Alphabet soup has joined chicken soup for health
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Alphabet Soup Has Joined Chicken Soup for Health. Carol J. Bickford, PhD, RN,BC [email protected] Health Care Today. Structure Process Outcomes. Inpatient Outpatient Ambulatory Care Office Practice Home Care/Home Health. Nursing Home Skilled Nursing Care Rehabilitation Longterm Care

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Health care today
Health Care Today

  • Structure

  • Process

  • Outcomes

Structure in flux



Ambulatory Care

Office Practice

Home Care/Home Health

Nursing Home

Skilled Nursing Care


Longterm Care

Assisted Living


Structure In Flux

Care process evolving
Care Process Evolving

  • Hospitals are critical care centers

  • Same day surgery and home care burden

  • Remote monitoring

  • Call for healthcare reform and national coverage

  • Who pays the bill? CMS, insurance plans, employers, individual pockets

First alphabet terms
First Alphabet Terms

  • MD, DO, PA

  • Registered Nurse

  • Advanced Practice Registered Nurse

    • CRNA - Certified Registered Nurse Anesthetist

    • CNM - Certified Nurse Midwife

    • NP - Nurse Practitioner

    • CNS - Clinical Nurse Specialist

Paper versus electronic
Paper Versus Electronic

  • Paper record format still predominant

  • CPR, EMR, EHR finally gaining implementation momentum long after 1991 IOM report

  • The Computer-Based Patient Record: An Essential Technology for Health Care, Revised Edition (1997,

Evidence based practice medicine
Evidence-based Practice/Medicine

  • NIH Roadmap-research to practice

  • National Guidelines Clearinghouse

  • National Library of Medicine

National health information infrastructure nhii
National Health Information Infrastructure (NHII)

  • Has been under discussion by National Committee on Vital and Health Statistics (NCVHS) for many years

  • Includes healthcare provider, population health, and personal health components

Nhii includes work about
NHII Includes Work About

  • CHI - Consolidated Health Informatics

  • RHIO - Regional Health Information Organizations

Office of the national health information technology coordinator onchit
Office of the National Health Information Technology Coordinator (ONCHIT)

  • Framework for strategic action

    • Inform clinical practice;

    • Interconnect clinicians;

    • Personalize care; and

    • Improve population health

  • David Brailer, MD, PhD, National Health Information Technology Coordinator


Critical standards work
Critical Standards Work Coordinator (ONCHIT)

  • HL7 – Health Level 7 – message format and now content

  • ICD-9 and ICD-10 – diagnosis

  • CPT-4 – outpatient procedures

  • HCPCS – inpatient procedures

  • SNOMED – NLM secured low cost national license

  • ABCcodes – complementary and alternative care

Electronic format
Electronic Format Coordinator (ONCHIT)

  • ASTM E-31, ISO TC-215, ANSI

  • E-mail and Instant Messaging

  • ANSI/ARMA 9-2004, Requirements for Managing Electronic Messages as Records

Action plan
Action Plan Coordinator (ONCHIT)

  • Confirm who is your healthcare provider and what are their qualifications

  • Ask your healthcare provider about their implementation of the EHR

  • Monitor the NCVHS testimony via webcast or personal attendance

Action plan1
Action Plan Coordinator (ONCHIT)

  • Express your concerns/decisions about a unique personal identifier

  • Monitor CMS, DHHS, HIPAA, and other health related websites for opportunities to provide public comment

  • Check out ARMA’s Health Industry ISG