Post on 13-Jan-2016
transcript
Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc.
Health Information Management
Chapter 15
Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Slide 2
Introduction
Health information management is a relatively new field that continues to grow in popularity among students of the health professions.
The advent of computer-based medical records makes this a high-demand career opportunity.
Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Slide 3
This chapter will examine:
How health information is used
Characteristics of high-quality data
Concerns of quality assurance
Importance of HIPAA
Functions of the NCHS
Types of healthcare statistics kept
Total quality management
Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Slide 4
Evolution of the Profession
American Health Information Management Association (AHIMA)
Began as the Association of Record Librarians of North America
Changed name to American Medical Record Association in 1970
Evolved into AHIMA in 1991
Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Slide 5
Advances in technology have brought healthcare from a paper-based environment to a computer-based environment.
Physicians and other healthcare providers can usually access patient and statistical information in a matter of seconds.
Evolution of the Profession
Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Slide 6
Move toward Computer-Based Records
In 2005, one quarter of the nation’s physicians used some form of computer-based medical records.
Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Slide 7
How Use of Electronic Records Reduces Medical Errors
Keeps prescriptions organized
Notes allergies clearly
Reduces costs by avoiding duplicate tests
Can reduce staffing needs
Note: Information entered into the computer is only as reliable as the person who entered the data.
Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Slide 8
Characteristics of High-Quality Health Data
Experts agree on nine characteristics of high-quality health data, which are:
Validity Reliability Completeness Recognizability Timeliness
Relevance Accessibility Security Legality
Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Slide 9
Characteristics of High-Quality Health Data
Validity: synonymous with accuracy. Healthcare information must be accurate to be usable.
Reliability: Healthcare professionals must be able to rely on the information presented.
Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Slide 10
Characteristics of High-Quality Health Data
Completeness: Incomplete records may lack vital information needed to care for the patient.
Recognizability: All users of health information must be able to interpret the data that are presented in the health record.
Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Slide 11
Characteristics of High-Quality Health Data
Timeliness: Health information must be entered into the record as soon as it becomes available so that decisions made are supported by the latest information about the patient’s condition.
Relevance: Information in the record must be relevant to be useful.
Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Slide 12
Characteristics of High-Quality Health Data
Accessibility: Healthcare data must be accessible to multiple users at one time.
Security: Precautions must be taken to prohibit intruders from accessing medical records.
Legality: The record must be completely legible and properly authenticated.
Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Slide 13
Quality Assurance
Activities designed to increase the quality of a product or service through process or system changes that increase efficiency or effectiveness.
Many people assume that quality is only a result of patient satisfaction surveys. This is actually only a small part of the quality-assurance process.
Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Slide 14
Challenges of Quality-Assurance Problems
Quality assurance is concerned with issues revolving around healthcare services, such as:• Overuse
• Underuse
• Misuse
Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Slide 15
Some Overused Treatments
Hysterectomies
Tympanostomy tubes
Antibiotics
Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Slide 16
Some Underused Treatments
Mammograms
Cervical cancer screenings
Beta-blockers for heart patients
Eye examinations for diabetic patients
Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Slide 17
Some Underused Treatments (cont’d)
Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Slide 18
Misuses of Healthcare Services
Laboratory tests that provide erroneous results
Medication errors
Hospital injuries to patients
Nosocomial infections
Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Slide 19
Discharge Rates
Percentages of people who leave a hospital without dying.
These rates are higher in some areas of the country than in others.
Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Slide 20
HIPAA
Health Insurance Portability and Accountability Act (HIPAA)
Became law in 1996
Became effective April 14, 2003
Applies to records that are created or maintained by healthcare providers, health plans, and healthcare clearinghouses that engage in electronic transactions
Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Slide 21
HIPAA Regulation
HIPAA is regulated by the Office of Civil Rights (OCR), which is a division of the Department of Health and Human Services.
Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Slide 22
Provisions of HIPAA’s Privacy Rule
Patients must give specific authorization before protected information can be disclosed.
Covered entities must provide patients with a copy of their privacy practices.
Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Slide 23
Provisions of HIPAA’s Privacy Rule
Pharmacies, health plans, and other covered entities must have specific patient permission before sending marketing materials.
Covered entities cannot use business associate agreements to circumvent the rule’s marketing provisions.
Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Slide 24
Provisions of HIPAA’s Privacy Rule
Patients generally can access their personal medical records and request changes to correct any errors.
Patients can request an accounting of nonroutine uses and disclosures of their personal health information.
Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Slide 25
Patient Confidentiality
Patients have the right to expect patient confidentiality with regard to their health records.
Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Slide 26
National Center for Health Statistics (NCHS)
Division of the Centers for Disease Control and Prevention (CDC)
Primary provider of health information statistics
Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Slide 27
NCHS Functions
Documentation of health status of the population and its subgroups
Identification of disparities in health status and use of healthcare by socioeconomic factors
Description of experiences with the healthcare system
Evaluation of the impact of health policies and programs
Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Slide 28
NCHS Functions
Monitoring of trends in health status and healthcare delivery
Identification of health problems
Support for biomedical and health services research
Provision of information for making changes in public policies and programs
Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Slide 29
Types of NCHS Statistics
Teenage pregnancy
Incidence of HIV infection
Alcohol and drug use
Births
Deaths
Communicable diseases
Infant health and mortality
Leading causes of death
Life expectancy
Sexually transmitted diseases
Suicide
Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Slide 30
Total Quality Management (TQM)
TQM consists of management and control activities designed to enhance the quality of services provided to patients.
Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Slide 31
Total Quality Management (TQM) (cont’d)
Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Slide 32
TQM Concept
Much of today’s TQM concepts originated with W. Edwards Deming.
Deming stressed an emphasis on quality rather than quantity, applying his principles to various types of businesses and managers.
Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Slide 33
Deming’s 14 Points for Management
Create constancy of purpose toward improvement of product and service.
Adopt the new philosophy.
Cease dependence on inspection to achieve quality.
End the practice of awarding business on the basis of price tag.
Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Slide 34
Deming’s 14 Points for Management
Constantly improve the system of production and service.
Institute training on the job.
Institute leadership.
Drive out fear so that everyone can work effectively for the company.
Break down barriers between departments.
Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Slide 35
Deming’s 14 Points for Management
Eliminate slogans, exhortations, and targets for the work force asking for zero defects and new levels of productivity.
Remove barriers that rob the hourly worker of his right to pride of workmanship.
Remove barriers that rob people in management and in engineering of their right to pride of workmanship.
Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Slide 36
Deming’s 14 Points for Management
Institute a vigorous program of education and self-improvement.
Make the company transformation everyone’s job.
Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Slide 37
The Joint Commission (TJC)
Nonprofit organization
Provides accreditation services to healthcare facilities
Voluntary process, but vital to healthcare organizations
Copyright © 2007 by Saunders, Inc., an imprint of Elsevier Inc. Slide 38
Risk Management
Any occurrence that could result in patient injury or any type of financial loss to the facility is called a risk. Risk management efforts focus on:
Loss prevention
Avoiding patient injury
Avoiding any financial loss resulting from liability
Avoidance of negative publicity resulting from sentinel events