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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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Presentation Transcript
health care today
Health Care Today
  • Structure
  • Process
  • Outcomes
structure in flux
Inpatient

Outpatient

Ambulatory Care

Office Practice

Home Care/Home Health

Nursing Home

Skilled Nursing Care

Rehabilitation

Longterm Care

Assisted Living

Telehealth

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, http://www.nap.edu)
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 http://www.ncvhs.hhs.gov/
  • Includes healthcare provider, population health, and personal health components http://www.ncvhs.hhs.gov/nhiilayo.pdf
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
  • http://www.hhs.gov/onchit/
critical standards work
Critical Standards Work
  • 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
  • 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
  • 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
  • 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
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