Question

1. In 50-100 words, provide a detailed example of how administration can train and support staff to effectively use knowledge management.

2. Explain "meaningful use."

3. What does the acronym HIPAA stand for? AND what is the purpose of HIPAA?

Answer 1

KNOWLEDGE MANAGEMENT

• It is a process of creating,sharing,using and managing the knowledge and information of an organization.It refers to a multidisciplinary approach to achieve organisational objectives by making the best use of knowledge.
• When we are working in an organization we become a part of that particular organization so its our responsibility to work hardly to achieve the goal.So the best example is, suppose if we are working in a hospital ,the goal of that organization is to provide a quality health care for all patients.As a staff we have to properly use our knowledge to take care of the patients and also the good knowledge helps us to improve the funtions of the hospital in a good manner.
• When comes to the administration department, they should make some rules and regulations and also shoud provide inservice education to the staffes which helps the staffs to improve their knowledge and also to get a complete knowledge about the newely arrived machines and how to operate it.

MEANINGFUL USE

It is the use of certified EHR(Electronic Health Records) technology in a meaningful manner.But now adays it is called as "promoting interoperability"as CMS focuses on increasing health information exchange and patient data access.

REQUIREMENTS

1. Eligible professional (Providers eligible for incentives)
2. Certified EHR
3. Meaningful use(three stages)
4. Specific Program

• Medicare
• Medicaid

ELIGIBLE PROFESSIONALS

MEDICARE	MEDICAID
Doctor of medicine	Physicians
Doctor of osteopathy	Dentist
Doctor of dental surgery	Certified Nurse Midwives
Doctor of dental medicines	Nurse Practitioner
Doctor of optometry	Physician's assisstant

CERTIFIED EHR

• ESR means Electronic Health Records that should be certified.
• Must have met CMS and Office of Natioanl coordinator for health information technology(ONC) established standards.
• It must be on the Certified Health IT Product List.(CHPL)

MEANINGFUL USE STAGES

STAGE 1	STAGE 2	STAGE 3
2011-2012	2014	2016
Data capture and sharing	Advance Clinical Process	Improved Outcomes
Using the information to track key clinical conditions.	Disease management,clinical disicion support	Focusing on decision support for natioanl high priority conditions
Communicating captured information for care coordination purposes	Quality meassurement	Achieving improvement in quality,safety and efficiency
Reporting of clinical quality meassures and public health information	Support or the patient access to their health information.	Access to comprehensive patient data
Capturing health information in a coded format	Bi-directional communication with public health agencies.	Patient access to self management tools

MEDICARE VS MEDICAID

MEDICARE	MEDICAID
Starts in calender year 2011	Starts in calender year 2011
Upto $44,000 over five years	Upto $63,750 over six years
Maximum of $18,000 on first year if EP bills medicare $24000 or more	Based on upto 85% of state calculated global average costs for ESR
For maximum reimbursement 1st year cost no later than 2012	1st year cost no later than 2016
No payment made after 2015	No payment made after 2021 or more than 5 years
Penalties start in 2015(1%) and increases by 1% every year until 2019 with a maximum of 5%.	No Medicaid penalty for failure to demonstrate Meaninful Use

Meaningful use must be met in order to achieve financia incentives and failure to meet meaningful use requirements may result in medicare penalties by 2015.

HIPAA (Health Insurance Portability and Accountability Act)

HIPAA is the cronym of the Health Insurance Portability and Accountability Act of 1996.The main aim of this act is to help the consumers to maintain their insurance coverage,it also includes a seperate set of provisions called Administrative Simplification.This includes

• Standardized electronic transmission of common administrative and financial transactions.Eg:billing, payments
• Unique health identifiers for individuals,employers,health plans and health care providers.
• Privacy and security standards to protect the confidentiality and integrity of individually identifiabe health information.

PURPOSES

• Guarantees health insurance access,portability and renewal.
• Preventing health care fraud and abuse
• Health Insurance tax deduction for self-employed
• Enforcement of group health plan provisions
• Makes law easier for people to keep health insurance
• Protect the confidentiality and security of the health care information
• Helps healthcare industry to control administrative cost.