Regulatory Environment
Explain how healthcare exchanges change the concept of outpatient treatment. Many clinical information systems now embed practice guidelines and clinical pathways into their electronic medical record systems. Discuss some of the advantages and disadvantages of this. Describe demand management and how it can increase consumer involvement in care. Compare and contrast disease management and case management.
Reading and Resources
• Ferrier, G. D., & Trivitt, J. S. (2013). Incorporating quality into the measurement of hospital efficiency: A double DEA approach. Journal of Productivity Analysis, 40(3), 337-355. https://search.proquest.com/docview/1448800469?accountid=169658
• Search the site for US Department of Health and Human Services “Hospital Compare” and use the interactive database to compare and contrast health plans, hospitals, etc. How might you use this site with patients as a case manager?
• Chapter 16 pages 297-316, Chapter 23 pages 395-404, Chapter 20 pages 367-375, Chapter 26 pages 439-447 in Fundamentals of Case Management Practice.
• Review clinical guidelines of the AHRQ
• Pizzi, Michael A,PhD., O.T.R./L. (2014). Promoting health, wellness, and quality of life at the end of life: Hospice interdisciplinary perspectives on creating a good death. Journal of Allied Health, 43(4), 212-20.
• Annicka G M van der,Plas, Vissers, K. C., Francke, A. L., Donker, G. A., Jansen, W. J. J., Deliens, L., & Onwuteaka-Philipsen, B. (2015). Involvement of a case manager in palliative care reduces hospitalisations at the end of life in cancer patients; A mortality follow-back study in primary care. PLoS One, 10(7)
• Meyer, Star,R.N., B.S.N. (2012). Care management role in end-of-life discussions. Care Management Journals, 13(4), 180-3.
• Review the National Committee for Quality Assurance certification criteria.
