| |
| |
Preface | |
| |
| |
| |
Introduction | |
| |
| |
Health IT and Medical Science | |
| |
| |
Meaningful Use and What It Means to Be an EHR | |
| |
| |
Why So Late? | |
| |
| |
Health IT in Health Reform | |
| |
| |
Evolution of Meaningful Use | |
| |
| |
Accountable Care Organizations | |
| |
| |
EHR Functionality in Context | |
| |
| |
| |
An Anatomy of Medical Practice | |
| |
| |
How Patients Reach Healthcare Organizations | |
| |
| |
Lab Sample Collection Before a Visit or Admission Date | |
| |
| |
HIPAA and Patient Identification | |
| |
| |
Intake, Demographics, Visits, and Admissions | |
| |
| |
Precertification and Prior Authorization | |
| |
| |
Emergency Admissions | |
| |
| |
Prioritization and Triage | |
| |
| |
Outpatient Care | |
| |
| |
Inpatient Care | |
| |
| |
Labs | |
| |
| |
Imaging | |
| |
| |
Administration and Billing | |
| |
| |
| |
Medical Billing | |
| |
| |
Who Pays, and How | |
| |
| |
Claims | |
| |
| |
Eligibility | |
| |
| |
Treatment | |
| |
| |
Billing | |
| |
| |
The Billing Process | |
| |
| |
Complexities in Billing | |
| |
| |
Adjudication | |
| |
| |
The Patient's Burden | |
| |
| |
| |
The Bandwidth of Paper | |
| |
| |
Workflow Tokens | |
| |
| |
Why Leave Paper? | |
| |
| |
Step 0: Health IT Humility | |
| |
| |
Normalized Data | |
| |
| |
Good Boundaries Mean Good Data | |
| |
| |
Data at Peace with Itself: Linked Data | |
| |
| |
Flexible Data | |
| |
| |
Assume Health Data Changes | |
| |
| |
Free Text Data | |
| |
| |
| |
Herding Cats: Healthcare Management and Business Office Operations | |
| |
| |
Major Business Office Activities | |
| |
| |
Insurance | |
| |
| |
Records | |
| |
| |
Demographics | |
| |
| |
Revenue Collection | |
| |
| |
Auditing | |
| |
| |
Accounting | |
| |
| |
Reporting | |
| |
| |
Licensing, Credentials, and Enrollments | |
| |
| |
Nonhealthcare Interactions | |
| |
| |
The Evolution of the Business Office | |
| |
| |
| |
Patient-Facing Software | |
| |
| |
The PHR as Platform | |
| |
| |
Sharing Data in Patient-Facing Software | |
| |
| |
Patients Using Normal Social Media | |
| |
| |
E-patients | |
| |
| |
The Quantified Self | |
| |
| |
Patient-Focused Social Media | |
| |
| |
Patient Privacy in PHR Systems | |
| |
| |
Specific PHR and Patient-Directed Meaningful Use Requirements | |
| |
| |
| |
Human Error | |
| |
| |
The Extent of Error | |
| |
| |
Dangerous Dosing | |
| |
| |
Discontents of Computerization | |
| |
| |
Process Errors and Organizational Change | |
| |
| |
Deep Medical Errors and EHR Solutions | |
| |
| |
Errors Caused by Human-Computer Mismatch | |
| |
| |
Best Practices | |
| |
| |
| |
Meaningful Use Overview | |
| |
| |
Outpatient Guidelines and Requirements | |
| |
| |
Inpatient Guidelines and Requirements | |
| |
| |
| |
A Selective History of EHR Technology | |
| |
| |
MUMPS: The Programming Language for Healthcare | |
| |
| |
Where Can We Buy Some Light Bulbs? | |
| |
| |
Fragmentation | |
| |
| |
In an Environment with Gag Clauses and No Consumer Reports | |
| |
| |
VistA History | |
| |
| |
| |
Ontologies | |
| |
| |
A Throw-Away Ontology | |
| |
| |
Learning from Our Example | |
| |
| |
CPT Codes, Sermo, and CMS | |
| |
| |
International Classification of Diseases (1CD) | |
| |
| |
E-patient-Dave-gate | |
| |
| |
Crosswalks and ICD Versions | |
| |
| |
Other Claims Codes | |
| |
| |
Drug Databases | |
| |
| |
SNOMED to the Rescue | |
| |
| |
SNOMED Example | |
| |
| |
SNOMED and the Semantic Web | |
| |
| |
UMLS: The Universal Mapping Metaontology | |
| |
| |
Extending Ontologies | |
| |
| |
Other Ontologies | |
| |
| |
Sneaky Ontologies | |
| |
| |
Ontologies Using APIs | |
| |
| |
Exercising Ontologies | |
| |
| |
| |
Interoperability | |
| |
| |
Some Lessons from Earlier Exchanges | |
| |
| |
The New HIE Rules | |
| |
| |
Strong Standards | |
| |
| |
Winning Protocols | |
| |
| |
The Billing Protocols | |
| |
| |
HL7 Version 2 | |
| |
| |
First-Generation and Second-Generation HIEs | |
| |
| |
Continuity of Care Record | |
| |
| |
HL7 v3, RIM, CDA, CDD, and HITSP C32 | |
| |
| |
The IHE Protocol | |
| |
| |
HIE with IHE | |
| |
| |
Managing Patient Identifiers with IHE | |
| |
| |
IHE Data Exchange, the Library Model | |
| |
| |
IHE in the NWHIN | |
| |
| |
The Direct Project/Protocol | |
| |
| |
The PCAST Report | |
| |
| |
The SMART Platform | |
| |
| |
Technology and Policy Were Sitting in the Tree | |
| |
| |
| |
HIPAA: The Far-Reaching Healthcare Regulation | |
| |
| |
Does HIPAA Cover Me? | |
| |
| |
Responsibilities of Covered Entities | |
| |
| |
HIPAA: A Reasonable Regulation | |
| |
| |
Duct-Tape HIPAA Strategies | |
| |
| |
Breach Notification Rules | |
| |
| |
In Summary | |
| |
| |
| |
Open Source Systems | |
| |
| |
Why Open Source? | |
| |
| |
Major Open Source Healthcare Projects | |
| |
| |
ClearHealth | |
| |
| |
Mirth Connect | |
| |
| |
VistA Variants and Other Certified Open Source EHR Systems | |
| |
| |
OpenMRS | |
| |
| |
Appendix: Meaningful Use Implementation Assessment | |