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COMMUNITY HEALTH APPLICATION

COMMUNITY HEALTH APPLICATION. COMMUNITY HEALTH NURSING(CHN) - synthesis of nursing practice and public health practice applied to promoting and preserving the health of populations.

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COMMUNITY HEALTH APPLICATION

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  1. COMMUNITY HEALTH APPLICATION

  2. COMMUNITY HEALTH NURSING(CHN) - synthesis of nursing practice and public health practice applied to promoting and preserving the health of populations. - requires comprehensive understanding and knowledge of the framework of the community, it’s resources, and the sociocultural issues impacting people within the community. - focus is on the population as a whole.

  3. Standard of CHN incorporate: • health promotion • health maintenance • health education • Health management • Coordination • Continuity of care

  4. computer systems or applications have been developed to support of the clinical practice but because of the broad scope of services there is a wide variance in applications. • Application examples may include population focused(tracking chidhood immunization rates in a health department), community of care needs(patient hospital data available in an outpatient setting for specific diagnostic groups), billing services(point-of-care system for documenting home healthcare assessment to create a home health related groupfor episodic payment).

  5. COMMUNITY HEALTH NSG DEV’T. • late 1960’s- CHn agencies have used computers. • Changing healthcare trends have been the impetus for increasingly sophisticated management information systems(MISs). • Further advancement led to four domains of concentration which directed unique MISs for practice:1) public health that focused on population interventions and the outcomes related to epidemiologic and mortality/morbidity trends; 2) home health that focused on skilled nursing care ; 3) special population community practices; 4) outpatient care that focused on intermittent, episodic or preventative care for individuals.

  6. HOMEHEALTH • Medicare and Medicaid legislation - enacted in 1965 - reimbursement for home care services was allowed. - expanded the demand of home care services - increased the number of home health agencies - increased the information needs that created the driving force for computer systems. • Balanced Budget Act - enacted in 1997 - October 1, 2000, the Center for Medicare and Medicaid Services instituted a prospective payment system(PPS) for Medicare home health benificiaries as part of the BBA.

  7. Public Health • defined by Institute of Medicine as a “coordinated effort at the local, state, and federal levels whose mission is fufilling society’s interest in assuring conditions in which people can be healthy”. • Focus: • Preventing, identifying, investigating, and eliminating community health problems • Assuring that community has access to competent personal healthcare services. • Educating and empowering individuals

  8. Public Health Challenges For all venues of CHN, software developers responded by developing electronistead IT systems instead of outdated IT systems. These It systems allow for the ff: * Relational databases that facilitate the retrieval of data for multiple purposes without rekeying. * Manipulation of data to create information and knowledge. * Point-of-care devices, computerized patient records, and electronic health records. * Clinical repositories as a strategic resource for quality and practice * Electronic interfacing systems to facilitate the sharing of data.

  9. Data Sets -minimum set of items of information with uniform definition and categories. Criteria that define a data set may include: • Utility for multiple users. • Terms that can be defined and measured • Common or shared language that is universally undersood • Relevance to nat’l or local needs • Uniformity with other applicable data sets • Data can be coded for computering processes • Data has portability • Data can be structured in compliance with HIPAA • Data can be collected easily and accurately.

  10. Uniform Data Set for Homecare and Hospice Two major categories: • Organizational level- data set includes items htat describe the organization, it’s services, its aggregate utilization, and its financial and personnel data • Individual level- items include demographic, clinical, service, and utilization data for patients .

  11. Outcome and Assessment Information(OASIS) - group of items that represents the core items of a comprehensive assessment for an adult home health patients. • Health Plan Employer Data Information Set • set of standardized performance measures designed to ensure that purchasers have the information for reliably comparing the performance of managed healthcare plans.

  12. Vocabulary Language - validated clinical reference languages, taxonomies, or terminologies that make healthcare knowledge more usable and accesible. - serves as the vehicle to format messages that are exchanged between computer systems and the coding and classification scheme used within the messages.

  13. Clinical Care Classification System - is a standardized language/vocabulary consisting of two interrelated taxonomies - the CCC of Nursing Diagnoses and the CCC of Nursing Interventions. CCC is designed to document, code, and classify for computer-processing patient care in any clinical setting by any healthcare provider using a standardized framework.

  14. OMAHA SYSTEM • research-based, comprehensive taxonomy designed to generate meaningful data following usual or routine documentation of client care. Three components: • Problem classification scheme • Intervention scheme • Problem rating scale for outcomes • Provides method for linking clinical data to demographic , financial, administrative, and staffing data.

  15. Community Health System - connotes those computerized It systems specifically developed and designed for use by community health agencies, community programs, and services. The following are some of the typically used systems in community health settings: • Categorical System- support data processing and tracking specific programs such as cancer detection, MCH immunization, or family planning. • Screening Programs- detect individuals afflicted with a specific disease or predisposing health condition. • Registration System- designed to identify state or local residents eligible for CHN services in clinics and homes. • Management Information System- provides the framework for collecting and reporting statistical as well as financial data needed for the management of health client and programs.

  16. Management Information System- provides the framework for collecting and reporting statistical as well as financial data needed for the management of health client and programs. • Statistical Reporting Systems- developed to collect and process statistical information primarily for state/local health departments such as epidemiologic and immunization data. • Special Purpose System- developed to collect statistical data for administering specific program, regardless of what type of agency offers the program.

  17. Home health Information System • Designed to support home healthcare, hospice, and private duty programs provided by the HHA’s, such as VNA’s, hospital-based programs, proprietary agencies, and other not-for-profit HHA’s. • Both he home healthcare industry and IT are changing rapidly due to some of the external driving forces including prospective payment, outcome measurement, electronic billing, dse management, and HIPAA isolation.

  18. Time-sharing Systems • Stand-Alone System • Portability of Data • Point-of-Care System • Reimbursable Models • Managed Care • Scheduling Systems

  19. Telemedicine - refers to the electronic transfer of medical information and services(voice, data and video), from one site to another using telecommunication technology. Technologies may include : • Telemonitors with peripheral biometric attachments for remotely monitoring biophysical parameters. • Videophone with two-way audio-video connectivity which allows for the visualization of client activity. • In-home message devices with disease management education, advise, and vital sign monitoring.

  20. Video cameras for monitoring all aspects of care delivery particularly focusing on wound management and home care aide supervision. • PC’s with Internet connectivity for supervised communication. • Video conferencing that allows clinicians, physicians, and other healthcare providers to communicate about patient-specific care.

  21. Community Health Telemedicine Systems • Links patient’s homes to healthcare facilities and healthcare professionals, homecare workers to their supervisors, and patients and families, with community resources.

  22. Community Health Network Systems -Innovative ambulatory care system especially developed to provide services by computer. -Performs a triads of actions but not necessarily diagnose. They include the following: • Download the patient record from hospital to home data base. • Enter a series of questions about symptoms using expert logic until the pathways are concluded. • Track self-care and, depending on the responses to questions, call or make an appointment with a clinician. • Provide additional information on the condition if self-care is chosen to assist the client to resolve the problem.

  23. Home High-Tech Monitoring Systems • Use computers to link patients at home to healthcare facilities. • Monitoring technology permits the transmission of healthcare information. • Used also for prevention. • Examples of monitoring device: *remote defirillator *alert systems

  24. Educational Technology Systems -Provide communication linkages, information access, and educational materials. -offer screening for compliance with health prevention standards and linkages to education.

  25. Future trends • Community health information will link multiple providers , patient information, and regulatory bodies on single system allowing for integration of data, continuity of care, and the tracking of outcomes across service providers. • Decision support systems will become more sophisticated allowing community health agencies to easily use, analyze, and operate on large data sets. • Geographic Information System will become a powerful tool for public health applications.

  26. Mapping applications will be used for disease surveillance and control, allocation of resources, health planning, measurement of environmental data, and many other health-related concerns.

  27. SUMMARY - describe various computer application found in community health. - presented an overview of the diff. types of community health systems including categorical systems, screening programs, client registration systems, and special purpose system - application for home health illustrated the importance of integrating various functions of service delivery into MIS, integrating the clinical, financial, operational, and administrative functions.

  28. THANK YOU .. GODBLESS US OPAL

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