Question

discussion 3, Standardized Terminologies and Languages

Pre-nursing students: Select one of the nursing terminologies and briefly discuss how it is related to data mining. (i selected, clinical care classification. CCC)

Healthcare administration students: Explain why accurate coding is essential for effective management of healthcare delivery systems.

Answer 1

Select one of the nursing terminologies and briefly discuss how it is related to data mining.

• The Clinical Care Classification (CCC) System is a standardized, coded nursing terminology that identifies the discrete elements of nursing practice. The CCC provides a unique framework and coding structure. Used for documenting the plan of care; following the nursing process in all health care settings.
• The CCC System was one of the standards in the first set of 55 national standards approved for use in the EHR, by the Department of Health and Human Services (AHIC, 2006) and the only national nursing terminology standard.
• Data Mining mainly extracts the meaningful patterns which were previously not known. These patterns can be then integrated into the knowledge and with the help of this knowledge essential decisions can becomes possible. A number of benefits are provided by the data mining. Some of them are as follows: it plays a very important role in the detection of fraud and abuse, provides better medical treatments at reasonable price, detection of diseases at early stages, intelligent healthcare decision support systems etc. Data mining techniques are very useful in healthcare domain. They provide better medical services to the patients and helps to the healthcare organizations in various medical management decisions.
• There are various techniques of data mining. Some of them are classification, clustering, regression, etc. Each and every medical information related to patient as well as to healthcare organizations is useful. With the help of such a powerful tool known as data mining plays a very important role in healthcare industry.
• Classification is one of the most popularly used methods of Data Mining in Healthcare sector. It divides data samples into,target classes. The classification technique predicts the target class for each data points. With the help of classification approach a risk factor can be associated to patients by analyzing their patterns of diseases.
• In CCC, Data mining helps to Capture patient care data using a standardized coded nursing terminology. Code electronic clinical encounters: diagnoses, interventions, and outcomes. Enable evidence-based practice protocols to process and analyze patient care data and to evaluate the effects of nursing care on patient outcomes.

Explain why accurate coding is essential for effective management of healthcare delivery systems.

• Medical coding is closely tied in with the process of medical billing, is an important facet to the health care industry.
• Medical coding takes the descriptions of diseases, injuries, and health care procedures from physicians or health care providers and transforms them into numeric or alphanumeric codes to accurately describe the diagnosis and the procedures performed.
• Proper medical coding is important on many levels, from ensuring accurate payment for physicians to creating a valid record of patient care history. In addition to aiding the medical billing process for procedures administered and helping expedite the payment of services for physicians, medical codes also serve the purpose of comparing projects and planning for under-served health care areas, aiding in administrative functions, as well as identifying symptoms that must be addressed and referenced by other physicians. Accuracy in coding in medical practice is critical to patient safety, rapid payment and efficient operations.
• Coding is critical as it can indirectly affect medical care, particularly as it relates to insurance reimbursements. Having the proper medical coding ensures that insurers have all the diagnostic codes required for appropriate payment.
• Coding is also critical for demographic assessments and studies of disease prevalence, treatment outcomes and accountability-based reimbursement systems.