The Relationship Between Accreditation Decisions, Reimbursement, Quality of Care, and Informatics

 

Many schools and health agencies have a certain set of standards that they are expected to
meet. “Accreditation is a term used to describe the process that institutions of higher education
undergo to confirm they meet the strictest educational standards. Accreditation is earned through
accrediting bodies, which are private, nongovernmental organizations that have been created
specifically to review higher education institutions and programs” (WorldWide Learn). In

 

Running Head: MODERN IMPACT OF INFORMATICS 6
relation to healthcare organizations, accreditation is a process of review that allows a healthcare
organization to show that it is able to meet the regulatory requirements and standards that was
established by a recognized accreditation organization (ACHC.org). There are several
accreditation agencies, however their common goal is to help the healthcare agencies keep track
of the quality care that is being provided, the satisfaction of the patients and care providers, and
safety. According to the text, “Informatics plays an important role during the accreditation
process. TJC [The Joint Commission] members often conduct interviews with frontline staff;
complete an on-site visit; and review safety data, incident reports, and adherence to quality
standards set by the institution along with many other data sets” (Hebda, Hunter, & Czar). It is
important to remember that this data is only as accurate as the information that has been put into
the system. Accreditation is earned as long as relevant data is documented. If this is not done,
then the facility risks not receiving its accreditation. This jeopardizes reimbursement if support
data are inaccurate, incomplete, or absent. The next thing that is affected is quality of care which
depends on the healthcare providers making proper decisions that are based on the appropriate
data found in data exchanges such as the patient’s chart. “Data sharing among providers,
organizations, and other relevant and secure entities can contribute to quality care. Informatics
specialists must be at the table as decisions are made about computer-and electronic-related
systems” (Hebda, Hunter & Czar). Informatic specialists may offer their own educational
expertise and wisdom to ensure that information systems are developed, implemented, and
evaluated in a useful way (Hebda, Hunter, & Czar).

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