D391 Healthcare Ecosystems (work in progress) Complete Guide

D391 Healthcare Ecosystems (work in progress) Complete Guide Healthcare System and Providers 1. What is the overall framework that supports healthcare services to individuals? Answer: The healthcare ecosystem or system. 2. Who are the key stakeholders in the healthcare ecosystem? Answer: Patients, providers, professional administrators, policymakers, and payers. 3. What are the three main purposes of the healthcare system? Answer: Affordability, access, and quality. Healthcare Providers 4. What role do healthcare providers play in the healthcare ecosystem? Answer: Providers perform various services such as doctors, nurses, physician assistants, and more. 5. What type of provider serves as a client's main point of contact throughout their stay in an inpatient facility? Answer: Hospitalists. 6. Which provider type is responsible for performing medical procedures, designing treatment plans, and coordinating with a client's entire medical team? Answer: Hospitalists. Patients 7. Who are the clients receiving healthcare services? Answer: Patients. 8. Where do patients find healthcare services to fit their needs? Answer: Various settings such as emergency departments, urgent care centers, retail clinics, and more. 9. What are the five types of healthcare services? Answer: Health promotion, disease prevention, diagnosis and treatment, rehabilitation, and chronic care. Healthcare Facilities 10. What type of facilities provided care for the disabled or ill in the 1700s before hospitals were established? Answer: Almshouses. 11. What is an example of an advanced practice professional? Answer: A nurse practitioner. 12. Where do patients receive ambulatory care? Answer: Health care provided outside of institutional settings. Funding Models 13. What is one of the three major forces affecting the development of hospitals? Answer: Advances in medical education. 14. How does the hospital industry categorize itself? Answer: By function or type of service provided, length of stay, and ownership or source of financial support. Government Organizations 15. Which government organization manages Americans' health issues and concerns and leads programs to advance medical research and public health? Answer: U.S. Department of Health and Human Services. 16. Which government program provides health care for family members of disabled or deceased military service members? Answer: The Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA). Cultural Competence 17. Why is cultural competence important in health services? Answer: Because clients' values and preferences will be respected. Disparities 18. Which type of disparity is a client experiencing if they have received nutritional counseling but have limited food selection due to being on a fixed income and shopping at a food pantry? Answer: Access to social needs. 19. Which facility should a 70-year-old client visit if they have been experiencing chest pain for an hour? Answer: Emergency medical center. A client is terminally ill and has a life expectancy of two months. Which facility should the client visit? A hospice What roles do health providers play in the healthcare ecosystem? - health and human services workers - doctors, mid-level providers, nurses - therapists (occupational & physical) - mental health providers - diagnostic/lab techs provider a person or institution that performs a service; for example, a healthcare worker performs health services. Why are institutional providers necessary in the healthcare ecosystem? They are facilities that provide health services to clients like hospitals, post-acute short- and long-term care facilities, and primary care facilities. A client has a runny nose and headache. Which healthcare provider does he need to see? Primary care physician A 75-year-old client who is recovering from knee surgery is ready to be discharged but is not yet ready to return home to resume independent living. Which type of facility is appropriate for this client's needs? A post-acute short-term care facility How do healthcare producers impact the purposes of the healthcare ecosystem? The impact of their work on the healthcare ecosystem determines the health system's survival. healthcare producers diverse individuals with various skills and knowledge who provide services to patients How do costs impact products and producers? costs affect barriers to entry and the ability to find buyers of products conventional medical devices are products that are easy to manufacture with relatively few barriers for entry for new companies and relatively little product differentiation (e.g., an IV pole) high technology medical devices require significant investment in research and development to design, often resulting in patents, and greater regulatory scrutiny from the FDA (e.g., a pacemaker, surgical instruments and implants) Class I medical devices low risk devices such as hand-held surgical instruments and ultrasonic cleaners; subject to "general controls" but most exempt from pre-market notification approval (501k) Class II medical devices considered to pose potential risks great enough to warrant higher regulation; includes more sterilization equipment and chemical indicators; 501k required Class III medical devices high risk devices such as implants, heart valves, pacemakers, etc.; 501k required; subject to high performance standards and post-market surveillance pre-amendment devices Refer to devices legally marketed in the United States by a firm before May 28, 1976 and which have not been (1) significantly changed or modified since then; and (2) for which a regulation requiring premarket approval application has not been published by FDA. These devices are also referred to as "grandfathered" devices and do not require regulatory submission (510(k) application). post-amendment device Devices that came after the Medical Device Amendment of 1976 Premarket Approval (PMA) the FDA process of scientific and regulatory review to evaluate the safety and effectiveness of Class III medical devices Implantable medical devices (IMD) such as pacemakers, artificial hip joints, etc. are an important category of PPI and can be a significant component of the total cost for high-cost medical procedures, such as surgical procedures GPOs Group Purchasing Organizations; entities created to represent groups of buyers (e.g. hospitals) in negotiations with medical device companies (and other suppliers) to obtain lower prices PPIs physician preference items; items for which physicians express strong preferences but don't generally bear the cost of their choice primary care Providers or practitioners (PCPs) Healthcare practitioners who provide healthcare services for common injuries or illnesses; includes physicians, advanced practice registered nurses, and physician assistants. advanced practice registered nurses (APRNs) Registered nurse with master's degree training who can serve as a primary care provider; includes nurse anesthetists, nurse midwives, nurse practitioner, and clinical nurse specialists. physician assistants (PAs) A medical professional who may practice preventive, diagnostic, and therapeutic medicine under the supervision of a physician or surgeon. Responsibilities may include taking a medical history, conducting a physical exam, and ordering and interpreting lab tests and X-rays required for making a diagnosis. medical home The primary source of ongoing preventive care or disease management for an individual or family. medical doctor (MD); allopathic physicians A physician who has obtained a Doctor of Medicine (MD) degree at an accredited allopathic medical school. doctor of osteopathy (DO); osteopathic physicians