Abstract
The use of patient records serves as a major tool in the collection of information for database use. However, healthcare providers must ensure that the collection process and the storage processes do not impede on the minimum requirements set forth by regulatory bodies. This report presents an Arizona based healthcare facility and assesses the model of care delivered, in order to understand the processes that go into data collection for research.
Introduction
Operating under the guidance of the Health and Human Services (HHS), the state of Arizona is well-known for its “state-of-the-art” facilities that offer novel therapy for; Cancer care/research, Hospice, Pediatric, Pioneering in Telemedicine (Arizona, 2014). What occurs in Arizona is essentially the crafting of procedure that is supported by intense amounts of patient and historical data through the application of a network of healthcare professionals that have integrated the use of these informational databases. Subsequently, Arizonians enjoy care as it is delivered through the Arizona Department of Health Services, which is overseen by the HHS. Although there are many aspects of healthcare delivery, which may be addressed in Arizona, this report will focus on the use of patient database systems and how they help to enhance healthcare in Behavioral Facilities.
In an event where an individual recognizes the need to receive specialized care for incidences related to behavioral health issues, they may seek treatment in one of the many Arizona based facilities. An encompassing list of all registered behavioral health clinics is presented on the official Arizona Department of Health Services website (Arizona, 2014). Additionally, this website is easily accessible to potential patients. It is not applicable to service providers but it is important to note that this site presents all the required information that is needed in an emergency situation where a patient must quickly select a provider. As a model, this site leads into the underlying attributes that actually allow providers to craft such an encompassing informational resource site.
Informational Databases – Proprietary Information
The integrated behavioral treatments that are offered through the Arizona Mercy Maricopa Integrated Care (AMMIC) center represent an efficient model of applying patient database use. Patients that may receive care at the AMMIC center are limited to individuals that suffer from behavioral health issues (Arizona, 2014). Behavioral health issues will include, but are not limited to; Schizophrenia, Major Depressive Disorder, Addiction, Bipolar, Phobia, and more (Arizona, 2014). Patients may receive care through admittance into walk-in clinics and/or may receive more intensive long-term care. AMMIC boasts a team of medical professional whom are trained in basic medical care procedures and whom specialize in issues related to behavioral health. Additionally, approximately 18% of the Arizona population is likely to suffer from mental health issues, and the cost for care of these individuals is quantified at $108.4 million annually (Arizona, 2014).
At the AMMIC facility procedures are crafted to meet the unique needs of each patient. The use of proprietary databases allows doctors, nurses and caregivers to deliver therapy, which is likely to yield the most desirable outcome. In order to construct efficient database patient information is collected at the point of admittance, and at intervals throughout the lifecycle of their care. It is important to note that a patient’s record is not set in stone for any healthcare facility. Each facility will meet the minimum requirements that have been mandated by the overseeing body (i.e. HHS). Furthermore, qualified advisory boards for certain scenarios provide guidance that providers “should” meet. Often, healthcare providers will meet the minimum information within guidance, but there may be “creative” ways of meeting these requirements. Therefore, the content of a patient record will be specific to its desired purpose.
For a facility in which the patients suffer from mental health issues a patient record is likely to contain; Surgical History, Family History, Behavioral History, Social History (including possible criminal record), Habits, Medication used (including illicit drugs), and additional complaints that the patient may have. In addition to these basic requirements, the Joint Commission (JC), indicates that medical records should contain the minimum information for a facility; Average monthly discharge rate, Monthly Delinquency (totals and timeframe), Quality Assessment, Readability, Clarity, Accuracy and Completeness. While this information is typical for a typical patient record, (or facility assessment), most organizations will provide more intensive records that far exceed these parameters (Joint Commission, 2014).
Administration of Data Collection and Exclusion
Prior to submission into a database (shared) certain information should be excluded. This includes proprietary patient information such as their name and other identifiable information. References to the medical professionals that conducted the particular procedure should be excluded, prior to storage into a database. The rationale behind this is not simply to maintain the privacy of those involved but to also eliminate a personal connection from the qualitative/quantitative data set (HCpro, 2014). The ability to eliminate any connections of “feelings” will allow researchers to control the amount of bias that may be applied from database information. Data should be collected after the patient has consented to the use of their information. It is important to note that Hospitals are sometimes viewed as “ineffective” when letting the patient know that their information may be utilized in a research setting. For cases where the procedure may be purely experimental the hospital care facility may fall under the rule of the International Review Board (IRB). The AMMIC must remain compliant with all regulations that have been set forth by the HHS and the IRB when collecting experimental data, and when applying this data.
Conclusion
In summary, a healthcare facility, such as the one referenced within this report must remain compliant to the oversight bodies in which they operate under. Patient records are required to contain minimum information which has been set forth as “recommendations” by committees such as the Joint Commission. In addition, facilities that intend to collect patient record information for storage and application in healthcare databases must ensure that they exclude all information that is specific to the identity of the patient and/or healthcare professionals, when/where applicable.