Tuesday, December 31, 2019
Social determinants of health are social, economic and physical factors that affect the health of individuals in any given population. There are fourteen social determinants of health but Income is perhaps the most important of these because it shapes living conditions, influences health related behaviors, and determines food security. In Canada, people with lower incomes are more susceptible to disease/ conditions, higher mortality rate, decreased life expectancy and poorer perceived health than people with high incomes. In numerous Canadian studies and reports, there has been more emphasis on health being based on an individualÃ¢â¬â¢s characteristics, choices and behaviours, rather than the role that income plays as a social determinant of health. Although Canada has one of the highest income economies in the world and is comprised of a free health care system, many low income families are a burden on the system because of the physical and mental health issues influenced by inco me insecurity. Low income individuals are heavier users of health care services because they have lower levels of health and more health problems than do people with higher incomes. This essay will address income as a social determinant of health in three key sections: what is known on the issue, why the issue is important and how can health and public policies address the issue. The main theme that runs through the essay is the income related health inequalities among low income groups compared toShow MoreRelatedThe Social Determinants Of Health2207 Words Ã |Ã 9 Pagesdisadvantage and significantly more health problems than the non-Aboriginal Torres strait Islander population in AustraliaÃ¢â¬ The social determinants of health Health as a whole is determined by the quality of life, as well as an individualsÃ¢â¬â¢ ability to create personal positive social and physical environments. These environments include homes, schools, workplaces and the community as a whole. According to the World Health Organisation (WHO, 2003), the social determinants of health are conditions in whichRead MoreSocial Determinants Of Health And Health Disparities1724 Words Ã |Ã 7 Pagespublic health analysis have increasingly focused on how social determinants of health influence health outcomes and disparities (Clarke, C. E., Niederdeppe, J., Lundell, H. C., 2012). They have also explored strategies for raising public awareness and mobilizing support for policies to address social determinants of health, with particular attention to narrative and image-based information Clarke, C. E., Niederdeppe, J., Lundell, H. C., 2012). The relationship between the social determinants of healthRead MoreThe Social Determinants Of Health An d Health898 Words Ã |Ã 4 PagesMental health outcomes vary differently by socioeconomic location for women and men. It is important to critically analyze the various social locations that low-income women living with mental health concerns are currently occupying. These women are occupying these social locations because of the structural inequities that they encounter in relation to their experiences with the social determinants of health. Explanatory frameworks are used to illustrate the relationship between the social determinantsRead MoreSocial Determinants Of Health And Health873 Words Ã |Ã 4 Pages Better research on immigrant health and health outcomes would go a long way to shining a light on how to tackle these problems. The current debate in the research concentrates on social determinants of health such as acculturation, which of course influences a lot of other health and healthcare decisions made by immigrants. However, only focusing on social determinants of health undermines the importance of other factors that also heavily affect immigrant health in the United States. SpecificallyRead MoreSocial Determinants Of Health And Health1238 Words Ã |Ã 5 Pagesthat are not in the proper state of health. The purpose of using social determinants is to create the optimal social/physical environment that will contribute and allow individuals to enjoy a healthier lifestyle, and thus become healthier. (Social Determinants of Health - Healthy People, n.d., p. 01) The Five key areas that are addressed in the social determinants of health are: Economic Stability, Education, Soc ial and Community Context, Health and Health Care, and Neighborhood and Built EnvironmentRead MoreThe Social Determinants Of Health1194 Words Ã |Ã 5 Pageswatching television, reading or watching over her six cats. Social Determinants of Health are conditions such as living conditions or environments one has experienced while living their life and how that affects oneÃ¢â¬â¢s health (Mikkonen, J., Raphael, D., 2010). In this case study of Norma James presented above, the three Social Determinants of Health (DOH) relevant to this case study are Income and Income Distribution, Health Services and Social Safety Net. The following of the paper will discuss theRead MoreThe Social Determinants Of Health1623 Words Ã |Ã 7 PagesStress has been identified as one of the social determinants of health. It has different meanings in various contexts, so a proper definition will give a good insight of the term. Ã Ã Ã Ã Stress can be defined as a state of emotional or mental disturbance resulting from adverse or demanding conditions. Ã Ã Ã Ã Stress can also be defined as a physical, chemical, or emotional factor that causes bodily or mental disturbance and could be a causal in disease formation. StressesRead MoreThe Social Determinants Of Health1377 Words Ã |Ã 6 Pages A group of fellow students and my self conducted a public health walk in the area of hackney borough. Our aim was to observe the community and how their surroundings affected their health. On 4th November 2014, we met at 10am and started our walk at St. Johns church. Prior to this day we met up to plan on our walk and how we will conduct it. While on our walk we observed how diverse and cultural the area was, we observed the people socialising in the street, the services available for these peopleRead MoreThe Social Determinants Of Health1306 Words Ã |Ã 6 PagesConditions of birth and peopleÃ¢â¬â¢s growth, lifestyles, occupations and age strongly influence their health. This essay focuses on children between the ages of zero to 19 and examines what the social determinants of health are. Firstly, it attempts to analyse poverty, family violence, addiction and the impacts on the health of younger New Zealanders who are exposed to those determinants. Secondly, strategies, initiative s and prevention services are identified at national, regional and local levels toRead MoreThe Social Determinants Of Health981 Words Ã |Ã 4 Pagesthe first time. The social determinants of health most likely had an impact on the life expectancy of the vulnerable populations (Gupta, 2004). Applying the primary health care principles such as equity, cultural competence, community participation and maximum self-reliance, health promotion and disease prevention, access to health services and resource, use of acceptable technology and involvement of government departments to Mrs AziziÃ¢â¬â¢s care will reduce the prevalence of health inequities amongst
Monday, December 23, 2019
Self-injurious behavior (SIB) in relation to aggression are two of the most common behavioral difficulties in people with developmental disabilities, especially those with autism spectrum disorder (ASD), as Lainhart stated (as cited in B. Williams R. Williams, 2011). For those with intellectual disabilities, SIB is quite prevalent, as an estimation of four to 16 percent of those with ASD engage in SIB (Amaral, Dawson, Geschwind, 2011). SIB in those with ASD tends to be classified as a highly repetitive behavior, either occurring in bursts after long periods with problematic behavior, or under highly specific stimulus contexts (OÃ¢â¬â¢Reilly, 1997). The most common forms of self-injurious behavior include: hair pulling, self-choking, Ã¢â¬Å"head banging, hand biting, and excessive self-rubbing and scratchingÃ¢â¬ (Edelson, n.d.; Iwata, Pace, Dorsey, Zarcone, 1994), [[NEED PAGE #]] and usually includes repetitive, self-inflicted, non-accidental injuries that often result in bleeding, broken bones, and permanent tissue damage (B. Williams et al., 2011). Examples of typical SIBs in those with ASD are comprised of self-biting, skin picking, self-punching, while the less common SIBS include eye pressing or gouging, pulling oneÃ¢â¬â¢s own hair, teeth, or fingernails, dislocation of joints, and knee to head hitting (Minshawi et al., 2014). Substantial medical problems may arise from SIB, such as, Ã¢â¬Å"cataracts, retinal detachment, permanent scars, contusions, soft tissue lacerations, and evenShow MoreRelatedThe Effects Of Self Injurious Behavior On Children With Developmental Disabilities And Asd904 Words Ã |Ã 4 PagesSelf-injurious behavior is one of the most devastating behaviors exhibited by people with developmental disabilities and ASD. The most common forms of these behaviors include: head-banging, hand-biting, and excessive self-rubbing and scratching. There are many other self-injurious behavior such as, impulsive SIB appeared to be associated with suicide attempts, a history of sexual abuse, and depression (Favaro, A., Santonastaso, P.1999) There are many possible reasons why a person may engage inRead MoreEssay about case study 11092 Words Ã |Ã 5 PagesÃ¯ » ¿Case Study 1: Martin Martin, a behavior analyst, is working with Sara, a 14-year-old girl with severe developmental delays who exhibits self-injurious behavior (SIB). The self-injurious behaviors included pulling her hair, biting her arm and banging her head against the wall. After conducting a functional analysis, Martin decided to employ an intervention program consisting of differential reinforcement of other (DRO) desired behavior. Martin collected data on Saras SIB before and during the interventionRead More Understanding Teens Who Self Injure Essay2050 Words Ã |Ã 9 PagesWho Self Injure Ã Ã Ã Ã Ã Imagine being sixteen years old and taking a razor to your arm because you feel so much pain inside that cutting is the only way to escape it. For a lot of people this idea seems strange and incomprehensible, but for many teenagers this is their reality. In a society with so much abuse, neglect and crime children are facing things that they never had to face in the past. Adolescents who are lacking more positive coping skills are turning to self-injurious behaviors to easeRead MoreEssential Question For Guide Learning Process And Growth1638 Words Ã |Ã 7 PagesEssential Question to Guide Learning Process and Growth The self-reflection, assessment of student performance, and learning environment assessment show that an essential priority in my practice is pursuing additional instructional and behavioral strategies to impact students with autism who currently exhibit Self Injurous Behavior SIB. As an educator, I am interested in creating a proactive environment to limit triggers that often lead to SIB in students with autism. Additionally, implementing appropriateRead MoreCornerstone Services Residential Group Homes2115 Words Ã |Ã 9 Pagesresidential group homes currently house 65 intellectually disabled individuals who are being tracked for self-harm and have been resistant to treatment (Behavioral Tracking). Several behavioral and medication therapies have been implemented, however, the detrimental behavior has persisted. This leads to the need for one to one supervision and other restricting interventions. Self-injurious behavior (SIB) is a persistent problem in the intellectually disab led community that can have an enormous negativeRead MoreWhy Are Some Children More Difficult Than Others?866 Words Ã |Ã 4 Pagescan have problem behavior, and without knowing the actual motive of the behaviors, it can be almost impossible to correctly address it. Examples of reasons children have problem behavior can include, but not limited to, a child s biology, their neurological development and their environment. So many different factors can cause a child to have problem behavior. A child that is showing behavior due to a mental handicap is going to need a different approach to correct the behavior than a child thatRead MoreHow Behavioral Treatments Are Based On Basic Principles And Research1476 Words Ã |Ã 6 PagesSelf-injurious behaviour (SIB) is a debilitating problem that affects individuals with developmental delays (Singh, Dawson, Gregory, 1980). SIB entails a range of chronic behaviours which lead to physical harm that occur frequently within a sustained period, e.g., include self-biting, self-hitting, and self-pinching (Favell et al., 1982). The adverse impact of SIB escalates as these individuals approach adulthood, with increasingly prevalent problems such as physical damage, social seclusion, andRead MoreBehavior Analysis, Health Care Professionals, And Psychologists883 Words Ã |Ã 4 PagesPunishment vs Reinforcement Behavior analysis, health care professionals, and psychologists require competent procedures to find responses to relevant questions and to stay current with scientific literature. Behavior analyses use the best research that is evidence-based that supports clinical expertise and patient values (Walker, 2007). It makes significant differences in how effective more or less interventions are with clients, their families and society (Slocum, 2012). Clients deserve the bestRead MoreCognitive And Intellectual Disorders, By Dr. Brian Iwata Essay1186 Words Ã |Ã 5 Pagesanalysis methodology of problematic behaviors. He has held faculty positions at both Johns Hopkins University School of Medicine and Western Michigan University before settling down at the University of Florida. After receiving his Ph.D. from Florida State University, Dr. Iwata set out to revolutionize the disciplines of behavioral and intellectual disorders, program development, and applied behavior analysis by accepti ng a director position at the Florida Center on Self-Injury and the University ofRead MoreSelf-Defeating Behaviors: Treatment and Therapies1136 Words Ã |Ã 5 PagesÃ¯ » ¿Self-defeating Behaviors: Therapies Introduction People seldom have tendencies of getting in their own way when they do not strive to overcome self-defeating behaviors. Such behaviors not only have the power to incapacitate ones best plans and most enthused ventures but also injure ones relationships with others. An individual who wants to avoid such awkward, damaging and thwarting errors must keep his mind open and must show a willingness to do something about such behaviors (Nelson 1999,
Sunday, December 15, 2019
Electronic Medical Record Implementation: Costs and Benefits Sheryl L. Venola Assignment 3 (24 July 2011) NURS 517 Intro to Health Care Financing Saint Xavier University Professor: Dr. Roger Green, DNP, MSN, BSN Abstract This paper discusses the adoption of an electronic medical record system purchased by Howard Regional Health System in Kokomo, Indiana; the rationale behind its timing and choice in expenditure; the ramifications of not implementing the system (e. We will write a custom essay sample on Electronic Medical Record Implementation: Costs and Benefits or any similar topic only for you Order Now g. recent health care legislation requirements); the benefits to the organization as well as to the patients it serves, and a cost effectiveness analysis. Additionally, the American Recovery and Reinvestment Act of 2009 is discussed including compliance mandates that will require eligible providers and health care institutions to meet electronic health technology implementation deadlines or face no compensation for their implementation as well as reductions in Medicare and Medicare reimbursements. Also included are discussions of the Ã¢â¬Å"meaningful useÃ¢â¬ guidelines established by the Centers for Medicare and Medicaid and the differences between electronic medical records and electronic health records. Finally, the advantages and disadvantages of electronic medical records are detailed. In response to the to changes in the health care delivery system as a result of the Affordable Care Act (ACA) signed into law in March of 2010, Howard Regional Health System (HRHS) has recently purchased the Cerner electronic medical record (EMR) system at a cost of $22,000,000. According to chief executive officer, James Alender, accountable care is the focus of this change in addition to stimulus money for electronic health record (EHR) system implementation, which could offset their initial expenditure by approximately $3,100,000 based on the volume of Medicare business the organization had in 2008 (Munsey, 2011). This monetary investment comes in the wake of health information technology implementation requirements set forth in the American Recovery and Reinvestment Act of 2009 (ARRA). The Recovery Act specifies that eligible providers and hospitals with a fixed Medicare and Medicaid patient populations must adopt EHR systems by 2015 or face reduction in their compensation under these programs (Department of Health Human Services [DHHS], 2009). Additionally, the act assigned funds to the Centers for Medicare and Medicaid Services (CMS) to assess existing EHR systems and to provide incentives for eligible providers and hospitals in implementing such systems. With continued funding and legislative measures affecting the organizationÃ¢â¬â¢s financial future, the adoption of the Cerner system seems to be one of the most important steps in ensuring its financial security in the years to come. If hospital executives and the Board of Trustees were to ignore the requirements set forth in the AARA and ACA legislation, the institution would be in serious jeopardy of losing not only is share of federal funding, but its ability to participate in health care delivery on any level at all. This would signal their demise and would certainly affect the surrounding community as it is one of two hospitals in Kokomo, Indiana, and is the only health care organization of its size in this region of the state. The patients Howard Regional serves will benefit from electronic recording of their health and medical information in many ways. Alender states that KokomoÃ¢â¬â¢s Ã¢â¬Å"snowbirdsÃ¢â¬ should have access to their records so they can be as mobile as they are, suggesting that this will reduce health care costs by reducing duplication of tests, if treatment is obtained away from home. He goes on to assert that digital records will allow more efficient movement of patients through the system allowing seriously ill patients to move more quickly through the emergency department, and other acute care departments within the system. Additionally, if that same patient requires further care away from HRHS, the treating hospital would have access to the previous records so that work already completed is not repeated (Munsey, 2011). Their medical information could be updated with each visit rather than their having to Ã¢â¬Å"provide the same information over and over again (Gurley, 2003). Ã¢â¬ Gurley also agrees that because patients and providers are better informed through electronic record-keeping, there is less duplication of testing as well as enhanced treatment coordination among health care providers. Along with the patients, the hospital reaps many tangible and intangible benefits from EMR as well. The information in the electronic record is easily accessible to multiple clinicians at multiple locations at the same time, with nearly immediate retrieval time. For this reason, it is updated frequently and is available for access at any workstation whenever the information is required making time spent with patients more efficient (Gurley, 2003). According to Shi and Singh (2003, p. 65), one of the most important aspects of electronic records is the integration of specific patient profiles with clinical decision making tools built into the software which provide evidence-based practice reminders and guidelines for effective, efficient treatment. This type of alert system can result in reduction of medication errors and in appropriate treatment options, saving both the patient and the clinician from harm. The data analysis capability of the EMR can also be used to identify developmen ts among patient populations allowing for early intervention when indicated. It can also be utilized to identify areas in which the organization may need to expand or scale back depending on the trends the data indicates (Dolan, 2011). Having used the Cerner system in the past, this RN noted that with the clinical record being streamlined in such a way that narrative documentation was necessary only by exception, completing it required less time, which left more time for bedside care along with completion of educational requirements, which were also mostly computerized. Hence, the savings could be significant and provide for increased nurse satisfaction related to the ability to provide more actual patient care as well as complete proficiencies without having to stay after a shift or come in on a day off. As mentioned above, EMR can reduce duplication of services, assist in fast-tracking acutely ill patients, reduce the duplication of tests and services that arenÃ¢â¬â¢t medically necessary (e. g. the patientÃ¢â¬â¢s condition has not changed substantially), allow clinicians to spend less time on documentation possibly reducing overtime, each of which can result in cost savings for the institution. According to Randall T. Huling Jr. , MD, president of Olive Branch Family Medical Center in Olive Branch, Mississippi, since switching over to EMR in January of 2010, they have increased revenue by an estimated $650,000 with an annual cost reduction of more than $85,000. Additionally, they have been able to raise provider productivity by 10,000 visits, raise their fee collection percentage from 68 to 72 percent, and increase the charges per patient from $157 to $172 (Byers, 2010). Wang et al (2003) performed a five-year cost-benefit analysis using primary data from several internal medicine clinics, using their own internally developed EMR system, utilizing a health care organization perspective framework and a conventional paper-based medical record as the reference point. Costs of implementation were approximated to be $3,400 per provider in the first year and included redesign of workflow processes, extraction of data from paper charts, and training. Yearly maintenance cost, including system and network administration and additional technical support personnel, were estimated to be $1,500 per provider annually. The temporary loss of productivity resulting from the transition to an electronic from a paper system, was interpreted using a decreasing loss rate of 20% in month one, 10% in the second month, and 5% in the third, returning to baseline in the following months. With annual averages for provider revenues, this cost amounted to $11,200 in the first year. Although their five-year net benefit per provider was $86,400 and the Ã¢â¬Å"net financial return to a health care organization from using an ambulatory medical record system is positive across a wide range of assumptions (Wang, et al, 2003, p. 401),Ã¢â¬ the authors cautioned that several variables could affect the net revenues organizations could expect. The patient mix can affect revenues depending on the number of capitated versus fee-for-service patients served by the health care organization. With capitated arrangements, savings to the patient resulting from decreased use of utilization of services, revenues accrue to the provider. However, less utilization of services in fee-for service arrangements result in loss of revenue to the provider, but the payer (i. e. the insurer) saves in expenses. They did postulate that these insurers might provide incentives to providers using EHR realizing that their profits could be increased with more providers utilizing these systems, The study evaluated cost savings from drug suggestions and warnings provided by the EMR software, which aided in prescribing of formulary drugs and prevention of adverse drug events. However, the study was not able to evaluate the intangible cost savings from averted malpractice claims, injury to patients, or reduced quality of life of clients. Additional tangible and intangible savings that were not included due to unavailability of sufficient data were reductions in malpractice premium costs, decreased staffing needs, less paper charting-related storage and supply costs, increased provider productivity, generic drug substitutions, enhanced reimbursement resulting from proper coding, and reduced denials related to insufficient documentation of medical necessity (Wang et al, 3003 p. 402). Limitations of the study cited by the authors included the fact that the research model was centered on primary data from their institution, published literature estimates, and an expert opinion panel which they convened. They also conceded that EMR implementation might produce other costs, including greater system integration expense for larger institutions dependant on the complexity of the various system interfaces involved. Additionally, although effectiveness of electronic medical record interventions has been well-established in inpatient settings, there is less certainty of their effects in the outpatient environment. Other costs could be related to decreased or lost productivity during unexpected network or computer system downtime, reassignment of clinical staff, or redesign of the workflow process (Wang et al, 2003, p. 402). Obviously the above results are based on one study utilizing results from a group of ambulatory clinics making it difficult to extrapolate data to a hospital setting even when that hospital has significant outpatient programs. Indeed, Thompson and Fleming (2008) pose questions regarding the uality and quantity of data found in existing literature, suggesting that health care institutions be cautious in their information sources in order to be better informed in the EMR decision-making process. The authors state that amount of comprehensive studies are lacking requiring hospitals to obtain more sources containing information they are seeking and rigorously compare data so that they can better extrapolate the results to their individual organizations (Thompson Fleming, 2008) . They also caution using staff time savings as a factor unless that variable is given a value and that it is used to actually cut costs. For example, if an average of 30 minutes per staff member is realized in utilization of the EMR, how will that impact staffing? Will staffing needs be reduced allowing for fewer staff members per shift, resulting in actual cost reductions? If staff are able to complete other duties that would have required use of overtime or coming in on days off, this would also decrease expenditures. However, the authors point out that staff members are often allowed to perform other tasks that donÃ¢â¬â¢t result in salary reductions, although this is implicit when staff time saving related to EMR is discussed (Thompson Fleming, 2008). It is obvious that the decision to adopt an electronic medical record is not an easy one to make given all the variables discussed previously, but the information presented thus far has not taken into account the more recent changes produced by health care reform. These changes are discussed in the following paragraphs. The American Reinvestment and Recovery Act provides incentives for eligible providers (EP) and health care organizations (i. e. those who serve a defined percentage of Medicare and Medicaid recipients) for the implementation of EHR. The use on EMR and EHR are have often been used interchangeably, but they are not the same. An electronic medical record is the legal record of the care a patient receives from a health care provider or institution during their encounter with either entity. The electronic health record belongs to the patient and encompasses the entirety of their care across all providers within a community, region or state (Garets Davis, 2006, pp. 2-3). For the purposes of reimbursement, however, providers must use a certified EHR (EHR Incentives, p. ). The recovery Act has appropriated $140,000,000 for each of fiscal years 2009 through 2015, with an additional $65,000,000 for 2016 to be used for administrative funding. Funds are to be made available until completely utilized. Ã¢â¬Å"In coordination with the Office of the National Coordinator (ONC) for Health Information Technology, CMS will develop the policies, such as the definition of Ã¢â¬Ëmeaningful use,Ã¢â¬â¢ needed to implement the incent ive program (DHHS, 2009). In addition, it will be necessary to provide education to eligible participants to facilitate their understanding of all the conditions and guidelines regarding their eligibility, the selection of Medicare or Medicaid incentive programs, the incentive payments, and the demonstration of Ã¢â¬Å"meaningful use. Ã¢â¬ Recovery Act reporting compliance will require guidance to individual states, which will involve Federal and State staff time and require modification of accounting and payment data reporting systems (DHHS, 2009). When the aforementioned requirements were set forth by the DHHS in 2009, the meaningful use guidelines had not yet been established. Following is a link to the summary overview for meaningful use objectives of EHR* (Blumenthal Tavenner, 2010) as it currently stands, which outlines the steps individual providers and health care institutions (hospitals, ambulatory care centers, clinics, et al) must take in order to receive stimulus funds for the costs associated with implementing electronic health systems (EHR). The initial payments will be made beginning in 2011 depending on each stateÃ¢â¬â¢s timing in adoption of the Medicare and Medicaid programs. For hospitals, the calculation is based on the volume of Medicare and or Medicaid patients served, but the baseline payment is $2,000,000. Each program is separate, but EPs and institutions can apply for one or both programs, however if they choose only one program, they cannot later add the other, so it benefits them to choose both at the outset since they can drop out of either one at any time (EHR Incentives). Given the stakes of not participating, providers should work diligently to eet all the requirements set forth in order to maximize the return on investment they should obtain in simply adopting EHR. The incentives offered will merely help them realize those return sooner rather than later. Finally, given the state of internet security and the governmentÃ¢â¬â¢s desire to push providers toward electronic data capture, it is only natur al that there would be concerns regarding EMR and EHR technology. Advantages of EHR over paper records include an expansive storage capability, availability of the data from many access points at the same time, and nearly immediate retrieval time (Gurley, 2003). The paper record is fragmented and depending on the charts used (e. g. some tend to fly open when dropped, causing paper to be scattered), pieces of the record can be lost. Additionally, when a patient is hospitalized more than once, their old chart must be retrieved in order to provide continuity of care. Electronic systems bypass this and allow clinicians to obtain information from previous visits much more quickly allowing the patient to have a streamlined entry to and exit from the system. Electronic health records also have built-in medical alerts and reminders allowing providers to be notified of abnormal lab results, potential drug interactions, and timing of tests required for monitoring blood levels associated with certain conditions or as a side effect of medications. It can also provide evidence-based practice plans for certain diseases and disorders facilitating the providerÃ¢â¬â¢s choices in judging the right path in caring for each patient. The electronic software allows the clinician to capture information enabling them to provide payers with the outcome based criteria they require in reimbursing the physician. Finally, EHR provides a major step in ensuring patient safety by clearly written order entry by physicians avoiding the mistakes that can occur with handwritten orders when those entries are illegible (Gurley, 2003). The major disadvantage of EHR adoption appears to be the costs associated with implementing them. According to Kent Gale, start-up costs could range from between four and five million dollars for a smaller (200-bed) hospital to $100,000,000 for an organization with three hospitals. He went on to tate that a typical 400-bed facility with a more extensive EHR would likely spend between $20,000,000 and $30,000,000 (Byers 2010). Also, unless one is technologically-savvy, there can be considerable learning needs on the part of physicians and staff. In these cases, it is much better to have systems that are more intuitive and user-friendly in order to get everyone onboard. As previously mentioned, privacy concerns are at the forefront in peopleÃ¢â¬â¢s minds where electronic documentation is concerned. Security measures must be ever-evolving in order to meet the challenge and audits of access to medical data must be done to ascertain the appropriateness of information access. Paper records have also had the potential for unauthorized access without the knowledge of the patient or provider and these invasions of privacy are much harder to detect (Gurley, 2003). Essentially, the electronic record has its advantages and disadvantages, but with all the benefits they can provide to patients, providers, insurance companies, as well as the government in collection of statistics, it appears to be the best choice for all concerned. With a great deal of effort and constant vigilance, electronic health records can provide for safer, more cost efficient care, and conserve resources for use in other areas that are currently lacking. I believe that in the end, Howard RegionalÃ¢â¬â¢s decision to adopt EHR will result in huge savings and increased revenues that will benefit not only the organization, but the communities they serve. References Blumenthal, D. , Tavenner, M. (2010, August 5). The Ã¢â¬Å"Meaningful UseÃ¢â¬ Regulation for Electronic Health Records. New England Journal of Medicine, 363, 501-504. Retrieved from http://ww. nejm. rg/doi/full/10. 1056/NEJMp1006114? ssource=hcrc Byers, J. (2010, November). EMR implementation: One day at a time. CMIO: Information, Evidence Effectiveness in Medicine, Digital. CMIO. net, 10-12. Retrieved from http://d27vj430nutdmd. cloudfront. net/5165/51383/51383. pdf Department of Health and Human Services Report (2009). Centers for Medicare Medicaid Services: Medicare an d Medicaid Incentives and Administrative Funding. Retrieved from http://www. hhs. gov/recovery/reports/plans/hit_implementation. pdf Dolan, P. L. (2011, May 2). Electronic medical records: What your data can tell you. American Medical Association: American Medical News. Retrieved from http://www. ama-assn. org/amednews. EHR Incentives: Eligibility. (n. d. ). Retrieved July 18, 2011, from Centers for Medicare and Medicaid Services website: https://www. cms. gov/pf/printpage. asp? ref=http://www. cms. gov/ehhttps://www. cms. gov/pf/printpage. asp? ref=http://www. cms. gov/ehhttps://www. cms. gov/pf/printpage. asp? ref=http://www. cms. gov/EHRIncentivePrograms/15_Eligibility. asprincentiveprograms/01_Overview. asprincentiveprograms/01_Overview. asp Garets, D. , Davis, M. (2006, January 26). Electronic Medical Records vs. Electronic Health Records: Yes there is a difference [White Paper]. Retrieved from A HIMSS AnalyticsTM website: http://www. himssanalytics. org/ Gurley L. (2003). Advantages and Disadvantages of the Electronic Medical Record. American Academy of Medical Administrators, 2004. Retrieved from http://www. aameda. org/MemberServices/Exec/Articles/spg04/Gurley%20article. pdf Munsey, P. (2011, March 26). Howard Regional up to the challenge. Kokomo Perspective. com. Retrieved from http://www. kokomoperspective. com Shi, L, Singh, D. A. (2008). Delivering health care in America: A systems approach. Sudbury, MA: Jones and Bartlett Publishers. Thompson, D. L. , Fleming, N. S. (2008, July). Finding the ROI in EMRs. Healthcare Financial Manager, 62(7), 76-81. Retrieved from http://www. hfma. org/publications/hfm-Magazine/hfm-Magazine Wang, S. J. , Middleton, B. , Prosser, L. A. , Bardon, C. G. , Spurr, C. D. , Carchildi, P. J. , Ã¢â¬ ¦ Bates, D. W. (2003, April 1). A cost benefit analysis of electronic medical records in primary care. American Journal of Medicine, 114(5), 397-403. Retrieved from http://www. amjmed. com/article/S0002-9343(03)00057-3/fulltext How to cite Electronic Medical Record Implementation: Costs and Benefits, Essay examples
Saturday, December 7, 2019
I Believe in Laughter Essay Have you ever laughed so hard that your stomach hurt? I believe in this kind of laughter. Being able to laugh at yourself and be okay with it. Laughing so hard that your stomach hurts and you cant catch your breath. The kind of laughter that even makes your face hurt from laughing so long. As a child, I was always doing crazy things or cracking jokes. My parents know all too well how much my mouth makes them laugh. Now, my mouth doesnt make them laugh because of my jokes, well sometimes, but more of what they call Sam-isms. Ideas that really make no sense to anyone, but me. When I share a Sam-ism with my parents, they usually just look at each other perplexed, and then burst out laughing after they think they figured out what I was trying to say. I eventually learned to laugh at it myself, after they explained to me how idiotic my Sam-ism was. An example is, last year I went to the doctor to see if I had a concussion and the physician asked me if I had any memory lapses since the incident. I soon replied with, Ã¢â¬Å"I donÃ¢â¬â¢t think so, but I donÃ¢â¬â¢t remember. My dad then rolled his eyes and explained to the doctor that I wasnÃ¢â¬â¢t brain damaged, this was normal. Another example, is that one day I was riding in the car and all of a sudden a great idea, or what I thought was a great idea, popped into my head. All of a sudden I blurted out, Ã¢â¬Å"wouldnÃ¢â¬â¢t it be awesome if they had drive through stores where you didnÃ¢â¬â¢t even have to get out of your car to go shopping? You could just drive into the store and drive around pulling the items you needed into you car until it was time to checkout. It took awhile to explain that one to my parents, and to realize myself that it was a stupid idea. When I get Sam-isms I never really think about them for too long until I decide to share them with others. As they would laugh and laugh about what I just said, I couldnÃ¢â¬â¢t figure out why they were laughing. Instead of just having the people that heard the Sam-ism laugh at me, I decided that I should be laughing at myself too. I started to get joy and amusement out of laughing at myself and thats why I believe in laughter. Just the simplest thing someone says can set off a laughter so strong that you canÃ¢â¬â¢t breathe because you are laughing so hard. It can bring joy to the world and turn someoneÃ¢â¬â¢s day around. The moral of the story is that I feel free to say whatever funny thing comes to mind and know that even if my friends and family are rolling laughing, I am right there with them laughing too! Dont take life too seriously. You miss the great moments that make great memories.