Temple UniversityCollege of Health Professions & Social Work

Department of Health Information ManagementM.S. in Health Informatics

Course Number: HIM 5004 Course Name: Introduction to Health Care Delivery

Credit Hours: 3

Faculty: Michael K. Harrington, MS, CHPOffice: Jones Hall, 3rd FloorTelephone: 610-675-7502E-mail: kharing@temple.edu

Course Description:

The health care delivery system is studied, with a focus on issues related to access, cost and quality. System components are examined including: important values and beliefs; the historical development of the health care system and the current status; health services financing; the role of health care professionals; the use of technology; outpatient, primary care, inpatient, managed care, long-term care and integrated services; issues for special populations; the process and purpose of health policy; and, future options for the delivery system.

Course Objectives

At the completion of the course, the student should:

1. Identify the main components and issues of the organization and delivery of healthcare in the United States.

2. Describe roles and interrelationships of various types of healthcare providers and facilities.

3. Distinguish among various healthcare financing models and their impact on acces, cost and quality across the continuum of healthcare.

4. Synthesize the impact of major policy, ethical, economic, professional and legal issues facing healthcare providers, insurers, policymakers and consumers.

5. Evaluate the impact of emerging health care issues on access, cost and quality of care.

TextbookRequired Shi, L. & Singh, D.A. (2012). Delivering health care in America: A systems approach (5th

ed.). Sudbury, MA: Jones and Bartlett.ISBN-13: 9781449626501

Additional "Recommended" readings are also indentified in the course schedule.

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Item Points Average LetterDiscussion Questions

16.667% 94-100 A 70-72 C-

Research Paper

25% 90-93 A- 67-69 D+

Presentation 15%

Final Exam 40% 87-89 B+ 63-66 D

80-82 B- 60-62 D-

77-79 C+ Below 60

F

73-76 C

Assignments and Exams

Final: A take home final will be cumulative, integrating all material covered in the course. The examination will be distributed one week prior to the due date.

Discussion Board Activities – Students will work independently on all discussion board activities. Four topics usually reflecting current healthcare issues will be posted to the Discussion Board throughout the course. One-week will be given to allow students to post to discussion board for a given topic.

Students are expected to post at least one substantive reply or commentary to the responses of fellow class members by the designated date on the calendar. Evaluation of discussion board participation will be based on student’s demonstration of understanding and application of course topics.

Please provide an introduction of yourself (describe your background and training related to healthcare and any other relevant information you’d like to share.) The introduction of yourself to others in the group helps to provide a context to others when examining your perspective on a given topic.

Discussion Board Grading Rubric

Participating 3 times during the week is measured by postings on 3 different days; you may actually make 5-6 postings, but participation only occurred 3 times during the week.

A Discussion (9-10 points) - participated 3 times, minimum of 5 postsA-level postings...

are made in a timely fashion, giving others an opportunity to respond are thoughtful, and analyze the content or question asked make connections to other content and real-life situations extend discussions already taking place, or pose new possibilities or opinions not

previously voiced

B Discussion (7-8) - participated 2 times, minimum of 4 postsB-level postings...

are made in a timely fashion, giving others an opportunity to respond are thoughtful, and analyze the content or question asked make connections to previous or current content or to real-life situations, but the

connections are unclear, not firmly established or are not obvious contain novel ideas, connections, and/or real-world applications, but they may lack depth,

detail and/or explanation

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C Discussion (6) - participated 1 time, minimum of 2 postsC-level postings...

are usually, but not always, made in a timely fashion are generally accurate, but the actual information they deliver seems thin and

commonplace make limited, vague connections between class readings and postings by other students contain few novel ideas, reflecting what other students have already posted, and what

class readings clearly articulate

D-F Discussion (0-5) - participated 1 time, 1 postD & F-level postings...

are not made in a timely fashion, if at all, keeping other students from reading and responding

are rudimentary and superficial, lacking any degree of analysis or critique contribute no novel ideas, connections, or real-world applications may be completely off topic

Examination of Healthcare Sector Group ProjectThe examination of the a healthcare sector assignment is a PowerPoint presentation that provides an overview of a segment of the healthcare industry of group’s choice, subject to approval of the instructor. Examples of healthcare sectors include but are not limited to: long tem care, home health care, hospice, mental health services, substance abuse treatment, care of incarcerated populations, acute care, ambulatory care and rehabilitation services. Paper is to include a brief overview of the patient population, major licensed-independent practitioners and other healthcare providers working in that environment and key reimbursement methods used. Issues of cost, access and quality and two challenges currently facing the sector must be also be addressed.

Examination of Healthcare Sector Group Project RubricOverview Each team will research a healthcare delivery topic and present your findings from an applied

healthcare perspective. Each project team will take the role of an internal or external consultant tasked with providing a managerial “briefing” regarding the issue along several dimensions:A description and assessment of the issue.A discussion of the potential impact of the issue on current healthcare issues/practicesRecommendations for managers regarding how to best deal with the issue going forward.

You should provide specific examples of how this issue impacts current healthcare delivery system.

Examples of healthcare sectors related to Access, Cost, and Quality includes but is not limited to: long term care, home health care, hospice, mental health services, substance abuse treatment, acute care, ambulatory care and rehabilitation services.

Description: In groups of 4 to 5, research a current topic in healthcare delivery related to Access, Cost, and Quality.

All topics are to be approved by me to ensure the scope is not too broad or narrow.

Deliverables15 minute PowerPoint presentation including voice to be submitted to digital drop boxPowerPoint slides must be referenced to source Bibliography as Word documentOne online evaluation of each team member (do not include one for yourself)

My Grading Your group will be graded on the presentation. The breakdown is provided below:

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75%

Class Grading 25%

Criteria Description %Presentation Style

o speak at appropriate volumeo ability to describe concepts in manner understandable to

audienceo demonstrate enthusiasm in subject mattero Ability to present presentation in time allotted (15 minutes)o slides clearly identify key points to serve as study guides for

students – bullet formato Concepts on slides must be referenced to source materialso Include bibliography as last slideo Presentation reflects firm understanding of subject matter and

identifies the salient issues

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Overview of Topic: Access, Cost, Quality

o Review of how the topic works in terms which can be understood by the audience

o Description of similar topics/services/issues that exist if appropriate

o What changes need to be made and will this enhance or replace a current service/issue

o Overview of the patient populationo How will it be made available and to what type of healthcare

consumero Major licensed-independent practitioners and other

healthcare providers working in that environment and key reimbursement methods used

20

Healthcare Advantages and Disadvantages

o Review of why this topic/service is prevalent or needed in healthcare. A description of the healthcare advantages or disadvantages which are making this issue increasingly prevalent in the healthcare marketplace. In other words, what is the need in the heatlhcare arena that can be satisfied by the implementation/use of this topic/service.

o What healthcare professionals/services use it (if any) and for what? Are they successful?

30

Impediments to adoption

o What problems exist with the topic/service and can the deployment of this have an impact on all areas of Access, Cost, Quality or if not, which ones and why.

o Is technology an impediment?o Is it a threat to an existing topic or service? If so what topic or

service?

30

Quality of Bibliography and research

o Were the research materials from high quality reputable sources?

10

Topic Allocation

o As soon as you identify your group, e-mail me with a listing of the first and last name of each group member

o Send an email to me of your topic and I will get back to you

Topics To be submitted by the third class and approved by me.

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Referencing items

You should have at least 10 sources.

References for the presentation must come from professional sources and professional journals

In addition, all documents must be available on the web.

Interviews with users of the topics/services are encouraged if available but should be supported or refuted with information available from published sources. For instance, if the interviewee says that the EMR was extremely expensive to implement, find a source that either agrees or disagrees with this concept.

Be careful of using vendors as a source without substantiation from another source. Clearly a vendor has a vested interest in portraying his product in the best light

References in "References" section

Sequence: Entries should be ordered alphabetically (in text and References section) according to authors' or editors' last names, or the title of the work for items with no author or editor listed. References in text must be included in Reference section and vice versa. References in text should be of the format: (Jones et al. 1995; Smith 1996).

References to items in periodicals: Author, title, journal, volume, number, month, year, pages. For authors, last names are given first, even for multiple authors.

References to reports or proceedings: Author's name and title of report (same style as above), report number, source, editor or publisher as appropriate, city and state, including date and pages.

References to Web pages: Author's name and title of Web page (same style as above), source and URL. Example:

Kock, N., Avison, D., Baskerville, R., Myers, M. and Wood-Harper, T. "IS Action Research: Can we Serve two Masters?," International Conference on Information Systems Internet Panel Supplement, 1999, http://ww2.cis.temple.edu/kock/ICIS99/ISARpanel/.

To cite files available on the WWW, give the author's name, last name first (if known); the full title of the work, in quotation marks; the title of the complete work (if applicable), in italics; any version or file numbers; and the date of the document or last revision (if available). Next, list the protocol (e.g., "http") and the full URL, followed by the date of access in parentheses.

Burka, Lauren P. "A Hypertext History of Multi-User Dimensions." MUD History. 1993.

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Schedule – Six Week Summer Session

Week Topic ReadingJuly 6 Chapter  12  Cost, Access, and Quality

Patient Protection and Affordable Care Act (ACA) Section 3022 Accountable Care Organizations (ACOs)Medical Home Model

Shi & Singh Chapter  12  Cost, Access, and Quality

Recommended Reading:AHRQ 2010 National Healthcare Quality Report. Available at: http://www.ahrq.gov/qual/nhqr10/nhqr10.pdf

Institute of Medicine. America's Uninsured Crisis: Consequences for Health and Health Care. 02; 2009. Report brief available at: http://www.iom.edu/Reports/2009/Americas-Uninsured-Crisis-Consequences-for-Health-and-Health-Care.aspx

July 11 Overview and Historical Perspective of Healthcare in the United StatesOn-line Class

Shi & Singh Chapter  1  A Distinctive System of Health Care Delivery

Shi & Singh Chapter  2  Beliefs,Values, and Health

July 13 Health Care Financing Shi & Singh Chapter  6  Health Services Financing

Recommended ReadingHow Private Insurance Works: A Primer (Kaiser Family Foundation) Available at: http://www.kff.org/insurance/upload/How-Private-Insurance-Works-A-Primer-Report.pdf

Robert Wood Johnson Foundation. (2009). Health Policy Brief: The federal government’s role in financing anddelivering health care. Available at: http://www.rwjf.org/files/research/82409healthaffairs7.pdf

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Week Topic ReadingJuly 18 Health Care Providers

Professional Staff OrganizationOn-line Class

Shi & Singh Chapter  3  The Evolution of Health Services in the United States

Shi & Singh Chapter  4  Health Services Professionals

Recommended Reading   Whelan. L. (2006). Competency assessment of nursing staff. Orthopedic Nursing. 25(3):198-202

Bass BL. et. al. (2009). Surgical privileging and credentialing: a report of a discussion and study group of the American Surgical Association. Journal of the American College of Surgeons. 209(3):396-404

  Outpatient and Primary Care Services   Inpatient Facilities and Services   

Shi & Singh Chapter  7  Outpatient and Primary Care Services Shi & Singh Chapter  8  Inpatient Facilities and Services   

July 20

July 25 Managed Care and Integrated OrganizationsLong Term Care On-line Class

Shi & Singh Chapter  9  Managed Care and Integrated OrganizationsShi & Singh Chapter  10  Long-Term Care

Recommended ReadingCowart, M E. (1996). Long-term care policy and the American family. Journal of Aging & Social Policy. 7(3-4):169-84

July 27 Health Services for Special Populations Shi & Singh Chapter  11  Health Services for Special Populations

Recommended ReadingExecutive Summary and Vision of the Future Sections from the Surgeon Generals Report on Mental Health (1999). Available at: http://www.surgeongeneral.gov/library/mentalhealth/home.html

Aug 1 Health Policy Patient Protection and Affordability Act of 2009On-line Class

Shi & Singh Chapter  13  Health Policy

Recommended ReadingOberlander, J. (2010) Long Time Coming: Why Health Reform Finally Passed. Health Affairs Vol 29;6;1112-1116

Kaiser Family Foundation. Americans Remain Divided on Health Reform But Are Confused About The Law And How And When It Will Affect Them . Available at: http://www.kff.org/kaiserpolls/8067.cfm

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Week Topic ReadingAug 3 Emerging Topics

Discussion of Healthcare Sector Assignment Projects Discussion of Health Care Ethical Issue Articles

Chapter  14  The Future of Health Services Delivery

Recommended ReadingStudent’s selection of one article either Kennedy Institute of Ethics Journal and The Hastings Center Report. (Available through Temple Library) and at: http://muse.jhu.edu/journals/

Aug 8 Project Presentations Prep ClassFinal Exam distributed

Aug 9 Presentations are due to me by 9:00 a.m.Aug 10 Project PresentationsAug 15 Final Exam

Course Evaluation

Blackboard o Blackboard is Temple’s comprehensive e-Learning platform used to deliver and manage course material on the web. You can use Blackboard to access course material, view your grades, and easily communicate with your instructor and classmates through e-mail and discussion forums. To activate a Blackboard account visit https://accounts.temple.edu.

o Students are responsible for checking the site daily for updates. Availability of Instructor

o I have posted office hours. During this time you should feel free to come by to discuss any issues related to this class. In addition, I am available by appointment for meetings outside of the scheduled office hour times.

o Please send an email requesting an appointment. I will try and accommodate your time constraints.

o Please also feel free to discuss issues with me via e-mail.

Reading and Class Participate

o The primary source of material for this course is the textbook. Please read assigned material before class as this will allow you to participate fully in class discussion.

o You are strongly encouraged to discuss your experiences on the job Class Etiquette o Please be respectful of the class environment.

o Cell phones, pagers, and laptop computers must be turned off and put away during class. Attendance Policy

o Class participation is intended to be an integral part of the course. Accordingly, regulr on-time full attendance is expected.

Academic Honesty

o Students are expected to comply with University and HIM Department guidelines regarding academic honesty. More information is available in the Graduate Bulletin at: http://www.temple.edu/grad/policies/index.htm and the MSHI Student Handbook available at: http://www.temple.edu/chpsw/departments/him/documents/HIstudenthandbookfinal_000.pdf

Exams o There will be one exam during the semester. Exam will be given when scheduled except in the case of extreme circumstances. Documentation for reason for change of exam date will be requested.

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Grades o Any discrepancies in grades must be brought to the instructor’s attention via e-mail within 1 week of the time the grade is posted to Blackboard.

Disability Accommodation

o It is Temple University’s policy to provide reasonable accommodations to students with disability under the ADA.  At the beginning of each semester, any student with a disability should inform the course instructor if instructional accommodations or academic adjustments will be needed.  For more information about the ADA and academic adjustments, contact the Office of Disability Resources and Services at 215-204-1280.

Freedom to Teach and Learn

o Freedom to teach and freedom to learn are inseparable facets of academic freedom. The University has adopted a policy on Student and Faculty Academic Rights and Responsibilities (Policy # 03.70.02) which can be accessed through the following link: http://policies.temple.edu/getdoc.asp?policy_no=03.70.02.  

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