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Electronic Health Records: An Audit and Internal Control Guide

Book Description

Electronic Health Records: An Audit and Internal Control Guide describes the infrastructure of electronic health records and the impact that the government's new criteria will have on the private and public marketplace. Understand what to look for in a health care record management system and find tips and helpful guidance for implementation. If you are trying to facilitate an audit of a health record management system, you can apply the example described in the model, which will serve as a timely model and invaluable resource.

Table of Contents

  1. Cover Page
  2. Title Page
  3. Copyright
  4. Dedication
  5. Contents
  6. Preface
  7. About the Author
  8. Acknowledgments
  9. Introduction
    1. USING THIS BOOK
  10. Chapter 1: Market Background
    1. E-HEALTH
    2. HOW IS ELECTRONIC INFORMATION CREATED?
    3. INFORMATION TECHNOLOGY CONSIDERATIONS
    4. HOW IS HEALTH INFORMATION CREATED?
    5. REVIEW OF PRIMARY HCC MARKET PLAYERS
    6. REVIEW OF HCC SECONDARY MARKET PLAYERS
    7. MAJOR INITIATIVE FOR E-HEALTH
    8. AUDIT IMPLICATION OVERVIEW
  11. Chapter 2: Industry Applications
    1. PUBLIC USES
    2. PRIVATE USES
    3. INFORMATION CONTINUUM
    4. MARKET STANDARDS AND INITIATIVES
    5. AGENCY FOR HEALTHCARE RESEARCH AND QUALITY
    6. HEALTH LEVEL SEVEN
    7. CERTIFICATION COMMISSION FOR HEALTHCARE INFORMATION TECHNOLOGY
    8. DEPARTMENT OF DEFENSE RECORDS MANAGEMENT PROGRAM
    9. ASSOCIATION OF RECORDS MANAGERS AND ADMINISTRATORS
    10. AUDIT IPLICATION OVERVIEW
  12. Chapter 3: Impact of E-Health on Case Management
    1. FINANCIAL PICTURE
    2. HOSPITAL-BASED FCM APPLICATION
    3. CONSUMER-BASED FCM APPLICATION
    4. MARKET PROBLEMS: THE INDUSTRY AS IT OPERATES TODAY
    5. CONSUMER FCM MODEL
    6. HEALTHCARE PORTFOLIO APPLICATION
    7. VIRTUAL CASE MANAGEMENT
    8. AUDIT IMPLICATION OVERVIEW
  13. Chapter 4: Data in an E-Health Environment
    1. DATA LIBRARY
    2. DATA INTELLIGENCE
    3. NEW DATA
    4. MORE NEW DATA
    5. PROCESSED DATA
    6. DATA WAREHOUSE
    7. AUDIT IMPLICATION OVERVIEW
  14. Chapter 5: Algorithms
    1. BACKGROUND
    2. UNDERSTANDING ALGORITHMS
    3. DATA ELEMENTS
    4. CASE STUDY
    5. ALGORITHM SELECTION
    6. AUDITOR IMPLICATION OVERVIEW
  15. Chapter 6: Data-Driven Health Decisions in an E-Health Environment
    1. KNOWLEDGE MODELS
    2. THIRD-PARTY VENDOR KNOWLEDGE MODEL
    3. KNOWLEDGE MODELS FOR WHITE-COLLAR AND ORGANIZED CRIME
    4. SAMPLE IDENTITY THEFT CASE
    5. MEDICAL IDENTITY THEFT
    6. MEDICAL IDENTITY THEFT–DEFINITION
    7. HOW MEDICAL IDENTITY THEFT OCCURS
    8. DAMAGES TO PRIMARY VICTIMS
    9. MEDICAL IDENTITY THEFT FROM A CONSUMER PERSPECTIVE
    10. DAMAGES TO SECONDARY VICTIMS
    11. MEDICAL IDENTITY THEFT FROM AN ENTITY'S PERSPECTIVE
    12. AUDITOR CONSIDERATIONS
    13. SAMPLE FRAUD CASE
    14. SAMPLE PHARMACEUTICAL FRAUD CASE
    15. AUDIT IMPLICATION OVERVIEW
    16. EXAMPLES OF WORLDWIDE ACTIVITY
  16. Chapter 7: Analytic Tools and Audit Checklists
    1. E-HEALTH AND HEALTHCARE BUSINESS PROCESSES
    2. PATIENT BUSINESS PROCESS
    3. PROVIDER BUSINESS PROCESS
    4. PAYER BUSINESS PROCESS
    5. PLAN SPONSOR BUSINESS PROCESS
    6. THIRD-PARTY VENDOR BUSINESS PROCESS
    7. AUDIT IMPLICATION OVERVIEW
  17. Chapter 8: Electronic Health Records
    1. CURRENT E-HEALTH OFFERINGS
    2. MARKET EVOLUTION
    3. E-HEALTH CONTENT STANDARDS
    4. E-HEALTH OFFERING VULNERABILITIES
    5. AUDIT IMPLICATLON OVERVIEW
  18. Chapter 9: Healthcare Portfolio
    1. HEALTH INFOMEDIARY SUPPORT
    2. PHR ATTRIBUTES
    3. FUTURE CONSIDERATIONS
    4. MAJOR MARKET ACTIVITY
    5. AUDIT IMPLICATION OVERVIEW
  19. Chapter 10: Conclusions
    1. MARKET OVERVIEW
    2. CONSUMER RESPONSE TO PHRS
    3. AUDIT IMPLICATION OVERVIEW
  20. Index