Statistics and Impact on Healthcare

Statistics play a very important role in health care.  They are able to measure disease outcomes, mortality and morbidity rates, groups of individuals at high risk, insurance costs and coverage’s, and a multitude of other factors.  Statistical evidence provides uniformity to abstract situations.  This impacts all aspects of health care from insurance companies, health care institutions, providers, employees, and patients.  Statistics and its impact are gaining momentum as we forge into the electronic era of mandatory health care reporting.

Federal statistics are used to ‘shed light’ on the topic of health care costs and availability. There are two types of surveys most frequently used to measure this data Bureau of Labor Statistics National Compensation Survey (NCS) and the Medical Expenditure Panel Survey Insurance Component (MEPS-IC) these statistical reviews measure the access, availability, and cost for healthcare to employees and employers.  The NCS collects data such as employee wages and salaries, overtime pay, sick leave, vacation benefits, and health and retirement plans for regulation, investigation and enforcement (Buckley, 2004).  The MEPS-IC survey is more specialized to an in-depth analysis of healthcare benefits such as the cost of individual and family plans, employee contributions, and establishment of level tables.  Statistics impact how the insurance coverage’s are dispersed, who is the source of funding such as Centers for Medicare and Medicaid (CMS) or private insurance, and which establishments are used to provide health care.  These surveys are conducted annually to ensure that affordable health care is available to everyone and agencies can denote any changes in trends and causation in an effort to offset disparities.

Statistics impacts health care by the creation and regulation of jobs.  According to the Bureau of Labor Statistics (2013) “the healthcare sector was responsible for nearly one-third of new healthcare jobs last month” (para, 1) budget cuts in Medicare and funding stand to jeopardize the ability to continue the increase in the employment sector.  The major contributor according to the BLS statistical report is the increased growth in the home health sector.  Since 2012 there have been over 93.000 new jobs created in healthcare (“BLS Report”, 2013).

The following graph represents health care jobs by sectors.  As you can see the home health industry is in second place with a total of 19% of health care jobs. 

U.S. Bureau of Labor Statistics (n.d.)

Statistics can reveal areas in health care that are under serviced or vice versa and ultimately provide ideas of where we need more training and employment efforts.

            Statistical evidence is of no use if we do not understand how it works and develops into scientifically based evidence or what we now call evidence based practice.  Statistical research by nature is ethical, rigorous, and systematic and when these "processes [are] applied rigorously [they] can improve patient care” (Sec. What are the Goals of Health Care Research, para, 4).  The code of conduct for health care professionals is to ‘do no harm’ and provide safe effective health care (“Statistics for Health”, 2004).  Statistics help develop the most current safe and effective treatments.

            The point to statistical health care methods is to improve patient care and ultimately safety.  These methods provide scientific evidence of proven situations good or bad and from there we are able to make suggestions on how to improve quality.  Statistics provides evidence of inequality in health care insurances, coverage’s, or job disparities.  These measures also show changes that have improved health care and how far we have come in patient care and safety.  Statistics will always have its place in health care for consistent monitoring and improvements.

Thanks Chelley                

References

BLS report: Home health sector generates nearly one-third of all new healthcare jobs in august. (2013, Sep 09). PR Newswire. Retrieved from http://search.proquest.com/docview/1430885948?accountid=32521

Buckley, J. E., & Van Giezen, R.,W. (2004). Federal statistics on healthcare benefits and cost trends: An overview. Monthly Labor Review, 127(11), 43-56. Retrieved from http://search.proquest.com/docview/235649923?accountid=32521

 U.S. Bureau of Labor Statistics (n.d.). Current employment statistics and the ambulatory health care industry. Retrieved from http://www.bls.gov/ro6/ro6_ces_ambulatory_hc.htm

 Statistics for Health Care Research (2004). Retrieved from www.sagepub.com/upm-data/9572_019596ch01.pdf‎



    

Accreditation and Continuous Quality Monitoring

 Health care facilities are under constant pressure to improve and maintain patient safety.  In order for facilities to accomplish this task they must have resources that are able to measure different levels of care.  Accreditation and continuous quality monitoring (CQI) are two ways health care facilities can make sure they are giving the best care and receive maximum insurance reimbursements for improved methods of patient safety and monitoring.   

Accreditation is an external independent review of the delivery of health care against nationally-accepted standards which includes periodic reviews of performance, processes, and outcomes (“Accreditation Association”, n.d.).  Organizations such as the Joint Commission on Accreditation of Health care Organizations (JCAHO) (which is the most common) are aimed at improving health care through basic safety standards and methods.  Their goals are to increase patient safety and quality control.  JCAHO was established  in 1951 for the primary goal of setting a standard for safety within hospital settings and in 1981 was changed to include other ‘healthcare organizations’ which included home health and hospice agencies  (“What is NCAQ”, n.d.).  Hospitals and health care entities seek for this approval since the Department of Health and Human Resources Center for Medicare and Medicaid (CMS) base reimbursements and preferred providers on this accreditation.

Health care providers want to seek accreditation approval since CMS relies heavily on the JCAHO surveys to ensure that health care facilities have met the health and safety standards they require.  CMS requires facilities to participate in accreditation authorities for maximum reimbursements.  One reason this approval is important is because other insurance companies tend to follow the lead of CMS guidelines for reimbursement procedures.  Accreditation ensures communities the safest care possible.  

As health care continues to change and the requirements to get maximum reimbursements are more difficult it is even more important that health care facilities achieve and maintain accreditation standards.  Every three years facilities are subject to an ‘on-site’ visit and given plenty of warning before the visit is to take place, allowing for plenty of time to get things in order if necessary.  Some of the items to be checked are:

Patient rights, governance  administration, quality of care, management and improvement, clinical records and health information, infection prevention and control, professional improvement, facilities and environment, and anesthesia and surgical services  (“Accreditation Association”, n.d.).  As you can see the inspections will consist of all areas to make sure the facility is doing everything they can to minimize errors and maximize safety.  Another area they use to ensure safety is continuous quality control or CQI policies.

Here is a link to a power point that can help explain in a little more detail the specific areas that accreditation is looking to assess and improve: Understanding Accreditation

Continuous quality improvement methods started to gain momentum in 1991 realizing these strategies could improve health care facility operations.  According to Vanderveen  “CQI is as an approach for examining interactive systems, layer by layer, in achieving improvement at all levels…. a step-by-step flow model that aids institutions in arriving at solutions in an orderly and systematic fashion” (para, 3).  Facilities are required to monitor their performance as part of accreditation which consists of brainstorming activities, structuring issues, problem focus, uncovering issues, and lessons to be learned (Vanderveen, 1991).  In order to implement CQI processes you must have a strong leader and a diverse team to work on it.  The reason for CQI is not to expose things individuals are doing incorrectly but to fix processes that can work more efficiently and safe (Vanderveen, 1991).  CQI is just as it is stated: continuous.  Facilities must continually reassess their work through teams, patient surveys, and outcomes to seek where they can find ways to make improvements.

Bottom line is accreditation and CQI are processes that health care entities must comply with in order to receive maximum benefits and safety for patients according to CMS.  The reasoning for this is to protect the public and give them access to the safest care possible. 

Thanks Chelley

 References

Accreditation Association for Ambulatory Health Care (n.d.).  What does accreditation mean for my care. Retrieved from http://www.aaahc.org/en/my-care/

What is NCQA and JCAHO ( n.d.).  Retrieved from http://www.healthcare-information-guide.com/NCQA.html

Vanderveen, L. (1991). CQI system puts process into improving hospital. Health Care Strategic Management, 9(2), 16-8. Retrieved from http://search.proquest.com/docview/226922337?accountid=32521

Evolution of Health Care Informatcs

The increasing trend in health informatics has led people to believe this field of study is new and just beginning but in actuality it has been developing since the 1960’s.  Let’s take a look at the following time line to see where this all begins.

 

In the mid 1960’s the group The American Society for Testing and Materials (ASTM) recognized a need for set standards with several areas of health care.  Theses areas included laboratory message exchange, data content, health information system security, and properties relating to electronic health record (“Evolution of Health”, n.d.).  This is the beginning of what we now call Health Information Management. 

By 1965 the College of American Pathologists developed a nomenclature (determined number sequence for disease coding) for pathology which is internationally recognized and currently used.  In 1974 a uniform discharge data set called ‘Uniform Hospital Discharge Data Set (UHDDS) was approved by Health and Human Services (HHS) and recommended by the National Center for Vital Health Statics (NCVHS).  This is a set of items that are based on standard definitions to increase consistent data collection across multiple users which decreases disparities in health care by the collection of consistent and reliable information.  Lynn Thomas (2012) states “unified data governance principles will help promote accuracy and consistency and reduce ambiguity…[and] establish the guidelines that will accurately and fairly represent performance and outcomes of care (para. 4).  This standardization will expose disparities in health care so we can address them and make improvements.   

The American College of Radiology and National Electrical Manufacturers Associations collaborated and recognized a need for a standard digital image format which is currently known as a DICOM image.  This was developed in 1985 which makes sharing electronic images possible without facing incompatibility issues.  This is interesting because this development is considered non-proprietary meaning that no one person owns the rights to the digital format and everyone shares it.  This is a concept of open source software which was initiated by Richard Stallman in 1983 by the development of the GNU Project or free software sharing, which has become vital in the success of implementing health information systems.

In 1987 was the first release of what we all know is Health Level7 (HL7).  This particular development included a variety of message format standards for patient orders, registration and observations reporting and by 1991 the Accredited Standards Committee (ASC) started developing interactive communication standards for the transmission of health claims, financial applications, and administrative transactions (“Evolution of Health”, n.d.).   As these developments matured they have brought us into an era of health information exchange.  There are not many hospitals, clinics, or health care facilities that do not have some sort of electronic exchange.  Most of this is due to the ‘meaningful use’ objectives implemented by the Federal Government.

Meaningful use is a termed dubbed by the Centers for Medicare and Medicaid (CMS) for the establishment of specific criteria to help improve the delivery, safety, and cost of health care through the use of electronic information or computers.   The objectives of ‘meaningful use’ are simple “achieving sustainable improvements in healthcare quality… [while maintaining] vision of better patient care at a lower cost” (“How do we get”, 2011, para. 1).  It is mandatory that health care entities participate in meaningful use measures and the government has a strategic timeline when these measures are to be implemented.

The latest health care initiative starting January 2014 is called blue button.  This is an interactive secure application that allows patients to view, download, and manipulate their health care information.  I have attached a podcast  by Lygeia Ricciardi, Director of the Office of Consumer eHealth at the Office of the National Coordinator for Health IT (ONC) in which she discusses the Blue Button initiative.  As we have followed some of the highlights of the progression of health informatics from the 1960’s through 2014 I hope this has given you an idea of where this technology began and where it is headed but ultimately it is for our safety and improvement of the health care system.  

Chelley Plueger R.T. ®
 

References

American health information management association; AHIMA calls for improved health information governance to unify standards for EHR use. (2012). Information Technology Newsweekly, , 443. Retrieved from http://search.proquest.com/docview/1095551688?accountid=32521

Evolution of health informatics. (n.d). Retrieved from http://www.himss.org/ResourceLibrary/GenResourceReg.aspx?ItemNumber=17863

HOW DO WE GET TO MEANINGFUL USE? (2011). Health Management Technology, 32(4), 10-2, 14, 16. Retrieved from http://search.proquest.com/docview/864536463?accountid=32521

Van Leeuwen, D. (Producer) (2013 , June 04). Using onc's patient engagement podcast. Using ONC's Blue Button to Engage and Empower Patients, Caregivers..and You. [Audio podcast]. Retrieved from http://www.himss.org/files/HIMSSorg/Content/podcasts/patientengagement/20130604_patientengagement.mp3