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U.S. Healthcare System > Exam 3 Review > Flashcards

Exam 3 Review Flashcards

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1
Q

Factors for successful HIT implementation

A
  1. uniform adoption of technology
  2. reliable HIT infrastructure
  3. system that is appropriate for the practice
  4. plan that details milestones of implementation
  5. ongoing training of all employees
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2
Q

electronic clinical decision support systems (CDSSs)

A

systems designed to integrate medical information, patient information, and decision making tools

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3
Q

4 key functions of a clinical decision support system

A
  1. administrative
  2. case management
  3. cost control
  4. decision support
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4
Q

e-prescribing

A

form of CPOE, consists of medication history, benefits information, and processing new and existing presscriptions

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5
Q

pharmacy benefit manager

A

PBM

  • -uses technology-based tools to assess and evaluate management of prescription component so it can be customized to address needs of the organization
  • -companies that administer drug benefits for employers and health insurance carriers
  • -integrate medical and pharmacy data of population to determine which interventions are most cost-effective and appropriate
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6
Q

telehealth

A

broad term that encompasses the use of IT to deliver education, research, and clinical care

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7
Q

Committee on Operating Rules for Information Exchange (CORE)

A

one of the largest electronic payment systems in the world, and has set up standards and operating rules for streamlining processes between providers and healthcare plans
-allows for real time access to patient information pre- and post- care

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8
Q

PhreesiaPad

A

wireless device with touch screen keyboard that patients can enter their demographic information and the reason they are visiting the doctor
-eliminates need for patients to replicate information each time they visit the doctor

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9
Q

PatientPoint

A

provides education to patients electronically while in the waiting room or exam room

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10
Q

MelaFind optical scanner

A

provides additional information a doctor can use in determining whether or not to order a biopsy
-goal is to reduce number of patients with unnecessary scars, and eliminates cost of unnecessary procedures

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11
Q

Civil law

A

focuses on wrongful acts against individuals and organizations based on contractual violations

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12
Q

defensive medicine

A

providers often order more tests and provide more services than necessary to protect themselves from malpractice lawsuits

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13
Q

Emergency Medical Treatment and Active Labor Act

A

EMTALA
1986
healthcare provider or organization is obligated to provide care to someone who has placed their trust in them
Medicare participants must receive emergency care from a hospital that provides dedicated emergency services

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14
Q

Children’s Health Insurance Program

A

CHIP

provides coverage for low-income children younger than 19 who live above the income level requirement for Medicaid

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15
Q

Civil Rights Act of 1964

A

prohibits discrimination based on race, sex, color, religion, and national origin

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16
Q

Age Discrimination in Employment Act of 1967

A

protects employees and job applicants 40 years and older from discrimination as it applies to hiring, firing, promotion, layoffs, training, assignments, and benefits

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17
Q

Pregnancy Discrimination Act of 1978

A

protects female employees who are discriminated against based on pregnancy related conditions, which constitutes illegal sex discrimination
-ex) a pregnant woman must be treated like anyone else, if she has morning sickness they have to offer sick leave if they allow sick leave for other nausea illnesses

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18
Q

Americans with Disabilities Act of 1990

A

focuses on individuals who are considered disabled, and ensures these individuals were not discriminated against and also allows reasonable accommodation

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19
Q

reasonable accommodation

A

employers that take reasonable action to accommodate a disabled individual such as providing special computer equipment or furniture to accommodate a physical limitation, and it should not cause undue financial hardship to the employer

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20
Q

Consolidate Omnibus Budget Reconciliation Act of 1986

A

COBRA
protects employees who lost or changed employers, they can keep insurance if they pay 102% of the premium, and also resulted in job lock because people were afraid to change jobs

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21
Q

Health Insurance Portability and Accountability Act of 1996

A

HIPAA
promotes patient information and confidentiality in a secure environment
-first federal legislation that provides in-depth protection of consumer’s health information

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22
Q

employee wellness programs

A

include promotion of exercise, health risk appraisals, disease management, and healthcare coaching

  • popular employee benefit
  • must promote health and cannot be a subterfuge discriminating against an employee
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23
Q

National Defense Authorization Act of 2008

A

employee can take up to 12 weeks of leave if a child, spouse, or parent has been called to active duty, and if a service member is injured the employee can take up to 26 weeks of leave

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24
Q

Patient Protection and Affordable Care Act of 2010

A

increases dependent coverage of health insurance to 26, and established a web marketplace to increase consumer awareness

  • eliminated lifetime and annual caps on reimbursement
  • created temporary reinsurance program for early retirees
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25
stakeholder management
focuses on the relationship between organizations and constituents, and how management recognizes the different expectations of each group
26
respect for autonomy
decision making may be different and healthcare providers must respect their patients' decisions even if they differ
27
Physician Payment Sunshine Act
part of the ACA, requires manufacturers of drugs, medical devices, and other products with relationships to CMS providers and CHIP programs to submit reports annually in payments and items of value
28
stewardship model of public health
public health officials should achieve the stated health outcomes for the population while minimizing restrictions on people's freedom of choice
29
Institutional Review Boards (IRB)
group formally designated to review and monitor biomedical research involving human subjects, and they have the authority to approve, require modifications in, or disapprove research
30
informed consent
one of the basic ethical protections for human subject research - allows individual to consider personal issues - provides opportunity to make a choice - requires disclosure of appropriate information
31
common rule elements of informed consent
- written statement with purpose and length of study - procedures and if they are experimental - foreseen risks and benefits - alternative procedures
32
preimplantation genetic diagnosis
PGD tests the embryo for tissue compatibility with their siblings prior to being transplanted into the mother, and if it is compatible and a sibling becomes ill, the baby can provide bone marrow transplants
33
genetic testing
carried out on populations based on age, gender, or other risk factors to determine if they are at risk for a serious genetic disease
34
diagnostic testing
identifies disease when a person exhibits symptoms
35
predictive and asymptomatic testing
identify gene changes that may increase likelihood of a person developing a disease
36
carrier testing
identify individuals who carry a gene that is linked to a disease
37
prenatal testing
identify fetuses with potential diseases or conditions
38
pharmacogenomic testing
assess how medicines react to an individual's genetic makeup
39
research genetic testing
focuses on how genes impact disease development
40
physician-assisted suicide
physician provides the means for death, but the patient ultimately administers the dose -legal in Oregon, Washington, and Vermont
41
presumed consent
if a parent does not actively oppose the transplantation, the procedure automatically occurs--in the US the consent must be received from family first
42
how many Americans suffer from a mental disorder in any one year?
1/4
43
half of all lifetime mental health illnesses begin by what age?
14
44
three-quarters of all lifetime mental health illnesses begin by age what?
24
45
annual economic, indirect cost of mental illness is estimated to be?
$79 billion
46
how many students with a mental disorder age 14 and older drop out of high school?
over 50%
47
mental health ranks what as limitation on health and productivity?
second only to heart disease
48
mental disorders
conditions that alter thinking processes, moods, or behavior that result in dysfunction or stress, most common are phobias, substance abuse, and affective disorders
49
phobias
excessive fear of objects or activies
50
behavioral services are provided by who?
psychiatrists, psychologists, social workers, nurses, counselors, and therapists
51
psychiatrists
specialty physicians who can prescribe medication and admit patients
52
psychologists
treat mental health but cannot prescribe drugs
53
commitment laws
laws that enable family members, law enforcement, or healthcare professionals to commit a person to a facility or a treatment program
54
voluntary commitment
people commit themselves, and they can leave of their own free will
55
involuntary commitment
people are being forced to receive treatment or are committed against their wishes, and cannot leave of their own free will
56
sections in the de facto mental health service system
specialty healthcare providers social service sector nonprofit groups and organizations
57
Mental Health Parity Act of 1996
ensures mental health services are being reimbursed on an equal level of traditional medical care 2008-group insurance plans that have coverage for mental illness and substance use disorders to provide benefits the same as other procedures
58
National Institute of Mental Health
world's largest funding agency of mental health research, refused to endorse 2013 DSM -9% of teens suffer from anxiety disorder, only 18% of those receive care
59
suicide is what leading cause of death among 5-14 years old
5
60
telebehavioral health
method of service delivery that broadens the availability to, quality of, and access to care across all behavioral health program areas--video conferencing
61
what percentage of the homeless population has mental health issues?
25%
62
NIMH's 4 Core Areas of Focus for mental health care
1. Promote Discovery in the Brain and Behavioral Sciences to Fuel Research on the Causes of Mental Disorders 2. Chart Mental Illness Trajectories to Determine When, Where, and How to Intervene 3. Develop New and Better Interventions that Incorporate the Diverse Needs and Circumstances of People with Mental Illnesses 4. Strengthen the Public Health Impact of NIMH-Supported Research
63
CAM
complementary and alternative medicine complementary-nonmainstream approach together with conventional medicine alternative-nonmainstream approach in place of conventional medicine
64
examples of CAM
acupuncture, chiropractic manipulation, diet therapies, meditation, natural products, yoga, and massage
65
what percentage of adults used CAM
40%
66
what was the most common reason people used CAM?
back pain
67
pay for performance
P4P aka value based purchasing healthcare payment systems that reward healthcare providers for their efficiency
68
telemedicine
use of information technology to enable healthcare providers to communicate with rural care providers regarding patient care or to communicate directly with patients basic form-telephone consultation
69
telemedicine is most frequently used in which fields?
pathology and radiology, images can be transmitted to a distant location
70
minute clinics
drugstore clinics in stores such as Rite Aid, Walgreen's, and CVS that increase access to care. they are open late, open on weekends, and no requirements for appointment
71
Japan's healthcare system
citizens must be covered by employee or national insurance for self employed or 75 years and older - enrollees must pay 30% coinsurance, children have 20%, and 70 years and older have 10% - Citizens Health Insurance covers everyone else - 9.5% GDP, may triple in 20 years
72
France's healthcare system
11. 6% of GDP - universal coverage for 99% of citizens - General National Insurance Scheme covers 80% citizens - enrollees pay 20% of salary, and 90% citizens have supplemental insurance - American doctors earn 5x average wage, French doctors earn 2x average wage - limit prescriptions of name brand drugs
73
Switzerland's healthcare system
- considered one of the best in the world - 99.5% citizens are covered, all residents are required to purchase - 11.7% GDP - citizens buy from private providers, they can't make profit on basic plan but can sell supplemental plan
74
health or medical informatics
science of computer application that supports clinical and research data in different areas of healthcare

U.S. Healthcare System (3 decks)

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