Classical Studies 2900 Lecture Notes - Actuarius, Hospitium, Byzantine Medicine

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tanhippopotamus305

31 May 2012

School

Western University

Department

Classical Studies

Course

Classical Studies 2900

Professor

Beate Gundert

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Document Summary

Byzantine medicine (6/7 c a. d. : alexandrian phase, oribasius 325-400, excerpt of galen, medical collection, synopsis, euporsita, aetios of amida, alexander of tralles, paulus of aegina (642 conquest of alexandra. This is the first phase of byzantine medicine where the first school of alexandria still ex- ists and most physicians are educated in alexandria. The first two come from asia minor (ami- da) and aetios also studied in alexandria and was a physician to the emperor justinian in constantinople. The last book is of obgyn and is based on soranus. The combination of galenic and humoral pathology and of soranus methondist ideas. Aetios also includes some magic in his books because he thinks that if patients demand this one should not withhold it from him. He tells us that the magnet is good for gout. He actually uses magic to take out a fishbone that gets stuck in the throat. With these sort of incantations, the bone is supposed to react.

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I will like you do grammar check, and rewrite it in another form. This is to avoid plagirsm. Thank you.

The purpose of this research is to explain some advantages and disadvantages of the implementation of the electronic medical record in a general hospital and specific units such as Neonatal intensive care unit. Also, it will emphasize different challenges that physician face when using the eMR as well as some solutions they offered in order to help them to overcome the challenge of typing. Most importantly, it will focus on the beneficial use of the eMR such as reduced time when charting specially in nursing as they spend a lot of time when documenting, it will reduce the time in half when using electronic medical record. Also, the research will review how the electronic medical record can enhance the quality of care to the patient. The electronic medical record will provide all the information needed by the physicians or any health care provider when giving care especially the critical patient who needs a quick intervention. This reseach will provide some information on how the eMR can improve quality of care. On the other hand, it will be discussed how the use of eMR can affect the relationship between a health care provider and the patient. As we know, health care providers have to keep a professional but close relationship with their patients in order to provide care and give the best intervention. However, when a health care provider uses electronic medical record some information might be lost when typing from a paper-based system into the eMR. The journals discuss multiple solutions to overcome and to reduce the risk of losing important information of our patient when typing or scanning the information into the eMR. Ventura, M.L., Battan, A.M., Zorloni, C., Abbiati, L., Colombo, M. Farina, S., & Tagliabue, P. (2011). The electronic medical record: pros and cons. The journal of maternal- fetal and neonatal medicine, 24(1), 163-166. doi: 10.3109/14767058.2011.607582 In this journal, researchers want to implement an electronic medical record in a neonatal intensive care unit. This system will enhance critical patientâs treatment because it will implement bedside clinical observation with machine monitoring data, and results from the laboratory. The time of charting for nurses was reduced but medical staff complained about the lack of automation in the reports. Through this journal researchers demonstrate that even though electronic medical record is beneficial because it reduces the charting time, it also can increase the risk for system error which can be fatal for the patients. In conclusion, electronic medical record should be reviewed for any complication that can influence patientâs life. Fox, G. S. (2014). The people versus the electronic medical record, last Thursday. Acad Pshychiatry, 38, 368-372. doi: 10.1007/s40596-014-0042-x In this journal, physicians express their concern about the use of electronic medical record. Physicians believe that the use of technology interferes with the face to face discussion between patients and doctors. Physician stated that the essential and precious communication has been diminished for both care givers and patients. Indeed, I believe with the use of electronic medical record, the lack of interaction and eye contact between the care giver and patient is increasing. This journal is really relevant within the nursing profession because it raises awareness of how important it is to keep the essential of communication between patients and health care providers. In brief, health care providers should find other way to obtain and record patient information to support the doctors and patient relationship. Ossoff, R. H., Thomason, C. D., & Appleton, J. (2010). Challenges with the electronic medical record. Journal of Health Care Compliance, 12(6), 51-54. Retrieved from http://search.proquest.com/docview/822639350?accountid=3455 The authors in this article examine the different challenges that doctors are facing with the use of electronic medical record. Firstly, physicians have to take training to learn how to use the system. However, to overcome the challenge of typing, physicians proposed an idea of creating well detailed templates that list all organs systems. Indeed, templates should be used just as a baseline of information, to help the users to remember the key elements while adding the patientâs information. This is a good point in documentation because even though templates are easier to fill out, medical staff should keep in mind that documentation should be well detailed. Although the templates might be well detailed, it is better to write your own finding when assessing a client. As the authors mention, templates should be used only as a baseline information. The population of interest regarding this journal will be health care providers and people that might want to go into the health care profession. Perez, S., & Keijzers, G. (2012). Missing data in the electronic medical record. Emergency medicine Australasia, 24 (4), 465. doi: 10.1111/j.1742-6723.2012.01564.x The authors of this research explain the problems that caused the transition from paper-based system to electronic medical record. With the implementation of the eMR all paper-based data are scanned into the eMR using pdf files and then destroyed. This caused many missing information in the eMR because they were destroyed before being verified in the eMR. Some solutions were addressed in this journal including; depositing the data collection sheets and separating them from the medical charts and placing them in the data collection boxes. This might decrease the loss of a patientâs important information. In brief, this journal addresses a very important topic about the importance of completely transferring the patientâs information into the eMR. Also, it creates an awareness to keep paper documentation even though the eMR is present. Hoffman, M.A., & Williams, M.S. (2011). Electronic medical records and personalized medicine. Hum genet, 130, 33-39. doi: 10.1007/s00439-011-0992-y The authors emphasize two important aspects of a fully functional electronic medical record. Firstly, it is necessary to present patients or clinicians with a high quality context detailed information when providing care. Secondly, the users must combine clinical information from different sources in order to guide the clinician to improve intervention for a given patient. According to this journal, the use of electronic medical record can increase quality of providing care. As health care professionals our main goal is to provide the best intervention to our patient and this journal proved that the use of eMR can improve the intervention given to the patient. This is because it can give doctors a quick access to patientâs information in a critical scenario or even when just proving care.

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Health Administration Set Primary Article: Al-Amin, M., Makarem,S. C., & Canose, J. (2016). The effects ofhospital-level factors on patientsâ ratings of physiciancommunication. Journal of Healthcare Management, 61(1),28â43.

Reference Article: White, H. L., & Glazier, R. H. (2011). Dohospitalist physicians improve the quality of inpatient caredelivery? A systematic review of process, efficiency and outcomemeasures. BMC Medicine, 9(58).

Milestone One Worksheet

Please complete this table to add context to your responses inthe Research Methods table below. Your instructor will providefeedback.

List the title and author of the article you chose.
Describe the purpose of the study.
What is the research question in the study?
What is the hypothesis of the study?

Research Methods: In this section of youranalysis, you will take a deep dive into the research methods usedby the authors of the study you chose to analyze. It is importantthat you are able to identify, describe, and discuss the datacollection and data analysis methodology used by theresearchers.

Important: Once you receive instructor feedbackon this table, revise it and include it in youfinal project submission in Module Seven.

Research Methods Table

Critical Element	Response to the Critical Element	One Example
Identify whether the study design is experimental orobservational. Support your identification with examplesfrom the study.
Identify the methods used to collect the dataand explain why the methods are appropriate based on the researchquestion.
Identify the data collected as quantitative orcategorical. Support your identification with examplesfrom the study.
Discuss the potential weaknesses of the datacollection methods used. Support your discussion withexamples from the study
Identify the data analysis methods used andexplain why the methods are appropriate based on the researchquestion.
Discuss the potential weaknesses of the data analysismethods used. Support your discussion with examples fromthe study.
Describe the key demographics of the populationsampled and identify the inclusion and exclusion criteria forparticipants.

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PROVIDE A RESPONSE OR STATEMENT TO THIS STUDENTS DISCUSSION:

1 - Please share your experience on selecting a managed care plan. Please discuss the advantages and disadvantages of your MCO plan.

Up until about ten years ago my company offered an HMO MCO plan option managed by Kaiser Permanente. This plan was less expensive in my paycheck deduction and offered $10 co-pays for every office visit and 100% hospitalization. In 1992 as a single young man in my twenties I found this option very attractive. I ended up getting married early that year, had a flu episode and a bout of food poisoning. My wife ended up with a hospitalization as well. What looked good on paper ended up being a very restricted healthcare experience. My office visits were restricted to only one clinic where the health care professional point of contact were physicians assistants under the supervision of an MD which we never saw. All of the prescriptions were for generic medicines and when my wife was hospitalized she was not allowed branded medicines either. We also thought she was discharged too early. The advantages of this type of plan are costs and simplicity. If we had not been sick that year we probably would have signed back up for it. The disadvantages were that our level of care was reduced to a less skilled health care professional and the attending physician who cared for my wife in the hospital discharged my wife early due to a time limit the HMO had placed on the length of stay for her illness code. That was the first and last year I chose an MCO plan for my health coverage.

2 - Many argue that there is no consistent, direct correlation between the cost of care and its quality in a managed care program. Do you agree or disagree?

In my personal experience managed care plans attempt to lower the primary care contact to non MD health care professionals such as Nurse Practioners and Physicians Assistants. While these clinicians are well trained and certainly have their appropriate place in medicine, they do not have the extensive medical training that MDs and DOs spend a minimum of 8 years mastering. These clinicians cost less than MDs and are very attractive way to reduce staffing costs. As a patient however I prefer the highest skilled level clinician caring for me and my family and am willing to pay more for this higher level of care. In my opinion Kaiser Permanente may have saved money but I was not happy with the level of care and medicines provided. They may have saved money that year but they lost me as a customer. Epstein et al, (2014) compared Accountable Care Organization (ACO) patients with non ACO patients and while they found that there were many differences in spending, age, and severity of illness, there was no difference in quality metrics despite non ACO members costing more overall. It would seem that in this example costs can be lowered without affecting quality outcomes. However ACO participants had access to significantly more participating clinicians and hospitals. What is missing from this study is a patient survey comparing the satisfaction of ACO and non-ACO patients.

3 - Do you think patients' choice of provider and access to care will be limited under ACOs?

In my personal experience and through observations of managed care offices and hospitals as a pharmaceutical representative, ACOs not only restrict the choice of provider and access to hospitals they utilize lesser trained medical professionals in Primary Care, Specialty and Hospitals in addition to restricting access to branded medications. This observation is in agreement with Epstein et al, (2014) in which ACO members cost less but had less access and choice of participating access points and clinicians.

4 - In what ways can an ACO succeed in both delivering high-quality care and spending health care dollars more wisely?

ACOs can be very useful in curbing costs. For those with limited health care budgets or those patients who receive public assistance an ACO model whether public or private. However Lewis et al, (2014) found that even though there was an almost even split between ACOs contracting for private and public contracts in the U.S.A., public contracts were less profitable than private ones due to public patients costing more to manage per capita than private ones. Quality was not examined. It would seem that an ACO would be ideal when faced with limited resources but ACOs may be reluctant to engage in contracts that are less profitable.

Classical Studies 2900 Lecture Notes - Actuarius, Hospitium, Byzantine Medicine

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