Billing and Review Perspectives in Healthcare

2020 ◽  
pp. 18-67
Author(s):  
Joel Fredrickson
Keyword(s):  
Information Technology ◽  
Quality Of Care ◽  
Healthcare Delivery ◽  
Data Capture ◽  
Diagnosis And Treatment ◽  
Healthcare Information Technology ◽  
Process Flow ◽  
Healthcare Data ◽  
Improve Patient

The relatively recent and more pervasive retention of electronic healthcare data has provided new opportunities for the advancement of analytics and business intelligence tools within healthcare. The tasks comprising the delivery process for healthcare provide numerous points for data capture, and associated analyses to improve efficiencies and quality of care. In general, healthcare data is extracted from transaction-based systems designed for billing, scheduling, and workflow. However, data characterizing medical events can be further leveraged to assist in the diagnosis and treatment of patients. In fact, healthcare information technology (HIT) to improve patient diagnosis and treatment is remarkably neglected. This chapter outlines the process flow for healthcare delivery, describes the data extracted during this process flow, details the enablers and inhibitors of HIT and accompanying analytics, presents concerns about data integrity and quality, and provides some methods for data cleansing and staging.

An Integrated Social and Behavioral System Approach to Evaluation of Healthcare Information Technology for Polychronic Conditions

2021 ◽  
pp. 1-14
Author(s):  
Thomas T.H. Wan ◽  
Bing Long Wang
Keyword(s):  
Information Technology ◽  
Healthcare Delivery ◽  
Healthcare Information Technology ◽  
Theoretical Frameworks ◽  
Behavioral Determinants ◽  
The Public ◽  
Behavioral System ◽  
Practical Evaluation ◽  
Efficiency And Effectiveness ◽  
Behavioral System Approach

Healthcare delivery systems are evolving with the advances in health information technology (HIT) development and its applications to coordinated or guided care for polychronic conditions. The design features of artificial intelligence in healthcare reflect the public interest in optimizing care coordination and communication between providers and patients. This article offers a practical evaluation and assessment of the relevance of theoretical frameworks and appropriate methodologies to formalize a multi-criteria optimization of a logic model applicable for achieving the system’s efficiency and effectiveness. In specifying theoretical constructs and evaluation methods for HIT evaluation, a three-fold purpose is to show the relevance of personal and behavioral determinants of HIT use, articulate the need for developing a transdisciplinary framework, and formulate appropriate multilevel modeling and causal analysis of the determinants of HIT use and its impacts on chronic care.

scholarly journals The impact of asynchronous e-visits on clinical outcomes and healthcare delivery: A systematic review (Preprint)

2021 ◽  
Author(s):  
Oliver T. Nguyen ◽  
Amir Alishahi Tabriz ◽  
Jinhai Huo ◽  
Karim Hanna ◽  
Christopher M. Shea ◽  
...  
Keyword(s):  
Systematic Review ◽  
Quality Of Care ◽  
Clinical Outcomes ◽  
Healthcare Costs ◽  
Healthcare Delivery ◽  
Healthcare Quality ◽  
Antibiotic Prescribing ◽  
Infection Management ◽  
The Impact

BACKGROUND E-visits involve asynchronous communication between providers and patients through a secure web-based platform, such as a patient portal, to elicit symptoms and determine a diagnosis and treatment plan. E-visits are now reimbursable through Medicare due to the COVID-19 pandemic. The state of the evidence regarding e-visits, such as the impact on clinical outcomes and healthcare delivery, is unclear. OBJECTIVE To address this gap, this systematic review examines how e-visits have impacted clinical outcomes and healthcare quality, access, utilization, and costs. METHODS MEDLINE, Embase, and Web of Science were searched from January 2000 through October 2020 for peer-reviewed studies that assessed e-visits’ impact on clinical and healthcare delivery outcomes. RESULTS Out of 1,858 papers, 19 studies met the inclusion criteria. E-visit usage was associated with improved or comparable clinical outcomes, especially for chronic disease management (e.g., diabetes care, blood pressure management). The impact on quality of care varied across conditions. Quality of care was equivalent or better for chronic conditions but variable quality was observed in infection management (e.g., appropriate antibiotic prescribing). Similarly, the impact on healthcare utilization varied across conditions (e.g., lower utilization for dermatology) but mixed impact in primary care. Healthcare costs were lower for e-visits for a wide-range of conditions (e.g., dermatology and acute visits). No studies examined the impact of e-visits on healthcare access. Available studies are observational in nature and it is difficult to draw firm conclusions about effectiveness or impact on care delivery. CONCLUSIONS Overall, the evidence suggests e-visits may provide comparable clinical outcomes to in-person care and reduce healthcare costs for certain healthcare conditions. At the same time, there is mixed evidence on healthcare quality, especially regarding infection management (e.g., sinusitis, urinary tract infections, conjunctivitis). Further studies are needed to test implementation strategies that might improve delivery (e.g., clinical decision support for antibiotic prescribing) and to assess which conditions are amenable to e-visits and which conditions require in-person or face-to-face care (e.g., virtual visit). CLINICALTRIAL not applicable

Health care process and patient experience

2013 ◽  
pp. 384-395
Author(s):  
Diana Delnoij
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Patient Experiences ◽  
Care Process ◽  
Negative Experiences ◽  
Patient’S Perspective ◽  
Hands On ◽  
Improve Patient ◽  
Patients Perspective

This chapter will help you to analyse the health care process and, in particular, the quality of this process and its outcomes from the patient’s perspective. You will read how you can measure quality from the patient’s perspective, how to interpret the findings, and how to take action based on the results. This chapter provides hands-on guidance with respect to the development and implementation of surveys measuring patient experiences. However, keep in mind that this is only a first step in the quality cycle. The results of such a survey give you a ‘diagnosis’ of the quality of care from the patients’ perspective. It does not really tell you what you should do to improve patient experiences, however. To find effective remedies for negative experiences, often you will have to do additional research.

Survey of senior frontline clinicians regarding the quality of information technology across the UK

2020 ◽  
Vol 26 (9) ◽  
pp. 220-226
Author(s):  
Sunny Deo
Keyword(s):  
Information Technology ◽  
Service Quality ◽  
Healthcare Delivery ◽  
It Services ◽  
Quality Of Information ◽  
It Service ◽  
Increased Risk ◽  
Questionnaire Method ◽  
The Uk

Background/Aims The quality of information technology (IT) services is key to effective healthcare delivery. However, the high aspirations of health ministers for IT services in hospitals may not be aligned with clinicians' perceptions. This study aimed to assess frontline clinicians' perceptions of the quality of IT services in their institutions. Methods The British Orthopaedics Directors Society online forum was used to invite a group of trauma and orthopaedic clinical leads from a range of hospitals to complete a short questionnaire regarding their perceptions of IT service quality in their practice. Results Negative perceptions of IT service quality were found to be common, with 45% of respondents rating their trusts' overall IT quality as poor or very poor. Of these, 13% deemed their trust's IT service quality to be so poor as to put patients at increased risk. Wide disparities were also reported between respondents' ratings of IT infrastructure quality and institutional responsiveness to concerns. Conclusions This small initial evaluation highlights concerning variations in clinicians' perceptions of IT service quality across different trusts. It also suggests the need for further, more detailed assessment and monitoring of IT quality improvement, for which the same questionnaire method may be useful.

Innovating in healthcare delivery: a systematic review and a preference-based framework of patient and provider needs

2019 ◽  
Vol 5 (2-3) ◽  
pp. 92-100
Author(s):  
Joseph S Salama ◽  
Alex Lee ◽  
Ashkan Afshin
Keyword(s):  
Systematic Review ◽  
Quality Of Care ◽  
Conceptual Framework ◽  
Unmet Needs ◽  
Healthcare Delivery ◽  
Process Of Care ◽  
Literature Reviews ◽  
Reducing Costs ◽  
Healthcare Innovation

Healthcare innovation is becoming a popular but poorly defined option for those who are seeking new ways of reducing costs while also improving the quality of care. The process of innovating in healthcare delivery can be improved by identifying and understanding the unmet needs of patients and providers. We conducted two systematic literature reviews to identify the needs of these stakeholders throughout healthcare delivery and developed a conceptual framework for innovating in healthcare. Our results reveal tension between patients’ and providers’ preferences across three major categories—treatment and outcomes, process of care and structure of care. Therefore, innovating in healthcare may be better understood as addressing the unmet needs of each stakeholder by easing or eliminating tensions between stakeholders. This conceptual framework may serve as a useful instrument for health policymakers, payers and innovators to alike make better decisions as they invest in healthcare innovations.

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