HCA Exam 2
✅✅
What are some of the main challenges and/ or changes posed by the growing use of
technology in the U.S.? - -technology is costly/ needs research
rise of customer expectations
organization of medical services changed
driven scope and content of medical training assessment
complex social/ ethical concerns
how do we define the term medical technology - ✅✅-application of scientific
knowledge to improve health and make efficient development
nanotechnolgy - ✅✅ -nano science and nanotechnology are the study and
application of extremely small things and can be used across all the other science
fields, such as chemistry, biology, physics, materials science and engineering
✅✅
what are the three main types of information technology used in medical care
delivery? - -clinical information
administrative information systems
decision support systems
clinical information systems - ✅✅ -supports patient care delivery and clinical
decision making
include electronic medical records
medical informatics encompass IT application that are designed to improve clinical
efficiency, accuracy, and reliability
administrative information systems - ✅✅ -enable the organization to carry out
financial and administrative support functions
decision support systems - ✅✅-provide analytical tools for managerial decision
making
✅✅
what are the four primary characteristics of electronic health records (EHRs)? -
-1. collection/ storage of health info on patients over time
2. immediate electronic access to person and population level info
3. availability of knowledge and decision support
4. support of efficient processes for health care delivery
HITECH act - ✅✅ -health information technology for economic and clinical health
act
created to motivate the implementation of electronic health records and supporting
technology in the US with financial incentives
,e-health -✅✅-broad coverage of electronic health services
m-health - ✅✅-mobile health, fitbit wearable devices
e-therapy - ✅✅-mental health/ substance abuse concern
telemedicine - ✅✅-virtual distance medicine
✅✅
what are some factors that drive innovation and technology diffusion -
-anthro-cultural beliefs and values
medical specialization
financing and payment
technology-driven competition
expenditure on research and development
supply-side controls
government policy
technological imperative - ✅✅ -implies the use of technology without cost
considerations, especially when the benefits to be delivered the use of technology
are small compared to the costs
governments role in technology diffusion - ✅✅ -government funds 46% of medical
technology R&D in the US aside from development, they have a responsibility to
intervene and ensure safety measures are in place as technology is introduced into
the marketplace (via the FDA)
responsibilities of the food and drug administration - ✅✅-government roles in tech
diffusion
regulation of drugs, devices and biologics
evolution of the approval process
drugs from overseas
securing the supply chain
regulation of medical devices and equipment
regulation of biologics
current federal legislation that regulates drugs and medical devices - ✅✅ -FDA
CON laws required hospitals to seek approval before acquiring major equipment/
projects certifications of need is an endorsement that numerous states require before
approving the construction of a new health- care facility. the central idea of con
legislation is the assertion that overbuilding and redundancy in health-care facilities
leads to higher health-care costs
classes of medical devices - ✅✅ -1. low risk
2. suntan booths, braces use and function
,3. premarket approval
health technology assessment - ✅✅ -any process of examining and reporting
properties of a medical technology used in health care, such as safety, effectiveness,
feasibility, and indications for use, cost, and cost-effectiveness, as well as social,
economic and ethical consequences, whether intended or unintended
✅✅-purchase of insurance
financing -
moral hazard of financing - ✅✅-if i have insurance, i will use it
1. patients consume more
2. leads to higher utilization or moral hazard
financing influences the supply and distribution of health professionals
four principles of insurance -✅✅ -1. risk is unpredictable for the insured
2. risk can be predicted with reasonable accuracy
3. insurance mechanism transfers risk from the individual to the group
4. members of insured group share losses
✅✅
principle cost of sharing - -**out of pocket not covered
deductible- cost you pay until insurance kicks in
copayment- overtime you see a provider
coinsurance- a percentage you have to pay
what is the purpose of a stop loss provision in an insurance plan - ✅✅ -annual out
of pocket max or stop loss - once you pay enough in the year then you stop paying
this helps so that people aren't spending a ton of money paying deductibles all of the
time. once they hit a certain number they no longer have to pay these deductibles.
protects against catastrophic loss
4 types of private insurance -✅✅ -managed care plans (HMO and PPO)
group insurance
self insurance
individual private health insurance
HMO - ✅✅-in a network, one set PCP
PPO - ✅✅-no referral from PCP needed, higher out of pocket
group insurance - ✅✅-coverage to members of a group that tends to be
employees of a company members of the group usually receive insurance at a
reduced cost because the insurers risk is spread across a group of policyholders
, self insurance -✅✅ -a person does not take out any third party insurance or a
business that is liable for some risk chooses to carry the risk itself and not take out
insurance through an insurance company
individual private health insurance - ✅✅-purchase on your own for you or your
family, not through an employer
6 ACA provisions impacting private coverage - ✅✅ -1. insurers mandated to enroll
young adults until age 26 under parent's plans
2. illegal to charge more or refuse coverage for preexisting conditions
3. all health plans had to include certain essential health benefits
4. fees imposed on insurers for selling plans through the exchanges
5. medical loss ratio (MLR)
6. legal US residents required to have health insurance or else pay a penalty tax
medicare - ✅✅-insurance for those over 65
medicaid - ✅✅-those below the poverty line depending on state
CHIP - ✅✅-children under the age of 19
free clinics/ ER - ✅✅-open to everyone with or without insurance
vets/ military - ✅✅-government funded VA hospitals
medicare part a - ✅✅-hospital insurance that covers inpatient hospital care, skilled
nursing care, home health care, hospice care
medicare part b - ✅✅ -voluntary program that covers doctors services, outpatient
care, preventative services, diagnostic tests, some therapies, durable medical
equipment
medicare c - ✅✅ -medicare advantage
includes all benefits from a and b, run by medicare-approved private insurance
companies, usually includes part d, may include extra benefits and services at extra
costs
medicare d - ✅✅ -voluntary program offering coverage to part a or b enrollees,
helps cover cost of prescription drugs run by medicare-approved private insurance
companies, doughnut hole
medicaid - ✅✅ -finances health care for the poor
almost entirely a taxpayer-financed program
means-tested program (eligibility depends on financial resources)
✅✅
What are some of the main challenges and/ or changes posed by the growing use of
technology in the U.S.? - -technology is costly/ needs research
rise of customer expectations
organization of medical services changed
driven scope and content of medical training assessment
complex social/ ethical concerns
how do we define the term medical technology - ✅✅-application of scientific
knowledge to improve health and make efficient development
nanotechnolgy - ✅✅ -nano science and nanotechnology are the study and
application of extremely small things and can be used across all the other science
fields, such as chemistry, biology, physics, materials science and engineering
✅✅
what are the three main types of information technology used in medical care
delivery? - -clinical information
administrative information systems
decision support systems
clinical information systems - ✅✅ -supports patient care delivery and clinical
decision making
include electronic medical records
medical informatics encompass IT application that are designed to improve clinical
efficiency, accuracy, and reliability
administrative information systems - ✅✅ -enable the organization to carry out
financial and administrative support functions
decision support systems - ✅✅-provide analytical tools for managerial decision
making
✅✅
what are the four primary characteristics of electronic health records (EHRs)? -
-1. collection/ storage of health info on patients over time
2. immediate electronic access to person and population level info
3. availability of knowledge and decision support
4. support of efficient processes for health care delivery
HITECH act - ✅✅ -health information technology for economic and clinical health
act
created to motivate the implementation of electronic health records and supporting
technology in the US with financial incentives
,e-health -✅✅-broad coverage of electronic health services
m-health - ✅✅-mobile health, fitbit wearable devices
e-therapy - ✅✅-mental health/ substance abuse concern
telemedicine - ✅✅-virtual distance medicine
✅✅
what are some factors that drive innovation and technology diffusion -
-anthro-cultural beliefs and values
medical specialization
financing and payment
technology-driven competition
expenditure on research and development
supply-side controls
government policy
technological imperative - ✅✅ -implies the use of technology without cost
considerations, especially when the benefits to be delivered the use of technology
are small compared to the costs
governments role in technology diffusion - ✅✅ -government funds 46% of medical
technology R&D in the US aside from development, they have a responsibility to
intervene and ensure safety measures are in place as technology is introduced into
the marketplace (via the FDA)
responsibilities of the food and drug administration - ✅✅-government roles in tech
diffusion
regulation of drugs, devices and biologics
evolution of the approval process
drugs from overseas
securing the supply chain
regulation of medical devices and equipment
regulation of biologics
current federal legislation that regulates drugs and medical devices - ✅✅ -FDA
CON laws required hospitals to seek approval before acquiring major equipment/
projects certifications of need is an endorsement that numerous states require before
approving the construction of a new health- care facility. the central idea of con
legislation is the assertion that overbuilding and redundancy in health-care facilities
leads to higher health-care costs
classes of medical devices - ✅✅ -1. low risk
2. suntan booths, braces use and function
,3. premarket approval
health technology assessment - ✅✅ -any process of examining and reporting
properties of a medical technology used in health care, such as safety, effectiveness,
feasibility, and indications for use, cost, and cost-effectiveness, as well as social,
economic and ethical consequences, whether intended or unintended
✅✅-purchase of insurance
financing -
moral hazard of financing - ✅✅-if i have insurance, i will use it
1. patients consume more
2. leads to higher utilization or moral hazard
financing influences the supply and distribution of health professionals
four principles of insurance -✅✅ -1. risk is unpredictable for the insured
2. risk can be predicted with reasonable accuracy
3. insurance mechanism transfers risk from the individual to the group
4. members of insured group share losses
✅✅
principle cost of sharing - -**out of pocket not covered
deductible- cost you pay until insurance kicks in
copayment- overtime you see a provider
coinsurance- a percentage you have to pay
what is the purpose of a stop loss provision in an insurance plan - ✅✅ -annual out
of pocket max or stop loss - once you pay enough in the year then you stop paying
this helps so that people aren't spending a ton of money paying deductibles all of the
time. once they hit a certain number they no longer have to pay these deductibles.
protects against catastrophic loss
4 types of private insurance -✅✅ -managed care plans (HMO and PPO)
group insurance
self insurance
individual private health insurance
HMO - ✅✅-in a network, one set PCP
PPO - ✅✅-no referral from PCP needed, higher out of pocket
group insurance - ✅✅-coverage to members of a group that tends to be
employees of a company members of the group usually receive insurance at a
reduced cost because the insurers risk is spread across a group of policyholders
, self insurance -✅✅ -a person does not take out any third party insurance or a
business that is liable for some risk chooses to carry the risk itself and not take out
insurance through an insurance company
individual private health insurance - ✅✅-purchase on your own for you or your
family, not through an employer
6 ACA provisions impacting private coverage - ✅✅ -1. insurers mandated to enroll
young adults until age 26 under parent's plans
2. illegal to charge more or refuse coverage for preexisting conditions
3. all health plans had to include certain essential health benefits
4. fees imposed on insurers for selling plans through the exchanges
5. medical loss ratio (MLR)
6. legal US residents required to have health insurance or else pay a penalty tax
medicare - ✅✅-insurance for those over 65
medicaid - ✅✅-those below the poverty line depending on state
CHIP - ✅✅-children under the age of 19
free clinics/ ER - ✅✅-open to everyone with or without insurance
vets/ military - ✅✅-government funded VA hospitals
medicare part a - ✅✅-hospital insurance that covers inpatient hospital care, skilled
nursing care, home health care, hospice care
medicare part b - ✅✅ -voluntary program that covers doctors services, outpatient
care, preventative services, diagnostic tests, some therapies, durable medical
equipment
medicare c - ✅✅ -medicare advantage
includes all benefits from a and b, run by medicare-approved private insurance
companies, usually includes part d, may include extra benefits and services at extra
costs
medicare d - ✅✅ -voluntary program offering coverage to part a or b enrollees,
helps cover cost of prescription drugs run by medicare-approved private insurance
companies, doughnut hole
medicaid - ✅✅ -finances health care for the poor
almost entirely a taxpayer-financed program
means-tested program (eligibility depends on financial resources)
