scholarly journals Including Language Access into Medicaid ACO Design

2016 ◽  
Vol 44 (3) ◽  
pp. 492-502
Author(s):  
Rachel Gershon ◽  
Lisa Morris ◽  
Warren Ferguson
Keyword(s):  
Health Care ◽  
Access To Health Care ◽  
Health Care Quality ◽  
Care Quality ◽  
Cost Of Care ◽  
Care Organization ◽  
Accountable Care ◽  
Language Access ◽  
Language Services ◽  
Payment Methods

Quality health care relies upon communication in a patient's preferred language. Language access in health care occurs when individuals are: (1) Welcomed by providers regardless of language ability; and (2) Offered quality language services as part of their care. Federal law generally requires access to health care and quality language services for deaf and Limited English Proficient (LEP) patients in health care settings, but these patients still find it hard to access health care and quality language services.Meanwhile, several states are implementing Medicaid Accountable Care Organization (ACO) initiatives to reduce health care costs and improve health care quality. Alternative payment methods used in these initiatives can give Accountable Care Organizations more flexibility to design linguistically accessible care, but they can also put ACOs at increased financial risk for the cost of care. If these new payment methods do not account for differences in patient language needs, ACO initiatives could have the unintended consequence of rewarding ACOs who do not reach out to deaf and LEP communities or offer quality language services.We reviewed public documents related to Medicaid ACO initiatives in six states. Some of these documents address language access. More could be done, however, to pay for language access efforts. This article describes Medicaid ACO initiatives and explores how different payment tools could be leveraged to reward ACOs for increased access to care and quality language services. We find that a combination of payment tools might be helpful to encourage both access and quality.

Patient-Centered, Integrated Health Care Quality Measures Could Improve Health Literacy, Language Access, and Cultural Competence

2019 ◽  
Author(s):  
Ignatius Bau ◽  
Robert A. Logan ◽  
Christopher Dezii ◽  
Bernard Rosof ◽  
Alicia Fernandez ◽  
...  
Keyword(s):  
Health Care ◽  
Quality Improvement ◽  
Health Literacy ◽  
Cultural Competence ◽  
Health Care Quality ◽  
Care Quality ◽  
National Committee ◽  
Patient Centered ◽  
Organizational System ◽  
Language Access

The authors of this paper recommend the integration of health care quality improvement measures for health literacy, language access, and cultural competence. The paper also notes the importance of patient-centered and equity-based institutional performance assessments or monitoring systems. The authors support the continued use of specific measures such as assessing organizational system responses to health literacy or the actual availability of needed language access services such as qualified interpreters as part of overall efforts to maintain quality and accountability. Moreover, this paper is informed by previous recommendations from a commissioned paper provided by the National Committee for Quality Assurance (NCQA) to the Roundtable on Health Literacy of the National Academies of Sciences, Engineering, and Medicine. In the commissioned paper, NCQA explained that health literacy, language access, and cultural competence measures are siloed and need to generate results that enhance patient care improvements. The authors suggest that the integration of health literacy, language access, and cultural competence measures will provide for institutional assessment across multiple dimensions of patient vulnerabilities. With such integration, health care organizations and providers will be able to cultivate the tools needed to identify opportunities for quality improvement as well as adapt care to meet diverse patients’ complex needs. Similarly, this paper reinforces the importance of providing more “measures that matter” within clinical settings.

scholarly journals Electronic medical record in cardiology: a 10-year Italian experience

2015 ◽  
Vol 61 (4) ◽  
pp. 317-323
Author(s):  
Clara Carpeggiani ◽  
Alberto Macerata ◽  
Maria Aurora Morales
Keyword(s):  
Health Care ◽  
Medical Record ◽  
Electronic Medical Record ◽  
System Integration ◽  
Health Care Quality ◽  
Care Center ◽  
Health Care Organization ◽  
Tertiary Care ◽  
Care Quality ◽  
Care Organization

SummaryObjectives:the aim of this study was to report a ten years experience in the electronic medical record (EMR) use. An estimated 80% of healthcare transactions are still paper-based.Methods:an EMR system was built at the end of 1998 in an Italian tertiary care center to achieve total integration among different human and instrumental sources, eliminating paper-based medical records. Physicians and nurses who used EMR system reported their opinions. In particular the hospital activity supported electronically, regarding 4,911 adult patients hospitalized in the 2004- 2008 period, was examined.Results:the final EMR product integrated multimedia document (text, images, signals). EMR presented for the most part advantages and was well adopted by the personnel. Appropriateness evaluation was also possible for some procedures. Some disadvantages were encountered, such as start-up costs, long time required to learn how to use the tool, little to no standardization between systems and the EMR technology.Conclusion:the EMR is a strategic goal for clinical system integration to allow a better health care quality. The advantages of the EMR overcome the disadvantages, yielding a positive return on investment to health care organization.

Quality improvement in large healthcare organizations

2016 ◽  
Vol 30 (1) ◽  
pp. 133-153 ◽  
Author(s):  
Elisabet Höög ◽  
Jack Lysholm ◽  
Rickard Garvare ◽  
Lars Weinehall ◽  
Monica Elisabeth Nyström
Keyword(s):  
Health Care ◽  
Quality Improvement ◽  
Health Care Quality ◽  
Health Care Systems ◽  
Care Quality ◽  
Care Organization ◽  
Longitudinal Case Study ◽  
Systematic Analysis ◽  
Content Type

Purpose – The purpose of this paper is to investigate the obstacles and challenges associated with organizational monitoring and follow-up (M & F) processes related to health care quality improvement (QI) and development. Design/methodology/approach – A longitudinal case study of a large health care organization during a system-wide QI intervention. Content analysis was conducted of repeated interviews with key actors and archival data collected over a period of four years. Findings – The demand for improved M & F strategies, and what and how to monitor were described by the respondents. Obstacles and challenges for achieving M & F strategies that enables system-wide and coherent development were found in three areas: monitoring, processing, and feedback and communication. Also overarching challenges were found. Practical implications – A model of important aspects of M & F systems is presented that can be used for analysis and planning and contribute to shared cognition of such systems. Approaches for systematic analysis and follow-up of identified problems have to be developed and fully incorporated in the organization’s measurement systems. A systematic M & F needs analytic and process-oriented competence, and this study highlights the potential in an organizational function with capacity and mandate for such tasks. Originality/value – Most health care systems are flooded with a vast amount of registers, records, and measurements. A key issue is how such data can be processed and refined to reflect the needs and the development process of the health care system and how rich data can be used for improvement purposes. This study presents key organizational actor’s view on important factors to consider when building a coherent organizational M & F strategy.

scholarly journals Adherence to Electronic Health Tools Among Vulnerable Groups: Systematic Literature Review and Meta-Analysis

10.2196/11613 ◽  
2020 ◽  
Vol 22 (2) ◽  
pp. e11613 ◽  
Author(s):  
Jelena Arsenijevic ◽  
Lars Tummers ◽  
Niels Bosma
Keyword(s):  
Health Care ◽  
Access To Health Care ◽  
Health Care Quality ◽  
Meta Analysis ◽  
Care Quality ◽  
Vulnerable Groups ◽  
Adherence Rate ◽  
Direct Communication ◽  
Design And Implementation ◽  
Electronic Health

Background Electronic health (eHealth) tools are increasingly being applied in health care. They are expected to improve access to health care, quality of health care, and health outcomes. Although the advantages of using these tools in health care are well described, it is unknown to what extent eHealth tools are effective when used by vulnerable population groups, such as the elderly, people with low socioeconomic status, single parents, minorities, or immigrants. Objective This study aimed to examine whether the design and implementation characteristics of eHealth tools contribute to better use of these tools among vulnerable groups. Methods In this systematic review, we assessed the design and implementation characteristics of eHealth tools that are used by vulnerable groups. In the meta-analysis, we used the adherence rate as an effect size measure. The adherence rate is defined as the number of people who are repetitive users (ie, use the eHealth tool more than once). We also performed a meta-regression analysis to examine how different design and implementation characteristics influenced the adherence rate. Results Currently, eHealth tools are continuously used by vulnerable groups but to a small extent. eHealth tools that use multimodal content (such as videos) and have the possibility for direct communication with providers show improved adherence among vulnerable groups. Conclusions eHealth tools that use multimodal content and provide the possibility for direct communication with providers have a higher adherence among vulnerable groups. However, most of the eHealth tools are not embedded within the health care system. They are usually focused on specific problems, such as diabetes or obesity. Hence, they do not provide comprehensive services for patients. This limits the use of eHealth tools as a replacement for existing health care services.

Patient satisfaction and brand loyalty in health-care organizations in India

2017 ◽  
Vol 11 (1) ◽  
pp. 73-87 ◽  
Author(s):  
Vinay Sharma
Keyword(s):  
Health Care ◽  
Patient Satisfaction ◽  
Quality Management ◽  
Conceptual Model ◽  
Health Care Quality ◽  
Care Quality ◽  
Care Organization ◽  
Total Quality ◽  
Content Type ◽  
New Instrument

Purpose This paper aims to examine the major factors affecting patients’ satisfaction and loyalty at a health-care organization in India. Design/methodology/approach A conceptual model has been developed that includes the behavioural dimensions of total quality management (TQM), patient satisfaction and loyalty. This study is exploratory in nature and has used the existing literature to build the conceptual model. Findings A solution for improving the quality of health-care services can be found in the application of total relationship management and TQM, together with a customer orientation strategy. Practical implications The results can be used creatively by hospitals to re-engineer and redesign their quality management processes and reorient the future directions of their more effective health-care quality strategies. Originality/value In this research, a study is described involving a new instrument and a new method which assure a reasonable level of relevance, validity and reliability, while being explicitly change-oriented.

scholarly journals Adherence to Electronic Health Tools Among Vulnerable Groups: Systematic Literature Review and Meta-Analysis (Preprint)

2018 ◽  
Author(s):  
Jelena Arsenijevic ◽  
Lars Tummers ◽  
Niels Bosma
Keyword(s):  
Health Care ◽  
Access To Health Care ◽  
Health Care Quality ◽  
Meta Analysis ◽  
Care Quality ◽  
Vulnerable Groups ◽  
Adherence Rate ◽  
Direct Communication ◽  
Design And Implementation ◽  
Electronic Health

BACKGROUND Electronic health (eHealth) tools are increasingly being applied in health care. They are expected to improve access to health care, quality of health care, and health outcomes. Although the advantages of using these tools in health care are well described, it is unknown to what extent eHealth tools are effective when used by vulnerable population groups, such as the elderly, people with low socioeconomic status, single parents, minorities, or immigrants. OBJECTIVE This study aimed to examine whether the design and implementation characteristics of eHealth tools contribute to better use of these tools among vulnerable groups. METHODS In this systematic review, we assessed the design and implementation characteristics of eHealth tools that are used by vulnerable groups. In the meta-analysis, we used the adherence rate as an effect size measure. The adherence rate is defined as the number of people who are repetitive users (ie, use the eHealth tool more than once). We also performed a meta-regression analysis to examine how different design and implementation characteristics influenced the adherence rate. RESULTS Currently, eHealth tools are continuously used by vulnerable groups but to a small extent. eHealth tools that use multimodal content (such as videos) and have the possibility for direct communication with providers show improved adherence among vulnerable groups. CONCLUSIONS eHealth tools that use multimodal content and provide the possibility for direct communication with providers have a higher adherence among vulnerable groups. However, most of the eHealth tools are not embedded within the health care system. They are usually focused on specific problems, such as diabetes or obesity. Hence, they do not provide comprehensive services for patients. This limits the use of eHealth tools as a replacement for existing health care services.

scholarly journals The Impact of Artificial Intelligence on Quality and Safety

2020 ◽  
Vol 10 (1_suppl) ◽  
pp. 99S-103S
Author(s):  
Michelle S. Lee ◽  
Matthew M. Grabowski ◽  
Ghaith Habboub ◽  
Thomas E. Mroz
Keyword(s):  
Artificial Intelligence ◽  
Health Care ◽  
Health Care Quality ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Care Quality ◽  
Cost Of Care ◽  
Quality And Safety ◽  
Future Outcomes ◽  
The Impact

As exponential expansion of computing capacity converges with unsustainable health care spending, a hopeful opportunity has emerged: the use of artificial intelligence to enhance health care quality and safety. These computer-based algorithms can perform the intricate and extremely complex mathematical operations of classification or regression on immense amounts of data to detect intricate and potentially previously unknown patterns in that data, with the end result of creating predictive models that can be utilized in clinical practice. Such models are designed to distinguish relevant from irrelevant data regarding a particular patient; choose appropriate perioperative care, intervention or surgery; predict cost of care and reimbursement; and predict future outcomes on a variety of anchored measures. If and when one is brought to fruition, an artificial intelligence platform could serve as the first legitimate clinical decision-making tool in spine care, delivering on the value equation while serving as a source for improving physician performance and promoting appropriate, efficient care in this era of financial uncertainty in health care.

scholarly journals Impact of the COVID-19 Pandemic on the Hospital: Inpatient’s Perceived Quality in Spain

2021 ◽  
Vol 8 ◽  
pp. 237437352199862
Author(s):  
Julio J Lopez-Picazo ◽  
Inmaculada Vidal-Abarca ◽  
Dolores Beteta ◽  
Mercedes López-Ibáñez ◽  
Elisa García-Vázquez
Keyword(s):  
Health Care ◽  
Health Care Quality ◽  
Health Care Organization ◽  
Perceived Quality ◽  
Care Quality ◽  
Point Of View ◽  
Care Organization ◽  
Perceived Quality Of Care ◽  
Ethical Approval

Although the Coronavirus disease 2019 (COVID-19) pandemic has generated a large amount of studies, the patient-perceived quality of care (PQ) in this context is still not well known, so more studies intending to focus on this issue are strongly needed. This study assesses changes on PQ in patients hospitalized in Spain during the first month of the COVID-19 pandemic and investigates differences between those admitted for this cause and the rest a descriptive study using the “Net Promoters Score” and the hospital regular monitoring plan. Due to this point of view, ethical approval is not applicable. Four PQ dimensions (nurse, physician, and nurse assistant actions [NA], and discharge information [DI]) were measured in all COVID patients (57) and in a sample of non-COVID patients (60) discharged at home during the first month of the pandemic, and also compared with another sample (384) from an immediately previous period. The COVID patients scored worse (8.2) than non-COVID ones (9.0; P < .0001), especially in NA and DI, and were more likely to be detractors (odds ratio [OR]: 3.05, P < .0001) and less to be promoters (OR: 0.64, P < .05). Global and DI net promoters score values before the pandemic were higher than afterward. In conclusion, the COVID-19 pandemic negatively and significantly influenced the health care quality as perceived by inpatients, both in COVID and in non-COVID ones, but more intensely in the former. As a health care organization, this knowledge meant an opportunity from improvement and to be better qualified to face the pandemic.

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