Component 1: Introduction to Health Care and Public Health in the U.S. Unit 2: Delivering Health Care Lecture 1 This material was developed by Oregon Health & Science University, funded by the Department of Health and Human Services, Office of the National Coordinator for Health Information Technology under Award Number IU24OC000015.

Health IT Workforce Curriculum Version 2.0/Spring 2011 Lectures in This Unit Lecture 1: Overview and the Organization of Federal Health Care Lecture 2: Government Health Care Services Lecture 3: Health Care Settings: Outpatient Clinics and Hospitals Lecture 4: Post-Acute Care, Long-Term Care, and Nontraditional Settings . Component 1/Unit 2-1 Health IT Workforce Curriculum Version 2.0/Spring 2011

Objectives of This Lecture Describe the organization of health care at the federal, state, and local levels Overview of the U.S. Department of Health and Human Services (HHS) Role of state governments in health care Local health care organizations Health IT Workforce Curriculum Version 2.0/Spring 2011 Component 1/Unit 2-1

Health IT Workforce Curriculum Purpose of the HHS Provides essential health care for all Americans Protects the needy or underserved State, local, and tribal levels Structure Office of the Secretary 11 operating divisions Health IT Workforce Curriculum Version 2.0/Spring 2011 Component 1/Unit 2-1

Organization of the HHS US Department of Health and Human Services organizational chart. http://www.hhs.gov/about/orgchart/. Health IT Workforce Curriculum Version 2.0/Spring 2011 Component 1/Unit 2-1

Administration for Children and Families Addresses the economic and social well-being of children, families, individuals, communities Vulnerable populations included Programs are both national, regional Well-known program: Head Start Health IT Workforce Curriculum Version 2.0/Spring 2011 Component 1/Unit 2-1

Administration on Aging Adults 65 years of age and older will be 19% of the U.S. population by 2030 AoA funds non-medical programs to prolong health and independence Programs are both home-based and community-based Multiple needs served: nutritional, logistical, legal, quality of life Health IT Workforce Curriculum Version 2.0/Spring 2011 Component 1/Unit 2-1

Agency for Healthcare Research and Quality Mission: Provide data on health care in the U.S. Quality, safety, efficiency, effectiveness, access Measurable outcomes: illness, death, spending All stakeholders are included Focus areas of research: Health information technology Effectiveness of treatments Quality improvement and patient safety Illness prevention and care management Health care value Health IT Workforce Curriculum Version 2.0/Spring 2011 Component 1/Unit 2-1

Agency for Toxic Substances and Disease Registry Mission: Prevent illness/disease from toxic/hazardous substances Examples: arsenic, asbestos, lead, mercury Origins: environmental pollution, waste sites, disasters Methods of intake: breathing, drinking, food, soil exposure Identifies exposures, evaluates risk, recommends action Prepares for emergencies/disasters Educates about toxicology, environmental medicine, chemical exposures Issues public health advisories Well-known example: Actions taken on and after 9-11-2001 Health IT Workforce Curriculum Version 2.0/Spring 2011 Component 1/Unit 2-1

Centers for Disease Control and Prevention Responsible for health promotion, disease prevention, reduction of injury or disability Prepares for emerging health threats Well-known example: “Swine” flu Various centers, institutes, offices Monitors, investigates, researches, develops policies, advocates, provides leadership and training Works with national and international partners Educates health care providers, consumers Health IT Workforce Curriculum Version 2.0/Spring 2011 Component 1/Unit 2-1

Centers for Medicare and Medicaid Services Medicare/Medicaid cover 25% of U.S. population Medicare Largest health insurer in the U.S. For elderly or disabled people Insured person pays premiums Medicaid For low-income patients and families Specific guidelines are determined by each state Insured person generally does not pay Children’s Health Insurance Program Health IT Workforce Curriculum Version 2.0/Spring 2011 Component 1/Unit 2-1

Food and Drug Administration Responsible for the safety and effectiveness of foods, drugs, and medical devices Also veterinary drugs, cosmetics, radiologic health, toxicology Evaluates and approves new drugs Regulates tobacco manufacture and marketing Office of the Commissioner and 8 centers Health IT Workforce Curriculum Version 2.0/Spring 2011 Component 1/Unit 2-1

Health Resources and Services Administration Mission: Improve access to health care People with low incomes, no insurance People with certain medical issues (such as patients with HIV/AIDS and children with special needs) People who are isolated (for example, in rural communities) Other services Oversees organ, blood, bone marrow donations Combats bioterrorism Compensates people for severe vaccination reactions Health IT Workforce Curriculum Version 2.0/Spring 2011 Component 1/Unit 2-1

Health IT Workforce Curriculum Indian Health Service Mission: Improve physical, psychological, and spiritual health of American Indians and Alaska Natives Accessible public health services Culturally sensitive; recognizes sovereign rights 564 federally recognized tribes in 35 states Medical and social issues Disparities in health and life expectancy Higher mortality from diseases, social problems Health IT Workforce Curriculum Version 2.0/Spring 2011 Component 1/Unit 2-1

National Institutes of Health World’s largest source of funding for medical research Funds universities, research institutions, its own laboratories 27 institutes and centers with focus on: Diseases (for example, cancer, heart disease, alcoholism and drug abuse, arthritis, diabetes) Specific groups (for example, children, the elderly) Research issues (for example, nursing, alternative medicine, information technology) Health IT Workforce Curriculum Version 2.0/Spring 2011 Component 1/Unit 2-1

Office of the Inspector General Protects the integrity of HHS programs Protects the health and welfare of people who benefit from HHS programs Performs nationwide audits, investigations Reports abuses to the Secretary and Congress Recommends corrections Examples of initiatives: “Stop Medicare Fraud” program “Health Care Fugitives” list Health IT Workforce Curriculum Version 2.0/Spring 2011 Component 1/Unit 2-1

Substance Abuse and Mental Health Services Administration Mission: Improve the health of people with mental illness/substance abuse, while reducing health care costs and social costs 8 strategic initiatives: Prevent substance abuse and mental illness Reduce the impact of violence and trauma Support military families Support patients with housing, employment, education Improve insurance coverage and access to treatment Promote information technology and electronic medical records Gather data to measure the success of programs Educate the public about mental illness and substance abuse Health IT Workforce Curriculum Version 2.0/Spring 2011 Component 1/Unit 2-1

Health IT Workforce Curriculum State Health Care All states have a Department of Health Organizational structures vary Responsible for disease treatment, health promotion, care of special groups State governments partner with HHS National Academy for State Health Policy Mission: Improve health care access and quality Encourages states to collaborate with federal government, private companies, other states Well-known example: national health care reform Health IT Workforce Curriculum Version 2.0/Spring 2011 Component 1/Unit 2-1

Local Health Care: Private Health Care Agencies Independent health care providers Single-provider practices Group practices Corporate health care Employees, families, retirees Some agencies operate community health centers Can have for-profit or nonprofit status Health IT Workforce Curriculum Version 2.0/Spring 2011 Component 1/Unit 2-1

Local Health Care: Hospitals Profit or nonprofit Government-supported or not General or specialty University-affiliated or community-based Single or chain Critical-access hospitals get Medicare reimbursement Health IT Workforce Curriculum Version 2.0/Spring 2011 Component 1/Unit 2-1

Health IT Workforce Curriculum Summary HHS Multiple agencies Oversight role: disease prevention, health care quality, medical insurance for special populations, research, mental health, food/drug safety, and more State departments of health Many of the same types of programs as HHS Local health care Private agencies Clinics and hospitals Health IT Workforce Curriculum Version 2.0/Spring 2011 Component 1/Unit 2-1