1) Name at least two of the key principles set forth in the Medicare/ Medicaid standards?

2) Name the seven parts of the hospice clinical record?

3) What is the difference between a primary data source and secondary data source?

4)What is a registry and its purpose? How does it differ from an index?

 

Answer:

Q.1. The two of the key principles set forth in the Medicare/ Medicaid standards include meaningful coverage and effective administration. Meaningful coverage - Medicaid must serve as a safety net program and any reform should ensure that current eligibility standards are, at a minimum, maintained. Effective administration- the program should improve and simplify administrative functions and ensure transparency and stakeholder engagement in the process.

Q.2. The seven parts of the hospice clinical record include:

• The initial plan of care, updated plans of care, initial assessment, comprehensive assessment, updated comprehensive assessments, and clinical notes.
• Signed copies of the notice of patient rights.
• Responses to medications, symptom management, treatments, and services.
• Outcome measure of data elements.
• Physician certification and recertification of terminal illness.
• Any advance directives
• Physician orders.

Q.3. The difference between primary data source and secondary data source is that primary data sources include information collected and processed directly by the researcher. Primary data sources includes first hand information collected through observations, surveys, interviews and focus groups. In contrast, secondary data sources include information retrieved through preexisting sources such as research articles, Internet or even library searches. The preexisting data also may include records and data already within the program such as publications and training materials, financial records, student/client data and performance reviews of staff. Primary data source can be more expensive and time-consuming when been collected, but it allows for more targeted data collection while secondary data source information is cheap because its ready collected, processed and reported by another researcher or entity.

Q.4.  A registry is an organized system for the collection, storage, retrieval, analysis, and dissemination of information on individuals who have either a particular disease, a condition that predisposes to the occurrence of a health related event, or prior exposure to substance or circumstances known or suspect to cause adverse health effects. The purpose of registry is to collect data related to patients with a specific diagnosis, condition or procedure. They play a role in post marketing surveillance of pharmaceuticals. It provides a real-world view of clinical practice, patient outcomes, safety and comparative effectiveness. Its purpose is to provide stakeholders in both the public and private sectors with information they can use to guide the design and implementation of patient registries, the analysis and interpretation of data from patient registries and the evaluation of the quality of a registry. Additionally, registry, provide the facility, as well as the providers and public health officials, with information needed to assess and monitor the health given in a particular population.

The difference between registry and index is that registry contain more extensive data than index. Patient medical records are the source of data for the indexes. Data from the patient medical records abstracted into the computer system. The computer then generates a computerized database which creates the indexes. The disease index is organized according to ICD-9-CM disease codes. The procedure index is organized according to ICD-9-CM and/or CPT/HCPCS procedures/services. The physician index is organized according to physician number.

Reference:

• Medicaid principles. (2018, July 3). Preserving and Enhancing Medicaid. https://www.partnershipformedicaid.org/core-principles/
• Gliklich, R. E., Dreyer, N. A., & Leavy, M. B. (Eds.). (2014). Registries for evaluating patient outcomes: a user's guide (No. 13). Government Printing Office.
• Bradley, C. J., Neumark, D., Oberst, K., Luo, Z., Brennan, S., & Schenk, M. (2005). Combining registry, primary, and secondary data sources to identify the impact of cancer on labor market outcomes. Medical decision making, 25(5), 534-547.
• https://hospicepatients.org/chart-denied.html#:~:text=Each%20patient's%20record%20must%20include,comprehensive%20assessments%2C%20and%20clinical%20notes.
• Coffman-Kadish, N. (2012). H ealth care facilities maintain many different secondary health data sets. These indexes, databases, and registers are used to classify and locate health records and other health information. Ease in locating infor-mation facilitates patient-care management and research, quality-of-care review, utilization management, and administrative and financial func-tions, as well as compliance with federal and state regulations and licen-sure requirements. Health Information Management: Principles and Organization for Health Information Services, 19, 129.