Ngā Rekoata Hauora: He Aha kei Roto, Nāna te Mana Ture, ā, Me Pēhea te Tikina o Tāu Kōpi

I te nuinga o ngā kawanatanga, nā te kaiwhakarato, nā te whare hauora rānei te mana o āu rekoata hauora, ā, nāu te mōhiohio kei roto. Nā konei ka tukua e te ture a te kawanatanga ki a koe te mana ki te tiki kōpi, kaua ko te tuhinga taketake. Ka whai mana te kaiwhakarato ki te 30 o ngā rā ki te whakahoki ki tētahi tono ā-tuhi, ā, kāore ngā pire kāore i utua hei take whakakore.

• Nā te tangata nana i hanga te tuhinga, nāna te tuhinga. Nāu te mōhiohio.
• Ka hoatu e te HIPAA ki a koe he mana whakatinana ki te tirotiro me te kōpi i tō huinga rekoata kua tohua.
• E toru tekau ngā rā hei whakahoki atu, kotahi te toronga 30-ra ki te panui ā-tuhi, 60 rā te mōrahi.
• Ka herea ngā utu ki ngā mahi kōpi, ngā taonga, me ngā mēra. Kāore te wā rapu e taea te utu.
• Ko ngā tuhinga psychotherapy me ngā kōnae whakawā te mea matua kāore e taea e koe te tono.

Ko āu rekoata hauora he tuhinga ture, ehara i te kōpaki tuhinga

Ko te whakamārama whai hua o ngā rekoata hauora penei: ko tō tuhinga te tuhinga e hangaia ana e ngā kaimātai hauora mō tō tiaki, tae atu ki ngā tuhinga toro, ngā mate, ngā rongoā, ngā hua whakamātautau, me ngā mōhiohio pire. Ko te kupu mahi a te HIPAA ko te huinga rekoata kua tohua, e kapi ana i te tuhinga, ngā rekoata pire, me ngā hua whakamātautau taiwhanga me ngā whakamātautau kei te pupuri a tētahi kaiwhakarato kua hipa, a tētahi mahere hauora.

Kia mahara ko wai te kaituhi. Ko te tikanga o te rekoata hauora e raruraru ai te tangata ko te whakaaro ko tō rekoata tērā pera me tō rourou rae. Ehara. Ka tuhia e ngā kaimātai hauora, mō koe, hei pūkete mō rātou i ngā mea i puta.

Ka mahi te rekoata hauora e toru ngā mahi i te wā kotahi. Ka kawea te manaaki mai i tētahi kaimātai hauora ki tētahi, ka whakamārama i te mea i pirehia, ā, ka noho hei taunakitanga ture mō te mea i mahia me āhea. Ko ēnei mahi whakamutunga e rua te take ka tuhia ngā rekoata hauora me te kaha o te tiaki ki te māramatanga me te mārama.

Kāore pea koe e manaaki i tō rekoata hauora, ā, kāore e nui

A, no ka pātai te tangata ko wai te manaaki i ngā rekoata hauora, ka pātai tonu ratou i te pātai he. Ko te ture kotahi: nau te mōhiohio, nā te kaiwhakarato, nā te whare rānei te manaaki i te rekoata tinana, i te rekoata hiko rānei, ā, nā reira te ture a te kawanatanga e hoatu ana ki a koe he kōpi, kāore rawa he tuhinga taketake.

Kāore he ture manaaki a-motu kotahi. E ai ki tētahi tātaritanga i whakaputaia i roto i te Journal of Urgent Care Medicine, tata ki te 20 ngā kawanatanga kei a rātou ngā ture e hoatu ana te rekoata ki te kaiwhakarato, ko New Hampshire anake te kawanatanga kei a ia te ture e hoatu ana ki te turoro, ā, tata ki te 29, 30 rānei ngā kawanatanga kāore he ture manaaki. Kāore hoki ngā kaimātai hauora i te mārama mō taua mea. I roto i tētahi pōti tākuta i whakahuatia i roto i taua tātaritanga, 33 ōrau i kī ka manaaki te turoro i ngā rekoata, 65 ōrau i kī ka manaaki te tākuta, ā, 2 ōrau i kī ka manaaki te kaihoko EHR.

Ka peka atu te aratohu a te kawanatanga i te manaaki katoa. Ko te ar guide ki te tiki me te whakamahi i āu rekoata hauora a HealthIT.gov ka kapi noa i tō mana ki te tirotiro, te titiro, me te kōpi. Kāore rawa e kī ana koe te manaaki i te rekoata.

Anei te mea kāore te nuinga o ngā whārangi e kī atu ki a koe: ko te tautohetohe manaaki he raruraru kua hipoki hei pātai ture. Ko te manaaki i te tuhinga he ture a te kawanatanga kua wehea, ā, kāore e puta ke ai tētahi mea e taea e koe te mahi. Ko te manaaki uru he kawanatanga, he rite, ā, ka taea te whakatinana. Nō reira mutu te pātai ko wai te manaaki ka tīmata te pātai me pēhea te tiki.

E tekau ngā wāhanga o te rekoata hauora oti, tae atu ki ngā wāhanga kāore koe e kite

Ko ngā wāhanga o ngā rekoata hauora he tino mōhiotia atu i te tūmanako o te nuinga o ngā turoro. Ko te tuhinga oti ka uru ki ngā mōhiohio tautuhi, te hitori hauora, te rārangi rongoā me ngā taapiri o nāianei me ngā inenga, te hītori hauora whānau, te hitori maimoatanga me te pokanga, ngā tohutohu i mua, ngā hua whakamātautau taiwhanga me te imaging, ngā puka whakaae kua hainatia, ngā tuhinga whakapai, me ngā mōhiohio pire, tahua rānei. Koia te tikanga me te mahi ahumahi, ehara i te rārangi tirotiro ture.

E ai ki a MedlinePlus, i roto i tōna aratohu mō ngā rekoata hauora whaiaro, ko ngā mea nui hei whakau atu kei te noho tika: te ingoa, te rā whānau, te momo toto, ngā hoapāherehere, ngā rā me ngā hua o ngā whakamātautau nui me ngā tātari, ngā mate nui me ngā pokanga me ngā rā, ngā mate pāwera, ngā mate roa, me te hitori whānau.

A, no ka tae mai tō kōpi, ka rite te ahua o ngā whakauru ki te werohanga. Ka penei te korero o tētahi tuhinga whakapai: "Pt presents w/ 3d hx sore throat, no cough, febrile to 101.2F. Rapid strep neg. Dx: viral pharyngitis. Plan: supportive care, RTC if symptoms worsen." Ka penei te korero o tētahi raina taiwhanga: "Potassium 5.4 mmol/L (ref 3.5 to 5.1) H." Ko taua kupu poto he wāhanga nā te mea he maha ngā tuhinga ka korerotia, ka tuhia e tētahi kaiwhakamaori hauora e mahi ana i runga i ngā tauira.

Panuihia tonu, ā, panuihia ngā rārangi rongoā me ngā mate pāwera tuatahi. Ko ēnei tokorua te mea e whakawhirinaki ana te kaimātai hauora e whai ake nei me te kore e tirotiro. A kia mahara ko te wāhanga hītori i hangaia mai i te mea i korerotia e koe i te toro, nō reira ngā mea hei kōrero ki tō tākuta, me te tino tika o te whakamārama e koe, ka noho hei putanga mau tonu.

Rekoata pepa, EMR, EHR, PHR: kotahi anake te momo e taea e koe te whakahaere

E whā ngā momo rekoata hauora e tutaki ai te turoro, ā, ka whakahoarite tonu ēnei.

Ko te EMR hoki te wāhi e tau ai te wetewete i muri i te pūmanawa wetewete hauora, i te kaiwhakamaori rānei kua oti i a ia. Tētahi whakatikatanga e tika ana kia mahia i nāianei: ko te takiuru ki te tomokanga turoro he matapihi ki te rekoata hauora a te kaiwhakarato, ehara i te kōpi nāu. Ki te whakarerekē ngā mahi i ngā tauira, ki te katihia rānei, ka katihia taua matapihi. Tikiake, tango rānei i ngā mea nui.

Te tono i āu rekoata: e rima ngā taahiraa me te karaka ture 30-ra

Ko te mōhio me pēhea te tono i āu rekoata hauora he mahi whakahaere, ehara i te mahi tiaki, ā, ka rere i runga i te karaka ture.

1. Whakapa atu ki te tari tika. Tono atu ki te tari rekoata hauora, ki te tari whakahaere mōhiohio hauora (HIM), ehara ki tō kaimātai hauora. Kāore ngā kaimātai hauora e whakahaere tukunga, ā, ko te whakatere atu ki a rātou ka taapiri atu tētahi wiki.
2. Whakaritehia ā-tuhi. Whakamahia tā rātou puka, he reta rānei kua tohua te rā e whakaatu ana i ngā kaiwhakarato, ngā wā i waenganui i ngā rā, me ngā momo rekoata e hiahia ana koe.
3. Tohua te āhua. Ka whakau atu a HealthIT.gov me noho ngā rekoata hei kōpi pepa, he konae hiko, he momo pāpāho rānei pēnei i ngā whakaahua x-ray.
4. Kia mau ki te 30 rā. Me whai mana te kaiwhakarato, te mahere rānei i roto i te 30 rā o te whiwhinga, me tētahi toronga 30-ra e whakaaetia ana mena ka tukuna e ia tētahi panui ā-tuhi o te whakaroa me tētahi rā whakaoti i roto i aua 30 rā tuatahi. E ono tekau rā te mōrahi.
5. Tūmanako he utu, engari he utu herea. Ka herea ngā utu ki te utu tika, e pērā ana te utu mō te mahi kōpi, ngā taonga, me ngā mēra. Kāore te wā o ngā kaimahi e rapu ana, e tiki ana i tō konae e taea te utu ki a koe.

Kia mau ki tētahi kōpi kua tohua te rā o te tono. Koira te timatatanga o te karaka me te taunakitanga o te wā i tīmata ai. Ā, ki te kī mai tētahi ki a koe me utua te pūtea i tō kaute i mua, he he tera: ka tika ki a koe tō rekoata ahakoa he nama ki te mahi koe.

Ki te hiahia koe ki te tiaki i te wā kei te haere tonu tō konae, ko te $39 te utu mō te toro tari ohorere ā-ipurangi a August ka hono koe ki tētahi kaimātai hauora kua raihana ki te ao, ka aromātai i ō tohu, ā, ka whakatau mena ka tika te rongoā. Kia mārama ki te herenga: kāore e taea e te toro telehealth te tiki, te tuku, te whakarerekē, te tere rānei i ngā rekoata kei te pupuri a tētahi atu kaiwhakarato. Me tuku tonu taua tono ki te tari HIM.

Ko ētahi rekoata turoro kāore e taea te tiki, ā, i ētahi wā tae atu ki tō tamaiti

E rua ngā kāwai o ngā rekoata turoro kei waho atu i te mana uru, ā, he iti rawa ēnei i te kerēme a ngā kaimahi. Ko ngā tuhinga psychotherapy, ko te tikanga ko ngā tuhinga takitahi a te kaimātai hauora e pupuri ana, e wehea ana rānei ki te taha o te toenga o te tuhinga, ka whakakorengia. Ka pērā hoki te mōhiohio i whakahiatoa hei whakarite mō tētahi whakawā ture.

Kaua e tukua kia whakaroa taua. Ko ngā rekoata tiaki hauora noa, tae atu ki ngā rongoā, ngā mate, ngā rā timatanga me te whakamutunga, me te maha o ngā hui, he wāhanga o tō tuhinga ā, ka taea e koe te tiki. Ko ngā tuhinga tukanga anake e pupuri motuhake ana te tiaki.

Ko ngā mātua te nuinga o te māngai whai mana o te tamaiti ka taea te tiki i te tuhinga a te tamaiti. Ko te American Academy of Pediatrics te whakarite i ngā whakakorenga: ka taea e te tamaiti te whakaae ki taua tiaki anake, pērā i ētahi ratonga whakaputa uri, i ngā ratonga hauora hinengaro rānei, ka whakahauhia te tiaki e te kooti, ki te whakaae rānei te mātua ki tētahi hononga whakawhirinaki i waenganui i te kaimātai hauora me te tamaiti. Ka taea hoki e te tākuta te whakakore i te uru ki te wā e whakapae ana te mahi taumate, te whakarerengā rānei.

Ki te whakaroa te kaiwhakarato i āu rekoata hauora, tērā pea he ture

Ko te whakaroa inaianei he tikanga whakahaere, ehara i te ratonga kino noa iho. I raro i te 21st Century Cures Act ture aukati mōhiohio, ka aukatia te nuinga o ngā kaiwhakarato ki te pokanoa, kia kaha ai, ki te uru atu ki ngā mōhiohio hauora hiko, tae atu ki ngā tuhinga haumanu me ngā hua whakamātautau, engari mena ka puta he whakakorenga motuhake i te 45 CFR Part 171.

Ko te pakitara mahi e tutataki ai te turoro he raruraru tauira. E ai ki ta te Journal of Urgent Care Medicine i whakamārama mō ngā kaiwhakahaere mahi, ka noho te uru ki te wā ka katihia te mahi, ka uru rānei ki tētahi tautohetohe pire ki tōna kaiwhakarato EHR, nā te mea ko te kaiwhakarato, ehara ko te kaimātai hauora, te manaaki i te pana. Kāore tō mana e memeha nā te kirimana kāore koe i te wāhanga o taua mea. Kia kaha.

Ki te hipokina koe e Medicare Advantage, Medicaid, CHIP, me te mahere ACA marketplace rānei, ko te CMS Ture Whakaoti mō te Interoperability me te Uru o te Turoro ka whai kia homai e tō mahere he uru hiko ki ngā kerēme me ngā raraunga hauora mā roto i te API uru turoro, nā te paerewa, te nuinga mā te taupāpāho waea pūkoro. Koina tētahi atu huarahi ki te nuinga o ngā raraunga rite.

A, no ka tika te kaha, tukua he amuamu HIPAA ki te Tari mo ngā Tikanga Tūmataiti a te HHS, ki te ripoata rānei i te aukati mōhiohio mā te tomokanga a te ONC. He mea nui tēnei nā te mea kāore he tika motuhake a te HIPAA ki te kawe kooti. Kāore koe e taea te tohe ki tētahi kaiwhakarato i raro i taua mea ki a koe anō, nō reira ko te huarahi amuamu te tikanga whakatinana kei a koe.

Ngā pātai maha tonu ka pātaia

Kei te kī mai a HIPAA kia hia te roa o te wā ka pupuri ai te kaiwhakarato i āku rekoata?

Kāore. Kāore a HIPAA e whakatau i te wā pupuri mō ngā tuhinga turoro. Ko te roa o te pupuri a tētahi mahi i tō konae ka whakahaerehia e te ture ā-kawanatanga me tō ake kaupapa here, nā reira ka rerekē te whakautu i te kawanatanga me te whare. Ko te ture a te kawanatanga e ono tau e kī ana te tangata ka pā ki ngā tuhinga whakahaere a te tangata kua hipa, ehara ki tō tuhinga. Pātai atu ki te tari HIM mō tā rātou tikanga pupuri.

Ka taea e au te whakatika i tētahi he i roto i taku rekoata hauora?

Āe. Ka taea e koe te tono whakatikatanga i raro i te 45 CFR 164.526, ā, me whakahoki atu te kaiwhakarato. Ka whakaaetia ki te whakakore i taua mea, hei tauira mena kāore i hangaia e rātou te whakauru, ki te whakapono rānei he tika, he oti. Ki te whakakore ratou, ka tika ki a koe te tuku i tētahi tauākī whakatikatanga ā-tuhi, ka haere tahi taua tauākī me te whakauru kua tautohetia.

Ka taea e au te tiki tonu i āku rekoata ki te reti taku tākuta, ki te katihia rānei te mahi?

Tērā pea āe. Ka tatatatia kia whakarite ngā mahi e katihia ana te tiaki konae, nō reira ka noho te konae ki tētahi atu kaimātai hauora, ki tētahi kamupene rekoata, ki tētahi mahi hoko rānei. Tīmata ki tō poari tākuta ā-kawanatanga, e maha nei te mōhio ko wai i tango i te tiaki, ā, ko te tari hauora ā-kawanatanga. Ki te whakamahi te mahi i tētahi kaiwhakarato EHR o waho, ka taea tonu e taua kaiwhakarato te pupuri i ngā raraunga.

Me kī atu rānei ahau ki te tari he aha taku hiahia ki āku rekoata?

Kāore. Kāore tētahi kaiwhakarato e taea te hanga he whakamārama hei tikanga tuku. Ka taea e ngā kaimahi te pātai i te wā e kōrero ana, ā, ka taea e koe te whakakore atu i te pai. Ko te mea ka tika tā rātou te tono ko tētahi tono ā-tuhi, kua hainatia hoki, e tautuhi ana i a koe, te taonga e hiahia ana koe, me te wāhi hei tukunga atu, me te whakamanatanga tika o te tuakiri i mua i te hoatutanga o tētahi mea.

Ka taea e taku kaituku mahi te kite i āku rekoata hauora?

Kāore i te nuinga o te wā. Ka herea te HIPAA ki ngā mahere hauora, ngā kaiwhakahaere, me ngā kaiwhakarato, ehara ki ngā kaituku mahi e mahi ana hei kaituku mahi, nō reira ko ngā konae e pupuri ana tō kaituku mahi hei wāhanga o tō rekoata mahi kei waho rawa atu i taua mea. Kāore tō kaituku mahi e taea te tiki i tō tuhinga mai i tō tākuta me te kore he whakamana ā-tuhi nāu. Ki te tuku koe i tētahi kerēme utu mahi, tētahi kerēme mate rānei, ka tonoa koe kia hainatia tētahi.

Ka taea e taku hoa rangatahi, taku tamaiti pakeke rānei te tono i āku rekoata mōku?

I ētahi wā. Ko te tangata whai mana ture ki te mahi māu, pērā i te manaaki hauora, i te kaitiaki rānei, ko tō māngai whai mana, ā, ka taea e ia te tono i te konae tika. Ko ētahi atu katoa, tae atu ki te hoa rangatahi, me whai mana whakamana HIPAA kua hainatia e whakaingoa ana i a rātou me te whakaatu i te mea ka taea te tuku. Hainatia tētahi i mua mena ka hiahia koe ki te āwhina ki te whakahaere i tēnei.

Te take nui: he ahua pōhēhē te manaaki, engari kāore ngā mana uru

Nā te kaiwhakarato te nuinga o te manaaki i te tuhinga. Nāu te mōhiohio kei roto, me tētahi mana whakatinana a te kawanatanga ki te tiki kōpi. E toru ngā tau e mau ana te toenga: 30 rā hei whakahoki atu, 60 rā te mōrahi ki te panui ā-tuhi, me ngā utu kua herea ki te mahi kōpi, ngā taonga, me ngā mēra. Tono atu he kōpi oti o āu rekoata hauora nāianei, i mua i te ruma ohorere, i te tari whakauru rānei o tētahi kaimātai hauora hou ka kaha te tono.

Whakakahoretanga: Ko tēnei tuhinga mō te mōhiohio anake, kāore hoki e kiia he tohutohu hauora. Me korero tonu ki tētahi kaiwhakarato hauora whai mana mō ngā whakatau whakapāha me ngā maimoatanga. Ki te rongo koe i tētahi ohorere hauora, karangahia te 911, haere rānei ki te ruma ohorere tata tonu atu.