Relationship between Accreditation Decisions, Reimbursement, Quality of care, Informatics.

 

Health care performance has been a driving force focus when it comes to how an
organization receives or renews their accreditations and reimbursements. Most health care
organizations like the hospitals, skilled nursing facilities, and long term care units receive higher
amounts of reimbursements based on the standards of quality of care they provide for their
patients. Informatics help in data collection, recording, and storing which are then used to
compare the quality of care and reimbursements an organization deserves. These four factors
affect each other one way or the other.
Accreditation is a form of external review that shows that a healthcare provider is meeting
regulations and standards set by external accreditation organizations like the AAHC, The Joint
Commission, and the National Committee for Quality Assessment. Annual surveys are

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SOCIAL MEDIA AND THE MODERN IMPACT OF INFORMATICS
conducted by surveyors from these accreditation organizations to decide whether to approve or
disapprove the accreditation. The surveyors focus on the standard of care delivery which
includes the training materials, data retention, and equipment maintenance. Areas of focus
quality improvement points like the number of falls, use of antipsychotic medications, injuries
from falls, skin issues like wounds, diet intakes, UTIs and CAUTIs, and many other areas in
patient care and satisfaction. Accreditation helps streamline operations, improve quality of care,
build trust with patients and the communities, improve patient outcomes, and also prompts health
organizations to improve quality and performance of care (PowerDMS, 2018).
Reimbursement process involves the quality of healthcare services provided by the healthcare
providers to their patients or clients. The facilities are responsible for providing and maintaining
quality care that meets the standard of care set by external accreditation organizations to
maximize the reimbursements. Compensation for patient care relies on the quantity, quality, and
complexity experienced in the provision of the healthcare services provided to the patients. The
extensive care given to patients who are unable to take care of themselves in skilled nursing
facilities or rehabilitation facilities is compensated highly compared to the care given to
oversight encouragement care in assisted living.
Informatics technology is used for electronic health records to help monitor the nursing care
practice, patient responses t care given, and the operation of the organization. Health informatics
goals are to decrease the cost by assisting providers in coordinating care, increasing the
efficiency of care by streamlining the workflow of care and increasing the safety of the patient
by decreasing errors. The care data like the MDS records are used by reimbursement services
like Medicaid and Medicare to gauge on the amount to reimburse to the healthcare organization
(Britton, 2015)

 

SOCIAL MEDIA AND THE MODERN IMPACT OF INFORMATICS
Conclusion

Social media is part of the advancing technology but use must be controlled to protect
patient’s private information, organizations reputation and liabilities, and personal security and
job protection. Employers and universities must continue to monitor the security of the
information pertaining to the services they provide to the community. The correlation of
accreditation decisions, reimbursement, quality of care, and informatics work hand in hand as
they influence the patient outcome. All these factors help improve the health care and its
delivery to meet the needs of the patients and in compensation of services provided to the
patients.

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