To prepare for the exam, be familiar with the following topics/concepts from the required
readings and lessons:
• ethical decision making (foundations ch 5) - the process of making informed choices
about ethical dilemmas based on a set of standards differentiating right from
wrong
Ethical dilemma - when moral issues raise questions that cannot be answered
with a simple, clearly defined rule, fact, or authoritative view
Morals - social convention about right and wrong human conduct that is so
widely shared that it forms a stable (although usually incomplete) communal
consensus
Moral dilemma - when some evidence a person is confronted with indicates
an action is morally right and other evidence indicates that this action is
morally wrong
E-health code of ethics 8 standards for development of health-related
websites:
▪ candor
▪ honesty
▪ quality
▪ informed consent
▪ privacy
▪ professionalism
▪ responsible partnering
▪ accountability
4 guiding principles to healthcare ethics:
▪ autonomy - the individual’s freedom from controlling interferences by
others and from personal limitations that prevent meaningful
choices, such as adequate understanding
▪ dependent on liberty & capacity for intentional action
▪ nonmaleficence - an obligation not to inflict harm intentionally and forms
the framework for the standard of due care to be met by any
professional.
▪ beneficence - actions performed that contribute to the welfare of others
, ▪ positive beneficence – requires provision of benefits
▪ utility – requires benefits and drawbacks be balanced
▪ justice - fair, equitable, and appropriate treatment in light of what is due
or owed to a person
• Bioethical standards
The nature and needs of humans as living, thinking beings
The purpose and function of the healthcare system in a human society
An increased cultural awareness of human beings’ essential moral status
• Telehealth
Wide range of health services that are delivered by telecommunications ready
tools, such as telephone, videophone, and computer
Telenursing helps fill the nursing shortage allowing nursing to see more
patients quicker, as well as the aging population
Telecommunication technologies used to deliver health-related services or to
connect patients and healthcare providers to maximize patients’ health
status.
A relatively new term in the medical/nursing vocabulary, referring to a wide
range of health services that are delivered by telecommunications-ready tools
such as the telephone, videophone, and computer.
Mhealth - real-time monitoring of patient vital signs, delivery of patient
information to practitioners and (where appropriate) clinical researchers, and
collection of community healthcare data. Specialized sensors and devices that
work as accessories to multiple health apps are also seeing tremendous
growth and innovation
Non-clinical health uses:
▪ distance education
▪ grand rounds
▪ administrative uses (meetings, etc)
▪ research
• Medical applications
Software developed for medical purposes, including home medical
monitoring system, medical databases for healthcare professionals, etc
Apps, are not regulated by the fda because they are not defined as medical
devices
An app is defined as a medical device and may be subject to regulation by the
fda if “the intended use of a mobile app is for the diagnosis of a disease or
, other conditions, or the cure, mitigation, treatment, or prevention of disease,
or if it is intended to affect the structure or function of the body of man”
• Medical devices - any device intended to be used for medical purposes
e.g., infusion pumps, ventilators, hemodynamic monitors
• Fda oversight for medical devices
Samd – software as a medical device
Simd – software in a medical device
• Privacy - an important issue related to personal information, about the owner or about
other individuals, that focuses on sharing this information with others electronically and
the mechanisms that restrict access to this personal information.
the office of civil rights (ocr), which is part of the u.s. department of health and
human services (usdhhs), is responsible for enforcing health insurance
portability and accountability act of 1996 ( hipaa ).
• Confidentiality - the mandate that all personal information be safeguarded by ensuring
that access is limited to only those who are authorized to view that information.
• Cybersecurity
The state of being protected against the criminal or unauthorized use of
electronic data, or the measures taken to achieve this.
With the expansion of technology. Facilities are taken more precautions
to prevent cyber-attacks. With the move towards advancing cybersecurity
is important, technology continues to grow.
Ensure all systems are adequately protected and patients remain safe
from harm
Ni are frequently called on to evaluate the safety and effectiveness of new
devices and software.
• Computer-aided translators - is a form of language translation in which a human
translator uses computer hardware to support and facilitate the translation process.
• Hippa - was established in the u.s. in 1996 to protect an individual's personal health care
information.
Signed by pres. Bill clinton
Healthcare institutions are required to meet all standards and comply with the
appropriate security measures in order to safeguard patient data.
Four parts to hipaa's administrative simplification
▪ electronic transactions and code sets standards requirements.
▪ privacy requirements.
, ▪ security requirements.
▪ national identifier requirements.
• Icd-10 coding - classification system for diseases or procedures into groups or categories
for reimbursement or claims processing
Maintained by the world health organization ( who ).
In the united states, there are separate standards for inpatient procedures and
ambulatory care procedures
Ambulatory care procedures are coded using the american medical association
(ama)’s cpt®
• Evaluation and management coding
Is a medical coding process in support of medical billing
Practicing health care providers in the united states must use e/m coding to be
reimbursed by medicare, medicaid programs, or private insurance for patient
encounters.
• Reimbursement coding
Is based on claims and documentation filed by providers using medical
diagnosis and procedure codes.
Commercial payers must use standards defined by the u.s. department of
health and human services (hhs) but are largely regulated state-by-state
• Clinical support tools
Are designed to help sift through enormous amounts of digital data to suggest
next steps for treatments, alert providers to available information they may not
Have seen, or catch potential problems, such as dangerous medication
interactions
Such as cds clinical decision support, a program used by providers.
Or various applications use by healthcare professionals to allow for
communicate between provider to provider and provider to patient
The tools are all used to benefit patient outcome
• Workflow analysis
Not an optional part of clinical implementations, but rather a necessity for
safe patient care fostered by technology.