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123-415: During the pre-digital era, patients suffered from inefficient and faulty clinical systems, processes, and conditions. Many medical errors happened in the past due to undeveloped health technologies. Some examples of these medical errors included adverse drug events and alarm fatigue . When many alarms are repeatedly triggered or activated, especially for unimportant events, workers may become desensitized to

246-698: A Privacy Official and a contact person responsible for receiving complaints and train all members of their workforce in procedures regarding PHI. An individual who believes that the Privacy Rule is not being upheld can file a complaint with the Department of Health and Human Services Office for Civil Rights (OCR). In 2006 the Wall Street Journal reported that the OCR had a long backlog and ignores most complaints. "Complaints of privacy violations have been piling up at

369-580: A branch of Health Canada called The Canada Vigilance Program is responsible for surveillance. Both healthcare professionals and consumers can report to this program. In Australia , the Therapeutic Goods Administration (TGA) conducts postmarket monitoring of therapeutic products. In the UK, a monitoring system called the Yellow Card Scheme was established in 1964. The Yellow Card Scheme

492-627: A covered entity. The act consists of 5 titles: There are five sections to the act, known as titles. Title I of HIPAA regulates the availability and breadth of group health plans and certain individual health insurance policies. It amended the Employee Retirement Income Security Act, the Public Health Service Act, and the Internal Revenue Code. Furthermore, Title I addresses the issue of "job lock" which

615-448: A drug is used, whether or not the event is associated with the administration of the drug. An ADR is a special type of AE in which a causative relationship can be shown. ADRs are only one type of medication-related harm. Another type of medication-related harm type includes not taking prescribed medications, known as non-adherence . Non-adherence to medications can lead to death and other negative outcomes. Adverse drug reactions require

738-475: A field generator and several EM sensors enabling proper scaling of the display to the patient’s body contour, and real-time view of the feeding tube tip location and direction, which helps the medical staff ensure correct placement and avoid placement of the tube in the lungs. 3D printing is another major development in healthcare. It can be used to produce specialized splints , prostheses , parts for medical devices and inert implants. The end goal of 3D printing

861-525: A hands-on experience of different procedures without the consequences of making potential mistakes. ORamaVR is one of the leading companies that employ such medical virtual reality technologies to transform medical education (knowledge) and training (skills) to improve patient outcomes, reduce surgical errors and training time and democratize medical education and training. Modern robotics have made huge progress and contribution to healthcare. Robots can help doctors in performing variety tasks. Robotics adoption

984-701: A health insurer to a health care provider either directly or via a financial institution. The EDI Benefit Enrollment and Maintenance Set (834) can be used by employers, unions, government agencies, associations or insurance agencies to enroll members to a payer. The payer is a healthcare organization that pays claims, administers insurance or benefit or product. Examples of payers include an insurance company, healthcare professional (HMO), preferred provider organization (PPO), government agency (Medicaid, Medicare etc.) or any organization that may be contracted by one of these former groups. EDI Payroll Deducted , and another group, Premium Payment for Insurance Products (820),

1107-516: A large amount of money to rectify the issue. The exposure of sensitive health information also can have negative impacts on individuals' relationships, jobs, or other personal areas. For the organization, the privacy breach can cause loss of trust, customers, legal actions, and monetary fines. HIPAA stands for the Health Insurance Portability and Accountability Act of 1996 . It is a U.S. healthcare legislation to direct how patient data

1230-424: A matter of science but also of beliefs, values, and ideologies. One of the mechanisms being suggested either as an element of or an alternative to the current TAs is bioethics , which is also referred to as the "fourth-generation" evaluation framework. There are at least two dimensions to an ethical HTA. The first involves the incorporation of ethics in the methodological standards employed to assess technologies while

1353-620: A one-year extension for certain "small plans". By regulation, the HHS extended the HIPAA privacy rule to independent contractors of covered entities who fit within the definition of "business associates". PHI is any information that is held by a covered entity regarding health status, provision of health care, or health care payment that can be linked to any individual. This is interpreted rather broadly and includes any part of an individual's medical record or payment history. Covered entities must disclose PHI to

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1476-487: A one-year extension to all parties. On January 1, 2012, newer versions, ASC X12 005010 and NCPDP D.0 become effective, replacing the previous ASC X12 004010 and NCPDP 5.1 mandate. The ASC X12 005010 version provides a mechanism allowing the use of ICD-10-CM as well as other improvements. Under HIPAA, HIPAA-covered health plans are now required to use standardized HIPAA electronic transactions. See, 42 USC § 1320d-2 and 45 CFR Part 162. Information about this can be found in

1599-446: A patient and the patient's authorized representatives without their consent. The bill does not restrict patients from receiving information about themselves (with limited exceptions). Furthermore, it does not prohibit patients from voluntarily sharing their health information however they choose, nor does it require confidentiality where a patient discloses medical information to family members, friends or other individuals not employees of

1722-618: A provider, recipient or authorized agent regarding the status of a health care claim or encounter, or to request additional information from the provider regarding a health care claim or encounter. This transaction set is not intended to replace the Health Care Claim Payment/Advice Transaction Set (835) and therefore, is not used for account payment posting. The notification is at a summary or service line detail level. The notification may be solicited or unsolicited. EDI Health Care Service Review Information (278)

1845-668: A reasonable effort to disclose only the minimum necessary information required to achieve its purpose. The Privacy Rule gives individuals the right to request a covered entity to correct any inaccurate PHI. Also, it requires covered entities to take some reasonable steps on ensuring the confidentiality of communications with individuals. For example, an individual can ask to be called at their work number instead of home or cell phone numbers. The Privacy Rule requires covered entities to notify individuals of uses of their PHI. Covered entities must also keep track of disclosures of PHI and document privacy policies and procedures. They must appoint

1968-506: A repository of information and expert content that can be used to "self-diagnose" instead of going to their doctor. For instance, one need only enumerate symptoms as search parameters at Google and the search engine could identify the illness from the list of contents uploaded to the World Wide Web, particularly those provided by expert/medical sources. These advances may eventually have some effect on doctor visits from patients and change

2091-528: A result, if a patient is unconscious or otherwise unable to choose to be included in the directory, relatives and friends might not be able to find them, Goldman said. HIPAA was intended to make the health care system in the United States more efficient by standardizing health care transactions. HIPAA added a new Part C titled "Administrative Simplification" to Title XI of the Social Security Act. This

2214-408: A ruler as cancerous, since pictures of malignancies typically include a ruler to show the scale. AI brings many benefits to the healthcare industry. AI helps to detect diseases, administer chronic conditions, deliver health services, and discover the drug. Furthermore, AI has the potential to address important health challenges. In healthcare organizations, AI is able to plan and relocate resources. AI

2337-482: A set of acknowledgments to indicate the results of the syntactical analysis of the electronically encoded documents. Although it's not specifically named in the HIPAA Legislation or Final Rule, it's necessary for X12 transaction set processing. The encoded documents are the transaction sets, which are grouped in functional groups, used in defining transactions for business data interchange. This standard doesn't cover

2460-406: A single dose or prolonged administration of a drug or may result from the combination of two or more drugs. The meaning of this term differs from the term " side effect " because side effects can be beneficial as well as detrimental. The study of ADRs is the concern of the field known as pharmacovigilance . An adverse event (AE) refers to any unexpected and inappropriate occurrence at the time

2583-453: A single new NPI. The NPI replaces all other identifiers used by health plans, Medicare, Medicaid, and other government programs. However, the NPI does not replace a provider's DEA number, state license number, or tax identification number. The NPI is 10 digits (may be alphanumeric), with the last digit being a checksum. The NPI cannot contain any embedded intelligence; in other words, the NPI is simply

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2706-579: A specific adverse drug reaction, especially for rare ADRs. Psychiatric ADRs are often missed as they are grouped together in the questionnaires used to assess the population. Many countries have official bodies that monitor drug safety and reactions. On an international level, the WHO runs the Uppsala Monitoring Centre . The European Union runs the European Medicines Agency (EMA). In

2829-548: A surgery with minimal incisions. Other robotics systems include the ability to diagnose and treat cancers. Many scientists began working on creating a next-generation robot system to assist the surgeon in performing knee and other bone replacement surgeries. Assistant robots will also be important to help reduce the workload for regular medical staff. They can help nurses with simple and time-consuming tasks like carrying multiple racks of medicines, lab specimen or other sensitive materials. Shortly, robotic pills are expected to reduce

2952-423: A suspect, a fugitive, a material witness, or a missing person. A covered entity may disclose PHI to certain parties to facilitate treatment, payment, or health care operations without a patient's express written authorization. Any other disclosures of PHI require the covered entity to obtain written authorization from the individual for disclosure. In any case, when a covered entity discloses any PHI, it must make

3075-922: A way regulated by HIPAA. Per the requirements of Title II, the HHS has promulgated five rules regarding Administrative Simplification: the Privacy Rule, the Transactions and Code Sets Rule, the Security Rule, the Unique Identifiers Rule, and the Enforcement Rule. The HIPAA Privacy Rule is composed of national regulations for the use and disclosure of Protected Health Information (PHI) in healthcare treatment, payment and operations by "covered entities" (generally, health care clearinghouses, employer-sponsored health plans, health insurers, and medical service providers that engage in certain transactions). The Privacy Rule came into effect on April 14, 2003, with

3198-402: Is a permeability glycoprotein (P-gp) efflux pump inhibitor, which when given with apixaban (a substrate for P-gp) will lead to increased absorption of apixaban, resulting in the same adverse effects as with CYP3A4 inhibition. Causality assessment is used to determine the likelihood that a drug caused a suspected ADR. There are a number of different methods used to judge causation, including

3321-415: Is a transaction set for making a premium payment for insurance products. It can be used to order a financial institution to make a payment to a payee. EDI Health Care Eligibility/Benefit Inquiry (270) is used to inquire about the health care benefits and eligibility associated with a subscriber or dependent. EDI Health Care Eligibility/Benefit Response (271) is used to respond to a request inquiry about

3444-414: Is a transaction set that can be used to transmit health care service information, such as subscriber, patient, demographic, diagnosis or treatment data for the purpose of the request for review, certification, notification or reporting the outcome of a health care services review. EDI Functional Acknowledgement Transaction Set (997) is a transaction set that can be used to define the control structures for

3567-505: Is able to match patients with healthcare providers that meet their needs. AI also helps improve the healthcare experience by using an app to identify patients' anxieties. In medical research, AI helps to analyze and evaluate the patterns and complex data. For instance, AI is important in drug discovery because it can search relevant studies and analyze different kinds of data. In clinical care, AI helps to detect diseases, analyze clinical data, publications, and guidelines. As such, AI aids to find

3690-573: Is available from a mailed or walk-in request than the internet; for example, the Medical Board of California removes dismissed accusations from website profiles, but these are still available from a written or walk-in request, or a lookup in a separate database. The trend to disclosure is controversial and generate significant public debate, particularly about opening up the National Practitioner Data Bank . In 1996, Massachusetts became

3813-446: Is being able to print out customized replaceable body parts. In the following section, it will explain more about 3D printing in healthcare. New types of technologies also include artificial intelligence and robots. 3D printing is the use of specialized machines, software programs and materials to automate the process of building certain objects. It is having a rapid growth in the prosthesis , medical implants, novel drug formulations and

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3936-460: Is common after hospital discharge in older adults, but methodological inconsistencies between studies and a paucity of data on risk factors limits clear understanding of the epidemiology. There was a wide range in incidence, from 0.4% to 51.2% of participants, and 35% to 59% of harm was preventable. Medication related harm incidence within 30 days after discharge ranged from 167 to 500 events per 1,000 individuals discharged (17–51% of individuals). In

4059-521: Is defined as any 63-day period without any creditable coverage. Along with an exception, it allows employers to tie premiums or co-payments to tobacco use, or body mass index. Title I mandates that insurance providers must issue policies without exclusions to individuals leaving group health plans, provided they have maintained continuous, credible coverage. (see above) exceeding 18 months, and renew individual policies for as long as they are offered or provide alternatives to discontinued plans for as long as

4182-536: Is delivered to a designated third party such as a family care provider. An individual may also request (in writing) that the provider send PHI to a designated service used to collect or manage their records, such as a Personal Health Record application. For example, a patient can request in writing that her ob-gyn provider digitally transmit records of her latest prenatal visit to a pregnancy self-care app that she has on her mobile phone. According to their interpretations of HIPAA, hospitals will not reveal information over

4305-518: Is electromagnetic (EM) technology guidance systems, used in medical procedures, allowing real-time visualization and navigation for the placement of medical devices inside the human body. For example, a neuro-navigated catheter is inserted into the brain, or a feeding tube placement in the stomach or small intestine, as demonstrated by the ENvue System. ENvue is an advanced electromagnetic navigation system for enteral feeding tube placement. The system uses

4428-599: Is in serotonin toxicity ( serotonin syndrome ). If medications that cause increased serotonin levels are combined, they can cause serotonin toxicity (though therapeutic doses of one agent that increases serotonin levels can cause serotonin toxicity in certain cases and individuals). Some of the medications that can contribute to serotonin toxicity include MAO inhibitors , SSRIs , and tricyclic antidepressants . Some medications can either inhibit or induce key drug metabolizing enzymes or drug transporters , which when combined with other medications that utilize

4551-496: Is increased with polypharmacy , especially in older adults. Two or more drugs that contribute to the same mechanism in the body can have additive toxic or adverse effects. One example of this is multiple medications administered concurrently that prolong the QT interval , such as antiarrhythmics like sotalol and some macrolide antibiotics , such as systemic azithromycin . Another example of additive effects for adverse drug reactions

4674-400: Is increasing tremendously in hospitals. The following are different ways to improve healthcare by using robots: Surgical robots are one of the robotic systems, which allows a surgeon to bend and rotate tissues in a more flexible and efficient way. The system is equipped with a3D magnification vision system that can translate the hand movements of the surgeon to be precise in-order to perform

4797-830: Is not limited to adverse events (of any type), but also looks at how genes may impact other responses to medications, such as low/no effect or expected/normal responses (especially based on drug metabolism). Abnormal drug metabolism may be due to inherited factors of either Phase I oxidation or Phase II conjugation. Phase I reactions include metabolism by cytochrome P450. Patients have abnormal metabolism by cytochrome P450 due to either inheriting abnormal alleles or due to drug interactions. Tables are available to check for drug interactions due to P450 interactions. Inheriting abnormal butyrylcholinesterase ( pseudocholinesterase ) may affect metabolism of drugs such as succinylcholine . Inheriting abnormal N -acetyltransferase which conjugated some drugs to facilitate excretion may affect

4920-703: Is owned by Internet Brands . Patient safety organizations and government programs which have historically assessed quality have made their data more accessible over the internet; notable examples include the HospitalCompare by CMS and the LeapFrog Group's hospitalsafetygrade.org. Patient-oriented software may also help in other ways, including general education and appointments. Disclosure of legal disputes including medical license complaints or malpractice lawsuits has also been made easier. Every state discloses license status and at least some disciplinary action to

5043-489: Is required or between payers and regulatory agencies to monitor the rendering, billing, and/or payment of health care services within a specific health care/insurance industry segment. For example, a state mental health agency may mandate all healthcare claims, Providers and health plans who trade professional (medical) health care claims electronically must use the 837 Health Care Claim: Professional standard to send in claims. As there are many different business applications for

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5166-449: Is required or between payers and regulatory agencies to monitor the rendering, billing, and/or payment of retail pharmacy services within the pharmacy health care/insurance industry segment. The EDI Health Care Claim Payment/Advice Transaction Set (835) can be used to make a payment, send an Explanation of Benefits (EOB), send an Explanation of Payments (EOP) remittance advice , or make a payment and send an EOP remittance advice only from

5289-438: Is supposed to simplify healthcare transactions by requiring all health plans to engage in health care transactions in a standardized way. The HIPAA/EDI ( electronic data interchange ) provision was scheduled to take effect from October 16, 2003, with a one-year extension for certain "small plans". However, due to widespread confusion and difficulty in implementing the rule, Centers for Medicare & Medicaid Services (CMS) granted

5412-429: Is the act of determining whether a particular user is allowed to access certain data and perform activities in a system like add and delete. The concept of health technology assessment (HTA) was first coined in 1967 by the U.S. Congress in response to the increasing need to address the unintended and potential consequences of health technology, along with its prominent role in society. It was further institutionalized with

5535-561: Is the inability for an employee to leave their job because they would lose their health coverage. To combat the job lock issue, the Title protects health insurance coverage for workers and their families if they lose or change their jobs. Title I requires the coverage of and also limits restrictions that a group health plan can place on benefits for preexisting conditions. Group health plans may refuse to provide benefits in relation to preexisting conditions for either 12 months following enrollment in

5658-625: Is used and includes two major rules which are privacy and security of data. The privacy rule protects people's rights to privacy and security rule determines how to protect people's privacy. According to the HIPAA Security Rule, it ensures that protected health information has three characteristics: confidentiality, availability, and integrity. Confidentiality indicates keeping the data confidential to prevent data loss or individuals who are unauthorized to access that protected health information. Availability allows people who are authorized to access

5781-460: Is worn on the user's wrist. This wearable technology allows people to track their steps, heart rate, floors climbed, miles walked, active minutes, and even sleep patterns. The data collected and analyzed allow users not just to keep track of their health but also help manage it, particularly through its capability to identify health risk factors. There is also the case of the Internet, which serves as

5904-682: The Kennedy – Kassebaum Act ) is a United States Act of Congress enacted by the 104th United States Congress and signed into law by President Bill Clinton on August 21, 1996. It aimed to alter the transfer of healthcare information, stipulated the guidelines by which personally identifiable information maintained by the healthcare and healthcare insurance industries should be protected from fraud and theft, and addressed some limitations on healthcare insurance coverage . It generally prohibits healthcare providers and businesses called covered entities from disclosing protected information to anyone other than

6027-508: The Department of Health and Human Services (HHS) to increase the efficiency of the health-care system by creating standards for the use and dissemination of health-care information. These rules apply to "covered entities", as defined by HIPAA and the HHS. Covered entities include health plans, health care clearinghouses (such as billing services and community health information systems), and health care providers that transmit health care data in

6150-591: The Naranjo algorithm , the Venulet algorithm and the WHO causality term assessment criteria. Each have pros and cons associated with their use and most require some level of expert judgement to apply. An ADR should not be labeled as 'certain' unless the ADR abates with a challenge-dechallenge-rechallenge protocol (stopping and starting the agent in question). The chronology of the onset of

6273-540: The Privacy section of the Health Information Technology for Economic and Clinical Health Act ( HITECH Act ). The Privacy Rule requires medical providers to give individuals access to their PHI. After an individual requests information in writing (typically using the provider's form for this purpose), a provider has up to 30 days to provide a copy of the information to the individual. An individual may request

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6396-627: The United States , the Food and Drug Administration (FDA) is responsible for monitoring post-marketing studies. The FDA has a reporting system called the FDA Adverse Event Reporting System , where individuals can report adverse drug events. Healthcare professionals, consumers, and the pharmaceutical industry can all submit information to this system. For health products marketed in Canada ,

6519-437: The bioprinting of human tissues and organs. Companies such as Surgical Theater provide new technology that is capable of capturing 3D virtual images of patients' brains to use as practice for operations. 3D printing allows medical companies to produce prototypes to practice before an operation created with artificial tissue. 3D printing technologies are great for bio-medicine because the materials that are used to make allow

6642-440: The Department of Health and Human Services. Between April of 2003 and November 2006, the agency fielded 23,886 complaints related to medical-privacy rules, but it has not yet taken any enforcement actions against hospitals, doctors, insurers or anyone else for rule violations. A spokesman for the agency says it has closed three-quarters of the complaints, typically because it found no violation or after it provided informal guidance to

6765-624: The DoTS classification. The U.S Food and Drug Administration defines a serious adverse event as one when the patient outcome is one of the following: Severity is a measure of the intensity of the adverse event in question. The terms "severe" and "serious", when applied to adverse events, are technically very different. They are easily confused but can not be used interchangeably, requiring care in usage. Seriousness usually indicates patient outcome (such as negative outcomes including disability, long-term effects, and death). In adverse drug reactions,

6888-656: The Health Care claim, there can be slight derivations to cover off claims involving unique claims such as for institutions, professionals, chiropractors, dentists, etc. EDI Retail Pharmacy Claim Transaction ( NCPDP Telecommunications is used to submit retail pharmacy claims to payers by health care professionals who dispense medications, either directly or via intermediary billers and claims clearinghouses. It can also be used to transmit claims for retail pharmacy services and billing payment information between payers with different payment responsibilities where coordination of benefits

7011-469: The Privacy Rule creates a right for any individual to refuse to disclose any health information (such as chronic conditions or immunization records) if requested by an employer or business. HIPAA Privacy Rule requirements merely place restrictions on disclosure by covered entities and their business associates without the consent of the individual whose records are being requested; they do not place any restrictions upon requesting health information directly from

7134-620: The Rule identifies various security standards, and for each standard, it names both required and addressable implementation specifications. Required specifications must be adopted and administered as dictated by the Rule. Addressable specifications are more flexible. Individual covered entities can evaluate their own situation and determine the best way to implement addressable specifications. Some privacy advocates have argued that this "flexibility" may provide too much latitude to covered entities. Software tools have been developed to assist covered entities in

7257-551: The U.S., females had a higher rate of ADEs involving opiates and narcotics than males in 2011, while male patients had a higher rate of anticoagulant ADEs. Nearly 8 in 1,000 adults aged 65 years or older experienced one of the four most common ADEs (steroids, antibiotics, opiates/narcotics, and anticoagulants) during hospitalization. A study showed that 48% of patients had an adverse drug reaction to at least one drug, and pharmacist involvement helps to pick up adverse drug reactions. In 2012, McKinsey & Company concluded that

7380-759: The act was to improve quality, safety, efficiency, and ultimately to reduce health disparities. One of the main parts of the HITECH act was setting the meaningful use requirement, which required EHRs to allow for the electronic exchange of health information and to submit clinical information. The purpose of HITECH is to ensure the sharing of electronic information with patients and other clinicians are secure. HITECH also aimed to help healthcare providers have more efficient operations and reduce medical errors. The program consisted of three phases. Phase one aimed to improve healthcare quality, safety and efficiency. Phase two expanded on phase one and focused on clinical processes and ensuring

7503-577: The adoption of health information technology , Congress passed the HITECH act as part of the American Recovery and Reinvestment Act of 2009 . HITECH stands for Health Information Technology for Economic and Clinical Health Act. It gave the department of health and human services the authority to improve healthcare quality and efficiency through the promotion of health IT. The act provided financial incentives or penalties to organizations to motivate healthcare providers to improve healthcare. The purpose of

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7626-418: The advancement of imagining technologies, including the use of faster and more data, higher resolution images, and specialist automation software, the capabilities of medical imaging technology are growing and yielding better results. As the imaging hardware and software evolve this means that patients will need to use less contrasting agents, and also spend less time and money. Further advancement in healthcare

7749-512: The advocacy group Health Privacy Project , said that some hospitals are being "overcautious" and misapplying the law, the Times reports. Suburban Hospital in Bethesda, Md., has interpreted a federal regulation that requires hospitals to allow patients to opt out of being included in the hospital directory as meaning that patients want to be kept out of the directory unless they specifically say otherwise. As

7872-780: The alarms. Healthcare professionals who have alarm fatigue may ignore an alarm believing it to be insignificant, which could lead to death and dangerous situations. With technological development, an intelligent program of integration and physiologic sense-making was developed and helped reduce the number of false alarms. Also, with greater investment in health technologies, fewer medical errors happened. Outdated paper records were replaced in many healthcare organizations by electronic health records (EHR). According to studies, this has brought many changes to healthcare. Drug administration has improved, healthcare providers can now access medical information easier, provide better treatments and faster results, and save more costs. To help promote and expand

7995-403: The assessments still did not use formal economic analyses. Aside from its development, however, assessment in the health technology industry has been viewed as sporadic and fragmented Issues such as the determination of products that needed to be developed, cost, and access, among others, also emerged. These, some argue, need to be included in the assessment since health technology is never purely

8118-450: The best treatments for the patients. Other uses of AI in clinical care include medical imaging , echocardiography , screening , and surgery . The ability of AlphaFold to predict how proteins fold also significantly accelerated medical research. Medical virtual reality provides doctors multiple surgical scenarios that could happen and allows them to practice and prepare themselves for these situations. It also permits medical students

8241-436: The case of electronic record requests. Individuals have the broad right to access their health-related information, including medical records, notes, images, lab results, and insurance and billing information. Explicitly excluded are the private psychotherapy notes of a provider, and information gathered by a provider to defend against a lawsuit. Providers can charge a reasonable amount that relates to their cost of providing

8364-550: The chances for an attacker to gain unauthorized information. In 2015 the Medical Access and CHIP Reauthorization Act (MACRA) was passed, pushing towards electronic health records. In the article "Health Information Technology: Integration, Patient Empowerment, and Security", K. Marvin provided multiple different polls based on people's views on different types of technology entering the medical field most answers were responded with somewhat likely and very few completely disagreed on

8487-539: The consumers. Several American organizations provide health technology assessments and these include the Centers for Medicare and Medicaid Services (CMS) and the Veterans Administration through its VA Technology Assessment Program (VATAP). The models adopted by these institutions vary, although they focus on whether a medical technology being offered is therapeutically relevant. A study conducted in 2007 noted that

8610-454: The copy, however, no charge is allowable when providing data electronically from a certified EHR using the "view, download, and transfer" feature which is required for certification. When delivered to the individual in electronic form, the individual may authorize delivery using either encrypted or unencrypted email, delivery using media (USB drive, CD, etc., which may involve a charge), direct messaging (a secure email technology in common use in

8733-527: The cost of the 50-100 million preventable error-related adverse drug events would be between US$ 18–115 billion. An article published in The Journal of the American Medical Association (JAMA) in 2016 reported adverse drug event statistics from emergency departments around the United States in 2013-2014. From this article, an estimated prevalence of adverse drug events that were presented to

8856-780: The current systems. Medical technology, or "medtech", encompasses a wide range of healthcare products and is used to treat diseases and medical conditions affecting humans. Such technologies are intended to improve the quality of healthcare delivered through earlier diagnosis , less invasive treatment options and reduction in hospital stays and rehabilitation times. Recent advances in medical technology have also focused on cost reduction. Medical technology may broadly include medical devices , information technology , biotech , and healthcare services. The impacts of medical technology involve social and ethical issues. For example, physicians can seek objective information from technology rather than read subjective patient reports. A major driver of

8979-639: The definition of "significant harm" to an individual in the analysis of a breach was updated to provide more scrutiny to covered entities with the intent of disclosing breaches that previously were unreported. Previously, an organization needed proof that harm had occurred whereas now organizations must prove that harm had not occurred. Protection of PHI was changed from indefinite to 50 years after death. More severe penalties for violation of PHI privacy requirements were also approved. The HIPAA Privacy rule may be waived during disasters. Limited waivers have been issued in cases such as Hurricane Harvey in 2017. See

9102-572: The emergency department (ED) was 4 events out of every 1000 people. This article reported that 57.1% of these adverse drug events presented to the ED were in females. As well, out of all of the adverse drug events presented to the emergency department documented in this article, 17.6% were from anticoagulants , 16.1% were from antibiotics , and 13.3% from diabetic agents. Health Insurance Portability and Accountability Act The Health Insurance Portability and Accountability Act of 1996 ( HIPAA or

9225-439: The establishment of the congressional Office of Technology Assessment (OTA) in 1972–1973. HTA is defined as a comprehensive form of policy research that examines short- and long-term consequences of the application of technology, including benefits, costs, and risks. Due to the broad scope of technology assessment, it requires the participation of individuals besides scientists and health care practitioners such as managers and even

9348-425: The fabrication with control over many design features. 3D printing also has the benefits of affordable customization, more efficient designs, and saving more time. 3D printing is precise to design pills to house several drugs due to different release times. The technology allows the pills to transport to the targeted area and degrade safely in the body. As such, pills can be designed more efficiently and conveniently. In

9471-788: The final rule for HIPAA electronic transaction standards (74 Fed. Reg. 3296, published in the Federal Register on January 16, 2009), and on the CMS website. The EDI Health Care Claim Transaction Set (837) is used to submit health care claim billing information, encounter information, or both, except for retail pharmacy claims (see EDI Retail Pharmacy Claim Transaction). It can be sent from providers of health care services to payers, either directly or via intermediary billers and claims clearinghouses. It can also be used to transmit health care claims and billing payment information between payers with different payment responsibilities where coordination of benefits

9594-404: The first state to require detailed disclosure of malpractice claims. Smartphones, tablets , and wearable computers have allowed people to monitor their health. These devices run numerous applications that are designed to provide simple health services and the monitoring of one's health with finding as critical problems to health as possible. An example of this is Fitbit , a fitness tracker that

9717-464: The future of medicine, 3D printing will be crucial as it can be used in surgical planning, artificial and prosthetic devices, drugs, and medical implants. The scale and capabilities of artificial intelligence (AI) systems are growing rapidly, notably due to advances in big data . In healthcare, it is expected to provide easier accessibility of information, and to improve treatments while reducing cost. The integration of AI in healthcare tends to improve

9840-440: The future, doctors might be giving a digital file of printing instructions instead of a prescription. Besides, 3D printing will be more useful in medical implants. An example includes a surgical team that has designed a tracheal splint made by 3D printing to improve the respiration of a patient. This example shows the potential of 3D printing, which allows physicians to develop new implant and instrument designs easily. Overall, in

9963-423: The future, nurse call buttons will not be needed in hospitals. Instead, robots will deliver medication, take care of patients, and administer the system. In addition, the electronic health record will look different. Healthcare providers will be able to enter the notes via speech-to-text transcriptions in real-time. Wachter stated that information will be edited collaboratively across the patient-care team to improve

10086-551: The general calculation (e.g., the beneficiary may be counted with 18 months of general coverage, but only 6 months of dental coverage, because the beneficiary did not have a general health plan that covered dental until 6 months prior to the application date). Since limited-coverage plans are exempt from HIPAA requirements, the odd case exists in which the applicant to a general group health plan cannot obtain certificates of creditable continuous coverage for independent limited-scope plans, such as dental to apply towards exclusion periods of

10209-443: The health care benefits and eligibility associated with a subscriber or dependent. EDI Health Care Claim Status Request (276) is a transaction set that can be used by a provider, recipient of health care products or services or their authorized agent to request the status of a health care claim. EDI Health Care Claim Status Notification (277) is a transaction set that can be used by a healthcare payer or authorized agent to notify

10332-509: The health industry might become a larger target for cyber-crime. Even with multiple different types of safeguards hackers somehow still find their way in so the security that is in place needs to constantly be updated to prevent these breaches. With the increased use of IT systems, privacy violations were increasing rapidly due to the easier access and poor management. As such, the concern of privacy has become an important topic in healthcare. Privacy breaches happen when organizations do not protect

10455-533: The healthcare industry), or possibly other methods. When using unencrypted email, the individual must understand and accept the risks to privacy using this technology (the information may be intercepted and examined by others). Regardless of delivery technology, a provider must continue to fully secure the PHI while in their system and can deny the delivery method if it poses additional risk to PHI while in their system. An individual may also request (in writing) that their PHI

10578-688: The important administrative safeguards' examples. It is essential to reduce the risks and vulnerabilities of the system. The processes are mostly the standard operating procedures written out as training manuals. The purpose is to educate people on how to handle protected health information in proper behavior. Physical safeguards include lock and key, card swipe, positioning of screens, confidential envelopes, and shredding of paper copies. Lock and key are common examples of physical safeguards. They can limit physical access to facilities. Lock and key are simple, but they can prevent individuals from stealing medical records. Individuals must have an actual key to access to

10701-430: The individual within 30 days upon request. They must also disclose PHI when required to do so by law such as reporting suspected child abuse to state child welfare agencies. Covered entities may disclose protected health information to law enforcement officials for law enforcement purposes as required by law (including court orders, court-ordered warrants, subpoenas) and administrative requests; or to identify or locate

10824-421: The information in electronic form or hard-copy, and the provider is obligated to attempt to conform to the requested format. For providers using an electronic health record ( EHR ) system that is certified using CEHRT (Certified Electronic Health Record Technology) criteria, individuals must be allowed to obtain the PHI in electronic form. Providers are encouraged to provide the information expediently, especially in

10947-400: The insurer stays in the market without exclusion regardless of health condition. Some health care plans are exempted from Title I requirements, such as long-term health plans and limited-scope plans like dental or vision plans offered separately from the general health plan. However, if such benefits are part of the general health plan, then HIPAA still applies to such benefits. For example, if

11070-431: The lock. Lastly, technical safeguards include access control, audit controls, integrity controls, and transmission security. The access control mechanism is a common example of technical safeguards. It allows the access of authorized personnel. The technology includes authentication and authorization. Authentication is the proof of identity that handles confidential information like username and password, while authorization

11193-807: The meaningful use of EHRs. Lastly, phase three focused on using Certified Electronic Health Record Technology (CEHRT) to improve health outcomes. In 2014, the implementation of electronic records in US hospitals rose from a low percentage of 10% to a high percentage of 70%. At the beginning of 2018, healthcare providers who participated in the Medicare Promoting Interoperability Program needed to report on Quality Payment Program requirements. The program focused more on interoperability and aimed to improve patient access to health information. Phones that can track one's whereabouts, steps and more can serve as medical devices, and medical devices have much

11316-566: The metabolism of drugs such as isoniazid , hydralazine , and procainamide . Inheriting abnormal thiopurine S -methyltransferase may affect the metabolism of the thiopurine drugs mercaptopurine and azathioprine . Protein binding interactions are usually transient and mild until a new steady state is achieved. These are mainly for drugs without much first-pass liver metabolism. The principal plasma proteins for drug binding are: Some drug interactions with warfarin are due to changes in protein binding. The risk of drug interactions

11439-555: The most common specifically identified causes of adverse drug events that originated during hospital stays in the U.S. were steroids , antibiotics , opiates/narcotics, and anticoagulants . Patients treated in urban teaching hospitals had higher rates of ADEs involving antibiotics and opiates/narcotics compared to those treated in urban nonteaching hospitals. Those treated in private, nonprofit hospitals had higher rates of most ADE causes compared to patients treated in public or private, for-profit hospitals. Medication related harm (MRH)

11562-441: The new plan offers dental benefits, then it must count creditable continuous coverage under the old health plan towards any of its exclusion periods for dental benefits. An alternate method of calculating creditable continuous coverage is available to the health plan under Title I. That is, 5 categories of health coverage can be considered separately, including dental and vision coverage. Anything not under those 5 categories must use

11685-433: The new plan that does include those coverages. Hidden exclusion periods are not valid under Title I (e.g., "The accident, to be covered, must have occurred while the beneficiary was covered under this exact same health insurance contract"). Such clauses must not be acted upon by the health plan. Also, they must be re-written so they can comply with HIPAA. Title II of HIPAA establishes policies and procedures for maintaining

11808-665: The number of surgeries. They can be moved inside a patient and delivered to the desired area. In addition, they can conduct biopsies, film the area and clear clogged arteries. Overall, medical robots are extremely useful in assisting physicians; however, it might take time to be professionally trained working with medical robots and for the robots to respond to a clinician's instructions. As such, many researchers and startups were working constantly to provide solutions to these challenges. Assistive technologies are products designed to provide accessibility to individuals who have physical or cognitive problems or disabilities. They aim to improve

11931-518: The parties involved." However, in July 2011, the University of California, Los Angeles agreed to pay $ 865,500 in a settlement regarding potential HIPAA violations. An HHS Office for Civil Rights investigation showed that from 2005 to 2008, unauthorized employees repeatedly and without legitimate cause looked at the electronic protected health information of numerous UCLAHS patients. It is a misconception that

12054-530: The patient data. The consequences of using inaccurate or improperly modified data could become useless or even dangerous. Health Organizations of HIPAA also created administrative safeguards, physical safeguards, technical safeguards, to help protect the privacy of patients. Administrative safeguards typically include security management process, security personnel, information access management, workforce training and management, and evaluation of security policies and procedures. Security management processes are one of

12177-587: The phone to relatives of admitted patients. This has, in some instances, impeded the location of missing persons. After the Asiana Airlines Flight 214 San Francisco crash, some hospitals were reluctant to disclose the identities of passengers that they were treating, making it difficult for Asiana and the relatives to locate them. In one instance, a man in Washington state was unable to obtain information about his injured mother. Janlori Goldman, director of

12300-418: The plan or 18 months in the case of late enrollment. Title I allows individuals to reduce the exclusion period by the amount of time that they have had "creditable coverage" before enrolling in the plan and after any "significant breaks" in coverage. "Creditable coverage" is defined quite broadly and includes nearly all group and individual health plans, Medicare, and Medicaid. A "significant break" in coverage

12423-401: The privacy and the security of individually identifiable health information, outlines numerous offenses relating to health care, and establishes civil and criminal penalties for violations. It also creates several programs to control fraud and abuse within the health-care system. However, the most significant provisions of Title II are its Administrative Simplification rules. Title II requires

12546-503: The privacy of people's data. There are four types of privacy breaches, which include unintended disclosure by authorized personnel, intended disclosure by authorized personnel, privacy data loss or theft, and virtual hacking. It became more important to protect the privacy and security of patients' data because of the high negative impact on both individuals and organizations. Stolen personal information can be used to open credit cards or other unethical behaviors. Also, individuals have to spend

12669-466: The public, but as of 2018, this was not accessible via the internet for a few states. Consumers can look up medical licenses in a national database, DocInfo.org, maintained by the medical licensing organizations which contains limited details. Other tools include DocFinder at docfinder.docboard.org and certificationmatters.org from the American Board of Medical Specialties . In some cases more information

12792-430: The quality and efficiency of complex tasks. Risks related to AI include the potential lack of accuracy, and privacy concerns related to the collected data. Delegating decisions to AI systems may also undermine accountability . Moreover, AI systems sometimes learn undesired behaviors from their training data. For example, an AI trained to detect skin diseases was found to have a strong tendency to classify images containing

12915-758: The quality of life with assistive technologies. The range of assistive technologies is broad, ranging from low-tech solutions to physical hardware, to technical devices. There are four areas of assistive technologies, which include visual impairment, hearing impairment, physical limitations, cognitive limitations. There are many benefits of assistive technologies. They enable individuals to care for themselves, work, study, access information easily, improve independence and communication, and lastly participate fully in community life. As part of an ongoing trend towards consumer-driven healthcare , websites or apps which provide more information on health care quality and price to help patients choose their providers have grown. As of 2017,

13038-501: The quality. Also, natural language processing will be more developed to help parse out keywords. In the future, patient data will reside in the cloud, and patients as well as authorized providers and individuals will be able to access their data from any device or location. Big data analysis will constantly be improving. Artificial intelligence and machine learning will be constantly improving and developing as it receives new data. Alerts will also be more intelligent and efficient than

13161-679: The risk analysis and remediation tracking. The standards and specifications are as follows: HIPAA covered entities such as providers completing electronic transactions, healthcare clearinghouses, and large health plans must use only the National Provider Identifier (NPI) to identify covered healthcare providers in standard transactions by May 23, 2007. Small health plans must use only the NPI by May 23, 2008. Effective from May 2006 (May 2007 for small health plans), all covered entities using electronic communications (e.g., physicians, hospitals, health insurance companies, and so forth) must use

13284-497: The role of the health professionals from "gatekeeper to secondary care to facilitator of information interpretation and decision-making." Apart from basic services provided by Google in Search , there are also companies such as WebMD that already offer dedicated symptom-checking apps. Adverse drug event An adverse drug reaction ( ADR ) is a harmful, unintended result caused by taking medication . ADRs may occur following

13407-458: The same effect as these phones. According to one study, people were willing to share personal data for scientific advancements, although they still expressed uncertainty about who would have access to their data. People are naturally cautious about giving out sensitive personal information. Phones add an extra level of threat. Mobile devices continue to increase in popularity each year. The addition of mobile devices serving as medical devices increases

13530-421: The same proteins can lead to either toxic or sub-therapeutic adverse effects. One example of this is a patient taking a cytochrome P450 3A4 (CYP3A4) inhibitor such as the antibiotic clarithromycin , as well as another medication metabolized by CYP3A4 such as the anticoagulant apixaban , which results in elevated blood concentrations of apixaban and greater risk of serious bleeds. Additionally, Clarithromycin

13653-400: The second is concerned with the use of ethical framework in research and judgment on the part of the researchers who produce information used in the industry. The practice of medicine in the United States is currently in a major transition. This transition is due to many factors, but primarily because of the implementation and integration of health technologies into healthcare. In recent years,

13776-421: The sector's growth is the consumerization of medtech. Supported by the widespread availability of smartphones and tablets, providers can reach a large audience at low cost, a trend that stands to be consolidated as wearable technologies spread throughout the market. In the years 2010–2015, venture funding has grown 200%, allowing US$ 11.7 billion to flow into health tech businesses from over 30,000 investors in

13899-527: The semantic meaning of the information encoded in the transaction sets. The Final Rule on Security Standards was issued on February 20, 2003. The Security Rule complements the Privacy Rule. While the Privacy Rule pertains to all Protected Health Information (PHI) including paper and electronic, the Security Rule deals specifically with Electronic Protected Health Information (EPHI). It lays out three types of security safeguards required for compliance: administrative, physical, and technical. For each of these types,

14022-849: The seriousness of the reaction is important for reporting. Some ocular antihypertensives cause systemic effects, although they are administered locally as eye drops , since a fraction escapes to the systemic circulation. Various diseases, especially those that cause renal or hepatic insufficiency, may alter drug metabolism. Resources are available that report changes in a drug's metabolism due to disease states. The Medication Appropriateness Tool for Comorbid Health Conditions in Dementia ( MATCH-D ) criteria warns that people with dementia are more likely to experience adverse effects, and that they are less likely to be able to reliably report symptoms. Pharmacogenomics includes how genes can predict potential adverse drug reactions. However, pharmacogenomics

14145-402: The sites with the most number of reviews in descending order included Healthgrades , Vitals.com, and RateMDs.com . Yelp, Google, and Facebook also host reviews with a large amount of traffic, although as of 2017 they had fewer medical reviews per doctor. Disputes around online reviews can lead to websites by health professionals alleging defamation. In 2018 Vitals.com was purchased by WebMD which

14268-826: The space. Medical technology has evolved into smaller portable devices, for instance, smartphones, touchscreens, tablets, laptops, digital ink , voice and face recognition and more. With this technology, innovations like electronic health records (EHR), health information exchange (HIE) , Nationwide Health Information Network (NwHIN) , personal health records (PHRs) , patient portals , nanomedicine , genome-based personalized medicine, Geographical Positioning System (GPS) , radio frequency identification (RFID), telemedicine , clinical decision support (CDS), mobile home health care and cloud computing came to exist. Medical imaging and magnetic resonance imaging (MRI) have been long used and proven medical technologies for medical research, patient reviewing, and treatment analyzing. With

14391-525: The subject of that information. In January 2013, HIPAA was updated via the Final Omnibus Rule. The updates included changes to the Security Rule and Breach Notification portions of the HITECH Act. The most significant changes related to the expansion of requirements to include business associates, where only covered entities had originally been held to uphold these sections of the law. In addition,

14514-503: The suspected ADR is important, as another substance or factor may be implicated as a cause; co-prescribed medications and underlying psychiatric conditions may be factors in the ADR. Assigning causality to a specific agent often proves difficult, unless the event is found during a clinical study or large databases are used. Both methods have difficulties and can be fraught with error. Even in clinical studies, some ADRs may be missed as large numbers of test individuals are required to find

14637-407: The systems and networks when and where that information is in fact needed, such as natural disasters. In cases like this, protected health information is mostly backed up on to a separate server or printed out in paper copies, so people can access it. Lastly, integrity ensures not using inaccurate information and improperly modified data due to a bad design system or process to protect the permanence of

14760-496: The technology being used in medicine. Marvin discusses the maintenance required to protect medical data and technology against cyber attacks as well as providing a proper data backup system for the information. Patient Protection and Affordable Care Act (ACA) also known as Obamacare and health information technology health care is entering the digital era. Although with this development it needs to be protected. Both health information and financial information now made digital within

14883-609: The use of a medication . Types A and B were proposed in the 1970s, and the other types were proposed subsequently when the first two proved insufficient to classify ADRs. Other types of adverse drug reactions are Type C, Type D, Type E, and Type F. Type C was categorized for chronic adverse drug reactions, Type D for delayed adverse drug reactions, Type E for withdrawal adverse drug reactions, and Type F for failure of therapy as an adverse drug reaction. Adverse drug reactions can also be categorized using time-relatedness, dose-relatedness, and susceptibility, which collectively are called

15006-493: The widespread adoption of electronic health records (EHR) has greatly impacted healthcare. In his book The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine's Computer Age , Robert Wachter aims to inform readers about this transition. Wachter states that there will be fewer hospitals in the future, and due to the advancement of technologies, people will be more likely to go to hospitals for major surgeries or critical illness. In

15129-502: Was set up to surveil medications and other health products. A study by the Agency for Healthcare Research and Quality (AHRQ) found that in 2011, sedatives and hypnotics were a leading source for adverse drug events seen in the hospital setting. Approximately 2.8% of all ADEs present on admission and 4.4% of ADEs that originated during a hospital stay were caused by a sedative or hypnotic drug. A second study by AHRQ found that in 2011,

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