Dynamics in Healthcare Exam Review

What has contributed to the rising cost of healthcare?

The introduction of new, innovative healthcare technology

How has the Affordable Care act (ACA) increased health access to care?

Expanding Medicaid coverage and establishing state marketplaces has decreased the number of uninsured Americans and substantially improved access to care for those who gained coverage.

What aspects of healthcare does the ACA cover?

Makes affordable health insurance available to more people, expands the Medicaid program to cover all adults with income below 138% of the FPL, and it supports innovative medical care delivery methods designed to lower the costs of health care generally.

What are the social determinants of health and how do they impact healthcare?

The conditions in the environments where people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks.

What are the categories of healthcare services provided by the US healthcare system?

Health promotion, disease prevention, diagnosis and treatment, and rehabilitation.

What are Federally Qualified Healthcare Centers? Who do they serve?

The Federally Qualified Healthcare Centers are healthcare centers that serve residents with low income.

What are the agencies that come under the Department of Health and Human Services? What are the responsibilities of these agencies?

Agencies that provide health and care for the people of the country. These agencies are responsible for applying their care onto these patients.

What are the aspects of the Patient Care Partnership?

-High quality hospital care.

-A clean and safe environment.

-Involvement in your care.

-Protection of your privacy.

-Help when leaving the hospital.

-Help with your billing claims.

What are some ways the public healthcare system is funded?

Through the Medicare program and provides grants to the states through the Medicaid program

Which populations are covered under Medicare? What coverage does Medicare provide?

Populations with low income are covered under Medicare and it covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.

How do hospitals use diagnostic related groups (DRG) for billing? What are copays and how do they impact costs to the healthcare system? What are deductibles and how do they impact costs to the healthcare system?

They assign a DRG when you're discharged and it bases the diagnosis and treatment they spent on you. Copays are a fixed amount ($20, for example) you pay for a covered health care service after you've paid your deductible. Deductibles are the amount you pay for covered health care services before your insurance plan starts to pay.

What are health maintenance organizations (HMO)?

A type of health insurance plan that usually limits coverage to care from doctors who work for or contract with the HMO

What are some of the demographic changes expected to take place in the US? How will these changes impact the healthcare system?

The aging of the population, the changing racial and ethnic composition of the population, etc. These changes will impact the healthcare system because there could be an increase of healthcare workers, but it will also bring in more patients to healthcare facilities.

What are instrumental activities of daily living (IADL) and activities of daily living (ADL)? What is the difference between the 2 groups?

IADL is managing finances and medications, food preparation, housekeeping, and laundry. ADL is activities related to personal care.

How are long-term care facilities funded?

Long-term care insurance, reverse mortgages, certain life insurance policies, annuities, and trusts.

What is the role and education of an occupational health and safety specialist?

Inspect workplaces for adherence to regulations on safety, health, and the environment.

What are healthcare disparities?

Differences between two or more groups in health insurance coverage, access to and use of care, and quality of care received

What is health information technology (HIT)?

the use of various forms of technology to improve the quality of health services to individuals and communities

What are Clinical Decision Support Systems (CDSS)?

An application that analyzes data to help healthcare providers make decisions and improve patient care.

What are the advantages and disadvantages of an electronic health record (HER)?

Advantages: Improved Quality of Care, Streamlined, Efficient Workflows, Financial Incentives, Better Use of Space.

Disadvantages: Privacy and Security Risks, Data Accuracy Issues, Malpractice Liability Concerns, Creating Unnecessary Patient Concerns.

What are the various workplace settings of healthcare workers?

In the home of the patient, in residential care, at schools, in research environments, and in other medical clinics.

Where can someone obtain an education in healthcare?

Universities

What are the components of common core knowledge?

Language arts, history and geography, visual arts, music, mathematics, and science,

What are some of the characteristics of a healthcare professional?

Hardworking, strong communication skills, passion for the field, empathy and compassion, etc. d

What is the definition of the following: licensing, accreditation, certification, malpractice, negligence?

Licensing

relating to the granting of an official license.

Accreditation

the action or process of officially recognizing someone as having a particular status or being qualified to perform a particular activity.

Certification

the action or process of providing someone or something with an official document attesting to a status or level of achievement.

Malpractice

improper, illegal, or negligent professional activity or treatment, especially by a medical practitioner, lawyer, or public official.

Negligence

failure to take proper care in doing something.

Why do healthcare professionals need continuing education (CE) courses? Who determines the requirements for CE courses?

Healthcare professionals need continuing education courses for spreading best practices and how to improve patient outcomes. Most employers and boards require CE.

What is the scope of practice for the different healthcare professions described in the text?

The activities that an individual health care practitioner is permitted to perform within a specific profession.

Which professions require a bachelor's degree in order to provide healthcare?

Registered Nurse, Respiratory Therapist, Social Worker, Speech Pathologist, etc.

Are there any healthcare professionals that do not require licensure or certification on order to provide healthcare services?

Caregiver, Medical biller, Pharmacy technician, Home Health aide, Medical scribe, etc.

Are there healthcare professionals that are expected to decline?

Nurses, physicians, medical officers, etc.

What is the scope of practice and specialization are for recreational therapists?

Maintaining their physical, mental, and emotional well-being; reducing depression and anxiety; improving basic reasoning skills; and strengthening confidence.

What is the difference between a physical therapist (PT) and a physical therapy assistant (PTA)?

PTs are mainly concerned with diagnosing patients and developing a rehabilitation program that is tailored to the patient's prognosis. PTAs on the other hand have more focus on preparing patients to be diagnosed and assisting in executing the rehabilitation plan.

What are community healthcare workers? What is their role and job function?

CHWs offer interpretation and translation services, provide culturally appropriate health education and information, help people get the care they need, give informal counseling and guidance on health behaviors, advocate for individual and community health needs, and provide some direct services such as first aid and blood pressure screening.

What are different types of sonographers?

Cardiac Sonographer, Obstetric Sonographer, Abdominal Sonographer, Vascular Sonographer, Bone Sonographer, Echocardiographer, Obstetrics, Ultrasonography, Pediatric Cardiac Sonography, Musculoskeletal sonographer, Breast Sonographer, Ultrasound tech, Abdomen sonographer.

What is the benefit of massage therapy?

Feeling of deep relaxation and calm.

What is the difference between psychiatric aides and psychiatric technicians?

Technicians typically provide therapeutic care and monitor their patients conditions. Aides help patients in their daily activities and ensure a safe and clean environment.

What is the educational requirement for vet techs? What is the scope of practice and licensure requirements for vet techs?

A vet tech has an Associate of Applied Science in Veterinary Technology. Vet Techs are trained to obtain and record patient case histories; collect specimens and perform laboratory procedures; provide specialized nursing care; prepare animals, instruments, and equipment for surgery, etc.

What is an HMO vs an EPO vs HMO vs private insurance?

EPO plans offer a larger network than an HMO plan but typically do not have the out-of-network benefits of PPO plans. EPO plans do not require you to select a primary care physician (PCP) giving you a broader network of providers.

How did the Area Agencies on Aging come to exist?

Building on a successful model pioneered in the southeastern region of the U.S., Area Agencies on Aging (AAAs) were formally established in the 1973 Older Americans Act (OAA) as the "on-the-ground" organizations charged with helping vulnerable older adults live with independence and dignity in their homes.

What is the definition of telemedicine?

Consultation among physicians at a distance

What is the definition of telehealth?

The provision of healthcare remotely by means of telecommunications technology.

What are teams that may be formed while a patient is receiving healthcare services? Who might be members of the teams?

Teams in health care consist of diagnosticians, prescribers, medication experts and members who tend to the ongoing daily needs of the patient. Each expert adds a specific value, creating a collective synergy so that patient needs can be most effectively met.

What is the definition of licensing of a healthcare professional?

A licensed medical professional is an individual who has completed the necessary education and training to practice medicine within a specific area of expertise.

What is the definition of certification of healthcare professional?

Certification is the process of obtaining, verifying, and assessing the qualifications of a practitioner

What is a communication impairment? Which professional would manage or treat communication impairment issues?

Communication impairment is a communication disorder is an impairment in the ability to receive, send, process, and comprehend concepts or verbal, nonverbal and graphic symbol systems. Speech-language pathologists (SLPs) work to prevent, assess, diagnose, and treat speech, language, social communication, cognitive-communication, and swallowing disorders in children and adults.

What is the role of a psychologist? What are the areas of specialization in this field?

Clinical psychologists provide a range of continuous mental and behavioral health care to individual patients, groups, couples or families. Clinical child and adolescent psychology is an APA specialty.

What is the job function of a healthcare manager?

Medical and health services managers set and carry out policies, goals, and procedures for their departments or facilities. Their duties include hiring, scheduling, and evaluating staff; monitoring compliance with state and federal guidelines; and developing reports and budgets.

What is the role of the Commission on Accreditation for Health Information Management Education (CAHIIM)?

To provide the public with effective and consistent quality monitoring of health informatics and health information management programs through maintenance of accreditation processes.

What are the components of a malpractice case? What does each side have to prove in a malpractice case?

(1) a professional duty owed to the patient; (2) breach of such duty; (3) injury caused by the breach; and (4) resulting damages.