Essentials of Health information management Principles & Practices

Results of escalating healthcare cost
medical necessity requirements, review of appropriateness of admissions, requirements for administration of quality and effective treatments
Continuum of care
a complete range of programs and services with the type of health care indicating the health care services provided
Primary care
preventive and acute care at the point of first contact usually a general practitioner
Secondary care
specialist or hospital staff to which a patient was referred to by a general practicioner who first diagnosed or treated the patient’s condition
tertiary care
specialized services by hospitals or facilities specially equipped to provide services witch may not be available at some hospitals
quaternary care
an extension of tertiary care which includes advanced levels of medicine that are highly specialized not widely used and very costly
for-profit
privately owned where profit is distributed to share holders
not-for-profit
excess income reinvested in the facility such as a government supported or public hospital
Department of Veterans Affairs
manages health care benefits for veterans who are eligible to receive care at VAMCs
Governing Board
has ultimate legal authority and responsibility for a hospital’s operation and quality of care
Hospital administrator
CEO Chief Executive officer
medical staff
consists of licensed physicians and other licensed providers as permitted by law
hospitalists
physicians who work in the hospital setting and treat patients who are receiving hospital-based care
Disaster recovery plan
ensures an appropriate response to internal and external disasters that may effect hospital staff, patients, visitors, and the community
Health Care Proxy
a legal document in which the patient chooses another person to make treatment decisions in the event the patient becomes incapable of making these decisions
living will
contains the patients instructions about the use of life-sustaining treatment
DNR
Do Not Resuscitate Order
Respite Care
gives temporary relief to primary care givers of homebound hospice patients
Hospital Administration
serves as liaison between medical staff and governing board and develops the plan to support the mission and goals of the organization
Utilization Management
reviews admission for all levels of care and monitors appropriate levels of care
biometrics
an identifier that measures a unique physical characteristic such as a fingerprint and compares it to a stored digital template for identity authentication
coding
involves assigning numeric and alphanumeric codes to diagnoses procedures and service
electronic signature
encompasses all technology options available that can be used to authenticate a document
contract services
services contracted by a facility in which credentialed staff are employed by contractor while containing costs by not providing benefits
licensure
mandates by law and provided by the state department of health to require compliance with state laws and regulations
regulation
interpretation of law that is written for compliance to the law
accreditation
voluntary process that a health care facility or organization undergoes to demonstrate that it has met standards beyond those required by law
deemed status
recognized the CMS as an equivalent substitute for CMS inspections
deeming authority
means that an accrediting organization’s standards have met or exceeded CMS’S conditions of participation and are eligible for reimbursement for Medicare and Medicaid
Standards
measures of a health care organization’s level of performance in specific areas