Improving Patient Care

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Improving patient care is a process that always has room for improvements. It is important to make sure patients receive the best quality care available. “Studies suggest that high quality patient care relies on careful documentation of each patient’s medical history, health status, current medical conditions, and treatment plans” (Glandon, Smaltz, & Slovensky pg. 3). To help with the process of quality care for patients HIPAA laws have been set in place. The Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996 required the Department of Health and Human Services to establish national standards for electronic healthcare transactions and national identifiers for providers, health plans, and employers” (Glandon, Smaltz, & Slovensky pg. 118). Health insurance portability and accountability act also known as HIPAA was passed by congress back in 1996 to give patients’ rights over their health care privacy.

With all the new technology that has been introduced into health care insurances and providers are able to conduct patient information electronically. By 2015 everything will be processed through computers and laptops nothing will be done on paper anymore. With that being said congress had to provide additional privacy protection for patients. According to Richard Gartee, “before HIPAA, no generally accepted set of security standards or general requirements for protecting health information existed in the healthcare industry.

At the same time, new technologies were evolving, and the healthcare industry began to move away from paper rocesses and rely more heavily on the use of computers to pay claims, answer eligibility questions, provide health information, and conduct a host of other administrative and clinically based functions” (Gartee pg. 392). Providing electronic health information can be critical for the providers and patients. To ensure privacy is still protected security standards were set. Security standards are there to provide security safeguards on electronic health care information and to provide additional re-assurance of a patient’s privacy over their health care information.

Security standards are divided into three categories, administrative, physical, and technical safeguards. Administrative safeguard is implemented to delegate security responsibility to one individual and provide security training. Physical safeguard “are the mechanisms required to protect electronic systems, equipment and the data they hold, from threats, environmental hazards and unauthorized intrusion. They include restricting access to EPHI and retaining off-site computer backups” (Gartee pg. 394). The last category, technical safeguards is the authentication used to access electronic patient health information.

The three categories combined will offer protection and assurance of electronic patient health information. Telehealth or telemedicine is a term used for giving or receiving health care over a distance, for example, computers, video, and email. Telemedicine is increasing rapidly within the health care field. Telemedicine has a variety of applications that are used in many different places, for example, jails, schools, and hospitals. Doctors are able to see their patients virtually and this is cost effective and convenient for the doctor and the patient.

One telemedicine application in particular is telepsychiatry which began in the 1990’s. Telepsychiatry “links a patient and clinician over a real-time interactive television link” (Hanson pg. 161). In other words doctors are able to visit a patient virtually instead of them having to come into an office. Patients are often located in regions with no private psychiatric practices or where hospitals do not employ staff psychiatrists” (Mearian para. 5). A health service rendered by telepsychiatry is easier for the patient because majority of patients feel more comfortable in their home.

It is easier for them to express all their feelings and whatever else bothers them. Patients are able to be themselves when they are in their own environment and this is helpful for the clinician to make his/her diagnosis. According to Dr. Avrim Fishkind, a psychiatrist in Houston has had an estimate of 60,000 participants with videoconferencing, and around about six people that refused it. “In many instances, telepsychiatry is a necessity, not just a convenience for doctors and patients. Everyone has that one doctor they feel safe and comfortable with.

With telemedicine we are able to keep that special bond and to some this is very important. Just as we are able to take college on-line clinicians can receive their education and training through communication links. Through Secure Telehealth a meeting room may be purchased at $300 month. “A web cam $92 and a special microphone $109 and Windows software are installed on each endpoint computer. Physicians connect with clinics in their meeting room by sending a link via email containing the URL and password for the meeting” (How Telepsychiatry Works para. ). Telepsychiatry promotes other Telehealth links, for example, electronic medical records. When the doctor is on a video conference with the patient the doctor is able to type the patient’s information on their medical profile while they are talking and the doctor can e-scribe their prescriptions to their pharmacy. For some this is much more convenient. “HIS” stands for “Health Information Systems”, this system is used to communicate patient information with laboratory and radiology equipment.

Nurses and doctors are able to pull up any information and picture images in their department. Health information systems are also set up as a business system as well. “It has file servers where users store their data documents, mail servers through which users send and receive e-mail, web servers that host the organization’s web sites”(Hanson pg. 96). Another component is “HL7”, which is an abbreviation for “Health Level Seven”. HL7 is a protocol, “message-based connection between two systems allowing information to be exchanged reliably between the systems” (Hanson pg. 98).

A good example of a facility that is currently using EHR is the Dumfries Health Care Facility. The Dumfries Health Care Facility Located in Quantico Virginia is currently using the electronic health record. They offer a website to their patients to see their entire health record at home at their convenience. They are able to see what has been provided to them over time. They can see their past tests that were provided, past visits, put in for prescription refills, schedule and cancel appointments, and speak to a nurse through a secure server if they have any questions or concerns.

When visiting the website, www. tricareonline. com, the patient is first instructed to enter their secure username and password that they used to set up their account. “Computer log on is the way in which individuals identify themselves to a local machine and or a network” (Hanson pg. 81). A good password should include combinations of upper and lowercase letters, numbers, symbols, and should be 6 to 12 digits long. It may seem time-consuming but this will help provide safety from individual hackers getting into their personal profile.

A password should have some meaning to the individual to help them remember their username and password, but not easy enough for someone to figure out. That is why upper and lower case letters, numbers, and symbols are required-suggested, but required. Once the login is complete the patient has several options to choose from, for example, request a refill, look over past health information, make appointments, and speak to a clinician via email. When scheduling an appointment the patient has several options to choose from with the drop-down box that is offered.

For example, they can choose new prescription request, physical, follow-up to go over labs, and many more options. This was done once before by receptionist and when selecting the reason for the appointment they would have certain codes to put in for insurance purposes, to show the reason for their request for payment. Now patients have the ability to do this from home. Then when selecting a day and time a calendar pops up showing available appointments and the patient can choose which time is good for them, they could also cancel if needed through the same site.

During the office visit the physician will sit down and go through the past visits with his or her computer. The physician is able to see blood work, x-rays, and any other tests performed. Once the physician is finished going over the patient information and they have went over the purpose of the visit the physician is able to type up prescriptions needed an e-scribe them to the pharmacy. The implementation of electronic medical records is widely used and it has worked very well for this facility. Not only is it convenient for the patient and physician but it allows patients to keep track of their medical history.

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