Do the benefits outweigh the costs?

How does the new technology benefit the patient?

How does the new technology benefit the physician?

Is there a difference between the new method and the previous method?

Johns Hopkins Hospital

King’s College (later Columbia University)

Baylor University Hospital

College of Philadelphia (later the University of Pennsylvania)

President Bush; President Obama

President Clinton; President Bush

President Reagan; President BushPresident Clinton; President Obama

President Clinton; President Obama

is not as widely used as the monolithic HIE architecture.

allows contributing institutions to maintain control over data for which they are responsible under HIPAA.

maintains a patient’s comprehensive data in one place and in one format.

allows all member institutions to periodically send copies of their clinical data to one central repository, where all the data reside together in one format.

Office of the National Coordinator for Health Information Technology (ONCHIT or “the ONC”).

American Recovery and Reinvestment Act (ARRA).

Health Information Technology for Economic and Clinical Health Act (HITECH).

Health Insurance Portability and Accountability Act (HIPAA).

Computerized Physician Order Entry (CPOE)

Monolithic health information exchange (HIE) architecture

Computerized decision support system (CDSS)

Federated health information exchange (HIE) architecture

shows little evidence of improvement in the ordering and completing of preventive care.

is mixed.

shows the effective magnitude of the improvement is large.

is conclusive and favorable.

They focused on effectively treating patients.

They tended to be under-populated, as not many people used them.

They focused on isolating the sick and mentally ill from the population at large.

They were places often visited by the friends and family of the patients.

Physicians

Joint ventures with hospitals

Corporate entities

Hospitals

There is a history of extremely positive results in establishing health promotion and disease prevention in the U.S. healthcare system.

The United States currently spends most of its healthcare dollars on disease prevention.

The delivery system and its reimbursement incentives have evolved as an acute illness complaint–response system.

Provider payment incentives always have favored prevention because of strong evidence of the cost-effectiveness of primary prevention.

The number and skill requirements of each discipline within the healthcare workforce

The declining number of physicians

The push for removal of nonmedical technology from the provision of health care

The aging of the population and advances in the treatment of acute and life-threatening conditions

A bachelor’s degree in social work

A master’s degree plus two years of supervised experience in a clinical setting

A master’s degree plus four years of supervised experience in a clinical setting

A doctoral degree

hospital-acquired, antibiotic-resistant infections.

patient injuries resulting from falls or mishandling by staff.

egregious, usually preventable errors that result in death or significant disability, such as surgery performed on the wrong body part.

granting hospital admitting privileges to inadequately trained physicians.

a joint federal-state program supporting basic health services for low income individuals and in which federal and state support is shared based on states’ per capita income.

a federal program dedicated to supporting individuals with long-term care needs.

a federal program targeting children living in poverty.

an entitlement program for Americans who are unable to obtain employment.

demonstrate the cost-effectiveness of early childhood preventive health programs.

provide additional federal resources to underfunded state Medicaid programs.

highlight the benefits of the Balanced Budget Act of 1997 to state legislatures.

enroll 10 million uninsured children in Medicaid whose family incomes were too high to qualify for Medicaid but too low to purchase private health insurance.

A 50% increase in federal matching funds for all new enrollees in the first year of participation and 25% additional federal matching funds for new enrollees every year thereafter

100% of state expenses for new enrollees through 2016 and dropping gradually to 90% of state expenditures for new enrollees through 2020 and for future years

100% of state expenses related to coverage for new enrollees through calendar year 2020

100% of state expenditures for new children enrollees through 2016 and 90% of state expenses for new children enrollees’ family members through 2020

play or pay.

health insurance tax.

individual mandate.

essential health benefit.

create a competitive health insurance market by providing web-based, easily understandable comparative information to consumers on plan choices with standardized rules regarding health plan offers and pricing.

decrease health insurance costs by impeding competition in the healthcare insurance market and exposing poorly performing health plans.

empower state insurance regulators to more effectively monitor the performance of health plans’ costs and quality.

give all consumers and purchasers the rights of appeal on increasing health insurance premium costs.

Physicians responding to reduced reimbursements by ordering more medical procedures

Patients’ demands for increased use of specialist services and Medicare’s obligation to pay for many unnecessary procedures

Fee-for-service payments for individual services provided during a beneficiary’s illness resulting in fragmented care with minimal coordination across providers and settings

Physicians’ resistance to accountability for medical care outcomes as compared with costs

changes from prior philosophies of providers’ individually-based care perspectives to perspectives on achieving improved population health status.

changes in medical and other professional schools’ educational curricula to include emphasis on population health.

recognizing that medical technology cannot solve the overarching problems of providing care for increasing numbers of aged and chronically ill Americans.

All of these are correct.