CSBI – HFMA 100% SOLUTION 2023//2024

CSBI – HFMA 100% SOLUTION 2023//2024 What has changed for Healthcare Analytics? - ANSWER 1 - Increased computing power and storage, decrease in cost; 2 - increased abundance of data in healthcare; 3 - increase in individuals having strong competencies Big Data - ANSWER Refers to the Growth in available data, massive continually increasing volume of live and stored data for analysis; and the increase in tools available for highly sophisticated ways to combine and analyze data to yield new information and insights. (Size Scope Speed) Big Data View Points - ANSWER Focused, Broad, Medium Focused Viewpoint - ANSWER Enables one to know the work or business in detail Broad Viewpoint - ANSWER Enables one to understand all the industry pieces and the background influencers Medium Viewpoint - ANSWER Enables one to know how one's business or work fits with the other pieces and how the other industry components fit and work with each other NKBDSI - ANSWER Nursing Knowledge Big Data Science Initiative NKBDSI Organization - ANSWER National organization committed to developing, implementing, and guiding a dynamic plan of action that ensures nursing data are captured and available in sharing, comparable formats to help improve health outcomes. Small Data - ANSWER A volume and format that makes it very readily accessible, informative and actionable. Triple Aim - ANSWER A key support under healthcare reform and the drive for achieving value. What are the Viewpoints/Approach for Healthcare Delivery? - ANSWER 1 - Providercentric Approach 2- Patient-centric Approach Provider-centric - ANSWER This approach is the traditional viewpoint for the healthcare delivery continuum. In this environment, the patient being cared for is guided along a care path that is largely predetermined and/or promoted by the provider. Includes the thought that patient being served do not have the necessary level of comprehension or understanding of their situation. Patient-centric - ANSWER The healthcare industry is shifting towards this approach. Based on the patient's condition and prospects for improvement, services are rendered in relation to the situation, as opposed to only considering how an individual progress through a series of facilities. HIPAA Act - ANSWER Health Insurance Portability and Accountability Act HITECH Act - ANSWER Health Information Technology Economic and Clinical Health Act HIPAA - ANSWER Covers how PHI is protected and handled. HITECH - ANSWER To promote and expand adoption of HIT, spells meaningful use requirements. BI is a prime source of data information for MU rules. Now promoting interoperability. Professionalism - ANSWER Basic values: Honesty and integrity, accountability, self regulation, specialized knowledge, building expertise, competency, image. The obligation to use one's specialized knowledge and expertise to add value What are the components of Healthcare delivery services? - ANSWER 1-What is provided - the healthcare care services 2-What ways it is provided - types of services 3-Whom/Where? Providers and locations, payment providers 4-How - components of effective operations - providers, locations, supplier, payors, insurers 5-Influencers - education, government, research What are internal components of healthcare service delivery? - ANSWER Medical care services, types of health services, providers and locations, ACA providers, Provider organization ownership status, supplier supply chain, payors, education/research, government. What are external components of healthcare service delivery? - ANSWER Economic factors, social values, global influences, population characteristics, political climate, technology developments, physical environment SDoH - ANSWER social determinants of health ( where people live, learn, work. and play) Their socioeconomic status, education, age, and access to health care. Healthcare Care Services - ANSWER How the patient is served and is the mission of the healthcare industry. Examples are: preventive, treatment-curative, treatmentchronic, restorative Types of Health Services - ANSWER Refer to locations, care settings or providers of care. Examples are: preventive, primary care, acute, specialty, subacute, chronic, long term, rehabilitative, end of life care Providers & Locations - ANSWER Adds complexity to the healthcare delivery service that patients must navigate. Patients must have contacts with these touch points are required for care. CPP Constrained Payment Providers - ANSWER Method in which payments for services paid are defined in advance of care. Examples are Accountable Care Organizations (ACO), Patient Centered Medical Homes (PCMHs), Medicare Advantage Plans, and service specific bundled payments Bundled Payments - ANSWER service programs where payment is made on the basis of expected costs for clinically defined episodes of care. Also known as global payments, case rate, episodic payment. Provider Organization Ownership Status - ANSWER Refers to Not For Profit or For Profit. Historically, physician entities were largely for profit, but now many are changing to not for profit status. Tax issues are affecting this area where efforts must be taken to ensure community service requirements are maintained for tax-exemptions. Supplier and supply chain - ANSWER Comprised of all for-profit entities, manufacturers of all kind, distributions organizations, purchasing entities. Examples are - pharmaceuticals, biomedical, life sciences, comsumables Government - ANSWER Key system component at the federal level. Has vast influence - Medicare, ACA implementation, FDA, Public health service, and general health regulations. examples are - public insurance financing, health regulations/policy, research funding, public health Economic Factors - ANSWER general economy, consumer sentiments and demand elasticity, economic development, demand elasticity by service, labor market/union strength, employer strength, demand elasticity, market liquidity Social Values - ANSWER Diversity, social cohesion, established precedents, religious preferences Global Influences - ANSWER Immigration, vacation travel, tourism, epidemics,