Healthcare Delivery Systems

Chapter 1 Health caution Deliin truth Systems There argon many interesting and important points in this chapter. Some of them include Pennsylvania Hospital founded by Ben Franklin was the 1st US hospital University of PA was the US first medical checkup school The AMA was founded in Philadelphia in 1847. The Flexner Report was published in 1910 and impacted the status of medical school education. Hill-Burton Act of 1948 provided federal monies to update hospitals JCAH which is now JCAHO was created in 1951. JCAHO is an freelancer accreditation agency for wellness c ar facilities (all fictional characters).Medic be and Medicaid were enacted by Congress in 1965 concealing Act of 1974 protect the privacy of information arrangements in federal wellness care facilities HCFA (now called CMS) was created in 1977 TEFRA in 1982 found the first Medicare prospective fee system EMTALA of 1985 protected patient roles against dumping HIPAA was passed in 1996 with components on standardiz ation, simplication, privacy, and security SCHIP was established in 1997 to provide wellness insurance to infants and children not covered at a lower place Medicaid Notice all of the abbreviations employ in chapter 1The use of abbreviations and acronyms is very prevalent in the health care and HIM field. Important Concepts in Chapter 1 Continuum of Care primary care, secondary care, and tertiary care. Most of us are familiar with primary care, care sought by a patient with medical professionals for current problem or maintenance of a problem. secondary coil care is seeing a specialist, dermatologist, neurologist, etc. for a problem, a good deal referred by your primary care or family doctor. Tertiary care is very much provided in specialty hospitals.This can include specialty radiograph (PET scan, MRI), burn treatment, genus Cancer treatment centers, etc. Health care deftness ownership, there are three kinds of facility ownership in general government, for profit, and not-fo r-profit non government (Faith-based hospitals for example). Hospitals are organized with a governing body at the top, sometimes referred to as a board of trustees. Within the hospital and most larger health care facilities (rehab, clinics) there will be an Health Information caution (HIM) or Medical Records Department.However, Medical Records is an older term. Typical functions of an HIM department include, coding, map abstraction, record processing, record storage and retrieval, medical transcription, release of information (ROI), crab louse registry, and index complying and retrieving. The size of the HIM department staff will vary and is unremarkably based on the bed size of the facility and/or one-year visits processed (discharged, ED, Outpatient surgery etc. ). One of the most visible components of a health care facility and an HIM department is the coding function.Coding is also seen in outpatient area for physician office and other types of non-hospital based healthcare . This is based partly on the fact the coding is tied to reimbursement and funding for the facility/provider. In the US there are two main coding systems use ICD-9-CM and HCPCS. HCPCS contains CPT codes which are often thought of as a separate system but CPT is part of HCPCS. CPT codes are used to reveal physician go regardless of the place of service (hospital, office, ED, clinic, etc. ).ICD-9-CM classification contains diagnoses codes which are used by all providers for coding. ICD-9-CM volume 3 is only used to report inpatient or acute care hospital procedures. Note CPT does not have any diagnoses codes in it. If a physician uses CPT to code/ lodge for procedures, ICD-9-CM moldiness also be used. A complete picture must be captured with the procedure and the diagnosis(ies) of the patient for coding/billing to be condition Licensure and accreditation your textual matter makes a distinction between these wo. Licensure is often governed by disk operating system and can be for an individual or a facility. Licensure is most often required for a health care provider or facility to operate in that specific state. Accreditation is for a facility and is most often voluntary. JCAHO is one accreditation body, others include AAAHC, AOA, CARF, NCQA, NCCHC. New Developments When the implementation of more digital engineering in the area of health care and specifically in the HIM area.Electronic health records (EHR) are being discussed and used more and more in the US. With this type of record gathering and storage, methods of authentication have been updated for the digital age. These include electronic signature. Security measures have also been updated which include smart cards and biometrics. Your textbook also includes some excellent websites for concepts in this chapter. You may also requirement to refer to this list when you are looking for journal articles to complete testing ground assignment 2-5 which will be due next week.