scholarly journals Developing Transparent Health Care Reimbursement Auditing Procedures

2013 ◽  
Vol 10 (1) ◽  
pp. 1-6
Author(s):  
Yonah Wilamowsky ◽  
Aliza Rotenstein ◽  
Sheldon Epstein
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Medical Practice ◽  
Medical Records ◽  
Care Providers ◽  
Private Insurer ◽  
Large Sets ◽  
Health Care Records ◽  
Health Care Reimbursement

The continued computerization of health care records has enabled easier sampling and analysis of large sets of medical records, making it easier than ever for Medicare, Medicaid and other private insurers to use statistical audits to determine and demand return of alleged overpayments to health care providers. However, there are sometimes statistical difficulties with the audits, and there is frequently not sufficient transparency in the procedures or their application to reproduce the results in order to determine whether they have been carried out correctly. This paper addresses concerns in sampling and analysis of data records by looking at the case of a specific audit of a medical practice carried out by a private insurer. If done properly, statistical audits can be a very useful tool, but often the methodologies are vague and the implementation is either wrong or not explained fully enough to reproduce and analyze.

scholarly journals Impact of COVID-19 on medical practice: A nationwide survey of dermatologists and health care providers in Iraq

2020 ◽  
Author(s):  
Mohammed Shanshal ◽  
Hayder Saad Ahmed ◽  
Hayder Asfoor ◽  
Raad Ibrahim Salih ◽  
Shehab Ahmed Ali ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Medical Practice ◽  
Nationwide Survey ◽  
Care Providers

scholarly journals The Use of Medical Records in Research: What Do Patients Want?

2003 ◽  
Vol 31 (3) ◽  
pp. 429-433 ◽  
Author(s):  
Nancy E. Kass ◽  
Marvin R. Natowicz ◽  
Sara Chandros Hull ◽  
Ruth R. Faden ◽  
Laura Plantinga ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Medical Records ◽  
Medical Information ◽  
Personal Information ◽  
National Institutes Of Health ◽  
Care Providers ◽  
Electronic Information ◽  
The Past ◽  
Growing Body

In the past ten years, there has been growing interest in and concern about protecting the privacy of personal medical information. Insofar as medical records increasingly are stored electronically, and electronic information can be shared easily and widely, there have been legislative efforts as well as scholarly analyses calling for greater privacy protections to ensure that patients can feel safe disclosing personal information to their health-care providers. At the same time, the volume of biomedical research conducted in this country continues to grow. The budget of the National Institutes of Health, for example, was $20,298 million in 2001, having more than doubled from a budget of $9,218 million 10 years before. This growing body of research includes increased efforts to use stored medical records as a source of data for health services, epidemiologic, and clinical studies.

Patient use of online medical records: an application of technology acceptance framework

2019 ◽  
Vol 28 (1) ◽  
pp. 97-115
Author(s):  
Surma Mukhopadhyay ◽  
Ramsankar Basak ◽  
Darrell Carpenter ◽  
Brian J. Reithel
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Medical Records ◽  
Perceived Usefulness ◽  
Security And Privacy ◽  
Care Providers ◽  
Content Type ◽  
The Us ◽  
Continued Use ◽  
Patient Use

Purpose Little is known about factors that affect patient use of online medical records (OMR). Specifically, with rising vulnerability concerns associated with security and privacy breaches, patient use of OMR requires further attention. This paper aims to investigate patient use of OMR. Using the Unified Theory of Acceptance and Use of Technology (UTAUT), factors affecting continued use of OMR were examined. Design/methodology/approach The Health Information National Trends Survey 5 (HINTS 5), Cycle 1 data were used. This is an ongoing nation-wide survey sponsored by the National Cancer Institute (NCI) of the USA. The subjects were 31-74 years old with access to the Internet. Descriptive information was projected to the US population. Findings In total, 765 respondents representing 48.7 million members of the US population were analyzed. Weighted regression results showed significant effects of perceived usefulness, visit frequency and provider encouragement on continued use of OMR while vulnerability perception was not significant. Moderating effects of these variables were also noted. Perceived usefulness and provider encouragement emerged as important predictors. Practical implications Insights may help design interventions by health-care providers and policymakers. Social implications Insights should help patient empowerment and developers with designing systems. Originality/value This is the first study to examine health-care consumers’ continued use of OMR using nationally representative data and real-world patients, many of who have one or more chronic diseases (e.g. diabetes, hypertension, asthma) or are cancer survivors. Results highlight factors helping or hindering continuing OMR use. As such, insights should help identify opportunities to increase the extent of use, project future OMR usage patterns and spread the benefits of OMR, including bringing forth positive health outcomes.

scholarly journals Plain Language Summary: Earwax (Cerumen Impaction)

2017 ◽  
Vol 156 (1) ◽  
pp. 30-37 ◽  
Author(s):  
Helene J. Krouse ◽  
Anthony E. Magit ◽  
Sarah O’Connor ◽  
Seth R. Schwarz ◽  
Sandra A. Walsh
Keyword(s):  
Health Care ◽  
Clinical Practice ◽  
Health Care Providers ◽  
Medical Practice ◽  
Clinical Practice Guideline ◽  
Practice Guideline ◽  
Evidence Based ◽  
Care Providers ◽  
Plain Language ◽  
Evidence Based Guideline

This plain language summary serves as an overview in explaining earwax (cerumen). The summary applies to patients older than 6 months with a clinical diagnosis of earwax impaction and is based on the 2017 update of the Clinical Practice Guideline: Earwax (Cerumen Impaction). The evidence-based guideline includes research that supports diagnosis and treatment of earwax impaction. The guideline was developed to improve care by health care providers for managing earwax impaction by creating clear recommendations to use in medical practice.

Hospital Consent for Disclosure of Medical Records

1998 ◽  
Vol 26 (3) ◽  
pp. 241-248 ◽  
Author(s):  
Jon F. Merz ◽  
Pamela Sankar ◽  
Simon S. Yoo
Keyword(s):  
Health Care ◽  
Child Abuse ◽  
Law Enforcement ◽  
Patient Care ◽  
Health Care Providers ◽  
Medical Records ◽  
General Rule ◽  
Care Providers ◽  
Bodily Harm ◽  
Prior Consent

Physicians and other health care providers owe ethical and legal duties to patients to maintain the secrecy of the information learned during the course of patient care. This obligation is fulfilled by limiting access to such information to only those involved in the patient's care-that is, to those within the “circle of confidentiality.” As a general rule, providers may only disclose to others with the written prior consent of the patient. Exceptions may be “ethically and legally justified because of overriding social considerations,” when permitted or compelled by law. For example, eleven states permit providers to disclose identified records to approved researchers.’ Many states compel disclosure in cases where a patient threatens serious bodily harm to another; require reporting to health or law enforcement authorities of communicable diseases, gunshot or knife wounds, or child abuse; and mandate reporting of cancer or other health care cases to state registries (such as immunization, birth, and abortion).

scholarly journals Longitudinal Health Care for Girls and Women With Turner Syndrome

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A733-A734
Author(s):  
Priyanka Ghosh ◽  
Zorkot Zeinab ◽  
Selma Feldman Witchel ◽  
Meredith Snook ◽  
Svetlana Yatsenko
Keyword(s):  
Health Care ◽  
Pilot Study ◽  
Health Outcomes ◽  
Turner Syndrome ◽  
Health Care Providers ◽  
Medical Records ◽  
Delayed Puberty ◽  
Care Providers ◽  
Monosomy X

Abstract Background Turner Syndrome (TS) is the most common chromosomal abnormality seen in females and is often diagnosed in childhood. The transition of patients with TS from pediatric to adult providers is characterized by inconsistency. As such, limited data are available to assess long term health outcomes of women with TS. Objectives: 1) To evaluate the long term health outcomes in women with TS followed at a single academic institution and 2) to establish clinical recommendations for evaluation, counseling, and planned transition of this population. Methods: A retrospective pilot study was performed by examining medical records of women with TS who presented with short stature or delayed puberty and were diagnosed with TS on the basis of cytogenetic analysis. Patients with monosomy X, mosaic monosomy X, or X chromosome structural abnormalities consistent with TS or mosaic TS diagnosis were included. Medical records from an academic children’s hospital and an affiliated women’s hospital were reviewed. Results: To date, 15 females aged 26-32 years were identified. Electronic records were available for 12/15 with age at diagnosis ranging from in utero to 15 years of age. Those with pediatric information available had documentation addressing use of growth hormone and pubertal hormone replacement therapies. Of the 12 patients, 11 had cardiac imaging performed; only one had an MRI. Consistent planned transition to adult health care providers was not evident. Of the 12 patients, 3 had consultation with a Reproductive Endocrinology and Infertility specialist; 3 had a diagnosis of anxiety or depression; 3 had a DEXA scan done (1 had osteopenia); 5 had dyslipidemia; and 2 developed insulin resistance. Conclusions: This pilot study confirms heterogeneity in practice patterns and variable interactions of women with TS with the healthcare system, especially as patients enter adulthood. Although some women were referred to subspecialists, our initial data uncover patient uncertainty about healthcare and transition recommendations. Our preliminary data indicate the need for early patient education in a collaborative, multi-disciplinary fashion. We plan to validate and extend our initial findings by reviewing additional medical records. Ultimately, we plan for expanded education, consistent surveillance recommendations, and planned transition of patients with TS from pediatrics to adult caregivers.

scholarly journals Usage Pattern Differences and Similarities of Mobile Electronic Medical Records Among Health Care Providers

2017 ◽  
Vol 5 (12) ◽  
pp. e178 ◽  
Author(s):  
Yura Lee ◽  
Yu Rang Park ◽  
Junetae Kim ◽  
Jeong Hoon Kim ◽  
Woo Sung Kim ◽  
...  
Keyword(s):  
Health Care ◽  
Electronic Medical Records ◽  
Health Care Providers ◽  
Medical Records ◽  
Usage Pattern ◽  
Care Providers

scholarly journals Lebanese Doctors Facing the SARS-CoV-2 Pandemic: Practical and Ethical Issues

2020 ◽  
Author(s):  
Nicole Gebara ◽  
Georges Dabar ◽  
Roland Eid ◽  
Fady Ghassan Haddad ◽  
Hampig Raphael Kourie ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Medical Practice ◽  
Ethical Issues ◽  
Well Being ◽  
Cross Sectional Study ◽  
Ethical Principles ◽  
Care Providers ◽  
Ethical Considerations ◽  
Cross Sectional

Abstract Background: In the light of the COVID-19 pandemic, the role of health care providers is essential to maintain the functioning of the health care system. Physicians accept a primary ethical duty to place the wellbeing and health of their patients above their own welfares. However, does the duty to patient well-being have any limit? Two ethical concerns are debated: public health’s ethical principles and medical ethics values. We aimed in this study to assess Lebanese physicians’ attitudes, practice and ethical considerations when treating their patients during the COVID-19 pandemic.Materials and methods: It’s a cross-sectional study conducted in March 2020 among a random sample of Lebanese physicians, using a questionnaire based mainly on a five-point Likert numerical scale to make the answers more reliable and valid. The questionnaire focused on the medical practice during the pandemic and the ethical considerations in public health and in medical practice. It also evaluates the physicians’ point of view toward the management of the pandemic in Lebanon. Results: A total of 318 physicians responded, with a mean age of 40 years. Five doctors of the total were affected by the COVID-19 infection (1.6%). 51.4% of medical specialists considered themselves to be at a higher risk of contracting the infection, while 52.3% of surgeons stated that they were at a lower risk. Doctors were neutral regarding treating patients according to any priority and discontinuing the ventilation of any patient with bad prognosis. The majority of doctors disagreed regarding the respect of the patient’s autonomy in refusing COVID-19 treatment with a mean score of 1.7/5. Finally, doctors expressed a neutral opinion regarding the ability of the country to manage such a pandemic with a mean score of 3.1/5. Conclusion: Although physicians recognize that they are at high risk of contracting COVID-19, they assume their responsibilities and their duty to treat, and they were neutral against any prioritization in treatment approach. However, applying the four ethical principles (autonomy, beneficence, non-maleficence and justice) may become challenging. Hence, more medical and ethical recommendations are required to guide physicians during this pandemic.

scholarly journals Supporting Heart Transplantation Aftercare through Mobile Access to Medical Records: Feasibility and Usability of the App “Phellow”

2021 ◽  
Author(s):  
Julia Müller ◽  
Lina Weinert ◽  
Laura Svensson ◽  
Rasmus Rivinius ◽  
Michael M. Kreusser ◽  
...  
Keyword(s):  
Health Care ◽  
Heart Transplantation ◽  
Health Care Providers ◽  
Outpatient Clinic ◽  
Medical Records ◽  
Routine Care ◽  
Care Providers ◽  
Mobile Access ◽  
Usability Problems ◽  
System Usability Scale

Abstract Background: Giving patients access to their medical records can improve health literacy, adherence to therapy, patients’ health-related self-care, doctor-patient communication, and quality of care. The application (app) phellow was developed to provide patients with mobile access to selected content of their medical records (i.e. physician letters, drug trough levels). It was tested at the heart transplantation (HTx) outpatient clinic at Heidelberg University Hospital among volunteer patients after heart transplantation as well as healthcare providers.Objective: The aims of this study were (1) to assess whether the phellow app can be effectively used by all users (usability) and (2) to determine if the app is feasible to be further implemented in routine care (feasibility). Methods: Usability was quantitatively measured through the System Usability Scale (SUS) among patients who actively used phellow. In addition, usability and feasibility were qualitatively measured through semi-structured guide-based interviews with patients (users, non-users) and health care providers from the HTx outpatient clinic. Quantitative data were analyzed descriptively and through correlation analyses. Qualitative data were pseudonymized, audiotaped, and transcribed verbatim. Themes were identified through thematic analysis.Results: The usability rating measured with the SUS questionnaire (N=31) was 79.9 (SD 14.1) which indicates a high usability. No statistically significant correlation was found between SUS scores and patients’ sociodemographic or phellow use characteristics. A more in-depth view on usability and feasibility was obtained from interviews with 16 patients and 7 health care providers (N=23). App appreciation, interest, and willingness-to-use were high. Tasks fit with clinic workflow and were perceived as clear. An improved technical support infrastructure, clearly defined responsibilities, and app-specific trainings were suggested for further implementation. Usability problems such as incompleteness of record, incomprehensible presentation of content, technical issues, and complex registration procedures were reported. Participants recommended usability improvements and suggested new functionalities.Conclusion: Despite some issues, usability of the phellow app was considered high. To be feasible for an implementation in routine care, usability problems should be solved. Accompanying research is crucial to monitor usability improvements and to assess effects of app use on patients and clinic workflow.

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