Medicine and Health Sciences Commons^™

Self-Inflicted Injuries: Designation For Risk Assessment Or Cost Avoidance, Brianna M. Robertson, Ralph E. Mckinney Jr., Lawrence P. Shao

Psychiatry

This paper considers the denial of health insurance benefits based on a participant's high-risk behaviors such as self-inflicted injuries. In many instances, healthcare benefits can be denied if patients are injured while engaging in criminal activities, from a self-infliction, and from injuries relating to the consumption of alcohol. With increases in healthcare expenditures and government regulation, the necessity for benefit reductions is directed at individuals engaging in high-risk behaviors. The belief is that high-risk behaviors can be modified by individuals. Unfortunately, modification of behaviors may not be available to everyone.

Burnout Syndrome In Hospital's Nurses: Causes And Consequences, Lama Bakhamis, Harlan M. Smith Ii, Alberto Coustasse, David P. Paul Iii

Management Faculty Research

PURPOSE: The purpose of this research was to examine the causes and consequences of Burnout Syndrome among RNs in U.S. hospitals to identify solutions to this problem.

METHODS: The methodology was the review of the literature and a semi-structured interview. There were seven primary databases and two websites used in this research, and 35 articles were used for this literature review.

RESULTS: Causes and risk factors of burnout syndrome among RNs have been categorized into four major areas: individual, management, organizational, and work characteristics. Burnout syndrome rate among RNs with age under 30 years was 43.6% higher …

Ransomware In Healthcare Facilities: The Future Is Now, Nikki Spence, David P. Paul Iii, Alberto Coustasse

Management Faculty Research

Cybercriminals have begun to target the healthcare industry with a type of malware called ransomware, malware that encrypts an infected device and any attached devices or network drives. After encryption, cybercriminals demand a sum of money, also known as a “ransom,” to release the devices from encryption. Without adequate disaster recovery and backup plans, many businesses are forced to pay the ransom. The purpose of this study was to determine the extent of recent ransomware infections in healthcare settings, the risk liabilities and cost associated with such infections, and to determine possible risk mitigation tactics. Financial costs associated with business …

Use Of Smartphones For Clinical And Medical Education, Jazmine Valle, Tyler Godby, David P. Paul Iii, Harlan M. Smith Ii, Alberto Coustasse

Management Faculty Research

Introduction: Smartphones for clinical and medical education have been on the rise and show contribution to healthcare and healthcare providers. Smartphones in healthcare facilities has been examined for utilization and efficacy, however, although the advantages are abundant some healthcare facilities and providers are reluctant to change due to threat of mixing personal apps with clinical care applications, distraction to the provider using the smartphone which has led to medication errors followed by errors linked to procedures, treatments, or tests. The purpose of this research was to examine the effects of smartphones in a clinical setting and for medical education to …

Provider Reimbursement Following The Affordable Care Act, Brandon Bowling, David Newman, Craig White, Ashley Wood, Alberto Coustasse Dr. Ph, Md, Mba

Management Faculty Research

Decreasing healthcare expenditure has been one of the main objectives of the Affordable Care Act (ACA). To achieve this goal, the Centers for Medicare and Medicaid Services (CMS) has been tasked with experimenting with provider reimbursement methods in an attempt to increase quality, while decreasing costs. The purpose of this research was to study the effects of the ACA on physician reimbursement rates from CMS to determine the most cost effective method of delivering healthcare services. CMS has experimented with payment methods in an attempt to increase cost effectiveness. Medicare has offered shared cost savings incentives to reward quality care …

Why Physicians Switch Electronic Health Record Vendors, Pete Andresen, Michelle Shussler, Kyle Sowards, Alberto Coustasse Dr.Ph. Md

Management Faculty Research

There are many factors involved when a physician chooses to switch Electronic Health Record [EHR.] vendors including system functionality, cost, poor customer service, company reputation, platform of software, meaningful use certification, and various others. The purpose of this research study was to locate the various reasons that lead to switching vendors and the barriers and benefits associated with doing so. System functionality and cost were the two largest deciding factors in switching vendors. Shifting regulatory standards require additional functionality to fulfill quality reporting measures including the Meaningful Use and Physician Quality Reporting Systems standards and many physicians and health systems …

Big Data: Harnessing The Beast!!, Rebecca Hovemeyer, Debra Stinson, Beteseb Gebremariam, Alberto Coustasse Dr. Ph, Md, Mba

Management Faculty Research

The healthcare industry’s growing use of health information technology has contributed to the enormous accumulation of health care data, leading to active use of the term big data. Although there has been large amounts and varieties of complex data captured during patient care, this data has remained vastly underutilized. The purpose of this study was to assess the variety of benefits and barriers of obtaining meaningful information from big data in healthcare.

The methodology utilized was a qualitative literature review that referenced 17 sources published between 2005 and 2016.Findings suggest that applied big data analytics within the healthcare arena can …

Icd-10 Implementation: Is The Workforce Ready?, David P. Paul Iii, D.D.S., M.B.A., Ph.D, Patricia A. Sacconi, Pamela Ann Glover, Robert Marriot, Alberto Coustasse Dr. Ph, Md, Mba

Management Faculty Research

After many delays, the U.S. finally implemented ICD-10-CM/PCS on October 1, 2015, bringing the U.S. into line with other industrialized nations, most of which have been using ICD-10 for many years. We outline the benefits and challenges to the preparatory activities of the ICD-10-CM/PCS implementation for the U.S. healthcare industry. To ease the transition, CMS allowed healthcare facilities to submit test claims prior to the implementation date, and delivered feedback on the acceptability of those claims. Early results indicated a relatively smooth transition, although some questions regarding the available data remain. Additional data, especially data concerning outcomes, is required.

The Trends In Dtca And Effects Of Dtca By Pharmaceutical Firms In The United States, Sathorn Preechavuthinant, William K. Willis Drph, Alberto Coustasse Drph, Md, Mba

Management Faculty Research

The Direct-to-Consumer Advertising (DTCA) of pharmaceutical firms has been defined as an attempt of pharmaceutical companies to advertise products directly to patients (comsumers). Pharmaceutical DTCA has been criticized due to its inappropriateness and some urged the need to strengthen regulations. The DTCA has an impact on the public from both a benefit and harm concern. The purpose of this study is to investigate the current trend of pharmaceutical DTCA in the US and its effect on patients, physicians, and drug utilization. The methodology used in the research is literature review and semi-structured interview. The pharmaceutical DTCA showed reduction in total …

Medicare Fraud, Waste And Abuse, Jamie Bush, Leslie Sandridge, Cierra Treadway, Kimberly Vance, Alberto Coustasse Dr. Ph, Md, Mba

Management Faculty Research

In 2014, the U.S. spent approximately $3 trillion on health care. Medicare accounted for $554 billion of these costs and around $60 billion were squandered due to incorrect billing methods, abuse, and fraud. Types of fraud included: kickbacks, up coding, and organized fraudulent crimes. To reduce the financial burden associated with these activities, the U.S. has created various fraud prevention programs. The purpose of this study was to identify methods of Medicare fraud, examine the various programs implemented by the U.S. government to combat fraud and abuse, and determine the effectiveness of these programs. While fraud prevention strategies have proven …

Long-Term Care Policy: What The United States Can Learn From Denmark, Sweden, And The Netherlands, David P. Paul Iii, D.D.S., M.B.A., Ph.D, K. Chad Schaeffer

Management Faculty Research

Paying for long-term care consumes a substantial, and growing, part of the spending on healthcare in the U.S. We examine the components and payment systems for long-term care systems in Denmark, Sweden and the Netherlands to determine what policy makers in the U.S. can learn from these countries about how to improve long-term care provision and financing in the U.S.

West Virginia Needle Exchange Program, Briana Washington, Sara Johnson

Theses, Dissertations and Capstones

Introduction: Needle Exchange Programs (NEPs) have been controversial aspects of public healthcare due to conflicting beliefs and opinions for public policies. NEPs allow Injection Drug Users (IDUs) the ability to exchange their used equipment for clean, unused supplies.

Purpose: The purpose of this literature review was to determine the effectiveness of needle exchange programs and the impact it has had on the reduction of HIV and viral hepatitis infections in people who inject drugs. It further explores if these strategies have had a positive impact on the reduction of HIV and viral hepatitis C in West Virginia.

Methodology …

Balance Score Card In Health Care Organization, Vani Pathuri, Huanyu Wang

Theses, Dissertations and Capstones

Balance Score Card is a strategic planning and management system and it helps in observing organizational business activities. This approach has improved the organizational performances. It has four perspectives of vision and strategy listed as financial, internal business, learning and growth, and customer perspective. A semi structured interview has been taken with Tanya Morton, who is ‎an Assistant Director of Nursing at Cabell Huntington hospital. Hospital graphs have shown that the utilization of BSC with Nurse Department have become more satisfied during the eight years, and the remaining three departments also showed satisfactory report with BSC.

Is Interoperability A Hindrance To The Nationwide Health Information Exchange (Nhie)?, Nitesh Patil, Sruthi Katamneni

Theses, Dissertations and Capstones

Introduction: HIE is the exchange of clinical data as well as healthcare data among the providers, healthcare institutions, and data repositories. Nationwide Health Information Network (NHIN), was adopted in the year 2004, under the Office of the National Coordinator for Health Information Technology (ONCHIT) with an objective to share the files electronically securely and in a safe manner.

Methodology: The literature review included 40 references in which information relevant to the purpose of this study was scrutinized; these references met the inclusion criterion. The methodology for this study was an extensive and thorough literature review. The sources utilized in this …

Telemedicine And Its Utilization In The Management Of Chronic Heart Failure Patients, Adejoke Sotome, Chirra Pooja

Theses, Dissertations and Capstones

Introduction: Telemedicine is well developed and very useful for heart failure patients in emergencies. Many cases of heart failures are due to inability of reaching the physicians on time and failure of assessing the patient disease condition at earlier stage.

Methodology: The methodology for this study was a literature review. Electronic databases used included EBSCO Host, Google Scholar, Academic Search Premier, PubMed, ProQuest, and Marshall Digital Scholar. A total of 32 sources were referenced.

Results: This literature review examined several studies and research articles on the significance of Telemedicine in the treatment of chronic heart failure patients with …

An American Epidemic: Burnout Syndrome In Hospital Nurses, David P. Paul Iii, Lama Bakhamis, Harlan Smith, Alberto Coustasse

Management Faculty Research

The number of Registered Nurses (RNs) in the United States (U.S.) is roughly three times that of physicians and surgeons, making RNs a critically important component of the U.S. healthcare system. RN Burnout – defined as the feeling of exhaustion from working long hours without rest – is a real concern, having been reported in many hospitals. The purpose of this research is to examine the causes and consequences of Burnout Syndrome among RNs in U.S. hospitals, in order to identify solutions to this problem. The methodology involves a review of the literature and semi-structured interviews. Seven primary databases, two …

Medicare And The Affordable Care Act: Fraud Control Efforts And Results, Sarah Clemente, Ronald Mcgrady, Rob Repass, David P. Paul Iii, Alberto Coustasse

Management Faculty Research

Medicare fraud and abuse costs are estimated at 3%-10% of overall Medicare spending, which is expected to expand considerably until 2024 and as such the amount of fraud dollars would be expected to increase proportionally. The purpose of this research was to determine how recent reforms, especially the Patient Protection and Accountable Care Act, may affect Medicare fraud and abuse and to uncover the best strategies to combat Medicare fraud. The breadth of fraud and abuse within Medicare as well as recent reforms to fight fraud including legislative reforms, delivery system reforms, and other reforms including the formation of HEAT …