1. Introduction to Healthcare and Public Health in the US Delivering Healthcare (Part 2) Lecture d This material (Comp1_Unit3d) was developed by Oregon Health and Science University, funded by the Department of Health and Human Services, Office of the National Coordinator for Health Information Technology under Award Number IU24OC000015.

2. Delivering Healthcare (Part 2) Objectives Describe the organization of clinical healthcare delivery in the outpatient setting, and the organization of outpatient healthcare (Lectures a-c) Describe the organization of ancillary healthcare delivery in the outpatient setting (Lecture d) Discuss the role of different healthcare providers, with an emphasis on the delivery of care in an interdisciplinary setting (Lecture e) 2 Health IT Workforce Curriculum Version 3.0/Spring 2012 Introduction to Healthcare and Public Health in the US Delivering Healthcare (part 2) Lecture d

3. Outpatient Laboratories Laboratory where tests are done on clinical specimens May be associated with a hospital or be freestanding The testing may be done in a location remote to the location where specimen was obtained 3 Health IT Workforce Curriculum Version 3.0/Spring 2012 Introduction to Healthcare and Public Health in the US Delivering Healthcare (part 2) Lecture d

4. What Can Laboratories Do? Pathology Anatomical Pathology Histopathology – studies whole tissues Cytopathology – at the cellular level Electron microscopic pathology Surgical Pathology Chemical pathology (clinical chemistry) General chemistry Endocrinology Immunology Toxicology 4 Health IT Workforce Curriculum Version 3.0/Spring 2012 Introduction to Healthcare and Public Health in the US Delivering Healthcare (part 2) Lecture d

5. Pathology (continued) Hematopathology –Diseases of blood cells Traditional microscopy Immunohistochemistry Flow cytometry Molecular diagnostic tests Blood banking - Transfusion medicine Cytogenetics 5 Health IT Workforce Curriculum Version 3.0/Spring 2012 Introduction to Healthcare and Public Health in the US Delivering Healthcare (part 2) Lecture d

6. Pathology (continued) Clinical microbiology – study of microorganisms –The lab may use culture methods to grow and identify organisms Forensic pathology –Specialized laboratory for medical and legal issues Molecular pathology –Development of molecular and genetic approaches to the diagnosis and classification of human tumors –Design and validation of predictive biomarkers 6 Health IT Workforce Curriculum Version 3.0/Spring 2012 Introduction to Healthcare and Public Health in the US Delivering Healthcare (part 2) Lecture d

7. Radiology services Radiology – branch of medicine that uses imaging technology to diagnose or treat diseases Radiologists – physicians who specialize in radiology Outpatient radiology services may be housed within a hospital or may be freestanding 7 Health IT Workforce Curriculum Version 3.0/Spring 2012 Introduction to Healthcare and Public Health in the US Delivering Healthcare (part 2) Lecture d

8. Radiology services Diagnostic radiology –X rays First X-ray taken by Wilhelm Röntgen in 1895 (his wife’s hand) 3.2 Image: (Röntgen, 1895) 8 Health IT Workforce Curriculum Version 3.0/Spring 2012 Introduction to Healthcare and Public Health in the US Delivering Healthcare (part 2) Lecture d

9. Radiology services Diagnostic radiology –Computerized Tomography (CT) scans –Magnetic Resonance Imaging (MRI) scans –Positron Emission Tomography (PET) scans –Ultrasound –Mammography –Bone density tests –Nuclear medicine tests 9 Health IT Workforce Curriculum Version 3.0/Spring 2012 Introduction to Healthcare and Public Health in the US Delivering Healthcare (part 2) Lecture d

10. Radiology services Interventional radiology – invasive tests –Angiography Teleradiology allows radiologists to review images remotely Technology allows images to be archived and retrieved at multiple sites – Picture Archiving and Communication System or PACS 10 Health IT Workforce Curriculum Version 3.0/Spring 2012 Introduction to Healthcare and Public Health in the US Delivering Healthcare (part 2) Lecture d

11. Ancillary Services Home healthcare (domiciliary care, home care) Care provided at the patient’s home Physician house calls Nurse visits Home health aides Help with activities of daily living (ADLs) 11 Health IT Workforce Curriculum Version 3.0/Spring 2012 Introduction to Healthcare and Public Health in the US Delivering Healthcare (part 2) Lecture d

12. Ancillary Services Hospice care For patients whose life expectancy is not expected to exceed 6 months (terminally ill patients) Palliative care outside the hospital At hospice institutions At home Multidisciplinary team for care 12 Health IT Workforce Curriculum Version 3.0/Spring 2012 Introduction to Healthcare and Public Health in the US Delivering Healthcare (part 2) Lecture d

13. Ancillary Services Physical therapy –Maintains function after injury or illness Occupational therapy –Helps patients maintain occupation Speech therapy –Helps patients recover from diseases that affect speech Care provided by ancillary staff 13 Health IT Workforce Curriculum Version 3.0/Spring 2012 Introduction to Healthcare and Public Health in the US Delivering Healthcare (part 2) Lecture d

14. Delivering Healthcare (Part 2) Summary – Lecture d Laboratory services Pathology services Radiology services Ancillary services 14 Health IT Workforce Curriculum Version 3.0/Spring 2012 Introduction to Healthcare and Public Health in the US Delivering Healthcare (part 2) Lecture d

15. Delivering Healthcare (Part 2) References – Lecture d Images 3.2 Image of first X-ray taken by Wilhelm Rontgen in 1895, of his wife's hand. The bones and her ring can be seen, similar to modern x-rays. 15 Health IT Workforce Curriculum Version 3.0/Spring 2012 Introduction to Healthcare and Public Health in the US Delivering Healthcare (part 2) Lecture d References Rontgen, Wilhelm (1895); Picture of first X-ray taken of his wife's hand. The bones and her ring can be seen, similar to modern x-rays. http://www.molecularpathology.org.uk http://www.molecularpathology.org.uk