Introduction and Unit 1Introduction and Unit 1Ch 1: Health Care Delivery Ch 1: Health Care Delivery

SystemsSystemsTuesday, March 8 at 8PM Tuesday, March 8 at 8PM

ESTEST

HS 410 - 01HS 410 - 01Adrienne Palmer, BSPH, MHA, FACHEAdrienne Palmer, BSPH, MHA, FACHE

IntroductionIntroduction

Instructor: Adrienne Palmer, BSPH, MHA, Instructor: Adrienne Palmer, BSPH, MHA, FACHEFACHE

Currently live in Arizona and work as a Currently live in Arizona and work as a healthcare administratorhealthcare administrator

Contact Information: Contact Information: Email: Email: apalmer2@kaplan.eduapalmer2@kaplan.edu AIM: apalmerlloydAIM: apalmerlloyd

Office Hours: Tuesdays, 6PM-8PMESTOffice Hours: Tuesdays, 6PM-8PMEST May also be online periodically during the workdays; you can May also be online periodically during the workdays; you can

always email me and we can set up a specific time as wellalways email me and we can set up a specific time as well

Introductions to ClassmatesIntroductions to Classmates

• Post your introduction in the “Introduce Yourself” Post your introduction in the “Introduce Yourself” forum.forum.

• Read you classmates’ introductions and see what Read you classmates’ introductions and see what you have in common.you have in common.

• You may have several classes together.You may have several classes together.

• Get to know each other for support and Get to know each other for support and socialization.socialization.

• No one else understands better what you are No one else understands better what you are experiencing than another student!experiencing than another student!

Throughout the class…Throughout the class… Make sure to read the announcements. There will Make sure to read the announcements. There will

be a new one each week.be a new one each week. Read the syllabus as it contains most everything Read the syllabus as it contains most everything

you need to know. you need to know. Go over all the information under the course Go over all the information under the course

home section on the left side of your screen.home section on the left side of your screen.

Review the CourseReview the Course

Familiarize yourself with the entire course.Familiarize yourself with the entire course. Note project and quiz/exam datesNote project and quiz/exam dates Read through all discussion questions and Read through all discussion questions and

select the one to answer during each unit. select the one to answer during each unit. Keep track of any questions and submit to Keep track of any questions and submit to

course questions section or email me. course questions section or email me.

Tips for text:Tips for text:

Weekly Reading Assignments Weekly Reading Assignments Skim through the chapter.Skim through the chapter. Go through again and review the section titles Go through again and review the section titles

and tables and charts. and tables and charts. Review the questions at the end of the Review the questions at the end of the

chapter and the workbook (these are likely chapter and the workbook (these are likely where quiz questions will come from).where quiz questions will come from).

Read the chapter.Read the chapter. It is expected that the chapter(s) be read It is expected that the chapter(s) be read

before the seminar. before the seminar.

Late work policyLate work policyLate work will not be accepted unless there Late work will not be accepted unless there

are clear and compelling extenuating are clear and compelling extenuating

circumstances. If you have extenuating circumstances that circumstances. If you have extenuating circumstances that prevent you from completing course assignments/exams you must prevent you from completing course assignments/exams you must contact your instructor immediately—prior to the contact your instructor immediately—prior to the assignment/exam/quiz due-date unless prevented from doing so assignment/exam/quiz due-date unless prevented from doing so by emergency circumstances. Examples of extenuating by emergency circumstances. Examples of extenuating circumstances are serious personal and/or family circumstances are serious personal and/or family illness/hospitalization, death in the family, weather-related illness/hospitalization, death in the family, weather-related evacuation/emergencies, work emergencies, and issues related to evacuation/emergencies, work emergencies, and issues related to active military assignment. Personal computer/software/internet active military assignment. Personal computer/software/internet connectivity issues and course blocks are not considered connectivity issues and course blocks are not considered extenuating circumstances. Granting of late-work submission due extenuating circumstances. Granting of late-work submission due to extenuating circumstances is at the discretion of the instructor to extenuating circumstances is at the discretion of the instructor and will require documentation for verification of extenuating and will require documentation for verification of extenuating circumstances. If late work submission is granted, the instructor circumstances. If late work submission is granted, the instructor will establish new due-dates and requirements without loss of will establish new due-dates and requirements without loss of course points.   course points.  

Due DatesDue Dates

All items in a unit are due on the last day of the All items in a unit are due on the last day of the unit (Tuesdays). unit (Tuesdays). NOTE: First post on discussion forum is due by the NOTE: First post on discussion forum is due by the

end of day Saturday of the unit with all posts due by end of day Saturday of the unit with all posts due by the end of day Tuesday. the end of day Tuesday.

All grades will be posted by the end of day All grades will be posted by the end of day Sunday of the following unit. Sunday of the following unit.

Must notify me to request any extension prior to Must notify me to request any extension prior to the due date with reasons as I must approve it the due date with reasons as I must approve it being late. being late.

Discussion BoardDiscussion Board To receive full credit for discussion boards, To receive full credit for discussion boards,

please post at least three substantial posts per please post at least three substantial posts per unitunit One post in response to discussion question by the One post in response to discussion question by the

end of day Saturday for that unit end of day Saturday for that unit Two posts in response to classmates by end of day Two posts in response to classmates by end of day

Tuesday for that unit Tuesday for that unit Think critically and use references. Think critically and use references. Make sure you are challenging each other and meet Make sure you are challenging each other and meet

the length requirements.the length requirements. Get to know your fellow classmates by engaging Get to know your fellow classmates by engaging

them to expand on their thoughts. Challenge them to expand on their thoughts. Challenge each other!!each other!!

ProjectsProjects Unit 4: Group Project. I will divide you into groups, number to be Unit 4: Group Project. I will divide you into groups, number to be

determined.determined. Watch one episode of a medical television show as assigned by Watch one episode of a medical television show as assigned by

instructor. Identify values portrayed by main characters in show, identify instructor. Identify values portrayed by main characters in show, identify ethical theory, analyze their behavior, impact on the patient, aspect of ethical theory, analyze their behavior, impact on the patient, aspect of ethical problems that were displayed and the ethical decision-making ethical problems that were displayed and the ethical decision-making process they used. Prepare a report for presentation, with charts. process they used. Prepare a report for presentation, with charts.

Unit 6: Create a chart to discuss quality healthcare issues per age Unit 6: Create a chart to discuss quality healthcare issues per age group, along with an APA paper discussion of the different groups. group, along with an APA paper discussion of the different groups.

Unit 7: Group Project. I will divide you into groups, number to be Unit 7: Group Project. I will divide you into groups, number to be determined.determined. Design a continuing education seminar for presentation to newly hired Design a continuing education seminar for presentation to newly hired

health information employees. APA format paper evaluating project. health information employees. APA format paper evaluating project.

All are due on the last day of the unit (Tuesday).All are due on the last day of the unit (Tuesday).

Quizzes/ExamsQuizzes/Exams Quizzes: Quizzes:

Units – all units (except 9)Units – all units (except 9) These range in length from 10-50 questions may These range in length from 10-50 questions may

consist of multiple choice, True/False, Fill in the consist of multiple choice, True/False, Fill in the blank, and essay questions. blank, and essay questions.

These are 1-hour in length and may only be accessed These are 1-hour in length and may only be accessed once. (This means that you may not have time to look once. (This means that you may not have time to look up each question!)up each question!)

Unit 10: Final ExamUnit 10: Final Exam This Exam is a test based on the material from the This Exam is a test based on the material from the

entire course. entire course. The final exam is a 220-point exam consisting of The final exam is a 220-point exam consisting of

true/false, multiple choice, and essay questions. You true/false, multiple choice, and essay questions. You will have 4 hours to complete this exam. (This means will have 4 hours to complete this exam. (This means that you may not have time to look up each that you may not have time to look up each question!)question!)

GradesGrades

Your grades will be listed in the gradebook. Your grades will be listed in the gradebook. I paste the grading criteria from the syllabus to I paste the grading criteria from the syllabus to

the end of your paper, and you will find your the end of your paper, and you will find your grade there, along with my comments.grade there, along with my comments.

All comments are meant to help you.All comments are meant to help you. My goal is your goal: your success.My goal is your goal: your success. If you have questions about your grade, just ask. If you have questions about your grade, just ask.

Avoiding Plagiarism Avoiding Plagiarism Review the “What You Need to Know About Plagiarism” under Documents Review the “What You Need to Know About Plagiarism” under Documents

on the Kaplan opening page.on the Kaplan opening page.

Using another author’s ideas or words without giving credit is plagiarism. Using another author’s ideas or words without giving credit is plagiarism. You do not have to use the exact words to be guilty – using ideas You do not have to use the exact words to be guilty – using ideas without giving credit is illegal, immoral, and unethical.without giving credit is illegal, immoral, and unethical.

Any citation used in your Any citation used in your

paper must be listed in the paper must be listed in the

Reference list.Reference list. Any reference listed must Any reference listed must

have been cited in the paper. have been cited in the paper.

These guidelines apply to These guidelines apply to

assignments and discussion assignments and discussion

forums. forums.

Did you know …???Did you know …???• Professors have a site – “Turnitin” - to which we Professors have a site – “Turnitin” - to which we

submit every project (and some discussion submit every project (and some discussion responses) to check for plagiarism. The report tells responses) to check for plagiarism. The report tells us how much of your paper is original and if anything us how much of your paper is original and if anything is “borrowed” from another source.is “borrowed” from another source.

• Submitting a paper that you wrote for another Submitting a paper that you wrote for another course is self-plagiarism.course is self-plagiarism.

• Plagiarism is reason for strong Plagiarism is reason for strong

discipline from Kaplan discipline from Kaplan

University, and also a University, and also a

possible reason for dismissal.possible reason for dismissal.

Don’t risk it!Don’t risk it!

Miscellaneous NotesMiscellaneous Notes There are no stupid questions – only those that are not There are no stupid questions – only those that are not

asked.asked. If a classmate states that he or she doesn’t If a classmate states that he or she doesn’t

understand something in the discussions, I want YOU understand something in the discussions, I want YOU to jump in and help. We teach each other here, and by to jump in and help. We teach each other here, and by helping someone else, you test your own helping someone else, you test your own understanding of the issue.understanding of the issue.

Any question I ask in the discussions is open to a Any question I ask in the discussions is open to a response from anyone. We are having discussions, not response from anyone. We are having discussions, not a one-on-one conversation.a one-on-one conversation.

Expect to get the blues once in a while. Just take a Expect to get the blues once in a while. Just take a good, deep breath, take a short break, and come back.good, deep breath, take a short break, and come back.

Do NOT give up. Together we will work through the Do NOT give up. Together we will work through the course.course.

By the end of the course, you will By the end of the course, you will be able to: be able to:

Compare standards and regulations for health record documentation.

Explain taxonomies, clinical vocabularies, terminologies and nomenclature used in healthcare settings.

Adapt organization and management principles in healthcare settings

Apply ethical reasoning to ethical issues within the field of health information management.

Chapter 1Chapter 1

US Health Care delivery systemUS Health Care delivery system Varied Varied ComplexComplex

Historical DevelopmentHistorical Development

Early history – health care providers, Early history – health care providers, communication methods, and societal communication methods, and societal views of healthcareviews of healthcare

Primitive timesPrimitive times Early civilizationEarly civilization Greek civilizationGreek civilization

Health Care in the United StatesHealth Care in the United States

Characteristics: health care providers, Characteristics: health care providers, influence of technology, influence of technology, organizational/societal efforts to improve organizational/societal efforts to improve health care, and role of patienthealth care, and role of patient 1776 to 19001776 to 1900 1900 to World War I1900 to World War I World War II to 1980World War II to 1980 1980 to present1980 to present

TransitionsTransitions

Stature of hospitals improvedStature of hospitals improved Move toward scientific advancesMove toward scientific advances Increased regulations Increased regulations

LicensingLicensing Accreditation Accreditation

Rise of private health insurance industryRise of private health insurance industry Federal government involvement Federal government involvement

(Hill Burton Act, CMS)(Hill Burton Act, CMS)

Flexner Report – Medical School ReformFlexner Report – Medical School Reform

Costs EscalateCosts Escalate

Tax asked equity and fiscal responsibility Tax asked equity and fiscal responsibility act (TEFRA) of 1982act (TEFRA) of 1982 PPS (prospective payment system)PPS (prospective payment system) DRGs (diagnosis related groups)DRGs (diagnosis related groups)

Development of managed careDevelopment of managed care

Managed CareManaged Care

HMO (health maintenance organizations)HMO (health maintenance organizations) IPA (independent practice associations)IPA (independent practice associations) PPO (preferred for provider organizations)PPO (preferred for provider organizations) Payment systemsPayment systems

Fee-for-serviceFee-for-service CapitationCapitation Pre-determined fee-for-service payment planPre-determined fee-for-service payment plan

Other InfluencesOther Influences

Consumer cultureConsumer culture Increased level of educationIncreased level of education DissatisfactionDissatisfaction Lax oversight regulatory agenciesLax oversight regulatory agencies Demand for higher quality careDemand for higher quality care Uninsured and underinsured concernsUninsured and underinsured concerns

Reaction to InfluencesReaction to Influences

HSA (health savings account)HSA (health savings account) Managed-care develops to contain costs Managed-care develops to contain costs

while maintaining high quality of carewhile maintaining high quality of care Changes in accreditation process – Changes in accreditation process –

JCAHO develops tracer methodologyJCAHO develops tracer methodology Some advocate national insuranceSome advocate national insurance OutsourcingOutsourcing ONCHITONCHIT

Public HealthPublic Health

Deals with community at largeDeals with community at large Protects and increases healthProtects and increases health Preventive delivery of medical, social and Preventive delivery of medical, social and

sanitary servicessanitary services Multiple rolesMultiple roles Communicable diseasesCommunicable diseases

Chronic diseasesChronic diseases Social and behavioral aspects of lifeSocial and behavioral aspects of life

Public HealthPublic Health

The federal levelThe federal level DHHADHHA CDCCDC FDAFDA NIHNIH CMSCMS AHRQAHRQ

Impact on the causes of deathImpact on the causes of death

Mental HealthMental Health

Mental health and mental illnessMental health and mental illness Historical development of mental healthHistorical development of mental health New series and treatments are developedNew series and treatments are developed Community mental health careCommunity mental health care Block grantsBlock grants

Occupational HealthOccupational Health

Employee health concernsEmployee health concerns Workplace hazardsWorkplace hazards OSHAOSHA Focus in the patient care settingFocus in the patient care setting

Improving employee healthImproving employee health Reducing exposure to healthcare facility- Reducing exposure to healthcare facility-

acquired infectionsacquired infections

Health Care Delivery SystemHealth Care Delivery System

Other entities exert a strong influenceOther entities exert a strong influence Professional associationsProfessional associations Volunteer health agenciesVolunteer health agencies Philanthropic foundationsPhilanthropic foundations International health agenciesInternational health agencies

Health Care SettingsHealth Care Settings

Continuum of careContinuum of care Four Types of Settings:Four Types of Settings:

Primary carePrimary care Secondary careSecondary care Tertiary careTertiary care Quaternary careQuaternary care

Health Care SettingsHealth Care Settings

Ambulatory health careAmbulatory health care Home health agencyHome health agency Hospice careHospice care HospitalHospital Long-term care facilityLong-term care facility

Nursing Home vs. Skilled Nursing FacilityNursing Home vs. Skilled Nursing Facility Rehabilitation care facility – hospital vs Rehabilitation care facility – hospital vs

care setting care setting

Health Care ProfessionalsHealth Care Professionals

PhysicianPhysician GeneralistsGeneralists Specialists (board-certified)Specialists (board-certified)

Physician assistant (PA)Physician assistant (PA) Surgical assistant (SA)Surgical assistant (SA)

Health Care ProfessionalsHealth Care Professionals

DentistDentist PodiatristPodiatrist ChiropractorChiropractor OptometristOptometrist NurseNurse Allied health professionalAllied health professional Issues:Issues:

Registration Registration Licensing Licensing

HIMHIM

One of the most rapidly growing areas of One of the most rapidly growing areas of allied health professionsallied health professions Increase need for patient dataIncrease need for patient data Correlation between health information Correlation between health information

reimbursementreimbursement Regulatory environmentRegulatory environment

Health information administratorHealth information administrator Health information technicianHealth information technician

Medical StaffMedical Staff

Medical staff organizationMedical staff organization Bylaws, rules, and regulationsBylaws, rules, and regulations Credentialing process Credentialing process Medical Staff CoordinatorMedical Staff Coordinator Types of Clinical privileges: Types of Clinical privileges:

FullFull AssociateAssociate CourtesyCourtesy ConsultingConsulting Temporary provisionalTemporary provisional

Questions?Questions?