Introduction and Unit 1 Ch 1: Health Care Delivery Systems Tuesday, March 8 at 8PM EST HS Adrienne Palmer, BSPH, MHA, FACHE

Introduction  Instructor: Adrienne Palmer, BSPH, MHA, FACHE  Currently live in Arizona and work as a healthcare administrator  Contact Information:   AIM: apalmerlloyd  Office Hours: Tuesdays, 6PM-8PMEST  May also be online periodically during the workdays; you can always me and we can set up a specific time as well

Introductions to Classmates Post your introduction in the “ Introduce Yourself ” forum. Post your introduction in the “ Introduce Yourself ” forum. Read you classmates ’ introductions and see what you have in common. Read you classmates ’ introductions and see what you have in common. You may have several classes together. You may have several classes together. Get to know each other for support and socialization. Get to know each other for support and socialization. No one else understands better what you are experiencing than another student! No one else understands better what you are experiencing than another student!

Throughout the class…  Make sure to read the announcements. There will be a new one each week.  Read the syllabus as it contains most everything you need to know.  Go over all the information under the course home section on the left side of your screen.

Review the Course  Familiarize yourself with the entire course.  Note project and quiz/exam dates  Read through all discussion questions and select the one to answer during each unit.  Keep track of any questions and submit to course questions section or me.

Tips for text: Weekly Reading Assignments  Skim through the chapter.  Go through again and review the section titles and tables and charts.  Review the questions at the end of the chapter and the workbook (these are likely where quiz questions will come from).  Read the chapter.  It is expected that the chapter(s) be read before the seminar.

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

Due Dates  All items in a unit are due on the last day of the unit (Tuesdays).  NOTE: First post on discussion forum is due by the end of day Saturday of the unit with all posts due by the end of day Tuesday.  All grades will be posted by the end of day Sunday of the following unit.  Must notify me to request any extension prior to the due date with reasons as I must approve it being late.

Discussion Board  To receive full credit for discussion boards, please post at least three substantial posts per unit  One post in response to discussion question by the end of day Saturday for that unit  Two posts in response to classmates by end of day Tuesday for that unit  Think critically and use references.  Make sure you are challenging each other and meet the length requirements.  Get to know your fellow classmates by engaging them to expand on their thoughts. Challenge each other!!

Projects  Unit 4: Group Project. I will divide you into groups, number to be determined.  Watch one episode of a medical television show as assigned by instructor. Identify values portrayed by main characters in show, identify ethical theory, analyze their behavior, impact on the patient, aspect of ethical problems that were displayed and the ethical decision- making process they used. Prepare a report for presentation, with charts.  Unit 6: Create a chart to discuss quality healthcare issues per age group, along with an APA paper discussion of the different groups.  Unit 7: Group Project. I will divide you into groups, number to be determined.  Design a continuing education seminar for presentation to newly hired health information employees. APA format paper evaluating project. All are due on the last day of the unit (Tuesday).

Quizzes/Exams  Quizzes:  Units – all units (except 9)  These range in length from questions may consist of multiple choice, True/False, Fill in the blank, and essay questions.  These are 1-hour in length and may only be accessed once. (This means that you may not have time to look up each question!)  Unit 10: Final Exam  This Exam is a test based on the material from the entire course.  The final exam is a 220-point exam consisting of true/false, multiple choice, and essay questions. You will have 4 hours to complete this exam. (This means that you may not have time to look up each question!)

Grades  Your grades will be listed in the gradebook.  I paste the grading criteria from the syllabus to the end of your paper, and you will find your grade there, along with my comments.  All comments are meant to help you.  My goal is your goal: your success.  If you have questions about your grade, just ask.

Avoiding Plagiarism Review the “ What You Need to Know About Plagiarism ” under Documents on the Kaplan opening page. 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 without giving credit is illegal, immoral, and unethical.  Any citation used in your paper must be listed in the Reference list.  Any reference listed must 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 …??? Professors have a site – “Turnitin” - to which we submit every project (and some discussion responses) to check for plagiarism. The report tells us how much of your paper is original and if anything is “borrowed” from another source. Professors have a site – “Turnitin” - to which we submit every project (and some discussion responses) to check for plagiarism. The report tells us how much of your paper is original and if anything is “borrowed” from another source. Submitting a paper that you wrote for another course is self- plagiarism. Submitting a paper that you wrote for another course is self- plagiarism. Plagiarism is reason for strong Plagiarism is reason for strong discipline from Kaplan University, and also a possible reason for dismissal. Don’t risk it!

Miscellaneous Notes There are no stupid questions – only those that are not asked. There are no stupid questions – only those that are not asked. If a classmate states that he or she doesn’t understand something in the discussions, I want YOU to jump in and help. We teach each other here, and by helping someone else, you test your own understanding of the issue. If a classmate states that he or she doesn’t understand something in the discussions, I want YOU to jump in and help. We teach each other here, and by helping someone else, you test your own understanding of the issue. Any question I ask in the discussions is open to a response from anyone. We are having discussions, not a one-on-one conversation. Any question I ask in the discussions is open to a response from anyone. We are having discussions, not a one-on-one conversation. Expect to get the blues once in a while. Just take a good, deep breath, take a short break, and come back. Expect to get the blues once in a while. Just take a good, deep breath, take a short break, and come back. Do NOT give up. Together we will work through the course. Do NOT give up. Together we will work through the course.

By the end of the course, you will 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 1  US Health Care delivery system  Varied  Complex

Historical Development  Early history – health care providers, communication methods, and societal views of healthcare  Primitive times  Early civilization  Greek civilization

Health Care in the United States  Characteristics: health care providers, influence of technology, organizational/societal efforts to improve health care, and role of patient  1776 to 1900  1900 to World War I  World War II to 1980  1980 to present

Transitions  Stature of hospitals improved  Move toward scientific advances  Increased regulations  Licensing  Accreditation  Rise of private health insurance industry  Federal government involvement  (Hill Burton Act, CMS)  Flexner Report – Medical School Reform

Costs Escalate  Tax asked equity and fiscal responsibility act (TEFRA) of 1982  PPS (prospective payment system)  DRGs (diagnosis related groups)  Development of managed care

Managed Care  HMO (health maintenance organizations)  IPA (independent practice associations)  PPO (preferred for provider organizations)  Payment systems  Fee-for-service  Capitation  Pre-determined fee-for-service payment plan

Other Influences  Consumer culture  Increased level of education  Dissatisfaction  Lax oversight regulatory agencies  Demand for higher quality care  Uninsured and underinsured concerns

Reaction to Influences  HSA (health savings account)  Managed-care develops to contain costs while maintaining high quality of care  Changes in accreditation process – JCAHO develops tracer methodology  Some advocate national insurance  Outsourcing  ONCHIT

Public Health  Deals with community at large  Protects and increases health  Preventive delivery of medical, social and sanitary services  Multiple roles  Communicable diseases  Chronic diseases  Social and behavioral aspects of life

Public Health  The federal level  DHHA  CDC  FDA  NIH  CMS  AHRQ  Impact on the causes of death

Mental Health  Mental health and mental illness  Historical development of mental health  New series and treatments are developed  Community mental health care  Block grants

Occupational Health  Employee health concerns  Workplace hazards  OSHA  Focus in the patient care setting  Improving employee health  Reducing exposure to healthcare facility- acquired infections

Health Care Delivery System  Other entities exert a strong influence  Professional associations  Volunteer health agencies  Philanthropic foundations  International health agencies

Health Care Settings  Continuum of care  Four Types of Settings:  Primary care  Secondary care  Tertiary care  Quaternary care

Health Care Settings  Ambulatory health care  Home health agency  Hospice care  Hospital  Long-term care facility  Nursing Home vs. Skilled Nursing Facility  Rehabilitation care facility – hospital vs care setting

Health Care Professionals  Physician  Generalists  Specialists (board-certified)  Physician assistant (PA)  Surgical assistant (SA)

Health Care Professionals  Dentist  Podiatrist  Chiropractor  Optometrist  Nurse  Allied health professional  Issues:  Registration  Licensing

HIM  One of the most rapidly growing areas of allied health professions  Increase need for patient data  Correlation between health information reimbursement  Regulatory environment  Health information administrator  Health information technician

Medical Staff  Medical staff organization  Bylaws, rules, and regulations  Credentialing process  Medical Staff Coordinator  Types of Clinical privileges:  Full  Associate  Courtesy  Consulting  Temporary provisional

Questions?