reDESIGN Nutrition Package

reDESIGN Nutrition Package

Locked Hair Blog Exchange: Dreadlocks vs Sisterlocks the benefits

Locked Hair Blog Exchange: Dreadlocks vs Sisterlocks the benefits

A Review of Methodist Healthcare strategic plan

A review of a healthcare strategic plan 2008-2012 A strategic plan is normally used as an outline to the purpose of an organization. The strategic plan will often include the goals of an organization and how the organization plans to meet those goals and objectives. In addition, the plan is majorly important, as investors and stockholders look to this plan to be able to determine the likelihood of its success. The mission statement will list the intent of the organization. More specific goals of the organization are pursuit after the initial statement if necessary. In addition, more information about the organization can be included, which includes SWOT areas, or strengths, weaknesses, opportunities and other relative threats to the organization. Firstly, according to Methodist hospital the mission “in keeping with its Christian heritage, exists to provide a broad based healthcare delivery system.” Methodist strategic plan came to pass as result of a series of meetings with the entire hospital environment. Assessments of the needs of the communities, in which it serves, were discussed in-depth in these meetings. Once the data or information from the meetings had been compiled, the leaders were able to gain a better perspective as to how to approach the needs of the community. According to Kash and Deshmukh, the approach of understanding and analyzing the rural community and health care environment can use hospital admissions data, public and physician surveys, a SWOT analysis, and tools to evaluate alternative strategies. The purpose of Methodists’ strategic plan was to identify the vision and direction for the organization for 2008-2012, with clarity. In addition, to identifying the vision, Methodist plan was able to further accent with influence the essence of good sound leadership. Methodist healthcares’ corporate objective was designed to carefully plan and allocate services and resources that are required or in demand to meet the particulars of it’s’ community. Secondly, according to Methodist its’ vision “will pursue a plan to continue to build and position the hospital as a comprehensive healthcare delivery system to meet the healthcare needs and expectations of the people in the communities served.” Methodist vision , development and creation of the Methodist healthcare strategic plan was a collaborative effort that was put forth by the Methodist Hospital Organization which included members of the Methodist Hospital Board of Directors, Methodist Hospital Union County Advisory Board, Medical Staff Executive Committee, Administrative staff, and the Methodist Hospital Volunteer Auxiliary and employees. The leaders of this organization came together in unison to confirm the Methodist mission. Thirdly, the future state of Methodist strategic plan will continue to be a work in progress (WIP) for the next few years. According to Newhouse, “As the hospital industry struggles with how to integrate diversity practices to improve patient satisfaction, increase the quality of care and enhance clinical outcomes for minority populations, understanding the planning process involved in this endeavor becomes significant for senior hospital administrators.” The 2008-2012 Strategic Plan is organized around four operating priorities that reflect the organization’s values and provide the focus for the work it will do, according to the Methodist. Clinical and Operating Excellence • The plan reflects the Board’s intent to maintain the traditional Methodist Hospital commitment to clinical and operating excellence by continuing to improve patient care, promote a culture of safety, and operating effectiveness. Community Service and Growth • The plan reflects the Board’s commitment to expand existing services and develop new services to meet the needs of patients and people in the communities Methodist Hospital services. Methodist will be a thriving organization. Medical Staff Engagement The plan reflects the Commitment to work with physicians to develop or expand services to meet community needs. Stewardship and Financial Prudence • The board is committed to ensuring Methodist Hospital’s ability to serve during turbulent times. Fourthly, by providing convenient high-quality care and rising to the challenge, Methodist has set higher standards for its organization, thus setting it apart from its competitors. These high quality care standards have embarked on a multitude of strategic priorities and have established sound foundations of a good quality organization. Each of the measurable priorities includes organizational standards, measurable benchmarks, and a commitment from upper management in achieving a high level of consistency throughout the organization. Continuous Quality Improvement (CQI) and Total Quality Management (TQM) systems are able to capture measurable and quantifiable results. From the onset information management in hospitals can also be stressful and overwhelming at times to its users. Therefore, as IT Managers in the healthcare industry and as healthcare leaders we must lessen this anxiety and make the distinction when necessary. However according to Winter, Ammenwerth, Bott, Brigl, Buchauer, Gräber “this is essential, because each of these information management levels views hospital information systems from different perspectives, and therefore uses other methods and tools.” These decision making tools or systems are able to provide a wealth of information used in making higher management level decisions. Methodist is dedicated to continued monitoring and review of its established performance expectations that are consistent with its mission for continuous quality improvement initiatives. Fifthly, outstanding Board members, a committed and capable medical staff and dedicated, knowledgeable health professionals are core components to support successful business solutions at Methodist. The support from these members is imperative as it relates to the initiatives of quality and Methodist mission and vision. In conclusion, Methodists’ strategic plan was designed to be dynamic; therefore is ready to meet the enormous challenges in a daily and rapidly changing hospital and healthcare environment. The most daunting component of the plan however, is to achieve the ideal economic and financial growth with as less burden on patients as possible. Nonetheless, Methodist like other business organizations is immobilized when unable to get the members of the organization to buy into the plan. In addition, the lack of awareness and negative perception were key issues, according to Kash and Deskmukh the prohibited the progression of a strategic plan. References Kash, B. A., & Deshmukh, A. A. (2013). Developing a Strategic Marketing Plan for Physical and Occupational Therapy Services: A Collaborative Project Between a Critical Access Hospital and a Graduate Program in Health Care Management. Health Marketing Quarterly, 30(3), 263-280. doi:10.1080/07359683.2013.814507 Newhouse, J. J. (2010). Strategic plan modelling by hospital senior administration to integrate diversity management. Health Services Management Research: An Official Journal Of The Association Of University Programs In Health Administration / HSMC, AUPHA, 23(4), 160-165. doi:10.1258/hsmr.2010.010003 Winter, A., Ammenwerth, E., Bott, O., Brigl, B., Buchauer, A., Gräber, S., & ... Winter, A. (2001). Strategic information management plans: the basis for systematic information management in hospitals. International Journal Of Medical Informatics, 6499-109. doi:10.1016/S1386-5056(01)00219-2 A review of Methodist Healthcare strategic plan www.quivvla.blogspot.com

Methodist hospital billing errors or Insurance claims

Methodist hospitals make errors all the time in the billing department. According to a medical-billing auditor, “more than 90 percent of bills that are reviewed are either wrong or padded beyond belief”. The Office of Compliance in the U.S. should lead in presenting accurate and complete documentation of all health services to the rendered care rather than providing guidance in billing according to Ossoff, Lampley, & Thomason. There are two kinds of codes on a medical bill, a diagnostic code and a procedural code. Any slight deviation or even simple typo could gravely impact a patient’s outcome. For example, errors can cause a higher bill or unwarranted charges or perhaps even misdiagnosis in some cases. It is estimated that as many as 80% of hospital bills have errors and that amounts to a 25% increase, on average, in how much they’re charging. Every health plan has different co-pays, deductibles, out of pocket maximums, and exclusions. With so many different plans, it’s hard to know which costs you are responsible for and which costs are covered by your plan. It is estimated that doctors in the U.S. leave approximately $125 billion on the table each year due to poor billing practices. According to healthcare and business technology, this is a stark reminder for physicians that providing optimal patient care is only one of the big factors in becoming a successful in the industry. Two of the most common factors contributing to a loss in profits:  Billing errors. It is estimated that up to 80% of medical bills contain errors. Insurance companies are very strict on correct medical billing and coding practices, and even the smallest mistake can cause an insurance company to reject a medical billing claim. This starts a long process requiring the doctor to fix the error, submit the claim a second time, and then wait (and hope) for the new claim to be accepted and processed. Medical billing errors can cause a doctor to have to wait several months or more before receiving payment for their services.  Failure to stay up-to-date on medical billing rules and regulations. These rules are constantly changing, requiring physicians and administrators to spend time and money on continuing education, software, or staff training to stay current, having a direct effect on the cash flow and profits of a practice. Secondly, medical billing is an extremely important component of the health care industry. When your doctor prescribes something, it is recorded in your medical record and you have rights to this information. Health insurance billing is complex and oftentimes confusing, and you may find yourself receiving bills for services that should have been covered by insurance or you thought were already paid for. In addition, third-party companies who take care of the Methodist’s billing are also prone to transcribing errors, as well. The greatest issue facing physicians today is not patient care; instead, many of today’s care providers are more concerned with the business side of health care, especially concerning medical billing and coding. To also add insult to injury, the economy is in such a delicate state, medical practitioner’s patients are affected as well as their own private practices. Unemployment, illegal – aliens, ACA, along with higher co-pays and deductibles, results in patients that are unable to afford medical services. In turn, practices end up losing tons of money. Thirdly, although you can’t account for everything, it is imperative that you double check your bill and if possible keep yourself a diary of the services that you have received during your hospital stay or visit. If you take into account, most if not all nurses’ work in shifts of twelve hours plus, three days straight it’s not too surprising to see key-in errors. It is also recommended that you keep a log of every test and medication you get and check it against your file, which can be ordered from the billing office. Requests fixes via certified letter and make a copy of everything. There is wealth of benefits of effective ongoing monitoring and auditing of claims processing that helps to identify mistakes prior to submission of claims, improves accuracy of medical coding and billing, and allows hospital to know their business more, according to Kusserow. As with everything else here of late, outsourcing medical billing may sound expensive upfront, according to healthcare business and technology. However, when everything is added up, it may end up being more beneficial over time. Here’s why:  Most billing services charge on a percent-basis, meaning they will only charge a percentage of the revenue they are bringing in for your company. With this in mind, they are going to be a lot more diligent about faster collections and resubmitting claims. Your current employees don’t have time to run through denied claims. A third-party professional is dedicated to this.  Employing a staff for billing purposes can get expensive. Even to hire just one new person, a practice has to think about the costs of training, the employee’s salary, benefits, and taxes, as well as compensation for turnover. Using an outside billing service eliminates the headache of training and familiarizing a staff with your billing software, procedures, coding, etc. A billing service has already trained professionals, who only make money when you do.  The amount of time doctors and nurses spend on billing and staffing concerns can be eliminated. This freed-up time can be used to care for patients – which is what you’re goal is in the first place.  Odds are, outsourced billing companies have more billing and coding expertise, and necessary resources. Even if you are still concerned with internally handling billing, an outside service can assist in providing proper software, such as EMR (Electronic Medical Records), packaged billing, and practice management. Sometimes for an added fee, there are companies that provide appointment reminders, electronic eligibility verification, patient follow-up, coding, consulting, and data reporting. For one lump sum, you can outsource services that might have been costly to handle within your practice.  Certified billing companies are compliant with the latest health care laws, like HIPAA and the Health Care Reform bill, so your staff can rest assured that the law is being followed. Many other practices with a manageable amount of patients find that handling all of the medical billing procedures in-house is more cost-effective. Here’s why:  Problems can be addressed immediately. With the billing staff only a few feet away in the same office, any problems that may arise with billing issues can be taken care of immediately and physicians will not have to wait to get a hold of a company, wait to get an investigation, or wait to get a response.  Physicians can control the productivity levels at the office. If workers are not working efficiently or productivity needs to increase, adjustments can be made accordingly since they work directly for that office. With outsourcing, the employees answer to their own company’s rules, regulations, managers, and bosses.  Billing staff has direct communication with physicians and other administrators. If there is a question about medical coding, physicians’ notes, or patient information, the billing staff can have access to the medical professionals who can best address their questions right then and there. Fourthly, whatever steps you take to resolve any billing disputes, make sure you document them in writing. Although outsourcing was once mainly used to provide such noncore services as dietary, housekeeping, and security, it has extended to top executive jobs, clinical areas, and a rising number of business functions, among them coding and billing, according to Hazelwood, Hazelwood, & Cook . Keep a record of all phone calls you made with the date and time of the call, the number you called, the people you spoke with, and what you discussed. This will be important if you ever need to follow-up on the matter in the future and will strengthen your case if you file an appeal with your insurer or the state. It is also recommended that you get request these documents as well and are as follows:  Reports by any technician handling a procedure, as well as the nurses who administer medication or shuttle you around in your paper gown  Itemized bills (request these from your doctors or hospital, possibly after your treatment visit)  Your insurance paperwork  Your own notes from each doctor visit In conclusion, there are certain types of services available to ensure the best record of care for patients and the best physician reimbursements for the services rendered. Remember when you’re done with your visit, be sure to request those medical orders from the billing office and keep them for your own record. For there have been times, when patients have received multiple claims, spanning over a short period for one single visit to the hospital. Unfortunately, this can be very frustrating to a patient and makes reconciliation impossible in some circumstances. Furthermore, patients should ask for a thorough explanation of charges from the hospital or doctor before they leave the hospital. In order to counteract these types of issues, it is recommended that you use certified mail in the event you encounter some medical billing errors. Use certified mail when requesting a corrected bill and use it to describe the problem to your insurer. Get as much documentation as possible because your claim will depend on that. It creates that paper trail that you’ll need if you so happen to find yourself in a civil court of some sort. References Hazelwood, S. E., Hazelwood, A. C., & Cook, E. D. (2005). Possibilities and Pitfalls of Outsourcing. Hfm (Healthcare Financial Management), 59(10), 44-48. KUSSEROW, R. P. (2014). Claims Processing Ongoing Monitoring and Auditing: Improves Revenue and Prevents Costly Errors. Journal Of Health Care Compliance, 16(5), 45-48. Ossoff, R. H., Lampley, S., & Thomason, C. D. (2012). Documentation: Only Required for Billing, Right?. Journal Of Health Care Compliance, 14(6), 53-61.

The feasibility of bar code scanning in the healthcare industry

The high frequency of medication errors often results in harm to patients and unnecessary cost; because of this their prevention is a worldwide priority for health systems. Patient rights are protected by the privacy and security rules of the Health Insurance Portability and Accountability Act of 1996 (HIPAA). These rules hold the healthcare industry accountable during the collection, viewing, and dissemination of patient information. A patient’s digital record or Electronic Health Record (EHR) is much more difficult to secure and maintain in today’s information age as compared to the prior paper generation. EHR system should address five core functionalities: • improve patient safety, • support the delivery of effective patient care, • facilitate management of chronic conditions, • improve efficiency, • and feasibility of implementation. Secondly, the barcode scanning solution in healthcare has the propensity to advance solutions that will assuredly, not paint the administrator into a corner with its advent, but offer considerable solutions to repeat occurrences or offenses in quality. Bar code scanning is ideal, because clinical decision making, is a complex process that depends on human ability to provide undivided attention and to memorize, recall, and synthesize huge amounts of data all vulnerable areas. For this purpose, IT systems can improve access to pieces of information, organize them, and identify links between them. Thirdly, the HIPAA privacy rule requires health care providers to ensure “appropriate safeguards to protect the privacy of personal health information”, according to Electronic Health records online. This rule must be followed each and every time a patient’s information is accessed. However, it doesn’t matter whether that information is on paper or in a digital format, security measures properly implemented and in place. According to online dictionary, the HIPAA security rule specifically regulates how a patient’s electronic health information is “created received, used, or maintained.” As a result of the HIPPA quality initiative, bar-coding in health care will not "open Pandora's box", but instead act as a catalyst used to aide in helping to meet or exceed customer expectations. Fourthly, the demand now is for implementation of Systems that use information technology (IT), such as computerized physician order entry, automated dispensing, barcode medication administration, electronic medication reconciliation, and personal health records, which are also, vital components of strategies to prevent medication errors. Bar-coding in healthcare is not beyond financial, moral, or intellectual means; however, there are certain concerns, such as the high costs of such systems that can be attained through economic incentives and government policies and or federal grants. Fifthly, bar code scanning is morally, ethically and legally acceptable inasmuch as the bar-coded medication administration (BCMA) systems require that the nurse who administers the medication at the bedside should scan the patient's identification bracelet and the unit dose of the medication being administered. The implementation of a control mechanism in place of this nature assures accountability and therefore offers the type of guarantee we desire to have in the healthcare industry. The bar- coding solutions in healthcare primarily will require some heavy financial sacrifice and perhaps even some silent investors from the surrounding communities. Nevertheless, IT systems specifically designed of health care bar-coding, can have deliver an abundance of Return on Investment (ROI) bottom line. In addition, according to the global language of business, automatic identification systems (bar code or RFID) can have a variety of application, including point-of-care scanning to match product data to patient data, verification of patient identity via a wristband, enabling the introduction of robotic dispensing systems, recording implant serial numbers in patient records and central registries, tracking and tracing of individual instruments through decontamination, stock control and supplies management, tracking assets throughout a network of facilities and much more. All these applications and systems enable the realization of associated health and economic benefits: reducing medication errors, preventing counterfeiting, saving costs and increasing the Healthcare supply chain efficiency and transparency. The cost of a barcode proposed solution is variable depending on the size and complexity of the project. According to Pub Med, online the cost of implementing and operating BCMA including electronic pharmacy management and drug repackaging over 5 years is $40,000 (range: $35,600 to $54,600) per BCMA-enabled bed and $2000 (range: $1800 to $2600) per harmful error prevented. However, automated data collection solutions, including bar-coding and radio frequency identification (RFID) technology, can help hospitals and acute healthcare facilities ensure accuracy, accountability, and patient safety inside the four walls. In conclusion, the cost is indeterminable if the problem were to go on unsolved. Research and studies have shown the number of adverse drug events prevented using BCMA was estimated by multiplying the number of doses administered using BCMA by the rate of harmful errors prevented by interventions in response to system warnings. The BCMA identified and intercepted medication errors in 1.1% of doses administered, 9% of which potentially could have resulted in lasting harm. References Markle Foundation. Connecting for Health. A Public–Private Collaborative. Final Report. 1 July 2003. Available at http://www.connectingforhealth.org/resources/final_phwg_report1.pdf (last accessed 9 February 2009.

The approximate costs associated with bar-coded system in health care

The purpose of this paper is to be able to calculate the costs associated with implementing and operating an inpatient bar-code medication administration (BCMA) system in a hospital or medical setting. Bar code assisted medication administration reduces medication errors, improves patient safety, the accuracy of medication administration and documentation. In a bar-coded system, all medications are electronically verified before being administered to patients. In addition, the dose of medication is double checked and against the patient’s medication record, that is on file. Afterwards, the route of the medication is automatically entered and verified during this process. In a properly implemented bar-coded medical facility, the scan of the medication brings up the correct medication on the patient’s medication record, therefore less subject to human error. Secondly, costs included direct expenditures on capital, infrastructure, additional personnel, and the opportunity costs of time for existing personnel working on the project. The number of adverse drug events prevented using BCMA was estimated by multiplying the number of doses administered using BCMA by the rate of harmful errors prevented by interventions in response to system warnings. BCMA identified and intercepted medication errors in 1.1% of doses administered, 9% of which potentially could have resulted in lasting harm. Implementation costs include: System design and planning IT infrastructure Interfaces with other information technology systems Training BCMA system Routine maintenance and operating expenses System quality control and refinement User support Project Bar-Code Scanning System design and planning $300,000.00 IT infrastructure $275,000.00 Interfaces with other information technology systems $75,000.00 Training $100,000.00 BCMA system $100,000.00 Routine maintenance and operating expenses $80,000.00 System quality control and refinement $120,000.00 User support $120,000.00 $1,170,000.00 Thirdly, Bar Code Medication Administration (BCMA), related costs were divided into direct capital costs and personnel costs for time spent during planning, staffing, training, and monitoring. Capital purchases consisted of the BCMA hardware, such as computers, servers, carts to move the computers from room to room, handheld bar-code scanners, and auxiliary computer batteries to ensure a consistent power supply. Also included were the software licenses, interfaces with other computer applications, ongoing maintenance/service support contracts for BCMA, and other systems and supplies necessary to make BCMA operational. Infrastructure capital investments such as building wireless capacity, drug repackaging equipment needed to support bar codes and construction (eg, to accommodate new repackaging equipment), were also included if these infrastructure improvements were incurred as part of the BCMA project. KN Recommendations: Barcode-Assisted Medication Administration Implement barcode-assisted medication administration in all healthcare facilities Scan patient’s wristband and medication prior to administration Rights: Patient, Drug, Dose, Time, Route, Reason proposed solution to the problem. In conclusion, medication errors are a significant source of avoidable healthcare costs and patient harm. BCMA implementation in the medical-surgical units, improved adherence to patient identification but more distractions of the nursing staff occurred and the medications administered were less frequently explained to the patient , according to Helmons, Wargel & Daniels. The Institute of Medicine (IOM) estimates that 400,000 preventable drug-related injuries, or adverse drug events (ADEs), occur in hospitals each year. Many small businesses have the impression that barcode systems are expensive and they simply can’t afford to implement one. When considering barcode systems, you need to also evaluate the long-term benefits for your business. One of the greatest assets of bar-coding is the added efficiency that it provides your business. There is less risk of human error when you’re not inputting prices at checkout; in fact, the whole process gets accelerated with the use of barcodes. Customer waiting time is shortened which will certainly make them happier. References Bonkowski, J., Carnes, C., Melucci, J., Mirtallo, J., Prier, B., Reichert, E., & ... Weber, R. (2013). Effect of barcode-assisted medication administration on emergency department medication errors. Academic Emergency Medicine: Official Journal Of The Society For Academic Emergency Medicine, 20(8), 801-806. doi:10.1111/acem.12189 Helmons, P. J., Wargel, L. N., & Daniels, C. E. (2009). Effect of bar-code-assisted medication administration on medication administration errors and accuracy in multiple patient care areas. American Journal Of Health-System Pharmacy: AJHP: Official Journal Of The American Society Of Health-System Pharmacists, 66(13), 1202-1210. doi:10.2146/ajhp080357 Raman, K., Heelon, M., Kerr, G., & Higgins, T. L. (2011). Addressing challenges in bar-code scanning of large-volume infusion bags. American Journal Of Health-System Pharmacy: AJHP: Official Journal Of The American Society Of Health-System Pharmacists, 68(15), 1450-1453. doi:10.2146/ajhp100655

Methodist Healthcare Policy and Procedure Manual

The terms medical record, health record, and medical chart are used interchangeably when describing the systematic documentation of a single patient's medical history and care across time within one particular health care provider's jurisdiction. Medical records includes a variety of types of "notes" entered over time by health care professionals, recording observations and administration of drugs and therapies, orders for the administration of drugs and therapies, test results, x-rays, reports, etc, according to an online dictionary. A patient's individual medical record identifies the patient and contains information regarding the patient's case history at a particular provider. “The U.S. health care system is in the midst of transforming from a fee-for-service system to a value-based system that delivers high-quality and cost-effective care.” (Koltov, M. K., & Damle, N. S. 2014) According to, the Handbook for Physicians and Medical Office Staff handbook, liability insurers, defense attorneys, and third-party payers remind physicians and other health professionals that the safety of patients, the outcome of litigation and the promptness of reimbursement depend on the adequacy, legibility, completeness, timeliness and accuracy of medical records. Firstly, medical records documentation is important for multiple reasons and has various operational and functional roles in the medical industry. Patient safety and provider protection are both protected by the information that is captured in the patient’s medical record. Every time you visit a hospital, physician or other health care provider, a record of your visit is made. This record may include your symptoms, examination and test results, diagnosis, treatment and plans for future care or treatment. Secondly, Methodist Healthcare organization addresses these issues by fostering the concept of top quality and continuity of care. Methodist Healthcare organization creates a means of communication between it’s’ providers and members about patient’s health status, preventive health services, treatment, planning, and delivery of care. In addition, Methodist Healthcare medical record standards reflect the importance of confidentiality and accessibility by authorized users only. Methodist healthcare weaknesses unfavorably are within the ability to oversee and manage risk management concerns relating to the mismanagement of records or improper disclosure of protected health information (PHI) that can lead to regulatory sanctions, network exclusions, and could affect licensure, accreditation, and Medicare and Medicaid reimbursement and participation. Medical records aide physicians in medical malpractice claims management and loss prevention activities. Upon any request being made, a complete documentation of any medical encounter must be made available. Promotion of continuous quality improvements includes good sound record documentation standards that reflect the importance of complete, timely, and accurate health information and are as follows: Member identifiers appear on every piece of documentation Entries are legible to others and are recorded in black or blue ink if on paper Entries are dated and authenticated by the author Documentation is made at the time service is provided Documentation must support all codes submitted Only standard medical abbreviations should be used in documentation All patient encounters, including telephone, fax, and electronic message exchanges are documented Documentation of any advance directives is in a prominent part of a member's medical record and includes whether or not a member has executed an advance directive, as well as documentation of any information about advance directives that was made available to the member Promptly forwarding the records ensures that the personal physician has a complete medical record on file The strength of Methodist healthcare is the ability to ensure compliance with laws, rules and regulations, and other benchmarks such as healthcare policies and procedures, Methodist healthcare managers are able to protect against unauthorized access and release, medical record management policies should address the physical security of paper-based documents, electronic record system security measures, and personnel access to both electronic and paper records. Methodist healthcare has a significant number of policies and procedures to cover all of the requirements that need to be covered. Certain responsibilities that meet and exceed customer expectation are as follows: Maintaining the privacy of your health record; Providing you with a copy of this Notice; Abiding by the terms of this Notice; Notifying you if we are unable to agree to a requested amendment or restriction; and Accommodating reasonable requests you may have to communicate health information by alternative means or at alternative locations. In conclusion, sound medical record documentation is important because it is being governed by gobs of laws on both state and federal levels. Medical records contain sensitive information, and increasing computerization and other policy factors have increased threats to their privacy. There are threats to privacy from modern record-keeping systems and from legislation. “Electronic health record systems contain clinically detailed data from large populations of patients that could significantly enrich public health surveillance.” (Vogel, J., Brown, J. S., Land, T., Platt, R., & Klompas, M. 2014) In order to protect patients these protectors have been established and are as follows:  Medical Ethics  The privacy portion of the Hippocratic Oath: "Whatsoever I shall see or hear in the course of my intercourse with men, if it be what should not be published abroad, I will never divulge, holding such things to be holy secrets."  The 1992 AMA statement, which states that medical information must be confidential to the greatest possible degree.  Laws and Other Legal Protection  The Privacy Act of 1974, which states that no federal agency may disclose information without the consent of the person. Agencies must also meet certain requirements for protecting the information. Federal Laws only cover federal agencies, such as Medicare and Medicaid. The bulk of medical records are covered by various, inconsistent and often ineffectual state laws. State Laws , this document allows you to look at the privacy laws, including medical privacy laws, for each state. Only about half of the states guarantee patients the right to see their medical records (CR, Oct. 1994, p. 629). You can obtain more information by looking in your state code or by contacting Privacy Journal.  Tort Law. This may include defamation, breach of contract, and other privacy-related torts. To determine whether your policies comply with state and federal laws regarding the storage and release of PHI, consult with an attorney about the following issues: Creating policies and procedures pertaining to both the on-site and off-site storage of medical records. Accurately labeling and storing records to aid in record retrieval and prevent improper access and/or destruction. Establishing functional redundancy to allow for medical record storage system back-up should the primary storage system fail Entering into Business Associate Agreements with any outside vendors with whom the practice may contract to store, retrieve, and/or destroy medical records on behalf of the practice. Tailoring policies and procedures to address special considerations pertaining to the electronic medical records (e.g., protections by password and encryption, storage and protection of metadata, etc.). Nevertheless, the biggest challenges are with implementing and using electronic medical records. Healthcare providers are experiencing difficulty with using the new systems and therefore, seek other individuals to enter the data into the systems for them. “A failure by physicians to take a lead on this will mean that they may become victims of pressure or legislation.” (Patrick, K. 2014). Documenting the information on both paper and in a computer system has overwhelmed some providers. Furthermore, the lacks of familiarity with the systems have impeded the progress and therefore some users are reluctant to the change. However, opportunities for improvements are possible if the providers will buy into the quality initiative and get the best results out of the system. References 1.) Patrick, K. (2014). Patients and their medical records: it is time to embrace transparency. CMAJ: Canadian Medical Association Journal = Journal De L'association Medicale Canadienne, 186(11), 811. doi:10.1503/cmaj.140834 2.) Koltov, M. K., & Damle, N. S. (2014). Health policy basics: physician quality reporting system. Annals Of Internal Medicine, 161(5), 365-367. doi:10.7326/M14-0786 3.) Vogel, J., Brown, J. S., Land, T., Platt, R., & Klompas, M. (2014). MDPHnet: Secure, Distributed Sharing of Electronic Health Record Data for Public Health Surveillance, Evaluation, and Planning. American Journal Of Public Health, 104(12), 2265-2270. doi:10.2105/AJPH.2014.302103