare technologies are also proving problematic. Patient portals, electronic medical records, and personal monitoring devices are all technologies that have the potential to radically improve the quality of healthcare and patient outcomes, as well as improve overall patient experiences. Because of their abundant benefits, these technologies need to be embraced and promoted through effective public health policies. Otherwise, disparities will continue to threaten to exacerbate…
Drawbacks that exist within the structure of healthcare institutions include the lack of universal implementation of the electronic health records, and the lack of consistency in service quality and delivery. Moreover, there are different systems for different classifications of patients depending on their insurance coverage. For instance, seniors on Medicare use different products and services within the system and may be processed differently at different institutions. The nature of healthcare insurance is also overly complicated. Because each state also has different rules, regulations, and healthcare issues, there is a potential for service disruptions and inconsistencies. Patients living in more than one state or who travel often will frequently encounter the inconveniences of the American health care system.
Not all healthcare institutions have the same structure, but many hospitals and other large healthcare organizations are structured similarly. Lack of consistency in healthcare is especially apparent among the elder population, which…
The Greatest Challenge to US Healthcare
The role is played by the government
The role played by the government in healthcare is a divisive issue. Many healthcare organizations executives do support the idea of extending healthcare coverage to the uninsured, however, who this is implemented is the cause of concern. There are numerous changes that are taking place in the healthcare industry and the government needs to catch up quickly. Policy development is the role of government and there is a need to ensure that there are timely and applicable policies in place to govern the provision of healthcare services to the masses. As it stands, healthcare is moving from fee-for-service to value outcomes and there should be policies in place to support this advanced move. Providers have been moving towards value-driven care and the government policies should be able to mirror this movement. While not all providers will be…
Practice Experience Interviews
Interview with "Jennifer," RN, MPH, director of quality assurance at a Veterans Affairs medical center.
In a telephonic interview with this nursing professional, questions were posed concerning how research is found, accessed and applied for quality assurances purposes. According to Jennifer, Veterans Affairs medical centers (VAMCs) typically feature up-to-date medical libraries that can be used by any staff member. The library resources at this VAMC included numerous peer-reviewed journals and Internet access for additional relevant journal articles. In addition, Jennifer reported that her office had Internet access as well as access to the hospital's intranet (the decentralized hospital computer program or DHCP) that links this VAMC with other VAMCs as well as regional offices and the VA's Central Office in Washington, DC.
When queried concerning how research was applied in her practice, Jennifer noted that her office was responsible for coordinating peer reviews of questionable medical practices…
Hand-held devices and portable digital assistants (PDAs) are being integrated into the health care setting in the United States. It is important to understand which devices are being used, how they are being used, what they are being used for, and why. Understanding the role that hand-held devices and other portable electronics play in health care can help to inform organizational policy, and help health care administrators better implement electronic medical records.
History of use
The first documented PDA was the Newton MessagePad, issued by Apple in 1993. It was described as being "revolutionary" (Wiggins, 2004, p. 5). Palm, Inc. developed the next big handheld device: the Palm Pilot, in 1996. By the late 1990s, PDAs were equipped for Internet access, and memory capacity and other features improved with each product release. Microsoft also entered the portable electronic devices marketplace in the 1990s. The devices were not yet being…
Alerndar, H. & Ersoy, C. (2010). Wireless sensor networks for healthcare. Computer Networks 54(15): 2688-2710.
Fornell, D. (2008). PDAs bring hand-held solutions to healthcare. Acuity Care Technology. Retrieved online: http://www.soti.net/PDF/PDAsBringHandHeldSolutionsToHealthcare_Article.pdf
Garritty, C. & El Emam, K. (2006). Who's using PDAs? Journal of Medical Internet Research 8(2).
Huang, V.W. (n.d.). PDAs in medicine. Power Point Presentation Retrieved online: https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=2&cad=rja&ved=0CF4QFjAB&url=http%3A%2F%2Fwww.cs.princeton.edu%2Fcourses%2Farchive%2Fspr02%2Fcs495%2Fpda.ppt&ei=xxqAUsq_NtTFqQG25IHwAQ&usg=AFQjCNE4Wf4YrX7slTbcdYJwxujV3rwgog&sig2=Uee9rvdDYwY0uYM33n1ZBg&bvm=bv.56146854,d.aWM
Healthcare: Clinical Integration
What is clinical integration
History of clinical integration
Goals of clinical integration
Importance of clinical integration
New payment models
Barriers to clinical integration
Lack of practitioner alignment
Lack of interoperability
How to achieve success in clinical integration
The future of health care systems
Physician acquisitions vs. clinical integration
HIEs -- solution to clinical integration?
Policy makers are beginning to appreciate the fact that only systemic change can effectively change, for the better, the manner of health care delivery in the U.S.; and that anything less would only alter the system's edges - with little or no substantial effect on cost-control, innovation-promotion, effectiveness of reward incentive schemes, coordination and coverage (AHA, 2010). Clinical integration has been found to be crucial to the change needed for the achievement of the aforementioned goals (AHA, 2010). Despite…
AHA. Clinical Integration -- the Key to Real Reform. Trend Watch. Retrieved from [HIDDEN]
Athena Health. (2014). History of the Clinical Integration Model. Athena Health. Retrieved from https://www.athenahealth.com/knowledge-hub/clinical-integration/clinical-integration-model.php
eHealth Initiative. (2012). The Rise of the Private Health Information Exchange and Changing Role of Public Exchanges. eHealth Initiative. Retrieved from [HIDDEN]
Fridsma, D. (2013). Interoperability Vs Health Information Exchange: Setting the Record Straight. Health IT Buzz. Retrieved from http://www.healthit.gov/buzz-blog/meaningful-use/interoperability-health-information-exchange-setting-record-straight/
Provider Document Guidelines)
Provider Documentation Responsibilities
Summary of Key Concepts
Authentication of patient record entries
All entries in the medical record must contain the author's identification. Author identification may be a handwritten signature, unique electronic identifier, or initials.
Abbreviations used in the patient record
All abbreviations use should be kept to an absolute minimum for effective and safe communication in patient care. Abbreviations should be avoided completely especially in drug prescriptions, operation lists and consent forms -- for example, the laterality of site of operation. Lists of approved abbreviations and their correct meaning should be established along with a list of 'Do not use' abbreviations to be followed by the healthcare professionals.
Legibility of patient record entries
The record must be legible to someone other than the writer. All entries must be legible to another reader to a degree that a meaningful review may be conducted. All notes should be…
Healthcare in the New Millennium
The Future Trends of Healthcare Delivery
The objective of this work is to present a new and improved healthcare delivery system for the new millennium. Future trends in healthcare and how they affect disease management, financial management, technology and the social aspects of health care delivery will be given consideration as well as integration of personal knowledge of the historical, social, ethical, technological and financial aspects of health care service delivery expressed as a vision for health care delivery in the United States.
Never before at any time in history have the challenges for the delivery of healthcare been so great. Neither has history witnessed the rash of serious new diseases emerging on a daily basis. The provision of quality, cost-effective patient care while managing to balance the needs of employees and physicians as well as trustees is a monumental challenge faced by healthcare executives.…
Global Best Practices Among Themes at First Annual World Healthcare Innovations in Technology Congress Presented by the ENBC, PR Newswire 23, June 2004.
Healthcare's Top Business Issues and Responses for 2005 A Capgemini Forecast
Hunter, Derek (2004) New Data on Health Insurance, the Working Poor and the Benefits of Health care Tax Changes WebMemo #492-2004 Apr 12. Online available at http://www.heritage.org/Research/Healthcare/wm492.cfm
On the Minds of Americans: The Crisis of Skyrocketing Health Care Costs 2004 Online available at http://www.house.gove/georgemiller/middleclass/middleclass.html
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
We can compare the healthcare workplace to what is seen by a person when he/she looks through a kaleidoscope: since there are numerous different patterns that appear as the moments pass by. The shortage of nurses which has been publicized widely and the high turnover rates amongst the nurses are some of the unwanted patterns which have occurred. The dependence of healthcare institutions on the nurse-managers for the retention and recruitment of nurses is steadily increasing (Contino, 2004).
There are a number of routes through which the critical care nurses have become the leaders. Most of these routes don't have any educational or managerial training as a part of the process. There is a need for effective strategies for the care leaders who provide critical care in order to inspire the staff and manage the departmental operations in an effective manner to get positive results. One of the strategies…
Adams, J., Erickson, J., Jones, D., & Paulo, L. (2009). An evidence-based structure for transformative nurse executive practice, Nursing Administration Quarterly, 33(4), 280-87
Advisory Board Web site. (2004). Available at: http://www.advisory.com .
Ales, B.J. (1995). Mastering the art of delegation. Nurs Manage. August; 26: 32A, 32E.
American Organization of Nurse Executives (2005). AONE Nurse Executive Competencies. Nurse Leader, 3(1), 15-22.
Health policy issues are now becoming more contentious throughout the world. The advent of the internet has created a much needed awareness of human rights and liberties. No longer are countries able to fully sheath society from information. A critical component of this information relates directly to health care and the overall well-being of societies constituents. Policy issues relating to health are now becoming paramount to voters and decisions makers. The Affordable Care Act is one of many illustrations that detail the desire for universal healthcare for all. In addition, many countries are mandating a standard health care system for all of their citizens irrespective of socio-economic status. Although costly, it appears that many constituents are willing to pay for the ability to extend healthcare to all. Outside the universal healthcare within individual countries, many are now looking to address worldwide health epidemics. Aspects such as food shortages, proper treatment…
1) Bell, B, Thornton, K. (2011). From promise to reality achieving the value of an EHR. Healthcare Financial Management, 65(2),51-56
2) Jamoom, E., Patel, V., King, J., & Furukawa, M. (2012, August). National perceptions of ehr adoption: Barriers, impacts, and federal policies. National conference on health statistics.
3) Rosenberg, Charles E. The Care of Strangers: The Rise of America's Hospital System (1995) history to 1920 table of contents and text search
4) Pollack, A. (2015, September 20). Drug Goes From $13.50 a Tablet to $750, Overnight. Retrieved October 1, 2015, from http://www.nytimes.com/2015/09/21/business/a-huge-overnight-increase-in-a-drugs-price-raises-protests.html?_r=0
Health Policy Analysis for Maryland AC (Affordable Care) Act
McLaughlin, & McLaughlin (2014) rank 11 areas of health innovation based on their impact on costs and quality of healthcare delivery. The process improvement is the highest ranking item. However, the authors identify data analytics, disease management, "non-physician delivery alternatives," and "alternative to fee-for service" (McLaughlin, & McLaughlin, 2014 p 335) as other innovation items that can enhance quality and reduce costs. Additionally, the authors point out that innovation in electronic medical records, diagnosis, and pharmaceuticals can also assist with quality and cost.
Objective of this health policy paper is to evaluate the items that can play important role in the health policy process of Maryland's ACA (Affordable Care Act).
Healthcare items for Health Policy Process for in Maryland Affordable Care Act
The ACA (Affordable Care Act) is a federal government legislation focusing on healthcare coverage for small groups and individuals.…
Abrams, M. Nuzum, R. Mika, S. et al. (2011). Realizing Health Reform's Potential How the Affordable Care Act Will Strengthen Primary Care and Benefit Patients, Providers, and Payers. The Commonwealth Fund.
Chin, W.W. Hamermesh, R.G. Huckman, R.S. et al.(2012). 5 Imperatives Addressing Innovative Challenge. Harvard Business School.
McLaughlin, C.P. & McLaughlin, C.D. (2014). Health Policy Analysis: An Interdisciplinary Approach.(2nd Edition). Burlington, Jones & Bartlett Learning.
Resnik, D.B. (2007). Responsibility for Health: Personal, Social, and Environmental. J Med Ethics. 33(8): 444-445.
Health of Indigenous Australian Using Ecological and Holistic Health Paradigm
Patterns of health and illness
Impact of Broader Environments
Health is a basic component of human life that comprises of multiple facets. The description of health has witnessed dramatic change during past few years, as it has become a holistic phenomenon. Previously, it was considered that a healthy person is the one who does not suffer from any ailment or illness. However in recent times, the physical, psychological and communal aspects of human life have been amalgamated to give a broader perspective to human health which is identical to the concept of indigenous communities (Hjelm, 2010).
Numerous organizations are working extensively for providing adequate health care to the world population since many decades. However, it is appalling to notice that discrimination on social, economic and…
Australian Institute of Health and Welfare 2012, Australia's health 2012, AIHW, Australia.
Biddle, N & Yap, M 2010, Demographic and Socioeconomic Outcomes Across the Indigenous Australian Lifecourse: Evidence from the 2006 Census, ANU E. Press, Australia.
Caltabiano, ML & Ricciardelli, L 2012, Applied Topics in Health Psychology, John Wiley & Sons, Great Britain.
Carson, B, Dunbar, T & Chenhall, RD 2007, Social Determinants of Indigenous Health, Allen & Unwin, Singapore.
Health Organization Case Study
The mission of Banner Healthcare is to make a difference in the lives of people through excellent patient care. They achieve this by providing leadership for excellence in patient safety and clinical care. Traditionally, healthcare institutions focused on analyzing aggregate performance, questioning causation, monitoring scorecards and identifying gaps. Planning and managing stages at integral to the process of achieving Banner Healthcare's vision. Planning entails the development of standards, rules, and work teams necessary for the work. Concurrent management involves patient-oriented care and coordinated health care. Across the various work teams, care management efforts and the number of people are involved in making clinical improvements across the organization have been gradually increasing.
This occurs regardless of whether they are work groups, system wide teams, strategic initiatives, and special projects. The work is organized under functional teams. Besides the functional teams, initiative work groups and clinical consensus groups…
Wickramasinghe, N. & Sharma, S.K. (2010). Creating knowledge-based healthcare organizations. Hershey Penns: Idea Group Pub.
Technology is one of the main drivers of change in healthcare, and it is up to healthcare organizations to join the rest of the world in adopting new technologies to run their industry better. In most industries, something like electronic record keeping has been done for decades and nobody was wringing their hands about it. It is absurd that this is even an issue for healthcare companies. The best thing is to stop talking about this as if it is an "issue" or a "challenge," and just get it done. If you were to design the health care system from scratch, of course everything would be electronic. The development and adoption of these technologies will improve the quality of healthcare immensely, so the only real question is not how will this challenge affect healthcare, but how quickly can healthcare get its act together and join the 21st century.…
Kumbroch, D. (2014). Affordable Care Act creates big demand locally for healthcare workers. WHNT. Retrieved November 17, 2014 from http://whnt.com/2014/09/17/aca-creates-big-demand-for-healthcare-workers/
Wister, A. (2009). The aging of the baby boomer generation: Catastrophe or catalyst for improvement? Health Innovation Forum. Retrieved November 17, 2014 from http://www.healthinnovationforum.org/article/the-aging-of-the-baby-boomer-generation-catastrophe-or-catalyst/
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
(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
isk Involved in Poor Chart Documentation: An Overview in Total Quality Management
Poor chart documentation in the behavioral health field is a concern for risk management and a critical area for total quality improvement. Poor chart documentation can lead to an audit by accrediting bodies and in severe circumstances lead to discharge. There are many legal ramifications associated with poor chart documentation. This paper will highlight the importance of poor chart documentation, the consequences of poor documentation, and suggest possible tools for resolving documentation errors. The best tool for eliminating chart documentation risk is developing a risk management system appropriate to the health care setting.
Poor chart documentation costs behavioral health providers thousands of dollars in malpractice costs every year. Errors related to chart documentation can be severe; a patient can suffer an untimely death for example. In fact, statistical evidence suggests that each year thousands of patients…
Aron, DC. & Headrick, L.A. (2002). Educating physicians prepared to improve care and safety is no accident: It requires a systematic approach. Quality and Safety in Health Care, 11, 168-173.
Burke, M., Boal, J., & Mitchell, R. (2004). Communicating for better care. American Journal of Nursing. 104(12), 40-47.
American Society of Healthcare Risk Management, American Hospital Association. (2004). The
growing role of the patient safety officer: Implications for risk manager. Chicago: American Hospital Association.
Changes to Healthcare Practice and Delivery: A Study of Two Detroit, MI Healthcare Facilities Separated by Twenty Years
Changes to technology and to the political and regulatory landscape have led to many changes in the ways that businesses in all manner of industries operate. Increased communications capabilities, the shrinking size and cost for advanced technologies, and a variety of other changes have provided many businesses with an opportunity to operate more efficiently, and in so doing have also made many industries and markets more competitive. An examination of some typical businesses operating in these industries today as compared to their counterparts that were in operation twenty years ago provides ample evidence of the changes that have occurred and the ways in which businesses have adapted.
The healthcare industry has by no means been immune from these changes, but in fact has changed more than many other industries due…
Anderson, J. & Aydin, C. (2005). Evaluating the organizational impact of health care information systems. New York: Springer.
Armoni, A. (2000). Healthcare information systems: challenges of the new millennium. Hershey, PA: Idea Group.
Wager, K., Lee, F. & Glaser, J. (2009). Health care information systems: a practical approach for health care management. New York: Wiley.
One such barrier is the pattern of supply-driven care that has proven extremely costly on the average consumer and patient. Essentially, this method of healthcare has created a multi-billion dollar industry, where patients' needs are put to the side in order for healthcare organizations to make the largest profit margin possible through a system that resembles a production line more so than a hospital facility. Unfortunately, "producers control demand" (O'Toole, 2009, p 48). With so many major companies profiting from this style of healthcare, they will undoubtedly put up a fight for reform initiatives like the Triple Aim Initiative, which is hoping to rework the system in order to save consumers the burden of costs, without reducing the quality of the care they receive. Moreover, the physician-centric model of most of today's healthcare systems also proves a barrier to the aims of the Triple Aim Initiative. Essentially, under this model,…
O'Toole. Eileen. (2009) Healthcare in the 21st century. The Nurse Practitioner, 34(7), 46-50.
World Health Organization. (2013).World Health Statistics 2013: Indicator Compendium. Web. http://www.who.int/gho/publications/world_health_statistics/WHS2013_IndicatorCompendium.pdf
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
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.
Each of these was included in the initial Senate bill, but was struck from the final Senate version. Despite the victories, the group isn't ready to pledge support for health reform bills. The AMA will not endorse any legislation unless Congress gets rid of the mandated payment cuts of more than $200 billion over 10 years in the government's Medicare program for the elderly. The cuts are part of Congressional action that was passed in 1997 in order to cut costs in the Medicare program, but have never gone into effect. There are also several hospitals, insurers, pharmaceutical manufacturers and advocacy groups that are withholding final support. Most of these groups have pledged support to health care reform in principle while working privately through lobbyists to protect their industries (Eaton and Pell, 2010).
Healthcare lobbyists range from very large companies and corporations to very small groups who are all looking…
BREAKING: Health care lobby invests in reform summit. (2010). Retrieved March 1, 2010, from Citizens for Responsibility and Ethics in Washington Web site:
Eaton, Joe and Pell, M.B. (2010). Lobbyists Swarm Capitol to Influence Health Reform.
Retrieved March 1, 2010, from the Center for Public Integrity Web site:
At which point, the overall costs of care will be passed on to the tax payer in the form of higher taxes. This leads to a decrease in the overall quality of care and it will not slow the price increases, as the government seeks to restrict access to these services. Then, when the program becomes broken (such as: what is happening to Social Security) removing or reforming the bureaucracy is nearly impossible. (Messerili, 2010)
A second argument that many critics make about universal health care is: it will stifle innovation. Whenever, the government is running any kind of program, they will place a large number of restrictions and regulations on the industry. When this takes place, you are causing some of the best and brightest minds to seek careers in other fields, as the restrictions from the government are too cumbersome. A good example of this would be: the…
Trends in Health Care Costs and Spending. (2006). Retrieved March 13, 2010 from Kaiser Foundation website:
Andersen, R. (2007). Changing the U.S. Health Care System. Washington D.C: National Academy Press.
Gratzer, D. (2002). Better Medicine. Toronto, on: ECW Press.
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
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New York: Basic Books
The expectations for these kinds of changes will be to see gradual shifts at first. Where, it may not seem like anything is changing at the facility. However, over the course of time, these kinds of changes will be obvious in the quality of treatment that is being provided will improve. As a result, the strategy will take approximately one year to fully implement a change in the atmosphere of the operating environment.
To ensure that these improvements can continue to be built upon a new system will be introduced of monitoring for shifts that are occurring. In this case, the committee that was established to implement these changes will become way of: monitoring the kinds of treatment that is being provided and the challenges that are facing the facility. This will be accomplished by having outside consultants conduct anonymous surveys of patients, staff members and within the community. They…
Online Customer Surveys. (2011). Key Survey. Retrieved from: http://www.keysurvey.com/solutions/healthcare-surveys.jsp
SWOT Analysis. (2010). Quick MBA. Retrieved from: http://www.quickmba.com/strategy/SWOT/
Badrick, T. (2002). Role of External Management. Clinical Leadership, 16 (5), 281 -- 286.
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Healthcare Partnership in the Community
Discuss an example of healthcare partnership in your community and specifically cite examples that show how nurses, both individually and collectively, influenced the care provided. What obstacles were confronted and what strategies were employed in order to effectively overcome them.
One community healthcare partnership that is salient in my mind is Texas Department of State Health Services' program on tuberculosis or TB. This group of projects is specifically handled by the Office of Border Health, specifically because communicable diseases transmitted over the Texas-Mexico border will inadvertently affect the state of community health of both countries (i.e., the U.S. And Mexico). Under the program, two projects have been successful and known for its accomplishment in helping decrease TB prevalence in communities near the Texas-Mexico border: Proyecto Juntos and TBNet.
Proyecto Juntos specifically centers on "bilateral TB control," centering its efforts to curbing TB prevalence by monitoring…
Texas Department of Health Services, Office of Border Health. Available at: http://www.dshs.state.tx.us/borderhealth/
Texas Organization of Nurse Executives. Available at: http://www.texasnurse.org/
Healthcare in Marketing (Lasik)
Lasik's Methods in Other Health Care Organizations
Customer profiling is a vastly unexplored marketing method in the health industry. While it has been used to target very specific markets, such as potential consumers of elective surgery, other markets have been largely neglected (arber 2001). The reasons for this are many, but mostly they include difficulties with medical data gathering, and legal issues regarding potential customer profiling.
Despite the above-mentioned difficulties, there are several organizations that can and do benefit from customer profiling. One such entity is the pharmaceutical industry (Winterhalter 2002). Here the customer being profiled is normally the health care professional, rather than the patient. y gathering geo-demographic data as well as customer loyalty information from a group of health professionals, pharmaceutical companies can significantly enhance the effectiveness of their marketing practices. This will further benefit not only the professionals, but also the healthcare consumer,…
Barber, F.A., R.K. Thomas, M. Huang. "Developing a profile of LASIK surgery customers." Marketing Health Services, Iss. 2, Vol 21. Chicago: Summer 2001.
Business Wire. "New Customer Wins Position Lawson as Dominant Enterprise E-business Solution Provider to Healthcare Industry." New Orleans, 2001.
Winterhalter, K. "Customer profiling in the healthcare industry." Weber Shandwick, 2002. http://www.browna2.fsnet.co.uk/PMLive/doctor_who_frame.htm
Such equipment should be adequate to ensure personnel are protected from chemical exposure to the eyes, skin, and respiratory tract. PPE may be upgraded or downgraded by the site industrial hygienist, HSM, or qualified Site Safety Officer based upon site conditions and air monitoring results (Levin, et al., 2002)
Work practice and administrative controls
Administrative controls or work practice controls are changes in work procedures such as written safety policies, rules, supervision, schedules, and training with the aim of reducing the interval, frequency, and sternness of exposure to hazardous chemicals or situations. Workers who handle hazardous chemicals in the workplace should be familiar with the administrative controls required fewer than 29 CF 1910.1200, and the OSHA Hazard Communication Standard. This controls are perhaps most important, because they impact your people directly. On the one hand, they are the simplest, since all it takes is education. On the other hand, education…
Annual report on 9/11 health (September, 2009). Retrieved on March 20, 2010 from http://www.nyc.gov/html/fdny/pdf/2009_wtc_medical_working_group_annual_report.pdf
Burright, D. et al., (1999). Evaluation guidelines for air sampling methods utilizing chromatographic analysis. OSHA Salt Lake Technical Center, U.S. Department of Labor: Salt Lake City, UT.
Harris, J.S., (ed.) (1997). Occupational medicine practice guidelines: Evaluation and management of common health problems and functional recovery in workers. The American College of Occupational and Environmental Medicine. Beverly, Mass.: OEM Press.
Levin, S. et al.,. (2002). Health effects of World Trade Center site workers. America Journal of Industrial Medicine 42:545 -- 547.
Centralization and decentralization of HM
Centralized HM operations are conducted within the HM department and they assume that all employee related actions be implemented by the human resources specialists. Such an endeavor creates a context in which the human resource actions are taken in an objective and professional manner. Specifically, the decisions are made based on the organizational benefits and the technical considerations at an overall organizational level. In the case of decentralization nonetheless, the human resource decisions are taken in a less formal manner and they are influenced by personal bias of the medical staff conducting the interviews. The benefit is nevertheless that of the staff decisions being made not on grounds of organizational benefits, but on skills and abilities at a medical level.
A centralized human resource department then supports organizational gains and objectives, whereas a decentralized human resources act supports professional and medical benefits. It is expected…
Connor, E.T., Educational tort liability and malpractice, University of Iowa, http://www.uiowa.edu/~c07p134/tort.htm last accessed on March 3, 2011
Salvador, F.A., Which is better? Formal authority or informal authority? Entrepreneur, http://www.entrepreneur.com.ph/features/article/which-is-better-formal-authority-or-informal-authority last accessed on March 3, 2011
Website of Medicare, http://www.medicare.gov last accessed on March 3, 2011
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.
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.
Health Unit Coordinator Description
A health unit coordinator may also be known as a unit clerk, ward clerk, or unit secretary (Health Unit Coordinator). They help maintain the facility's service and performance. One of the main responsibilities is acting as a liaison between patients and staff, which includes communicating with doctors, nurses, patients, other departments, patients, and visitors that visit the patients.
Prospects of health unit coordinator positions are in hospitals, clinics, nursing homes, health maintenance organizations, and home health agencies all across the nation. Employment opportunities for this position are expected to grow in demand as agencies require more help to coordinate services and performance. The start salary can range from $21,600 to over $24,000. The health unit coordinator may specialize in several different areas, such as reception, scheduling, safety protocols, or patient interaction.
High school courses of algebra, biology, chemistry, computer skills, data processing, psychology, English, composition, social…
Health Unit Coordinator Certification, Exam, and Licensing Information. (2012, Dec 8). Retrieved from Edcation Portal: http://education-portal.com/articles/Health_Unit_Coordinator_Certification_Exam_and_Licensing_Information.html
Health Unit Coordinator. (n.d.). Retrieved from Health Careers Center: http://www.mshealthcareers.com/careers/healthunitcoord.htm
This research focuses on the health impacts of the Industrial evolution on various sectors of the British population, and hypothesizes that working class and poor laborers suffered from poorer health than their wealthier counterparts due to exposure to pollution and to lack of exposure to a varied diet.
Public health and the public health system existing in the 21st century is unrecognizable from what existed just a century before. As Wohl (1983) points out, poverty, ignorance, and poor sanitation plagued British public health throughout the Victorian era. It is important to understand what prompted the changes that led to increased knowledge, awareness, and application of ethical principles in health care. Armed with this knowledge, the bioarchaeologist and health care specialists alike can work together to transform health care outcomes in the future.
In particular, the Industrial evolution impacted individual and public health in significant and measurable ways. Coal…
Wohl, A.S. (1983). Endangered Lives: Public Health in Victorian Britain.London: J.M. Dent.
Health Promotion Lesson Plan
The concept of health promotion is thought of as "the science and art of helping people change their lifestyle to move toward a state of optimal health" (Dunphy et al., 2011, p 25). Serious heart conditions can be prevented, which is why it is so important to utilize community education techniques in order to help try to warn community members of the complications before they occur. This current lesson plan works to create three separate community lesson plans, based on specific age ranges. The age 18-29 focuses primarily on the use of social media and health advocacy efforts in association with the American Heart Association. For ages 30-49, there is also a focus on these two, combined with more community oriented issues, and for 50-60, there is much more of a focus on financial training along with community organized workshops.
Prevention has become a major issue…
References McLeod, Saul. (2010). Erik Erikson. Developmental Psychology. Simply Psychology. Web. http://www.simplypsychology.org/Erik-Erikson.html
Health Care Finance
Assets and Liabilities
Assets and liabilities are found in a balance sheet. Baker and Baker (2011, p. 107) define a balance sheet as a record of "what an organization owns, what it owes, and basically, what it is worth."
Payroll taxes due
Assets, in basic terms, are all those items that an entity owns. In essence, an asset should have some value attributable to it. Current assets, according to Shim and Siegel (2000, p. 25), "are assets expected to be converted into cash or used up within one year or the normal operating cycle of the business, whichever is greater." They include such items as cash and stock. Long-term assets, on the other hand, include all those assets or items an entity does not intend to consume within a single year. Examples include, but…
Baker, J.J. & Baker, R.W. (2011). Health Care Finance: Basic Tools for Nonfinancial Managers (3rd ed.). Sudbury, MA: Jones and Bartlett Publishers.
Shim, J.K. & Siegel, J.G. (2000). Financial Management (3rd ed.). Hauppauge, NY: Barron's Educational Series, Inc.
esearch has shown that good communication amid patients and health care providers is directly connected to a person's happiness, treatment adherence and affirmative health results (Cultural Competency for Health Care Providers, 2007).
The goal of a lot of provider-oriented health it tools is to make relevant patient information flawlessly and unmistakably accessible to providers at the point of care. In so doing, these tools can decrease clinical indecision related to blurred or mistaken patient information that may be found in a handwritten medical record. In the nonexistence of desired information or in the presence of blurred or uncertain data, providers may undervalue patient precise information while at the same time overweighting their own medical viewpoints, suppositions, prejudices, or stereotypes about certain kinds of patients. If apparent and precise patient information is accessible to the clinician, the utilization of this information should augment, getting rid of the need for relying on…
Cultural Competency for Health Care Providers. (2007). Retrieved March 13, 2011, from Web
The health care industry is heavily regulated and has several special risk areas that need to be looked out for. An effective compliance program is necessary in order to mitigate these risks. In addition to the challenges that are associated with taking care of patients, health care providers are subject to huge and sometimes intricate sets of rules that govern the coverage and reimbursement of medical services. Because federal and state sponsored health care programs play such a big role in paying for health care, compliance with these rules are necessary in order to avoid penalties that can occur. These penalties can include such things as recoupment of improper payments, along with sanctions imposed by Medicare and Medicaid against health care businesses that engage in abuse or fraudulent practices (Corporate esponsibility and Corporate Compliance: A esource for Health Care Boards of Directors, (n.d.).
A good health care administrator will…
Corporate Responsibility and Corporate Compliance: A Resource for Health Care Boards of Directors. (n.d.) Retrieved April 3, 2009, from Office of the Inspector General Web site:
Health Administration. (n.d.). Retrieved April 3, 2009, from Web site:
"Studies of the relationship between managed care penetration in the health care market and expenditures for Medicare fee-for-service enrollees have demonstrated the existence of these types of spill over effects" (Bundorf et al., 2004).
Managed care organizations generate these types of spillover effects by increasing competition in the health care market, altering the arrangement of the health care delivery system, and altering physician practice patterns. Studies have found that higher levels of managed care infiltration are linked with lower rates of hospital cost inflation and lower physician fees are consistent with competitive effects. "Other studies demonstrate the impact of managed care on delivery system structure including hospital capacity, hospital admission patterns, the size and composition of the physician workforce and the adoption and use of medical equipment and technologies. More recent evidence has linked market-level managed care activity to the process, but not the outcomes of care" (Bundorf et al.,…
Altman, D.E. And L. Levin. (2005). The Sad History of Health Care Cost Containment as
Told by One Client. Health Affairs, 24(1).
Bodenheimer, T. (2005). High and rising health care costs. part 1: Seeking an explanation.
Annals of Internal Medicine, 142(10), 847-54.