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A personal health record (PHR) is a health record where health data and other information related to the care of a patient is maintained by the patient. This stands in contrast to the more widely used electronic medical record, which is operated by institutions and contains data entered by clinicians to support insurance claims. The intention of a PHR is to provide a complete and accurate summary of an individual's medical history which is accessible online. The health data on a PHR might include patient-reported outcome data, lab results, and data from devices such as wireless electronic weighing scales or from a smartphone.
Health technology is defined by the World Health Organization as the "application of organized knowledge and skills in the form of devices, medicines, vaccines, procedures, and systems developed to solve a health problem and improve quality of lives". This includes pharmaceuticals, devices, procedures, and organizational systems used in the healthcare industry, as well as computer-supported information systems. In the United States, these technologies involve standardized physical objects, as well as traditional and designed social means and methods to treat or care for patients.
The National Committee for Quality Assurance (NCQA) is an independent 501(c)(3) nonprofit organization in the United States that works to improve health care quality through the administration of evidence-based standards, measures, programs, and accreditation. The National Committee for Quality Assurance operates on a formula of measure, analyze, and improve and it aims to build consensus across the industry by working with policymakers, employers, doctors, and patients, as well as health plans.
Self-care has been defined as the process of establishing behaviors to ensure holistic well-being of oneself, to promote health, and actively manage illness when it occurs. Individuals engage in some form of self-care daily with food choices, exercise, sleep, and hygiene. Self-care is not only a solo activity, as the community—a group that supports the person performing self-care—overall plays a role in access to, implementation of, and success of self-care activities.
Patient safety is a discipline that emphasizes safety in health care through the prevention, reduction, reporting and analysis of error and other types of unnecessary harm that often lead to adverse patient events. The frequency and magnitude of avoidable adverse events, often known as patient safety incidents, experienced by patients was not well known until the 1990s, when multiple countries reported significant numbers of patients harmed and killed by medical errors. Recognizing that healthcare errors impact 1 in every 10 patients around the world, the World Health Organization (WHO) calls patient safety an endemic concern. Indeed, patient safety has emerged as a distinct healthcare discipline supported by an immature yet developing scientific framework. There is a significant transdisciplinary body of theoretical and research literature that informs the science of patient safety with mobile health apps being a growing area of research.
A Patient Safety Organization (PSO) is a group, institution, or association that improves medical care by reducing medical errors. Common functions of patient safety organizations are data collection, analysis, reporting, education, funding, and advocacy. A PSO differs from a Federally designed Patient Safety Organization (PSO), which provides health care providers in the U.S. privilege and confidentiality protections for efforts to improve patient safety and the quality of patient care delivery
A patient-reported outcome (PRO) is a health outcome directly reported by the patient who experienced it. It stands in contrast to an outcome reported by someone else, such as a physician-reported outcome, a nurse-reported outcome, and so on. PRO methods, such as questionnaires, are used in clinical trials or other clinical settings, to help better understand a treatment's efficacy or effectiveness. The use of digitized PROs, or electronic patient-reported outcomes (ePROs), is on the rise in today's health research setting.
In general, quality of life is the perceived quality of an individual's daily life, that is, an assessment of their well-being or lack thereof. This includes all emotional, social and physical aspects of the individual's life. In health care, health-related quality of life (HRQoL) is an assessment of how the individual's well-being may be affected over time by a disease, disability or disorder.
The Medical Expenditure Panel Survey (MEPS) is a family of surveys intended to provide nationally representative estimates of health expenditure, utilization, payment sources, health status, and health insurance coverage among the noninstitutionalized, nonmilitary population of the United States. This series of government-produced data sets can be used to examine how individuals interact with the medical care system in the United States.
Patient-centered outcomes are results of health care that can be obtained from a healthcare professional's ability to care for their patients and their patient's families in ways that are meaningful, valuable and helpful to the patient. Patient-centered outcomes focus attention on a patient's beliefs, opinions, and needs in conjunction with a physician's medical expertise and assessment. In the United States, the growth of the healthcare industry has put pressure on providers to see more patients in less time, fill out paperwork in a timely manner, and stay current on the ever-changing medical advancements that occur daily. This increased pressure on healthcare workers has put stress on the provider-patient relationship. The Patient-Centered Outcomes Research Institute (PCORI) is a United States Government funded research institute that funds studies that compare healthcare options to find out what options and situations work best for patients of different circumstances. PCORI uses their research to increase the quality of healthcare and push the healthcare system towards a more patient-centered approach. The Beryl Institute, a non-profit institute dedicated to the improvement of patient experience through Evidence-based research, released data that found that over 90% of patients believe patient-centered outcomes to be "extremely important" to their healthcare experience. Individuals that participated in this study by the Beryl Institute claimed that the aspects of healthcare that they see as most influential to their healthcare experience include effective communication, pain management, a clear and well-explained plan of care and a clean and comfortable environment. In addition to this data, women were found to have the largest issues with lack of patient-centered care, reporting higher rates of pain and less empathy than men.
In United States healthcare, service excellence is the ability of the provider to consistently meet and manage patient expectations. Clinical excellence must be the priority for any health care system. However, the best healthcare systems combine professional (clinical) service excellence with outstanding personal service. Although health care in the United States is touted as the “world’s largest service industry,” the quality of the service is infrequently discussed in medical literature. Thus, many questions regarding service excellence in healthcare largely remain unanswered.
The Patient-Reported Outcomes Measurement Information System (PROMIS) provides clinicians and researchers access to reliable, valid, and flexible measures of health status that assess physical, mental, and social well–being from the patient perspective. PROMIS measures are standardized, allowing for assessment of many patient-reported outcome domains—including pain, fatigue, emotional distress, physical functioning and social role participation—based on common metrics that allow for comparisons across domains, across chronic diseases, and with the general population. Further, PROMIS tools allow for computer adaptive testing, efficiently achieving precise measurement of health status domains with few items. There are PROMIS measures for both adults and children. PROMIS was established in 2004 with funding from the National Institutes of Health (NIH) as one of the initiatives of the NIH Roadmap for Medical Research.
Health care quality is a level of value provided by any health care resource, as determined by some measurement. As with quality in other fields, it is an assessment of whether something is good enough and whether it is suitable for its purpose. The goal of health care is to provide medical resources of high quality to all who need them; that is, to ensure good quality of life, cure illnesses when possible, to extend life expectancy, and so on. Researchers use a variety of quality measures to attempt to determine health care quality, including counts of a therapy's reduction or lessening of diseases identified by medical diagnosis, a decrease in the number of risk factors which people have following preventive care, or a survey of health indicators in a population who are accessing certain kinds of care.
NRC Health is a company which provides healthcare products and subscription-based solutions in United States and Canada. It was founded in 1981 and is currently based in Lincoln, Nebraska.
Patient satisfaction is a measure of the extent to which a patient is content with the health care which they received from their health care provider.
The Comparative Effectiveness Research Translation Network (CERTAIN) is a learning healthcare system in Washington State focused on patient-centered outcomes research (PCOR) and comparative effectiveness research (CER), leveraging existing healthcare data for research and healthcare improvement, incorporating patient and other healthcare stakeholder voices into research, and facilitating dissemination and implementation of research evidence into clinical practice.
The Surgical Care and Outcomes Assessment Program (SCOAP) is a clinician-led, performance benchmarking and quality improvement (QI) registry for surgical and interventional procedures.
The nine-item Patient Health Questionnaire (PHQ-9) is a depressive symptom scale and diagnostic tool introduced in 2001 to screen adult patients in primary care settings. The instrument assesses for the presence and severity of depressive symptoms and a possible depressive disorder. The PHQ-9 is a component of the larger self-administered Patient Health Questionnaire (PHQ), but can be used as a stand-alone instrument. The PHQ is part of Pfizer's larger suite of trademarked products, called the Primary Care Evaluation of Mental Disorders (PRIME-MD). The PHQ-9 takes less than three minutes to complete. It is scored by simply adding up the individual items' scores. Each of the nine items reflects a DSM-5 symptom of depression. Primary care providers can use the PHQ-9 to screen for possible depression in patients.
Press Ganey Associates is a South Bend, Indiana-based health care company known for developing and distributing patient satisfaction surveys. As of January 2017, its Medical Practice Survey was the most widely used outpatient satisfaction survey in the United States.
Value-based health care (VBHC) is a framework for restructuring health care systems with the overarching goal of value for patients, with value defined as health outcomes per unit of costs. The concept was introduced in 2006 by Michael Porter and Elizabeth Olmsted Teisberg, though implementation efforts on aspects of value-based care began long before then in the 1990s. With patient value as the overarching goal, VBHC emphasis systematic measurement of outcomes and costs, restructuring provider organizations, and transitioning toward bundled payments. Within this framework, cost reduction alone is not seen as proper strategy for healthcare systems: health outcomes have to improve to enhance value. Although value-based health care is seen as a priority in many health systems worldwide, a global assessment in 2016 found many countries are only beginning to align their health systems with VBHC-principles. Additionally, several studies report incoherent implementation efforts, and there seem to be various interpretations of VBHC, both within and across countries.
References
- ↑ Cleary PD, Crofton C, Hays RD, Horner R (November 2012). "Advances from the Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Project. Introduction". Medical Care . 50 Suppl: S1. doi:10.1097/MLR.0b013e31826ec0cb. PMID 23064270.
- ↑ "About CAHPS". AHRQ.
- ↑ "CAHPS Health Plan Survey". www.ahrq.gov. Retrieved 2024-01-12.
- ↑ "CAHPS Hospital Survey". www.ahrq.gov. Retrieved 2024-01-12.
- ↑ "CAHPS Clinician & Group Survey". www.ahrq.gov. Retrieved 2024-01-12.
- ↑ Levine RE, Fowler FJ, Brown JA (Dec 2005). "Role of cognitive testing in the development of the CAHPS Hospital Survey". Health Serv Res. 40 (6 Pt. 2): 2037–2056. doi:10.1111/j.1475-6773.2005.00472.x. PMC 1361243 . PMID 16316437.
- ↑ Price PA, Stucky B, Parast L, Elliott MN, Haas A, Bradley M, Teno JM (Jul 2018). "Development of valid and reliable measures of patient and family experiences of hospice care for public reporting". Journal of Palliative Medicine. 21 (7): 924–932. doi:10.1089/jpm.2017.0594. hdl: 2027.42/146458 . PMID 29649404. S2CID 4783667.
- ↑ Hays, RD; Shaul, JA; Williams, VS; Lubalin, JS; Harris-Kojetin, LD; Sweeny, SF; Cleary, PD (Mar 1999). "Psychometric properties of the CAHPS 1.0 survey measures. Consumer Assessment of Health Plans Study". Medical Care. 37 (3 Suppl): MS22-31. doi:10.1097/00005650-199903001-00003. PMID 10098556.