Health IT JumpStart
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Patrick Wilson, along with Scott McEvoy, founded Vital Signs Technology, a leading technology services organization for the medical industry. A 17-year veteran of the computer industry, Wilson has managed information security for Contra Costa County (California) Health Services, and also worked for several Silicon Valley start-ups as director of IT, CTO, and other positions. His many certifications include MCSE+ Security, CompTIA Security+, CISSP, CERT, and FEMA.

Scott McEvoy has 18 years of experience, including as IT manager, director, and senior director of worldwide information systems. He is a Microsoft Certified Professional, Microsoft Small Business Specialist, and Certified Professional in Healthcare Information and Management Systems (CPHIMS).

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Introduction xiii

Chapter 1 Healthcare Ecosystem: Past, Present, and Future 1

Healthcare Primer 2

Computer Use in Healthcare 9

Healthcare IT Lingo 14

Government Regulations 16

Workflows in Medical Practice 26

Keeping Current 32

Chapter 2 Building Relationships and Continuing Education 37

MGMA 38

HIMSS 39

HITRUST 39

MS-HUG 40

Cisco Connected Health 41

CompTIA Health IT Community 42

Local Communities 44

Regional Extension Centers 45

Blogs Worth Reading 47

Chapter 3 Healthcare Lingo 53

Medical Terminology 54

Color Codes 56

Healthcare Terminology 57

Chapter 4 HIPAA Regulations 71

HIPAA Overview 72

HIPAA Elements 73

Title II: Administrative Simplification and Fraud Prevention 75

Electronic Data Interchange 105

Chapter 5 HITECH Regulations 125

HITECH Background 126

Business Associates 127

Breach Notification 129

Penalties 132

Accounting of Disclosures 133

Minimum Necessary 134

Marketing and Sale of PHI 135

How HITECH Affects Different CE Scenarios 135

National Health Information Network 136

Personal Health Records 138

Chapter 6 ARRA Funding 141

ARRA Background 142

EHR Adoption 143

Funding for Eligible Professionals 144

Funding and Eligibility for Hospitals 146

Medicaid Incentives 147

Meaningful Use: Stage 1 148

Proposed Meaningful Use Objectives: Stage 2 and Stage 3 156

Chapter 7 PCI and Other Regulations 167

PCI-DSS 168

Massachusetts 201 CMR 17.0 179

California State Law SB 1386 184

Sarbanes–Oxley 186

Chapter 8 Operational Workflow: Front Office 195

Medical Practice as a Business 196

Basic Workflow 197

Patient Impact 203

Keys to Successful Processes 205

Chapter 9 Operational Workflow: Back Office 209

Revenue Management Cycle 210

Contracts 211

Medical Coding and Billing 211

HIPAA and EDI 213

Claims Process 214

Charge Creation 215

Collections Process 219

Third-Party Billing 222

Chapter 10 Operational Workflow: Nursing 227

Nursing Process 228

Operational Workflow 230

Evidence-Based Practice 234

Nursing Technology Implementation 236

Nursing Technology Innovations 239

Chapter 11 Operational Workflow: Clinician 247

Challenges 248

Needs of the Clinician 252

Point-of-Care Devices 255

Implementing the Right Technology 257

Remote Access 259

Continuing Education 261

Regional Extension Center 261

Chapter 12 Clinical Applications 265

Maternal and Infant Care Systems 266

Radiology Information Systems 267

Picture Archiving and Communications System 268

Encounter Forms 271

Prescription Labels 272

Patient Eligibility 273

Third-Party Databases for Drugs 273

Third-Party Databases for Toxicology 274

Laboratory Systems 275

Disease Registries 276

Emergency Department Systems 277

Cardiology Systems 278

Clinical Decision Support Systems 278

Pharmacy Systems 279

Chapter 13 Administrative Applications 285

Practice Management System 286

Accounting Applications 289

Payroll Systems 290

Single Sign-On 291

Email 293

Hosted vs. Local Solutions 298

Servers 299

Productivity Applications 300

Payer Portals 301

Phone Systems 302

Chapter 14 Tying It All Together with Technology 307

Sizing a Practice 308

Network 310

Servers 314

Workstations 319

Regulatory Compliance 322

Deploying the EHR 324

Working with Physicians and Clinicians 326

Maintaining Sanity in Life 327

What’s in Our Toolkit? 330

Deployment Tasks Based on Practice Size 335

Chapter 15 Selecting the Right EHR Vendor 345

High-Level Overview 346

Controlling the EHR Blues 347

Challenges of Deploying an EHR System 348

EHR Benefits 349

Pricing Models 355

Narrowing the Selection 357

Computing Model 365

Should You Partner with an EHR Vendor? 368

Standard Terms and Contract Language 372

Summing It Up 374

Terms to Know 374

Review Questions 375

Appendix Answers to Review Questions 377

Glossary 391

Index 403

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