Discussion Topic: Decision Support Applications
INSTRUCTIONS: Respond to all posts; response to classmates should be thoughtful and advance the discussion, response should make and/or frequent informed references to unit material or scientific literature, follow APA style if resources are used, 75 word minimum in response per post
CLASSMATE POST #1
Research health data stewardship and in your post show why it is important. Why does it matter in the discussion of a national health information network (NHIN)? Assess how the architecture of the NHIN permits this.
Hello everyone,
Data stewardship is important especially when it comes to healthcare where the patient health data i.e. personal identity, health issues, home address and even bank account is involved. It is responsible to make sure that the patient’s file in the system is being used appropriately to limit any threat that could harm the patient and the organization.
In order to protect the data and all its assets it is important to follow the policies, rules and guidelines of the National Health Information Network (NHIN) to have and provide a better service and meet their goals when it comes to standards and to have a more secured health information system in the network or via internet.
Thanks,
Jhosie
CLASSMATE POST #2
Health data stewardship is defined as the responsibility and accountability of data for processes that safeguard effective control and use of data, to ensure the appropriate use of said data. This data is derived from people’s personal health information. Data use includes storage, collection, exchange, analysis, aggregation and viewing. By actively stewarding data, networks will get added value while streamlining frivolous costs (Washington.edu, 2021).
The National Health Information Network (NHIN) demonstrates this set of services, policies and practices that steward health information exchange across the internet. It accommodates nationwide health information exchange across various entities. This data is intended to be used by health care providers, federal agencies, and healthcare information exchanges. It was created to improve the efficiency, accuracy, and quality of healthcare data exchange. The NHIN provides the technical, operational, and legal platform to provide this information (Healthit.gov, n.d.).
~Krystyn Lange~
Discussion Topic: HIPAA Security Violations and Training
INSTRUCTIONS: Respond to all posts; response to classmates should be thoughtful and advance the discussion, response should make and/or frequent informed references to unit material or scientific literature, follow APA style if resources are used, 75 word minimum in response per post
CLASSMATE POST #3
Utilization Management is the review of services to ensure that they are medically necessary, provided in the most appropriate care setting, and at or above quality standards.
When utilization management and the revenue cycle teams work together, it can save the hospital a ton of money and create operational efficiencies. Utilization management could be a number of things. UM could be a plan, process or approach used for claims processing, resource utilization, denial prevention, risk management and quality review.
“The integration of the Utilization Management department and its processes within hospital operations can increase care efficiency and decrease revenue loss.”
Weiner, Meliza. Accessed 2021, March 27. The Importance of Utilization Management in Healthcare.
Casey Blount
CLASSMATE POST #4
A Case Manager analyzes patient information and reviews the functional state and the ability to make decisions that relates to the continuation of care and the discharge needs. Utilization managers collaborate with insurance payors to manager resources for patients. The Utilization manager make sure that the hospital receives the correct reimbursement. A Utilization Manager would have to incorporate medical necessity for treatment and review cases and retroactive review any unbilled accounts.
The work of a Case Manager would make a positive impact of the patients life to make sure they have the resources they need in order to succeed with their care. The Utilization Manager would help offset those costs for the staff helping those patients getting resources. If a Case Manager does not do what is needed to prevent readmission than it could negatively impact reimbursement for the hospital.
References:
What is a case manager? (n.d.).
Expert Solution Preview
Introduction: In this scenario, the topic of discussion is healthcare-related and focuses on decision support applications as well as HIPAA security violations and training. As a medical professor in charge of creating college assignments and answers for medical college students, I will provide thoughtful responses to my classmates’ posts.
Answer to Classmate Post #1:
Data stewardship is important in healthcare because it involves the patient’s personal identity, health issues, home address, and bank account. The responsible use of a patient’s file in the system can limit any threat that could harm the patient and the organization. To maintain a more secure health information system, it is important to follow the policies, rules, and guidelines of the National Health Information Network (NHIN). These guidelines will provide better service and meet standards to ensure that any data exchanged among healthcare providers, federal agencies, and healthcare information exchanges are of high quality.
Answer to Classmate Post #2:
Health data stewardship is the act of safeguarding the effective control and use of data to ensure it is appropriately used. The National Health Information Network (NHIN) is a nationwide health information exchange that accommodates various entities. It is intended to improve the efficiency, accuracy, and quality of healthcare data exchange, and it provides the technical, operational, and legal platform to transfer information. The NHIN provides a set of services, policies, and practices to improve health information exchange across the internet.
Answer to Classmate Post #3:
Utilization management (UM) is the review of services to ensure they are medically necessary and provided in the most appropriate care setting. When UM and revenue cycle teams work together, they can create operational efficiencies and save the hospital a ton of money. The integration of UM processes within the hospital operations can increase care efficiency and decrease revenue loss. UM can be used for claims processing, resource utilization, denial prevention, risk management, and quality review.
Answer to Classmate Post #4:
A Case Manager reviews patient information and assesses the functional state to make decisions regarding the continuation of care and discharge needs. Utilization Managers collaborate with insurance payors to manage resources for patients and ensure the hospital receives the correct reimbursement. Incorporating medical necessity for treatment, reviewing cases, and retroactive review of any unbilled accounts is part of a UM’s job. Proper work by a Case Manager can positively impact the patient’s life to ensure they have the resources needed for care, while a UM can help offset these costs for the hospital. If a Case Manager fails to prevent readmission, it may negatively impact reimbursement for the hospital.
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