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Items out of date/or needing attention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-Immunizations missing or out of date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
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