Standard Performance MeasuresStandardperformance measures are a way of collecting data across similar functions,processes, costs, and providers. Benchmarking against these standards hasproven to be useful in healthcare as a tool to measure many facets of quality.Carefully evaluating these measures allows for management to design appropriateprograms to assist with healthcare service needs and patients to make decisionsabout facility and provider services. Best Doctors, Inc. and WebMD areexamples of these tools. Your discussions will focus on the use of informationfrom these websites to make healthcare decisions.UsingScholarly sources or the Internet, research about these measures and how theyallow management to design appropriate programs to assist with healthcareservice needs.Basedon your readings and research, answer the following:• Presenta brief overview of the purpose for each of the Best Doctors, Inc. products.How are the ‘Best Doctors’ of each type determined? Visit the officialBest Doctors website at http://www.bestdoctors.comNext read a casestudy about Mary Jones below.Maryfaced several challenges in her ordeal, mainly dealing with her diagnosis andtreatment. This was a result of her ability to seek additional assistance andto find diagnosis. She reviewed the WebMD website for additionaldata and other specialty physician sources. Visit the official WebMDwebsite athttp://www.webmd.com• Doyou feel this could have been addressed differently? Why?• Basedon the information presented in this case, what are your observations aboutcurrent consumer involvement in healthcare? What does this case teach about theuse of computers to seek healthcare information?MaryCase Study Whena loved one is critically ill, healthcare information that is reliable isrequired quickly. There are many ways to access healthcare information, fromInternet searches to panels of specialists. How the information is used inproviding quality care is one of the key points for this discussion. In thefollowing case study, Mary faces many challenges. For many of us, looking up aset of symptoms is usually what we think of when using such sources as theInternet to find healthcare information. However, there are many other aspectsof our healthcare that we need to know and access. As a healthcare consumer weneed to be informed. Asin the past weeks, you will respond to discussion questions based on the casestudy. CaseStudy:Mary Jones was working at the press bending machine when she suddenly feltsevere pain in the lower right side of her body. She yelled for the shopforeman who immediately called emergency services. Upon arrival to the localhospital emergency room (ER), she was rushed to the examination room. Thetriage nurse evaluated Mary’s pain. Mary had signed a release form at the startof this process to allow Mr. Jones (Mary’s husband had met them at thehospital) to complete the necessary paperwork. While filling out forms, Mr.Jones had informed the intake clerk that he currently is unemployed and they donot have health insurance. Mary’s employer doesn’t offer healthcare insurance.The clerk asked what other means will they have to demonstrate their ability topay for services. Mr. Jones had informed the clerk that they do have somepersonal savings that should be enough to pay for services. Mr. Jones thensigned an agreement to pay for all charges incurred. Aftertalking with Mary and examining her medical history, the ER physician hadconcluded the pain may be related to a flare up from a recent work-relatedinjury (one month prior). She had tripped and fell on an oily floor hurting herlower back area. At the time, the diagnosis was a deep bruise. He recommendedfor her to take a few days off and to take the prescribed pain medication. Thisis the same medication Mary was prescribed following her fall a month earlier. Marywent home and on the doctor’s recommendation she took the next day off;however, the pain would not go away; even with the pain medications hercondition seemed to be getting worse. Mary and her husband John decided to lookup her symptoms on the Internet. Using WebMDthey found her symptoms (especially when they included nausea) are more relatedto gallbladder inflammation (cholecystitis). With that information they calledDr. Avon with their concerns. Dr. Avon explained that he read the ER report andexamined the test (sonogram and lab tests) and it did not show any indicationwith problems with Mary’s gallbladder. Dr. Avon explained Mary doesn’t have afamily history of gallbladder inflammation and doesn’t have the typical riskfactors associated with the illness (e.g., obesity). Dr. Avon is concernedabout the pain and now the nausea that she is experiencing and asks Mary tomeet him at the hospital for more tests. Thefollowing morning Mary underwent tests including a magnetic resonance imaging(MRI), a sonogram, and other lab analysis. Dr. Avon, with the assistance of agastrologist, a neurologist, and an oncologist, could not determine an exactdiagnosis for her increasing level of pain and nausea. Dr. Avon suggested usingthe service of Best Doctors.Inc. This is a service used to assist patients andphysicians in challenging cases that do not fit the diagnostic protocols anddecision trees. Dr. Avon, with the consent of Mary, contacted Best Doctors.Inc.They requested all of Mary’s medical records including the records of herprevious injury. The case was reviewed by a panel of doctors from the HarvardMedical School. Uponexamination, the panel found an oversight in the original diagnosis for theinjury. The initial MRI taken just after the injury revealed no acute ortraumatic issues with her lower lumbar and spinal areas. Upon comparing herprevious MRI results with the one taken now, a minor inflammation between L4and L5 was revealed. The herniated area was very small but seemed to be causinga radiating effect for pain. The nausea may be a result of an allergic reactionto the pain medication Mary resumed taking. Records indicate that she wasnauseated during the initial treatment for her injury but it was attributed tothe injury and not the medications. Dr. Avon tookthe information and in consultation with Mary and his medical team, recommendedsurgery to repair her disc. The surgery and recovery period were successful. It isnow three weeks later and Mary received the bills for the ER, hospital stay,and from the surgeon and anesthesiologist. The hospital bill alone was $12,950;adding in the physicians’ charges, Mary’s total bill was over $18,000 dollars.Mary didn’t realize the charges would be that high, especially when thehospital only told her the charges regarding the hospital stay and supplies.Her savings was just over $2,000 dollars and she did not have the means to comeup with the monies in the agreed upon twenty-one days after receiving thebills. Marycontacted the hospital and physicians regarding the bills. The hospital hadagreed to extend the payments to ninety days from the original twenty-one days.The physicians did not offer a payment plan but agreed to also extend the fullpayment due in ninety days. Mary did not have the funds to make such payments.After several months of attempting to make smaller payments and the increasingpressures through collection agencies to pay her medical bills, Mary sought legalassistance. Upon contacting an attorney, it was ascertained that all hermedical bills were associated with her original work-related injury. Mary’sattorney, through negotiations with her employer’s workers compensationcarrier, corrected this oversight. Mary’s employer and their workerscompensation insurance carrier covered all charges related to the injury andreimbursed Mary for all payments paid as well as any work lost during thisordeal.
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