Final exam and rutgers exam study guide

What has contributed to the rising cost of healthcare?

Healthcare inflation has increased due to patients receiving more medical care. Like other industries, inflation affects medical operations, supplies, administration, and facilities costs. Healthcare facilities have also taken a hit due to staff shortages and lower wages

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

The Affordable Care Act (ACA) expanded eligibility for affordable health coverage in two main ways: by creating health insurance marketplaces with federal financial assistance that reduces premiums and deductibles and by allowing states to expand Medicaid to adults with household incomes up to 138 percent of the federal poverty level (FPL)

What aspects of healthcare does the ACA cover?

The ACA covers Ambulatory patient services (outpatient services), Emergency services, Hospitalization, Maternity and newborn care, Mental health and substance use disorder services, including behavioral health treatment, Prescription drugs, Rehabilitative and habilitative services (those that help patients acquire, maintain, or improve skills necessary for daily functioning) and devices, Laboratory services, Preventive and wellness services and chronic disease management, Pediatric services, including oral and vision care

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

Social determinants of health (SDOH) are the non-medical factors that influence health outcomes. They are the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life

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

The US healthcarte system provides Mental health care,

Emergency medicine, Prenatal care Ambulatory care, Chronic illness care, Hospitalization, Dental care, Laboratory Services, Preventive and wellness services, and Primary care

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

Federally Qualified Health Centers (FQHCs) deliver high quality health care to all people regardless of their ability to pay. You don't need health insurance to receive care at a health center. They serve the uninsured as well as patients with Medicaid, NJ FamilyCare, Medicare and private insurance

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

1. Centers for Disease Control and Prevention (CDC)

Responsibilities: Protect public health through disease control and prevention.

2. Food and Drug Administration (FDA)

Responsibilities: Ensures the safety and effectiveness of food, drugs, medical devices, and cosmetics.

3. National Institutes of Health (NIH)

Responsibilities: Conducts and supports medical research to improve health and cure diseases.

4. Centers for Medicare & Medicaid Services (CMS)

Responsibilities: Manages Medicare, Medicaid, and the Children's Health Insurance Program (CHIP).

5. Substance Abuse and Mental Health Services Administration (SAMHSA)

Responsibilities: Leads efforts to reduce the impact of substance abuse and mental illness.

6. Health Resources and Services Administration (HRSA)

Responsibilities: Improves access to healthcare for people who are uninsured, isolated, or medically vulnerable.

7. Administration for Children and Families (ACF)

Responsibilities: Promotes the well-being of families, children, and communities.

8. Agency for Healthcare Research and Quality (AHRQ)

Responsibilities: Improves the quality, safety, efficiency, and effectiveness of healthcare.

9. Indian Health Service (IHS)

Responsibilities: Provides healthcare services to American Indians and Alaska Natives.

10. Administration for Community Living (ACL)

Responsibilities: Supports older adults and people with disabilities to live independently.

What are the aspects of the Patient Care Partnership?

The care team decides collaboratively about care activities, care planning, and decision-making

What are some ways the public healthcare system is funded?

Local, State, and Federal agencies

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

Medicare Part A (hospital insurance): This covers services such as lab tests, hospital stays, and skilled nursing facility care.

Medicare Part B (medical insurance): This covers outpatient services such as durable medical equipment (DME) and visits with healthcare professionals

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 deductables and how do they impact costs to the healthcare system.

Hospitals use DRGs to determine the amount they charge Medicare for a person's care. Instead of charging for each individual service, they charge a predetermined amount based on condition, necessary procedures, and discharge status. DRGs do not generally affect a person's out-of-pocket costs

What are health maintenance organizations (HMO)?

HMOs combine the financing and delivery of comprehensive healthcare services and supplies

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

Aging Population: The U.S. population is aging, with the number of people aged 65 and above projected to nearly double by 2060. This will increase the demand for geriatric care, chronic disease management, and end-of-life care. Increasing Diversity: The U.S. is becoming more ethnically and racially diverse

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

Basic ADLs or physical ADLs are skills required to manage one's basic physical needs, including personal hygiene and grooming, dressing, toileting, transferring or ambulating, and eating. In contrast, instrumental ADLs include more complex activities related to living independently in the community

How are long-term care facilities funded?

Medicaid

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

Review, evaluate, and analyze work environments and design programs and procedures to control, eliminate, and prevent disease or injury caused by chemical, physical, and biological agents or ergonomic factors.You need a high school diploma to become a OSS

How does health literacy impact overall health and the healthcare system?

Adults with limited health literacy obtain less information from disease prevention and control materials, and may be less likely to undergo screening or to successfully manage their illness

What are healthcare disparities?

A difference between population groups in the way they access, experience, and receive healthcare

What is health information technology (HIT)?

health technology, particularly information technology, applied to health and health care. It supports health information management across computerized systems and the secure exchange of health information between consumers, providers, payers, and quality monitors

What are Clinical Decision Support Systems (CDSS)?

A traditional CDSS is comprised of software designed to be a direct aid to clinical-decision making

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

While EMRs offer substantial benefits in terms of accessibility, cost reduction, and improved patient care, they also bring challenges like potential information gaps, security concerns, and integration issues

What are the various workplace settings of healthcare workers?

Hopsitals, Clinicals, Offices of physicians, Academic settings, Governemet settings

Where can someone obtain an education in healthcare?

High schools, CTE programs, College, Medical school, hospitals and medical centers

What are the components of common core knowledge?

The Common Core initiative only specifies what students should know at each grade level and describes the skills that they must acquire in order to achieve college or career readiness

What are some of the characteristics of a healthcare professional?

Communication skills, Empathy, Problem solving skills, Critical thinking, Adaptability, Communication, Knowledgeable, Passion for the field

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

Licensing : A legal authorization granted by a government (usually a state) that allows an individual to practice a specific profession

Accreditation : A formal recognition that a healthcare organization (such as a hospital or school) meets established quality standards

Certification : A non-governmental process by which a professional organization recognizes an individual as having met certain qualifications and competencies in a specific area

Malpractice : A type of professional misconduct or failure by a healthcare provider to meet the standard of care, resulting in harm to a patient

Negligence :A failure to exercise reasonable care, resulting in unintended harm to a patient

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

Continuing education (CE) ensures that doctors, nurses, and allied health professionals remain competent, efficient, and up to date with the latest best practices in patient care. It also enhances career growth, improves patient outcomes, and keeps healthcare institutions compliant with industry standards

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

Medical Assistant (MA)

Scope of Practice:

Take vital signs (blood pressure, pulse, temperature)

Administer medications (under supervision)

Perform basic lab tests

Assist with exams and procedures

Handle administrative duties (scheduling, billing)

2. Home Health Aide (HHA)

Scope of Practice:

Help with activities of daily living (ADLs): bathing, dressing, eating

Monitor patient condition and report changes

Assist with basic exercises

Support light housekeeping and meal preparation

3. Personal Care Assistant (PCA) / Caregiver

Scope of Practice:

Provide companionship

Help with mobility, feeding, and hygiene

Perform household tasks like laundry and meal prep

4. Medical Scribe

Scope of Practice:

Document physician-patient encounters in real time

Enter medical records and coding information

Assist with charting and record-keeping

5. Certified Nursing Assistant (CNA)

Scope of Practice:

Assist with ADLs

Measure vital signs

Provide basic patient care (feeding, hygiene)

Assist nurses with tasks

6. Registered Nurse (RN)

Scope of Practice:

Assess patient health

Administer medications and treatments

Develop and manage care plans

Educate patients and families

Supervise other healthcare staff

7. Physician (MD or DO)

Scope of Practice:

Diagnose and treat illnesses

Prescribe medications

Perform surgeries

Oversee patient care and healthcare teams

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

Medical Services Manager

Health Educator

Biomedical equipment technician

Pharmaceutical marketing

Registered Nurse

Respiratory therapist

Medical laboratory scientist

Chemist

Clinical Trial Manager

Health information Specialist

Public Health Nurse

Care Manager

Community Health Worker

Cytotechnologist

Dental hygienist

Geneticist

Imaging specialist

Nuclear medical technology

Occupational health and safety

Surgical technologist

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

Medical Assistants, Home Health Aids, Personal Care Assistants, Healthcare Administrative Staff, and Medical Scribes

Are there healthcare professionals that are expected to decline?

The U.S. is projected to experience a shortage of Registered Nurses (RNs) that is expected to intensify as Baby Boomers age and the need for health care grows

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

Scope of practice

Recreational therapists work with doctors, nurses, psychologists, social workers, physical therapists, and occupational therapists to care for patients of all ages, from infants to the elderly. Therapists provide different services for patients depending on where they work

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

The PTA works under the supervision of a PT to provide treatment interventions, progress patients, document in the medical record and communicate with the supervising PT

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

Community health workers act as intermediaries between their clients and providers of healthcare and social services. They identify health-related issues, collect data, and discuss clients' health concerns within the community

What are the different types of sonographers?

Diagnostic Medical sonographer

Musculoskeletal sonographer

Cardiac Sonographer

Breast Sonographer

Vascular Sonographer

Vascular Tech

Abdominal sonographer

Gynecologic sonography

Obstetric Sonographer

Neurosonology sonographer

Gynecology

Abdominal sonography

Executive sonographer

Pediatric Sonography

Ultrasound technician

Abdomen

Cardiac Sonography

Echo Sonographer

Neurosonography

Radiology Technologist

Ultrasound Technologist

Breast ultrasound

What is the benefit of massage therapy?

Help reduce stress. Lessen pain and muscle tightness. Increase relaxation. Improve the work of the immune system

What is the difference between psychiatric aides and psychiatric technicians?

Psychiatric technicians and aides care for people who have mental illness and developmental disabilities. 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?

Education Requirements: High School and College

In addition, a strong grasp of algebra is integral to understanding medication calculations. After high school, aspiring vet techs must earn a degree from an American Veterinary Medical Association (AVMA) accredited veterinary technology or veterinary nursing program

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

Like HMOs, EPOs cover only in-network care. But the networks are generally larger. They may or may not require referrals from a primary care physician. Premiums are higher than HMOs, but lower than PPOs

How did the Area Agencies on Aging come to exist?

Area Agencies on Aging 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 and communities

What is the definition of telemedicine?

The remote diagnosis and treatment of patients by means of telecommunications technology.

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?

Core teams , These are directly involved in caring for the patient. They usually consist of team leaders and members who are direct-care providers such as nurses, dentists, pharmacists, doctors, assistants...etc. They also include case managers.

What is the definition of licensing of a healthcare professional?

Licensing has been upheld as a mechanism for administering and enforcing standards among the health professionals within a state

What is the definition of certiification of a 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?

A person with aphasia may have trouble understanding, speaking, reading, or writing. Speech-language pathologists are professionals who work with people with communication problems and can diagnose and treat the type of difficulty you're having

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

Psychologists typically do the following: Study behavior and brain function by observing, interviewing, and surveying individuals. Identify psychological, emotional, behavioral, or organizational issues and diagnose disorders. Research and identify behavioral or emotional issues, such as anxiety and depression

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)?

CAHIIM was created by American Health Information Management Association (AHIMA). It provides students with consistent quality monitoring of health informatics and health information management programs through their accreditation processes

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

All malpractice cases are composed of four elements that must be alleged and proved: (1) the IR owed a duty to the patient, (2) a breach of the duty occurs, (3) the breach is a cause of an injury that is compensable, and (4) the patient actually suffers an injury