CPHIMS Study Exam with 100% Correct Answers 2023

Issues for health care providers - Correct Answer-High, rapidly rising costs. Highly variable clinical quality. Patient safety issues. Need for evidence-based decision making. Complex administrative processes. Increasing consumerism and heightened expectations. Research and technology advances. Fragmented delivery. Influences by politics, leadership,culture, social values, financing, economics, etc. Health care consumerism - Correct Answer-Encroaching more and more upon doctor subject matter. Also, services such as personal health records, websites, etc. Primary care - Correct Answer-Generally, provided by doctors. May be independent or within a hospital system. Secondary care - Correct Answer-Provided in a hospital. Examples include surgery, ICU services, neonatal, etc. Tertiary care - Correct Answer-Complex care such as trauma, transplant services, etc. Sub-acute care or Intermediary care - Correct Answer-E.g., skilled nursing Not-for-profit/non-profit - Correct Answer-Owned by community, religious order, government, etc.; not taxed except for for-profit subsidiaries, which are investment arms to help fund non-profit activities For profit - Correct Answer-Owned by individuals or corporations; taxed on both income and property. E.g., HCA Acute inpatient facilities - Correct Answer-Require overnight stay. MSA - Correct Answer-Metropolitan statistical area. Population 50k. One way to classify a hospital Rural Hospital - Correct Answer-Smaller, remote. Usually provide a wide range of primary and some more advanced services. Community Hospital - Correct Answer-Operate in less dense areas than MSA or urban hospitals, but not as remote or rural as rural hospitals. May provide a wide range of services. Government payor - Correct Answer-"Insurance" for health care services that are paid for by taxes. Varies by country. Example in US is Medicare or Medicaid. Private payor - Correct Answer-Insurance paid for privately, usually via an employerprovided benefit. Teaching hospital - Correct Answer-Affiliate with a medical school or other health professions school. Academic medical center - Correct Answer-Owned by a medical school. Non-teaching hospital - Correct Answer-No formal training. Ambulatory centers/clinics - Correct Answer-Provide services to patients without an overnight stay. E.g., doctors offices, outpatient treatment and surgery, diagnostic services, primary care, etc. Usually first point of entry into the healthcare system. Long term care services - Correct Answer-30 plus day length of stay. Often called nursing homes or nursing facilities and can include skilled care, intermediate care, rehabilitation, mental health care, or even home health care. Skilled care - Correct Answer-Full time care of an RN for chronic and serious conditions. Intermediate care - Correct Answer-Personal, broad based care with assistance for activities of daily living. Rehabilitation - Correct Answer-Long term care that may range from several weeks to years. May include mental health care. Home health care - Correct Answer-Outpatient and at home. May be free standing or part of a health system. Profit or non-profit. Public health agencies and programs - Correct Answer-Funded by the government. In the USA, mostly primary care and public health services, but may affect public policy. In US mostly for folks below the poverty line, but serve a larger audience in other countries. Community health programs - Correct Answer-Usually funded by grants. Mostly for folks without access to care and who are indigent or migrant. Also for targeting key medical issues such as obesity, smoking, breast feeding, etc. Group practices - Correct Answer-Physician practices. Can be a single specialty or multiple specialties. Can be private but funded by the government at the same time. May also work under the governance of a hospital. Solo practice - Correct Answer-A single physician practice. Becoming less common and harder to sustain financially. CPOE - Correct Answer-Computerized practitioner order entry. Applies mostly to pharmacies. Decreases ordering errors. Pharmacies - Correct Answer-Key component of health care system that provides medication either in house at a hospital or as a free standing retail outlet. Pharmacists are key members of the team. Integrated Delivery Network (IDN) - Correct Answer-AKA IDS (Integrated delivery system). An organization of a variety of providers offering services across a continuum of care and integrated in administration and information sharing. Their aim is to decrease costs, increase effectiveness, improve outcomes, and improve quality. Formed through merger and acquisition, joint ventures, alliances, and networks. Merger and acquisition - Correct Answer-When two or more organizations merge their assets to create a single new organization. Joint venture - Correct Answer-When two or more organizations join to create a third, new organization. Alliance - Correct Answer-When two or more organizations share resources without owning any common assets. Network - Correct Answer-An alliance of serveral providers. Very ambitious. Key factors for IDN/IDS success - Correct Answer-Physician involvement and interoperable information systems. Private financing payment system - Correct Answer-Commericial private insurance (most common in developed countries) or out-of-pocket payments (fee for service) to pay for healthcare services. Fee-for-service - Correct Answer-Payment system based on per day or per procedure payment. The incentive for the provider is to add services or days of care, so case managers are used to manage the care episode. National health insurance system - Correct Answer-A type of public health care financing. Paid for by taxes, but the providers are private. An example is Canada, and works somewhat like Medicaid in the US. National health system - Correct Answer-A health care delivery system where the government is responsible for both the delivery and payment of health care. This is the European Union model. Public health care financing - Correct Answer-Either national health insurance system or national health system. It leads to a more widespread provision and use of primary care and increased life expectancy. Primary care physicians - Correct Answer-Pediatrics, family care, general practitioners, internists Specialist physicians - Correct Answer-Non primary care such as oncology, ophthalmology, endocrinology, etc. Some do not have direct patient care, such as radiologists, pathologists, anethesthiologists, and research doctors. Other roles for physicians - Correct Answer-administration, board members, government and payor organizations, vendor companies, consultants, informatics (CMO). Mid level practitioners - Correct Answer-Physician assistants and advanced practice nurses Physician assistants - Correct Answer-24-36 months training; usually rural. Advanced practice nurses - Correct Answer-Clinical nurse specialists, nurse practitioners, midwives, nurse anesthetists; can prescribe limited meds Nurses - Correct Answer-Largest category of health care professionals, especially in hospitals. RNs make up more than 50% of the health care workforce. Includes nursing informaticists. Functions of the IT department - Correct Answer-Operations and technical support Applications management Specialized groups IT administration IT operations and technical support - Correct Answer-Help desk IT applications management - Correct Answer-Acquires, develops, and implements new systems (rarely new development); provides ongoing enhancements. IT specialized groups - Correct Answer-E.g., process improvement and management engineers IT administration - Correct Answer-Oversees functions of the IT department; provides IT governance and structure; develops and implements a strategic IT plan; manages staffing and budget. Chief Information Officer (CIO) - Correct Answer-Usually an IT executive (rarely an MD) who manages all the infrastructure (phones, help desk, medical and non medical applications such as HR, accounting, finance, etc.); manages the department and provides leadership. Chief Technology Officer (CTO)