Saturday, November 30, 2013

Assignment 14 notes

Ohio does have a state immunization registry.  The ODH Immunization Program seeks to prevent 17 vaccine-preventable diseases with currently available vaccines. The diseases include:
Diphtheria, tetanus and pertussis
Haemophilus influenzae type b                
Hepatitis A
Hepatitis B
Human papillomavirus
Measles, mumps and rubella    
Meningococcal  (meningitis)
Pneumococcal  (pneumonia)  
Varicella  (chicken pox)
Zoster (shingles- adults only)

Diseases on the notifiable/reportable list can be found at:

They are classified as:

Class A
Report immediately by telephone

Class B1
Report by the end of the next business day

Class B2
Report by the end of the work week

Class C
Report outbreaks by the end of the next business day

Saturday, November 23, 2013

Assignment 13 Legal

Assignment 13- Legal
Five common categories of information on a medical staff application are:  Personal information (including residence status), medical education, formal medical training (residency/fellowship), licensure (active) and Certifications.  I believe these are the most important categories needed.  The personal information should include residence status because it will help determine where the candidate is located and if they would need to relocate for the position.  Medical education is important in researching the candidates degrees received for validity.  Formal medical training should include information on residency and fellowships.  This information will help in determining how much experience the candidate has received and in what type of settings they have worked in to get that experience.  Licensure and certifications both help provide the candidates medical credential validity for working in any specific specialty or practice.

Credentialing refers to the process of reviewing and validating the qualifications of physicians and other licensed practitioners for granting medical staff membership to provide patient services.  It serves as a form of protection to: 
1. Protect the public from professional incompetence
2. Protect the medical staff from working with incompetent professional
3. Protect the facility from liability due to providing inadequate care
4. Protect the rights of the medical staff from unfair restrictions on their practice
Professional incompetence can be avoided or at least lowered by assuring credentialing takes place.  A physician should have qualifying degrees, licenses, and other certifications.  Insuring the practitioner’s credentials protects the employees from having to work with unqualified individuals who would cause liability or incompetence for the organization. 
Brodnik:  Fundamentals of Law for Health Informatics and Information Management

Saturday, November 16, 2013

Personal Health Records

Week 11 Assignment PHR for patients use
I started my search for information on PHRs or Personal Health Records the same way an unknowledgeable patient would.  I began with an internet search for personal health record.  Unfortunately, the results can give information pertaining to practitioner as well as patient usage.  Changing my search words several times made similar results.  All of the sites I found were mainly for practitioner or clinical use.  The few links for patients required account sign-up with credit card even to get something as simple as basic information. 
I checked supplied by AHIMA.  Their site teaches you how to create your own PHR from scratch with a few simple directions and instructions. 
                The site suggests checking with your Healthcare Provider, Insuring company or Employer to see if they offer PHR software or website service.  I checked with my personal insurance provider who did not offer a PHR available on the internet.  I am not employed so I could not check an employer.  I then tried my medical provider and they only offer a Patient Portal that allows you to access basic information such as appointments and privacy rights.  I will mention that the only PHR I actually have knowledge of came about by accident.  My grandmother-in-law wanted a Medicare Alert Bracelet for safety as she is very ill.  I searched for M.A. Bracelets and found one that actually includes a built in memory computer mini drive.  The drive contains software PHR that you bring up on your computer and works as a Fill-in-the-blank system.  There are places for all the expected sections of a traditional PHR, areas to add all medications, and it is easily editable.  The software on the bracelet only cost the price of the bracelet purchase (20$).  It is portable, can be kept on the person, looks exactly like a traditional metal medical alert bracelet and is easily accessible by Ipad, laptop, or computer.  This is the easiest user friendly system I found.
                Some of the problems associated with electronic PHRs are security/privacy, acceptability, and accuracy.  Records that are internet based may not be accessible in times of power outages, locations without computer access, or just not easily accessed.  Most of the commercial systems are paid for by monthly charged payments.  A missed payment might mean limited or discontinued access.  Security can be a major issue with records kept on the internet.  Security access must be kept safe from hacking and identity theft, just signing-up with a Secured site may not be enough.  Accessibility must also be made safe and maintained by both the patient and company.  This would include password security and identity checks.  Another problem is acceptability.  Will a healthcare facility or hospital even be willing to accept information contained in a PHR?  The last problem would be accuracy.  If a patient has a PHR it may not necessarily contain accurate information.  Outdated information such as incorrect medication dosages or medical conditions could cause dangerous outcomes or delay medical treatment.
                A problem with PHRs in general is that there is a lack of standards for PHRs.  As technology has begun to make EHRs more accessible to patients as PHRs there will be an increase in patient usage, as a result, the government is beginning to take notice.  CCHIT or Certification Commission for Healthcare Information Technology was founded in 2004 and has certified EHRs since 2006.  The federal government recognized CCHIT as a certifying body; it established the first comprehensive, practical definition of what is needed in EHRs.  These national efforts are expected to have a trickle-down effect on organizations attempting to provide EHRs and PHRs for patients. (Brodnik)

Brodnick:  Fundamentals of Law for Health Informatics and Information Management

Monday, November 11, 2013

Patient Rights and Quality Improvement programs

Describe how patient rights and quality improvement programs are linked.

The Institute of Medicine published a report titled Crossing the Quality Chasm—A New Health System for the 21st Century.  This report identified six broad objectives that should be central to the US healthcare system.  The report stated that healthcare should be safe, patient-centered, efficient, effective, equitable, and timely.  The Joint Commission is using this information to focus activities for the onsite accreditation survey and is publishing measurement data on its website at  Consumers can search for an organization and check how the Joint Commission measures, and determines their accreditation status. 
Quality improvement processes are guided by the federal agencies such as CMS and AHRQ.  At the federal level, the Affordable Care Act established the National Strategy for Quality Improvement in Health Care, known as the National Quality Strategy.  
Patients’ Rights:  Central to providing quality healthcare is ensuring that patients are aware that they have rights related to clinical care and also to other aspects of healthcare, such as communication about their care and protection of privacy.  Specific patient rights are externally driven by both government and private standards and internally driven by organizational policies.
Some common sources of patient rights are:  American Hospital Association Patient Care Partnership, Medicare Conditions of Participation, HIPAA Privacy Rule Revisited, The Joint Commission Standards, Facility Policy Regarding Patient Rights, Right to Admission/Duty to Treat, Impact of Hill-Burton, EMTALA/Anti-Dumping, Right to Discharge, Safekeeping of Property, and Patient Obligations.

Brodnik: Fundamentals of Law for Health Informatics and Information Management

Sunday, November 3, 2013

The four elements of HIPAA Privacy Rule that relate to required reporting laws

Assignment 10 Legal
Describe the four elements of the HIPAA Privacy Rule that relate to required reporting laws.
The first element includes both Abuse and Neglect of Children and Abuse and Neglect of the Elderly and Disabled.  Reporting abuse and neglect is routinely required by state laws and must be reported to local or county law enforcement or county children’s services.  Each state has its own child abuse and neglect statutes based on the federal law of Child Abuse Prevention and Treatment Act of 1996 and amended by the Keeping Children and Families Safe Act of 2003.
The second element is the Vital Records element.  Vital records concern birth, death, marriage, divorce, abortion, and fetal deaths.  The Model State Vital Statistics Act and Regulations provide uniform guidance to states to understand definitions, registration procedures, disclosure procedures, and processes related to states’ vital statistics functions. 
The third element is Communicable Diseases reporting.  A communicable disease is defined by state law.  States require reporting of “notifiable” communicable diseases through state laws for the purpose of tracking outbreaks and preventing spread of disease.  Lists of diseases can vary by state but, may include quarantine diseases outlined by the World Health Organization.  The Center for Disease Control (CDC) keeps a list of Notifiable Diseases classified by potential for endemic or epidemic spread and danger to public health.
The last element of required reporting includes Reportable Deaths.  State laws require certain deaths to be reported including: accidental, homicidal, suicidal, sudden, and suspicious in nature.  Usually these deaths are reported to the medical examiner or coroner.  Also, deaths resulting from abortion or induced termination of pregnancy are reportable. 
Brodnick:  Fundamentals of Law for Health Informatics and Information Management