Hospitalizations account for more than 30% of the total annual costs for healthcare and around 20% of all hospital admissions occur within 30 days of a previous discharge. A readmission is defined as any re-entry to a hospital 30 days or less from a prior discharge. A financial impact is that US Medicare and Medicaid will either not pay or will reduce the payment made to hospitals for expenses incurred. By the end of 2015, over 2600 hospitals will incur these losses from a Medicare and Medicaid expense that exceeds $24B annually. These situations are expensive and often preventable: one-third of readmissions may be preventable, so there is room for improvement in care and reduction in cost. Bates and his coauthors suggest that all health care organizations should use algorithms to predict who is likely to be readmitted. Readmission for patients with heart failures is very high in the US. In a simple study conducted on 1,095 patients, only two automated phone calls were made within 30 days to check on the status of their health. Of those reported having a negative response, 37 percent were readmitted—compared with 16 percent positive and 14 percent neutral respondents’ readmissions. The only problem with this test was that the …show more content…
This allows for the doctors, nurses and other caregivers to train the patients about managing their health and reporting the status back on a regular basis. Identifying patients at risk exploiting clinical and behaviour data can guide efficient resource allocation and utilization and reduce lots of costs. For example, chronic diseases account for about 86 percent of healthcare expenditures in the US. Severe chronic conditions such as heart disease, arthritis, asthma and diabetes alone cost 33 percent of total spending. Obviously, we can’t stop the population from aging, but we can make the healthcare system more efficient through big
State and federal regulations, national accreditation standards, and clinical practice standards are created, and updated regularly. In addition, to these regulations, OIG publishes a compliance work plan annually that focuses on protecting the integrity of the program, and prevention of fraud and abuse. The Office of the Inspector General examines quality‐of‐care issues in nursing facilities, organizations, community‐based settings and occurrences in which the programs may have been billed for medically unnecessary services. The Office of the Inspector General’s work plan for the fiscal year 2011 highlights five areas of investigation for acute care hospitals. Reliability of hospital-reported quality measure data, hospital readmissions, hospital admissions with conditions
Introduction “Health informatics is the science that underlies the academic investigation and practical application of computing and communications technology to healthcare, health education and biomedical research” (UofV, 2012). This broad area of inquiry incorporates the design and optimization of information systems that support clinical practice, public health and research; understanding and optimizing the way in which biomedical data and information systems are used for decision-making; and using communications and computing technology to better educate healthcare providers, researchers and consumers. Although there are many benefits of bringing in electronic health systems there are glaring issues that associate with these systems. The
There is limited data on predictors of discharge and readmission for hospital inpatients. According to Rothman, Rothman, & (), “Unplanned hospital admissions are a major quality and cost issue in the US healthcare system”. About 20% of Medicare patients are readmitted to the hospital within 30 days, at an estimated cost of $17 billion per year (). Now that Medicare has begun to reduce payment to hospitals with high readmission rates, hospitals are looking for more effective ways of reducing readmissions. In order to develop new systems to address these concerns, there must be evidence in place to support to their use.
Many new technologies are being used in health organizations across the nations, which are being utilized to help improve the quality of health care. Electronic Health Records (EHRs) play a critical role in improving access, quality and efficiency of healthcare ("Electronic health records," 2014). In order to assist in expanding the use of EHR’s, in 2011 The Centers for Medicaid and Medicare Services (CMS), instituted a EHR incentive program called the Meaningful use Program. This program was instituted to encourage and expand the use of the HER, by providing health professional and health organizations yearly incentive payments when they demonstrate meaningful use of the EHR ("Medicare and medicaid," 2014). The Meaningful use program will be explored including its’ implications for nurses, nursing, national policy, how the population health data relates to Meaningful use data collection in various stages and finally recommendations for beneficial improvement for patient outcomes and population health and more.
Hospital readmission can impact the patient, nursing practice, the hospital, and the health care system. The patient’s quality of life can be altered physically, psychologically, and economically (Whittaker, 2014) and recurrent hospitalization is a good predictor of increased risk of mortality (Hummel, Katrapati, Gillespie, DeFranco, & Koellig, 2013). Moreover, a patient in an acute care setting has an increased risk of contracting hospital-acquired infections such urinary tract infections, sepsis, C. difficile, and methicillin resistant Staphylococcus aureus (medicare.gov|Hospital Compare, 2013). Nursing practice is impacted as patients spend the majority of their acute care stay with the bedside nursing staff. According to...
To determine if the hospital can perform this many operations, one should compute the equipment (operating room) and labor (surgeon) requirements per day and compare it to the current equipment and labor capacity per day.
Health informatics is best described as the point where information science, medicine, and healthcare all meet. It encompasses the resources, devices, and methods required to optimize the acquisition, storage, retrieval, and the use of information in health and biomedicine. Health informatics incorporates tools such as: computers (hardware and softwar...
Standardizing The Hospital Discharge Process for Patients with Heart Failure to Improve the Transition and Lower 30 day Readmission. http://www.cfmc.org/integratingcare/files/Remington%20Report%20Nov%202011%20Standardizing%20the%20Hospital%20Discharge.pdf
Readmissions has become a spotlight in the healthcare world. “The problem of readmissions to the hospital is receiving increased attention as a potential way to address problems in quality of care, cost of care and care transitions. Interventions are underway to reduce hospital readmissions at the state and national level” (Elixhauser & Steiner, 2010). “Approximately 20% of Medicare beneficiaries are readmitted within 30 days of discharge and these readmissions have been estimated to cost the American public > $15 billion per year. The Patient Protection Affordable Care Ace of 2010 has created new incentives to reduce admissions using the publicly reported measures because hospitals with high readmission rates can lose
Each day we are faced with making decisions regarding the plan of care and discharge of a patient based on the number of days an insurance company allows to treat the patient. Most times the days allowed are less than what is required to assist the patient back to their prior level of function and ability to safely return home. This causes an internal struggle for the provider and can lead to easily accepting what the insurance company allows even though it is not always best for the patient. Typically, we follow the rule of always doing what is right, which could mean that we keep the patient on the unit longer than the insurance will provide payment.
CHMIS targeted data for the stakeholders who were the primary consumers and benefactors of the data assessments. Another function of CHMIS was to facilitate billing and determine patient eligibility for cost reductions, making CHMIS a transaction system. (J Am Med Inform Assoc, 2010 ) CHMIS was a new concept, and faced many challenges that ultimately failed as a whole, but provided many learning lesson opportunities. The system was quite unaffordable, it lacked sufficient technological support, and the premise of the system caused security concerns. Lessons learned, and... ...
Historically (before 1880s), only few hospitals were originated in some big cities of U.S. Initially, the hospital system mainly run by religious organization and it served a primary purpose of palliation. According to Shi and Singh (2010), the function of hospitals at that time was more of “social welfare” (such as taking care of homeless people and helping those without families) than practicing medicine (p.56). Over the years, the functionality and the services offered by the hospitals has changed dramatically. However, it’s primary function to treat sick individuals has remained the same. Nowadays, hospitals also function as a research center, a medical educational institution, and is a major source of employment in the community (Sultz
Yignesh Ramachandran states in an article that health informatics “manages all aspects of the effective and efficient planning, collection, organization, implementation, analysis and use of data to create information within the healthcare system.” It gives easier access of client information to the interprofessional team. This system can improve the quality of health care, lowers paperwork and increase productivity. It also decreases the interpersonal time with clients.
To better understand the roles needed to enhance the public health infrastructure; one must first know the purpose of a health informatician. An informatician is a person who studies or work in the field of informatics. According to the American Medical Informatics Association Inc., “Public Health Informatics is the application of informatics in areas of public health, including surveillance, prevention, preparedness, and health promotion. Public health informatics and the related population informatics, work on information and technology issues from the perspective of groups of individuals” (2016). In order to build a solid infrastructure
While we may not know exactly what health care will look like in 2050, technological advances will improve the diagnosis and treatment of the chronic health conditions we face. Personalized predictive medicine will allow for living longer healthier lives as wireless monitoring systems allow patients to stay connected to health providers (Lawrence, 2010). The focus will shift from treating acute illnesses to finding and treating ailments before they become serious with more costly complications. This more balanced health care system will become a more affordable arrangement for meeting the primary medical needs of patients in the US (Lawrence, 2010).