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Flashcards in Unit 2: Overview of Information Systems Deck (43):
1

Tri-service Initiative

Began w/ the Integrated Inpatient Product Team (IIPT) that is operated by the Military Healthcare System (MHS).

2

Based on the goals of initiatives, what do our electronic health recs aim to accomplish?

They aim to fully standardize and optimize the use of best practices, minimize trng., decrease variances so the MHS can maximize use of its Information Technology investment.

3

What are the primary uses of CHCS?

Primarily used for booking appts. and for some order entry procedures.

4

What are the advantages of using AHLTA?

AHLTA means shorter waits for patients, faster reporting of diagnostic test results, improved used of medical and professional resources, and significant improvement in the quality of patient care.

5

What are the AHLTA functions?

It is used for all aspects of patient care, including order entry and coding.

6

The use of electronic health record allows for --

Standardization of processes and sharing of docs across DOD and VA Tx facilities.

7

why are electronic health records different in some MTFs?

Initially, MTFs were allowed to customize/modify their electronic health rec content to meet workflow/clinical needs. this led to a diff. version at every MTF

8

What are the two primary purposes of ASIMS?

1) ensure individual medical readiness requirements are current
2) ensure all AF members have been provided necessary or recommended preventive services

9

What are the functions of the IMR software?

It is an automated way of recording, verifying, and storing vital info about individual medical readiness metrics, preventive health assessment (PHA) exams, individual medical readiness, physical examination standards, and clinical preventive services standards.

10

What is the primary function of IMR?

To provide "real-time" medical readiness assessment of IMR requirements to CCs, individuals, and PCMs so they can manage and optimize the readiness stats of their assigned or enrolled AF personnel.

11

IMR Green status represents --

-Immunizations complete/up-to-date
-PHA within the last 18 months
-Dental class 1-2
-Lab reqs current
-No deployment limiting profile

12

IMR Yellow status represents --

Items out of date/or needing attention

13

IMR Red status represents --

-Immunizations missing or out of date
-PHA more than 18 months ago
-Dental class 3 or 4
-Lab reqs missing
-DLC profile

14

AFCITA

Air Force Complete Immunizations Tracking Application -- an automated database program that records, verifies, and stores, clinical readiness info about immunizations

15

Dental Classifications

Managed through the Dental Classification Management System (DCMS) to PIMR automatically.
Class 1-2 will be reflected as GREEN
Class 3-4 will reflect as RED

16

What references are used for deployment limiting profiles?

AFI 48-123, Medical Examinations and Standards
AFI 10-203, Duty Limiting Conditions

17

HEAR survey --

Health Evaluation Assessment Review - is one of the health stratification surveys used to assist the PCM managing care for their enrolled population; provides info related to pt. health risk and needs, projects services: including need for prevention, case mgmt., and disease mgmt. programs.

18

Condition Mgmt

Is a system that coordinates and improves all of the services provided to patients with a given set of medical conditions

19

Demand Mgmt

Once implemented, it will reflect the activities of a health system designed o create a healthy environment, decrease morbidity and mortality, and encourage the use of effective decision-support and self-mgmt. tools

20

What does Condition (Disease) Mgmt target?

High cost, high volume, and complex diseases/conditions, using performance metric tools to focus on key processes and outcomes.

21

Medicare

Health care financing for the elderly

22

Medicaid

healthcare financing for the poor

23

Health Maintenance Organization (HMO) Act of 1973

Act enables managed med care plan to increase in numbers and expanded enrollments though health care programs financed by grants, contracts, and loans.

24

TRICARE Region 1/Northeast

Sierra HMO

25

TRICARE Region 2/Mid-Atlantic

Humana

26

TRICARE Region 3/Southeast

Humana

27

TRICARE Region 4/Gulf South

Humana

28

TRICARE Region 5/Heartland

Humana

29

TRICARE Region 6/Southwest

Health Net Fed. Services (HNFS)

30

TRICARE Region 7/Central

TriWest

31

TRICARE Region 8/Central

TriWest

32

TRICARE Region 9/SoCal

HNFS

33

TRICARE Region 10/Golden State

HNFS

34

TRICARE Region 11/Northwest to include Alaska

HNFS

35

TRICARE Region 12/Hawaii

Contractor through lead agent (Not HMO)

36

TRICARE Region 13/TRICARE EU

Contractor through lead agent (Not HMO)

37

TRICARE Region 14/TRICARE PAC

Contractor through lead agent (Not HMO)

38

TRICARE Region 15/TRICARE LAT AMER. & CANADA

Contractor through lead agent (Not HMO)

39

What are the three Tricare options for beneficiaries?

TRICARE PRIME
TRICARE STANDARD
TRICARE EXTRA

40

Tricare PRIME

- Voluntary HMO option
- AD & Deps do not have to pay the annual enrollment fee
- Receive care from military and civilian providers

41

Tricare STANDARD

- AKA -- CHAMPUS
- no required enrollment
- May use Tricare Extra
- Tricare will pay 0% of approved allowable cost for outpatient care for AD families and 75% for retirees, their fams and all other eligible.

42

Tricare EXTRA

- Pt have to use a provider listed on the network of civilian health care professionals.
- similar to standard
- No enrollment or annual fee
- you have to satisfy and annual deductible for outpatient care
- Tricare pays an additional 5% of the healthcare services when pts use the network providers offered through Tricare Extra
-Raises cost share 85% for AD fam members and 80% for retirees and their family members and other eligible beneficiaries

43

Tricare For Life

- New program as of 1 OCt. 2001
- all Medicare eligible military (excluding AD fam members' beneficiaries become eligible for all Tricare benefits)
- Medicare eligible beneficiaries must enroll in Medicare Part B