Combo with Essentials of HIM: Ch1 - Health Care Delivery Systems and 1 other

876 terms by AloysiusWeasley

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Imhotep

World's first known physician

Hippocrates

Father of medicine

Hippocratic Oath

Adopted as an expression of early medical ethics

Leeuwenhoek

First to use a microscope to examine microbes

Pasteur and Koch

Established the theory of disease

Pasteur

Proved that microbes are living organisms and that killing microbes stops the spread of disease

Lister

Starting using disinfectant to sterilize surgical wounds and invented aseptic surgery

Roentgen

Discovered x-rays

Curie

Discovered radium and provided a weapon for cancer

Ehrlich

Introduced chemotherapy

Fleming

Discovered Penicillium

Florey

Isolated penicillin from the mold.

1981

Year HIV and AIDS were identified

Pennsylvania Hospital

Benjamin Franklin founded this first United States hospital in 1751

1847

The American Medical Association was founded in this year.

American Medical Association

AMA stands for __________.

American Osteopathic Association

AOA stands for _________.

American College of Surgeons

ACS stands for _________.

American College of Surgeons

This organization was founded in 1913 to improve the quality of care for surgical patients by establishing standards for surgical education and practice.

1946

The Centers for Disease Control was established in this year

Centers for Disease Control

CDC stands for __________.

Joint Commission on Accreditation of Hospitals

This independent, non-profit organization was created in 1951 to provide voluntary accreditation

18

Medicare is title _____ of the Social Security Amendments of 1965.

19

Medicaid is title ____ of the Social Security Amendments of 1965.

Health Care Financing Administration

The Centers for Medicare & Medicaid Services used to be called the ___________.

Health Care Financing Administration

HCFA stands for _______.

Centers for Medicare & Medicaid Services

CMS stands for _______.

Tax Equity and Fiscal Responsibility Act of 1982

This act established the first Medicare prospective payment system which was implemented in 1983. It allowed the implementation of Diagnosis Related Groups.

Tax Equity and Fiscal Responsibility Act

TEFRA stands for _______.

COBRA

Established in 1985, this allowed former employees, retirees, spouses, domestic partners, and eligible dependent children who lose coverage the right to temporary continuation of health coverage at group rates.

Consolidated Omnibus Budget Reconciliation Act

COBRA stands for ________.

Emergency Medical Treatment and Labor Act

Established in 1985, this act addressed the problem of hospitals' failure to screen, treat, or appropriately transfer patients by establishing criteria for the discharge and transfer of Medicare & Medicaid patients.

Emergency Medical Treatment and Labor Act

Also known as the antidumping statute

Emergency Medical Treatment and Labor Act

EMTALA stands for ________.

Patient Self-Determination Act

Established in 1990, this act required consumers to be provided with informed consent, information about their right to make advanced health care decisions (advanced directives), and information about state laws that impact their legal choices in health care decisions.

advanced directives

Do Not Resusciate Order, Durable Power of Attorney for Health Care, Health Care Proxy, Living Will, and Organ/Tissue Donation are examples of _________.

Health Insurance Portability and Accountability Act

Established in 1996, this act mandates administrative simplification regulations that govern privacy, security, and electronic transactions standards for health care information.

Health Insurance Portability and Accountability Act

HIPAA stands for __________.

2001

Health Care Financing Administration changed their name to the Centers for Medicare & Medicaid services in what year?

Medicare Prescription Drug Improvement and Modernization Act

Established in 2003, this act restructured medicare in order to provide recipients with prescription drug savings and additional health care plan choices.

Medicare Prescription Drug Improvement and Modernization Act

MMA stands for _________.

American Recovery and Reinvestment Act

In 2009, this act authorized an expenditure of $1.5 billion for grants for the acquisition of health information technology systems.

continuum of care

A complete range of programs and services

primary care

Services that include preventive and acute care; the point of first contact.

primary care

Services typically provided by a general practitioner or other health professional who has first contact with a patient seeking treatment.

secondary care

Services provided by a medical specialist or hospital staff members to a patient whose primary care was provided first by a general practitioner.

tertiary care

Services provided by a specialized hospital equipped with diagnostic and treatment facilities not generally available at hospitals.

tertiary care

Hospitals that provide burn center treatment, neonatology, neurosurgery, and pediatric surgery provide ___________.

quaternary care

Advanced services provided by tertiary care centers that are highly specialized and not widely used.

for-profit

Privately owned hospitals; excess income is distributed to shareholders and owners.

not-for-profit

Hospitals that reinvested extra income back into the facility.

government, voluntary

Two types of not-for-profit hospitals are _________.

government supported

Hospitals that are supported by local, regional, or federal taxes.

25

Government supported hospitals make up _______ percent of all health care facilities.

government supported

A VA hospital is an example of a __________ facility.

proprietary

Hospitals owned by corporations or private foundations.

15

Proprietary hospitals make up _____ percent of all health care facilities.

voluntary

Not-for-profit hospitals operated by religious or other not-for-profit groups.

60

Voluntary hospitals make up _____ percent of all health care facilities.

teaching

Hospitals affiliated with a medical school.

Intern

An individual in their first year of graduate medical education.

resident

A physician who has completed an internship and is engaged in a program of training designed to increase his or her knowledge of the clinical discipline.

chief resident

Physician in his or her final year of residency.

Domagk

Discovered the ability of sulfa drugs to cure infections

1955

Year the Salk polio vaccine was licensed

1765

Year the first medical school was founded

University of Pennsylvania

The first medical school was founded at ____________.

1913

Year American College of Surgeons was founded.

1897

Year American Osteopathic Association was founded.

1935

Year Congress passed the Social Security Act.

1965

Year Medicare and Medicaid was established

1951

Year the Joint Commission was established.

governing board; administration; medical staff; departments, services, and committees; contracted services

What is the top-down organizational structure for a health care facility?

governing board

Group that serves without pay and is represented by professionals from the business community.

governing board

This group is responsible for hospital organization, management, control and operations, and for appointing medical staff.

governing board

This group is responsible for the overall health of the organization.

hospital administration

Group that serves as a liaison between the medical staff and the governing board.

hospital administration

This group is responsible for developing a strategic plan for supporting the mission and goals of the organization.

CFO

This person reports to CEO and is responsible accounting, billing, and payroll

CIO

This person reports to the CEO and is responsible for information resource management.

COO

This person reports to CEO and is responsible for ancillary services.

medical staff

Consists of licensed physicians and other licensed providers as permitted by law who are granted clinical privileges.

governing board

The medical staff is approved by the ___________.

clinical departments, medical specialty, chairperson, medical staff committees, hospital committees

The medical staff is organized into ________ by _________, with a _________ appointed to each department, and members to serve on ____________ and ___________.

medical staff credentials committee

This group reviews and verifies medical staff applications and submits recommendations to the executive committee.

department chairperson

Once the credentials committee reviews a medical staff application, the application then goes to this person.

executive committee

This group reviews medical staff applications and recommendations, votes, and makes recommendations to Medical Staff.

active

Medical staff involved in the delivery of medical services and administrative functions.

associate

Medical staff under consideration for active status

consulting

Highly qualified medical staff that provide expertise in an specific area

courtesy

Medical staff who occasionally admits a patient to the hospital

honorary

Former medical staff held in high regard and honored with emerti status

bylaws

The rules and regulations of the health care organization as guided by federal and state regulations and accreditation standards.

bylaws

These are created and voted on by the medical staff; they delineate medical staff responsibilities.

departments

Clinical laboratory, HIM, radiology, medical staff are examples of hospital ____________.

committees

Hospital ______________ are multidisciplinary and comprised of representatives from various departments.

agenda

A listing of all items of business to be discussed

review minutes, old business, member reports, new business, other business, next meeting, adjournments

List the seven items on a standard agenda.

minutes

Concise, accurate records of actions taken and decisions made during the meeting.

date, place, time of meeting; members present; members absent; guests present; items discussed; actions taken; adjournment time; date, place, time of next meeting; secretary's name and signature

What 9 things should be in the meeting minutes?

health information

Department responsible for allowing appropriate access to patient information in support of clinical practice, health services, and medical research while maintaining confidentiality of patient and provider data.

RHIA, RHIT

Health information administrative functions are directed by __________ and _________.

HIM administrators

These individuals develop, monitor, and improve HIM systems, ensure continuous quality operation, participate in committees, and establish department policies and procedures.

cancer registrars

These individuals use computerized registry software to conduct lifetime follow-up on cancer patients, electronically transmit data to state and national agencies, and generate reports and information for requesting entities.

cancer registrars

These individuals coordinate the national survey process through the ACS commission on cancer and arrange monthly or bi-monthly cancer committee meetings.

coding

Involves assigning numeric and alphanumeric codes to diagnoses, procedures, and services.

RHIA, RHIT, CCS

Coding is performed by _______, __________, or _______.

CPT

Coding method used only for ambulatory/outpatient procedures and services.

current procedural terminology

CPT stands for _________.

AMA

CPT is put out by the _________.

ICD-9-CM

Used to collect information about diseases and injuries and to classify diagnosis and procedures.

HCPCS Level II

Codes developed by CMS and used to classify report procedures and services.

health care procedure coding system

HCPCS stands for __________

image processing

HIM department responsible for converting paper to electronic health records via digital media, scanned images, and voice recognition.

need-to-know

Only employees who have been granted ________ status are allowed access to EHR.

locked

Records that are in litigation or behavioral health records are usually _________.

incomplete record processing

This included the assembly and analysis of discharged patient records for deficiencies.

universal chart order

All records are organized in the same order as when the patient was on the nursing floor.

logged into the tracking system, physician is notified

Once the record is analyzed for deficiencies, it is __________, and then __________.

medical transcription

Involves the accurate and timely transcription of dictated reports

record circulation

Includes the retrieval of patient records for the purpose of inpatient readmission, outpatient clinic visits, authorized quality management studies, and education and research.

cancer registry, coding, document conversion, medical transcription, release of information, trauma registry

Provide six examples of HIM contracted services.

licensure

State laws require a health care facility to obtain this before providing services to patients.

regulation

An interpretation of a law that is written by the responsible regulatory agency.

Code of Federal Regulations

The codification of the general and permanent rules published in the Federal Register.

accreditation

The voluntary process that a health care facility or organization undergoes to demonstrate it has met standards beyond those required by law.

standards

Measurements of a health care organization's level of performance in specific areas - more rigorous than regulations

survey

Process conducted both off-site and on-site to determine whether the facility complies with standards.

deemed status

Organization has met the conditions of participation which allows them to accept reimbursement for CMS

ORYX initiative

Integrates outcomes and other performance measurement data into the accreditation process for quality improvement purposes.

Shared Visions - New Pathways Initiative

Changed the scoring and accreditation process, focusing on whether organizations are making improvements system-wide.

Periodic performance review

Developed by the joint commission, this is a continuous survey process that helps organizations meet the continuous demand for accountability and is used for self-evaluation.

National Patient Safety Goals

Developed by the JC, these help organizations focus on providing high quality patient care.

privacy, security, electronic transactions standards

HIPAA sets regulations for the _______, _______, and __________ for health care information.

predetermined rate, discharge diagnosis

Diagnosis related groups required acute care hospitals to be reimbursed at a ______ according to ________.

hippocrates

First to consider medicine both a science and art, separate from practice of religion.

ACS

The _______ developed the minimum standard for hospitals.

voluntary accreditation

The primary purpose of the Joint Commission is to provide ________.

professionals from the community

The membership of the governing board is represented by _________.

credentials

This committee consists of medical staff who review and verfy medical staff applications.

utilization management

A person from this department works with case managers of insurance companies to determine the appropriateness of admissions.

incomplete record processing

The assemby and analysis of discharged patient records.

procedures and services

The CPT coding book is published annually to assign what type of codes.

AMA

Who publishes the CPT coding book?

risk management

A hospital committee that is responsible for analyzing trends of accidents and establishing priorities for dealing with high-risk areas is ___.

National Committee for Quality Assurance

Private non-profit organization established to assess and report on the quality of managed care plands is called the _______.

better, higher quality

Health care consumers are _____ educated and demand _______ health care.

modern

The implementation of standards for sanitation, ventilation, hygiene, and nutrition occurred during ______ medicine.

monks and nuns

In the Middle Ages, the care of patients was based on charity and was often managed by _______.

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