NHA Module 1: Foundational Knowledge and Basic Science

Scope of Practice

the standards that a medical professional may perform within the limits of the medical license, registration, or certification

• MA works under a provider and performs tasks allowed by state and provider approval

MA Roles

• work with provider in outpatient or ambulatory setting

• administrative duties and clinical duties

• obtains medical histories

• gives patient education

• performs laboratory tests

• prepares and administers immunizations

Administrative duties

greeting patients, scheduling, handling correspondence, answering telephones, pt registration, updating and working in pt records, sending insurance claims, collecting pt responsibility amounts like copays.

Clinical Duties

• Collecting and processing lab specimens

• Performing diagnostic testing (EKG, spirometry)

• Preparing and cleaning examination rooms

• Preparing the patient for evaluation and procedure

• Measuring vital signs​​​​​​​

• Preparing medications and administering immunizations

Variables impacting scope of practice

• training

• medical office’s organizational policies

  • must adhere to state and government guidlines

Additional certifications

• Certified medical administrative assistant (CMAA)

• Certified phlebotomy technician (CPT)

• Certified EKG technician (CET)

• Certified billing and coding specialist (CBCS)

• Certified electronic health records specialist (CEHRS)

Physicians

must complete 8 years of school then 2-7 year residency.

• medical doctor(MD)

• doctor of osteopathy(DO)

Medical doctors

allopathic providers that diagnose illnesses, provide treatments, perform procedures like surgical interventions, and write prescriptions

Doctors of osteopathy

do modern medicine, surgical procedures, and use manipulative therapy to treat pts

Physician Assistant (PA)

• practice under supervision of MD or DO

• can make clinical decisions

• need 4 years of college then 2 years of PA school

Nurse Practitioner (NP)

• provide basic pt care services

  • diagnose, prescribe meds for common illness.

• require training beyond registered nurse (RN)

• most states require they work under supervision of a physician

Licensed practical nurse (LPN)

• must be licensed in their state

• one year of schooling and a board exam

• limited in scope and are there to measure vital signs, administer meds, and perform clinical care like wound treatment

• used a lot in long-term care setting

Registered nurse (RN)

• must complete more schooling in form of associate degree, diploma, or baccalaureate.

• must bass board exam

• RNs have broader scope of practice than LPN

• work in clinical settings, public health agencies, administrative capacities, and educational settings

Allied Health Professionals

• medical lab technicians

• medical receptionists

• occupational therapists

• pharmacy technicians

• physical therapists

• radiology technicians

Medical Laboratory technicians

perform diagnostic testing on blood, bodily fluids, and other specimens under the supervision of a medical technologist.

Medical receptionist

checks pts in and out. answers phones, schedules appointments, and administrative stuff

Occupational therapists

assist patients who have conditions that disable them developmentally, emotionally, mentally, or physically.

Pharmacy technicians

dispense routine medications without expertise of licensed pharmacist

• must work under supervision of pharmacist

physical therapists

assist patients in improving mobility, strength, and range of motion.

Radiology techicians

using imaging equipment to help provider in diagnosing diseases

Licensure

• regulated by state statutes and through medical practice acts

• is accomplished by examination, reciprocity, or endorsement

reciprocity

agreement or arrangement allowing residents in one state to obtain a license in another state

endorsement

process of a state/territory giving a license to an applicant who is licensed in good standing at the equivalent designation in another jurisdiction

Certification

states require different certifications or no certifications for MAs to perform certain procedures

Maintaining certification

for NHA, the certification is valid for 2 years and people must either retake the certification exam or complete 10 hours of continuing education to renew

Inpatient

when pt is admitted to hospital or facility

Ambulatory

care in outpatient facility

• primary care clinics

• specialty care clinics

• home health

• mobile health units

• hospice

primary care clinics

pt is seen for routine visits like wellness checks, prevention counseling, chronic conditions, medication management, and minor acute needs

Speciality Care clinics

pt has complex or severe diseases and conditions.

• seen for routine visits by specialized doctors

Home health

refers to care provided to those who can’t leave their home easily

• physical, occupational, and speech therapy are common

• us ordered for a set period, based on an acute event. Service is complete once goals are reached

Mobile health units

bring health care to communities that need it most

• equipped with transportation that allows for use of specialized medical equipment

Hospice

end-of-life-care focused on comfort rather than curing pt.

• pt qualifies for this if they have terminal illness and are at end stage

• can be done inpatient or outpatient

Patient-centered medical home (PCMH)

partnership between a pt and their care team where health is the focus, not a single condition.

• healthcare team: includes a provider (Physician, nurse practitioner, and PA), CMAA, CCMA, nurses, and pharmacist

Telehealth and Virtual Visits

health care delivered virtually via video call.

• used to prevent pt from coming in contact with communicable diseases, increase convenience, and increase opportunity

• telehealth can’t do diagnostic testing, find new pain symptoms, or do a physical examination

Patient portals

• allows pt to log into a pt version of the EHR to see test results, visit notes, and pt education materials.

• some portals allow pt to schedule appointments without needing to call office.

Fee for service

where providers and medical facilities bill insurance and pts for the services provided.

• every medical service and test procedure has a procedural code and charge

• The medical billing department sends it to insurance, who then charges the pt a predetermined amount for which they are responsible

Value based plan

the quadruple aim

• improved pt outcomes

• improved pt satisfaction

• lower cost

• health care professional well being

insurance coverage that changes the amount of reimbursement based on health outcomes of pt and the quality of service they recieved.

managed care

umbrella term for plans that give health care in return for scheduled payments and coordinated care through a defined network of providers and hospitals

Capitation

pt is given a per-month payment based on their demographics and medical history.

• payment rates are tied to expected usage.

• providers try to help pt avoid high cost procedures and tests

Health maintenance organization (HMO)

medical insurance group that provides coverage of health care services for a period of time and a fixed annual fee

Preferred provider organization (PPO)

a network of physicians, other health care practitioners, and hospitals that have joined together to contract with insurance companies, employers, or other organizations to provide health care to subscribers for a discounted fee.

Point of service (POS)

a type of health insurance plan that is based on lower medical costs in exchange for more limited choice.

General practitioners (GP)

treat acute and chronic illnesses and give pt preventive care and health education

• takes a holistic approach to general practice, considering biological, psychological, and social aspects

Family practitioners

offer care to whole family, are familiar with numerous diseases and disorders

• preventative care is the primary concern

Internists

• give comprehensive care for adults

• diagnose and trat chronic and long-term conditions

Specialty health care services

used when a disease or diagnosis escalates beyond the expertise of a PCP.

these people focus on diagnosing and treating disorders of specific body systems

allergist

evaluates disorders and diseases of immune system

• adverse reactions to meds, foods, anaphylaxis, autoimmune disease, and asthma

anesthesiologist

manages pain through sedation meds during surgery

Cardiologists

diagnoses and treats diseases or conditions of the heart and blood

dermatologist

skin conditionsen

endocrinologist

hormonal and glandular conditions

gastroenterologist

diseases of the GI tract

gynecologist

internal reproductive system and fertility disorders

hematologists

trats blood and blood producing organs

• anemia, leukemia, and lymphoma

Hepatologists

treats liver, biliary tree, gallbladder, and pancreas

neonatologist

care of newborns that are ill or prematureneph

nephrologist

manages diseases and disorders of the kidney and associated structures

obstetrician

provides care of pt during and after pregnancy

oncologist

treats and provides care for pt with cancerpth

optalmologist

diagnoses and treats diseases and conditions of the eye

orthopedist

treats injuries and diseases of bones, joints, muscles, tendons, and ligaments

Neurologist

diseases and disorders of brain and nervous system

otalaryngologist

treats conditions of ear, nose, and throat

pediatrician

manages newborn to adolescent healthpsych

psychiatrist

diagnoses and treats mental disorders and conditions

radiologist

uses and interprets imaging to detect abnormalities in body

urologist

manages disorders of urinary tract

Ancillary services

provides convenience for pt and increases revenue for organization

• urgent care

• laboratory services

• diagnostic imaging

• occupational therapy

• physical therapy

Complementary therapies

• acupuncture

• chiropractic medicine

• energy therapy

• dietary supplements

analgesics

• relieve pain

• acetaminophen

• hydrocodone

• codeine

Antacids/anti-ulcer

• Gastroesophageal Reflux Disease (GERD)

• Esomeprazole, calcium carbonate, famotidine

antibiotics

• bacterial infections

• Amoxicillin, ciprofloxacin, sulfamethoxazole 

Anticholinergics

• Smooth muscle spasms

• Ipratropium, dicyclomine, hyoscyamine

Anticoagulants

• Delay blood clotting

• Warfarin, apixaban, heparin

Anticonvulsants

• Prevent or control seizures

• Clonazepam, phenytoin, gabapentin

Antidepressants

• Relieve depression

• Doxepin, fluoxetine, duloxetine, selegiline

Antidiarrheals

• Reduce diarrhea

• Bismuth subsalicylate, loperamide, dipehnoxylate/atropine

Antiemetics

• Reduce nausea, vomiting

• Metoclopramide, ondansetron

Antifungals

• Fungal infections

• Fluconazole, nystatin, miconazole

Antihistamines

• Relieve allergies

• Diphenhydramine, cetirizine, loratadine

Antihypertensives

• Lower blood pressure

• Metoprolol, lisinopril, valsartan, clonidine

Anti-inflammatories

• Reduce inflammation

• Ibuprofen, celecoxib, naproxen

Antilipemics

• Lower cholesterol

• Atorvastatin, fenofibrate, cholestyramine 

Antimigraine agents

• Relieve migraine headaches

• Topiramate, sumatriptan, rizatriptan, zolmitriptan

Anti-osteoporosis agents

• Improve bone density

• Alendronate, raloxifene, calcitonin

Antipsychotics

• Psychosis

• Quetiapine, haloperidol, risperidone

Antipyretics

• Reduce fever

• Acetaminophen, ibuprofen, aspirin

Skeletal/muscle relaxants

• Reduce or prevent muscle spasms

• Cyclobenzaprine, methocarbamol, carisoprodol

Antitussives/expectorants

• Control cough, promote the elimination of mucus

• Dextromethorphan, codeine, guaifenesin

Antivirals

• Viral infections

• Acyclovir, interferon, oseltamivir

Anxiolytics (anti-anxiety)

• Reduce anxiety

• Clonazepam, diazepam, lorazepam

Bronchodilators

• Relax airway muscles

• Albuterol, isoproterenol, theophylline

Central nervous system stimulants

• Reduce hyperactivity

• Methylphenidate, dextroamphetamine, lisdexamfetamine

Contraceptives

• Prevent pregnancy

• Medroxyprogesterone acetate, ethinyl estradiol, drospirenone

Decongestants

• Relieve nasal congestion

• Pseudoephedrine, phenylephrine, oxymetazoline

Diuretics

• Eliminate excess fluid

• Furosemide, hydrochlorothiazide, bumetanide 

Hormone replacements

• Stabilize hormone deficiencies

• Levothyroxine, insulin, desmopressin, estrogen

Laxatives, stool softeners

• Promote bowel movements

• Magnesium hydroxide, bisacodyl, docusate sodium

Oral hypoglycemics

• Reduce blood glucose

• Metformin, glyburide, pioglitazone

Sedative-hypnotics

• Induce sleep/relaxation

• Zolpidem, temazepam, eszopiclone