Ms. Sarah Williams, a 65-year-old woman, presents with a history
For the final project, you will imagine yourself as a HIM professional at Global Care Medical Center. You will begin by reviewing a health record. Then, you will compare it to the Joint Commission (TJC) standards. You will then report on findings related to the hospital’s compliance with laws, standards, and regulations regarding how health record documentation is collected, stored, and eventually reported. In addition, you will analyze storage options for medical records and propose a recommendation for storage to enhance disaster recovery and data security. You will also assess the performance of the computer systems. For more information on the parts of the project, review the Milestones section below. For the final project, the following critical elements must be addressed: Analysis of Health Record: Examine the patient health record and answer the following questions: Does the patient have a family history of diabetes? What report did you find this information on? What procedure was performed? Who was the surgeon? What type of anesthesia was used? What medications were prn (as needed)? What report did you find this information on? TJC: In this section, you will review The Joint Commission (TJC) (E-dition) Standards as they relate to the health record. dentify the data TJC routinely reviews for compliance with Record of Care (RC) standards as listed in the TJC E-dition. Evaluate where the record is complete and where it is missing data. Based on the missing data, outline the TJC standards where the hospital is deficient and describe the content of each TJC standard that was violated. How will these deficiencies impact compliance? Systems and Technology: In this section, you will examine and report on what technology is being used and how it is being used within the organization. Describe how the organization utilizes technology for collecting and storing data. Describe the gaps or issues with functionality of the current collection and storage system(s). Based on the identified gaps or issues, recommend types of technology and storage options that would serve the organization better. Be sure to justify each recommendation. Secondary Data Sources: For this next section, you will examine the secondary data sources the hospital utilizes and report on your findings. Explain how secondary data sources are created and how they are used to build local and national registries. Evaluate what type of policy would ensure the required data elements are present in the patient record for data collecting registry purposes. Conclusions and Recommendations: For the final section, you will compile your findings thus far, and make recommendations for the professional management of patient health information within the organization. Based on your audit of the medical health record, explain which data items are required for patient care and compliance with requirements. Based on your identification of TJC requirements for information management standards and quality measures, report your findings on the organization’s compliance or noncompliance with such requirements. Outline the compliance with a local and national registry from the secondary sources and its importance. Make recommendations for any identified compliance deficiencies and defend your recommendations.
******CLICK ORDER NOW BELOW AND OUR WRITERS WILL WRITE AN ANSWER TO THIS ASSIGNMENT OR ANY OTHER ASSIGNMENT, DISCUSSION, ESSAY, HOMEWORK OR QUESTION YOU MAY HAVE. OUR PAPERS ARE PLAGIARISM FREE*******."
