3-4 page essay based on chapter 5!! Health Care Computer Applications
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9781133787778_PPT_ch05.pptxIntroduction to Healthcare Information Technology
Chapter Five
Medical Business Operations
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Objectives
Define frequently used healthcare terms
Identify and describe the functions of certain healthcare departments
Describe the uses for clinical software
List and describe the steps in the clinical process or environment
Identify and describe the functions of various medical devices
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Healthcare IT: Challenges and Opportunities
Health care is one of the largest industries in the US
14.2 million workers
Bureau of Labor Statistics forecast:
Over 3 million new jobs in healthcare between 2008 and 2018
Home healthcare services
One of the fastest growing areas until 2018
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Medical Terminology
Healthcare
Specialized terminology
Numerous acronyms
Imaging
Often called radiology
Use of technologies to provide visual representation of internal body structures
Can eliminate the need for biopsies or surgery in some cases
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Medical Terminology (cont’d.)
Major types of imaging technologies
X-ray
CT scan
Fluoroscopy
Magnetic resonance imaging (MRI)
Ultrasound
Nuclear medicine
Newer techniques
Capsule endoscopy
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Figure 5-1 Modern x-ray machine
© Tyler Olson/www.Shutterstock.com
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Primary Care Physician
Over 20 physician specialties in medicine
Primary care physician specialties
Family or general practice
Broad range of ailments and chronic disorders
Internal medicine
Adult diseases and chronic disorders
Pediatrics
Diagnosis and treatment of children
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Stat
Term meaning “immediately”
Derived from Latin word statim
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Acuity
Measure of the degree of patient disease or injury
Can refer to:
Severity
Time sensitivity
Physical effects
Psychological suffering
High-acuity patient less healthy than low-acuity patient, in general
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Code Blue
Emergency code
Indicates patient needs immediate help
Can be announced over the public address system
Expedites correct staff moving to location where patient needs help
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Trauma Levels
Trauma
Physical wound or injury to the body
May be caused by accident or violence
Commonly treated at hospital ERs
Trauma center
Centers classified according to their ability to handle different types of trauma
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Table 5-1 Trauma center levels and resources
© Cengage Learning 2013
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Controlled Substances
Controlled Substances Act of 1970
Established government control of certain drugs and chemicals known as controlled substances
Classification scheme with five levels
Schedule 1 substances
High abuse potential
No currently accepted medical use
Schedule 2 substances
Can cause dependence
High abuse potential
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Controlled Substances (cont’d.)
Schedule 3 substances
Lower abuse potential than schedule 1 and 2
Example: drugs containing less than 15mg hydrocodone per dosage
Schedule 4 substances
Lower abuse potential than schedule 3
Examples: diazepam, alprazolam, propoxyphene
Schedule 5 substances
Cough and cold preparations with limited quantities of certain narcotics
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Controlled Substances (cont’d.)
Healthcare providers that use controlled substances:
Have well-defined policies and procedures for use
Example controlled substance policy components
Locked storage
Staff authorization to access
Substance abuse protocol
Substance audits
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Electronic Medical Record
Medical record (chart)
Location where provider records aspects of diagnosis and treatment
Electronic medical record
Can be viewed by authorized individuals anywhere in the world
Can be interfaced to other electronic systems
Lab or radiology results can be instantly updated
Controlling access can be more difficult than with paper record
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Electronic Health Record
Broader than an EMR
Includes demographics, billing, and all historical medical information
Gives providers the widest possible perspective on a patient
Potential for abuse of information exists
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Medical Departments
Ambulatory/day surgery
Provides surgery on an outpatient basis
Behavioral health
Provides care for mental disorders
Cardiac care units
Treat patients requiring specialized cardiac monitoring
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Medical Departments (cont’d.)
Cardiovascular
Includes advanced cardiac specialties
Electrophysiology
Heart failure
Heart transplantation
Dermatology
Treats skin diseases:
Usually on an outpatient basis
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Medical Departments (cont’d.)
Ear, nose, and throat
Also called otolaryngology
Facial plastic surgery
Laryngology (voice)
Neuro-otology (middle/inner ear, base of skull)
Otology (ear)
Rhinology (sinuses)
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Medical Departments (cont’d.)
Emergency room
Treats patients with life-threatening condition or immediate need
Certified to a specific trauma level
Intensive care unit
Treats patients needing high level of specialized care
Can include intensive monitoring with electronic equipment
Patient may need ventilator, feeding tubes, etc.
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Figure 5-3 Intensive care monitoring
© Edwin Verin/www.Shutterstock.com
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Medical Departments (cont’d.)
Laboratory
Provides chemical, microbial, microscopic, and other studies to diagnose and treat injury
Medical/surgical
Care for adult patients before and after surgery
Nuclear medicine
Uses radioactive decay of radiopharmaceuticals to diagnose and treat disease
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Medical Departments (cont’d.)
Obstetrics/gynecology
Provides care for the female reproductive system
Obstetrics provides care surrounding childbirth
OB/GYN related departments
Family birth center
Labor and delivery
Neonatal intensive unit
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Medical Departments (cont’d.)
Occupational therapy
Care for patients recovering from injury to regain work-related skills
Helping people with disabilities accomplish self-care tasks
Oncology
Care for cancer patients
Operating room
Department where surgical operations are conducted
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Medical Departments (cont’d.)
Ophthalmology
Diagnose and treat various eye conditions
Pediatrics
Specialized treatment for children
Patients may be medium or high acuity
Physical therapy
Assists patients to regain lost range of motion
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Medical Departments (cont’d.)
Plastic surgery
Provides reconstruction of the human body
Post-anesthesia care unit
Provides care during recovery from anesthesia
Radiology
Provides imaging equipment using x-ray, ultrasound, or nuclear isotopes to diagnose disease or injury
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Medical Departments (cont’d.)
Respiratory
Provides breathing treatments for inpatients or outpatients
Bronchodilators
Pulmonary rehabilitation
Mechanical ventilation
Transitional/progressive care unit
Provides transitional care between CCU/ICU and standard care unit
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Clinical Software
Software
Set of instructions that helps hardware process data into information
Clinical software
Used to manage data and information in a clinical environment
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Patient Tracking
Patient tracking software benefits
Tracks services provided
Manages patient demographics
Manages patient visit history
Tracks time-specific illnesses like allergies
Many patient tracking systems can interface with scheduling, medical records, and lab software packages
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Scheduling
Scheduling software manages patient scheduling process
Capabilities
Quickly scan for open appointments
Track patient cancellations, no-shows, and reschedules
Track patient visits by time of check-in and departure
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Order Entry
Computerized physician order entry (CPOE)
Electronic systems transmit physician’s orders to other healthcare professionals
Advantages of CPOE
Instant availability of patient’s medical history
Current information helps prevent unwanted drug interactions
Statistical reports improve resource management
Linking diagnoses to the order improves billing management
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Billing/Coding/Auditing
Billing software helps manage billing process
Software decision engines can validate claims
Submits claims to appropriate payer
International Statistical Classification of Diseases and Related Health Problems Codes (ICD-9)
List of over 13,000 codes used in billing
ICD-10
Complete revision of the diagnosis code set
Includes about 68,000 codes
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Table 5-2 ICD-9 and ICD-10 code examples
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Billing/Coding/Auditing (cont’d.)
Audit software
Computer algorithms determine whether correct CPT and ICD codes are used
Can use historical data for trending and analysis to predict and improve performance
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Practice Management
Practice management software (PMS) functions
Patient tracking
Scheduling
Computerized physician order entry
Billing
Coding
Audit
PMS can be interfaced with EMR systems
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The Clinical Environment
Clinical process (clinical environment)
Sequence of operations that must occur for the patient to be examined, diagnosed, and treated
May vary by environment
Common features of the clinical environment
Registration, consultation, examination, CPOE, dictation/transcription, referrals
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Registration
Patient must be registered or admitted:
Prior to being seen by medical staff
Examples of patient data collected during registration
Contact information
Billing information
Next of kin
Current medications
Other pertinent information
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Consultation
Also known as medical history
Questions about pain levels, location, and intensity
Brief history of activity:
To determine if behavior or actions contributed to the illness
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Examination
Checking the patient’s physical status
Vital signs
Body temperature
Blood pressure
Pulse rate
Respiratory rate
Initial examination normally performed by nurse or other medical professional
Patient examined in more detail by a physician
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Physician Order Entry
Process of storing and transmitting orders to other healthcare providers
Types of order entry
Handwritten or typed paper orders
Verbal orders
CPOE
Digital signatures
Encrypted messages similar to handwritten signatures
Allow for electronic transmission and storage
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Dictation/Transcription
Used with verbal orders
Centralized voice-recording system shared among physicians
Transcriptionist transcribes orders to electronic, paper, or film format
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Referrals/Consults
Physician may refer (send) patient to another professional for further diagnosis
Consult
Communication between physicians or specialists regarding a patient’s diagnosis or treatment
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Medical Devices
FDA regulates the manufacture and distribution of medical devices in the US
Definition of medical device
Recognized in the official National Formulary or the United States Pharmacopoeia
Intended for use in the diagnosis or prevention of disease
Intended to affect the structure or function of the body without chemical action
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Computerized Axial Tomography Scanner
Tomography
Imaging technique in which sections are created by a penetrating wave
Computerized axial tomography (CAT or CT)
X-ray system in which the tomography is created by computer processing
Advantages of CAT scans
High contrast resolution
Tissues that differ in density may be distinguished
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Electrocardiogram Machine
Electrocardiogram (EKG or ECG)
Two-dimensional representation of electrical heart activity
Read by trained professionals to detect heart disease or abnormality
EKG machines
Commonly transported by hand or small cart
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Electroencephalograph Machine
Measures ionic current flows within the brain’s neurons
Usually portable and transported by utility cart
Trained professionals can read EEG:
To determine disorders such as coma, epilepsy, and brain death
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Glucose Monitor
Portable electronic device that directly reads level of glucose in the blood
Results available in seconds
Used in diagnosis of diabetes mellitus
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Magnetic Resonance Imaging
Uses very strong magnetic fields to create image of internal body structures
Certain viewpoints more easily obtained than with other imaging techniques
Greater detail of internal body structures compared with traditional techniques
MRI machines
Large (room-size)
Complex
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Figure 5-6 Human brain scan from an MRI
© Donna Beeler/www.Shutterstock.com
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Portable X-Ray Machine
X-ray machine
Uses x-rays to cast static shadows of internal body structures on film or image sensor
Large devices (typically room-size)
Portable x-ray machine
Can be transported to the patient:
In cases where patient cannot be easily transported to a traditional x-ray machine
Machines are portable yet heavy
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Positron Emission Tomography
Positronic emission tomography (PET) scans
Certain radiopharmaceuticals behave in different ways in different body organs
Radiopharmaceutical administered to a patient emits gamma rays
PET scanner creates 3D image of tracer concentration
Scanners are large and complex
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Ultrasound
Uses high-frequency sound waves to image soft tissue structures
Image quality less detailed than x-ray or other technologies
Ultrasound uses
Evaluating fetal health during pregnancy
Evaluating blood flow to the brain
Diagnosis of heart abnormalities
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Vascular/Nuclear Stress Test
Cardiac stress test
Used to determine the heart’s response to physical stress
Vascular or nuclear stress test
Uses radiopharmaceuticals that emit gamma rays
Gamma camera captures detailed images of blood flow in the heart
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Vitals Cuff
Standard baseline measurements
Body temperature
Blood pressure
Pulse rate
Respiratory rate
Vitals cuff
Device that integrates the entire vital sign measurement process
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Medical Interfaces
Standards for exchange of health information
Health Level Seven
e-prescribing
Continuity of Care Document (CCD)
Continuity of Care Record (CCR)
International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10)
Current Procedural Terminology (CPT)
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Medical Interfaces (cont’d.)
Standards for exchange of health information (cont’d.)
Systematized Nomenclature of Medicine (Snomed)
National Drug Code ID (NDCID)
Picture archiving and communication system (PACS)
Evaluation and Management Coding (E/M codes)
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Summary
Health care has specialized terminology and numerous acronyms
Hospitals have different medical departments that provide different types of patient care
Clinical software is used to manage and manipulate data and information in the clinical environment
The healthcare environment workflow may include registration, consultation, examination, physician order entry, dictation/transcription, and referrals or consults
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Summary (cont’d.)
Medical devices are used to diagnose and treat patients and are regulated by the FDA
There are many interfaces and standards that support information sharing between devices and systems
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