Medicine and Health Sciences Commons^™

Managed Care And Accountable Care Organizations, David P. Paul, Diego Arroyo, Bethany Daniel, Heather Graves, Krisitn Neal, Alberto Coustasse

Management Faculty Research

Managed care generally, and more specifically, accountable care organizations (ACOs) have attempted to provide coordination of patient care in order to eliminate or reduce unnecessary procedures and or test redundancy. The purpose of this research was to study the effects of managed care in accountable care organizations by decreasing health care costs by increasing efficiency in health care.

Can Utilizing A Computerized Provider Order Entry (Cpoe) System Prevent Hospital Medical Errors And Adverse Drug Events?, Krista Charles Ms, Margaret Cannon Ms, Robert Hall Ms, Alberto Coustasse Drph, Md, Mba, Mph

Management Faculty Research

Computerized provider order entry (CPOE) systems allow physicians to prescribe patient services electronically. In hospitals, CPOE essentially eliminates the need for handwritten paper orders and achieves cost savings through increased efficiency. The purpose of this research study was to examine the benefits of and barriers to CPOE adoption in hospitals to determine the effects on medical errors and adverse drug events (ADEs) and examine cost and savings associated with the implementation of this newly mandated technology. This study followed a methodology using the basic principles of a systematic review and referenced 50 sources. CPOE systems in hospitals were found to …

A Business Case For Tele-Intensive Care Units, Alberto Coustasse, Stacie Deslich, Deanna Bailey, Alesia Hairston, David Paul

Management Faculty Research

Objectives: A tele-intensive care unit (tele-ICU) uses telemedicine in an intensive care unit (ICU) setting, applying technology to provide care to critically ill patients by off-site clinical resources. The purpose of this review was to examine the implementation, adoption, and utilization of tele-ICU systems by hospitals to determine their efficiency and efficacy as identified by cost savings and patient outcomes.

Methods: This literature review examined a large number of studies of implementa­tion of tele-ICU systems in hospitals.

Results: The evidence supporting cost savings was mixed. Implementation of a tele- ICU system was associated with cost savings, shorter lengths of stay, …

Personal Health Records: Is Rapid Adpoption Hindering Interoperability?, Jana Studeny, Alberto Coustasse

Management Faculty Research

The establishment of Meaningful Use criteria has created a critical need for robust interoperability. A universal definition for a Personal Health Records (PHRs) has not been agreed upon. Standardized code sets have been built for specific entities but integration between them has not been supported. The purpose of this research study was to explore the hindrance and promotion of interoperability standards in relationship to PHRs to describe interoperability progress in this area. The methodology for this study was conducted following the basic principles of a systematic review, with 61 articles used for this research study. Lagging interoperability has been stemmed …

Medicare Fraud In The United States: Can It Ever Be Stopped?, Chelsea Hill, Alex Hunter, Leslie Johnson, Alberto Coustasse

Management Faculty Research

The majority of the United States health care fraud has been focused on the major public program, Medicare. The yearly financial loss from Medicare fraud has been estimated at about $54 billion. The purpose of this research study was to explore the current state of Medicare fraud in the United States, identify current policies and laws that foster Medicare fraud, and determine the financial impact of Medicare fraud. The methodology for this study was a literature review. Research was conducted using a scholarly online database search and government Web sites. The number of individuals charged with criminal fraud increased from …

Expanding Technology In The Icu: The Case For The Utilization Of Telemedicine, Stacie Deslich, Alberto Coustasse

Management Faculty Research

Introduction: Telemedicine has been utilized in various healthcare areas to achieve better patient outcomes, lower costs of providing services, and increase patient access to care. Tele-intensive care unit (ICU) technology has been introduced as a way to provide effective ICU services to patients with reduced access, as well as to decrease costs and improve patient care.

Materials and Methods: The methodology for this qualitative study was a literature search and review of case studies. The search was limited to sources published in the last 10 years (2003–2013) in the English language. In total, 55 references were used for this research …

Electronic Prescribing: Improving The Efficiency And Accuracy Of Prescribing In The Ambulatory Care Setting, Amber Porterfield, Kate Engelbert, Alberto Coustasse

Management Faculty Research

Electronic prescribing (e-prescribing) is an important part of the nation's push to enhance the safety and quality of the prescribing process. E-prescribing allows providers in the ambulatory care setting to send prescriptions electronically to the pharmacy and can be a stand-alone system or part of an integrated electronic health record system. The methodology for this study followed the basic principles of a systematic review. A total of 47 sources were referenced. Results of this research study suggest that e-prescribing reduces prescribing errors, increases efficiency, and helps to save on healthcare costs. Medication errors have been reduced to as little as …

Reduction Of Intensive Care Unit Length Of Stay: The Case Of Early Mobilization, Alex Hunter, Leslie Johnson, Alberto Coustasse

Management Faculty Research

Bed rest or immobilization is frequently part of treatment for patients in the intensive care unit (ICU) with critical illness. The average ICU length of stay (LOS) is 3.3 days, and for every day spent in an ICU bed, the average patient spends an additional 1.5 days in a non-ICU bed. The purpose of this research study was to analyze the effects of early mobilization for patients in the ICU to determine if it has an impact on the LOS, cost of care, and medical complications. The methodology for this study was a literature review. Five electronic databases were used, …

The American Epidemic: The U.S. Nursing Shortage And Turnover Problem, Patrick Cox, William K. Willis, Alberto Coustasse

Management Faculty Research

Introduction: Nursing shortages have been on the rise throughout the country which has continued to become a problem due to an aging baby-boomer population causing increased turnover through the United States (U.S.). With this need for nurses expected to rise, determining the root causes of this problem are essential for health care providers as costs continue to grow.

Methods: The methodology for the qualitative study was a literature research review of case studies as well as a semi-structured interview. Five electronic databases were minded. Thirty-six articles were utilized in this study.

Results: Through the use of a conceptual framework the …

How Effective Is Capitation At Reducing Health Care Costs?, David P. Paul Iii, Jennifer Brunoni, Tasha Dolinger, Irina Walker, Danielle Wood, Alberto Coustasse

Management Faculty Research

Due to skyrocketing healthcare costs in the U.S., several strategies, including capitation, have been utilized to reduce overall cost. Capitation has helped to contain costs by placing a limit on the amount of reimbursement that is offered to the provider for specific types of patients and care. In order for physicians to improve their profitability under capitation, their practices must become more cost efficient. The purpose of this research was to analyze the effects of capitation on the overall reduction of healthcare cost.

Medical Education, Pdas And Smartphones: Welcome To The 21st Century, David P. Paul, Nicole Moussa, Sara Asad, Brad Pershing, Alberto Coustasse

Management Faculty Research

PDAs and Smartphones allow medical professionals to access medical information more easily than ever before. This literature review examines use of these devices and associated “apps” in medical education, finding widespread use by medical students, residents, and faculty. Surprisingly, little generational bias was noted.

Early Mobilization In Icu Patients, Alex Hunter, Leslie Johnson, William Willis, Alberto Coustasse

Management Faculty Research

Introduction: Bed rest or immobilization is frequently part of treatment for patients in the intensive care unit with critical illness. The average intensive care unit length of stay was 3.3 days and for every day spent in an intensive care unit bed, the average patient spent an additional 1.5 days in a non-intensive care unit bed. Daily costs have increased more than 30% from 2000-2005 with an average daily cost of $3518. Weaning from mechanical ventilation has been correlated with increased intensive care unit and hospital length of stay. Mechanical ventilation has been correlated with the development of intensive care …

Does Computerized Physician Order Entry Reduce Medical Errors?, Krista Charles, William K. Willis, Alberto Coustasse

Management Faculty Research

Introduction: Computerized Physician Order Entry (CPOE) is a system that allows physicians to electronically order patient services. The services that can be ordered, but are not limited to include: prescriptions, labs, x-rays, and referrals. Adopting CPOE will eliminate the use of paper orders with illegible hand writing. The purpose of this research project was to examine the cause of medical errors and to determine if adopting a CPOE system would be an effective solution to this problem.

Results: The results of this study show that CPOE can reduce medical errors and adverse drug events significantly. CPOE coupled with other systems …

Medical Tourism: Comparing Coronary Bypass Surgery In The U.S. And Abroad, William K. Willis, Alberto Coustasse

Management Faculty Research

Rising health care costs have employers searching for remedies to the increasing rates they pay for employee health insurance. The development of U.S. health insurance policies, with the option of utilizing medical tourism as a low cost care provider for treatment of cardiac coronary bypass surgery provides a method for receiving treatment. The medical tourism approach to providing treatment for bypass surgery has prompted hospitals in India, Thailand, and Singapore to seek U.S. patients. A comparison of costs for bypass treatment between the U.S. and these countries illustrates some of the issues and concerns that arise when making such comparisons. …

Financial Advantages Of Hospitals’ Relationships With Accountable Care Organizations, David P. Paul Iii, Rodrigo Carmago, Thaisa Carmago, Stacie Deslich, Alberto Coustasse

Management Faculty Research

Accountable care organizations are groups of providers who agree to accept the responsibility for elevating the health status of a defined group of patients, with the goal of enabling people to take charge of their health and enroll in shared decision-making with providers. The large initial investment required (estimated at $1.8 million) to develop an ACO implies that the participation of large health care organizations, especially hospitals and health systems, is required for success. Findings of the study suggest that ACOs based in a larger hospital organizations are more likely to meet CMS criteria for formation because of financial and …

The Business Case For The Efficiency And Effectiveness Of Tele-Intensive Care Units, David P. Paul, Deanna Bailey, Alesia Hairston, Stacie Deslich, Alberto Coustasse

Management Faculty Research

A tele-Intensive Care Unit (tele-ICU) is the use of telemedicine in an Intensive Care Unit (ICU) setting, using technology to provide care to critically ill patients by off-site clinical resources. This literature review examined a large number of studies of the implementation of tele-ICU systems in hospitals. Generally, implementation of a tele-ICU system was associated with cost savings, shorter lengths of stay, and decreased mortality. Implementation of tele-ICUs is initially relatively expensive but result in cost savings and better clinical outcomes. Intensivists working these systems are used more effective providing better clinical outcomes for patients at lower costs for hospitals.

Electronic Prescribing And Its Implementation In The United States, Kate Englebert, Amber Porterfield, William K. Willis, Alberto Coustasse

Management Faculty Research

Introduction: Electronic prescribing (e-prescribing) is an important part of the nation’s push to create an electronically accessible national health system. E-prescribing allows providers to send prescriptions electronically to the pharmacy and can be stand-alone systems or part of an integrated electronic health record system.

Methodology: The methodology for this study was a literature review. Electronic databases accessed include EBSCOhost, PubMED, and Google Scholar. Additionally, government websites and a semi-structured interview were used. A total of 39 sources were referenced for the review.

Results: The results of the literature review demonstrated that e-prescribing reduces prescribing errors, increases efficiency, and helps save …