AMBULATORY CARE INFORMATION SYSTEM

Provides automated processing of data and information such as allergies and medical alerts, patients accounting system such as charging, billing, discounts and concessions, diagnostics imaging treatments, and etc. With this system, the patient waiting time is optimized through effective queue management. It involves one-time registration required per visit. It also facilitates the management of doctors schedule.

WHERE AMBULATORY CLIENTS ARE BEING TREATED

-Covers a wide range of health care services that are provided for patients who are not admitted overnight to a hospital.

ORGANIZATION OF AMBULATORY HEALTH CARE

Ambulatory clinics and surgery centers Singleand multispecialty group practices Diagnostic laboratories Health maintenance organizations

Independent physician associations

Birthing centers College and university health services

OTHER ORGANIZATIONS THAT SERVE AMBULATORY POPULATION:

Faculty medical practices Community health centers Prison health centers Indian health centers Hospital-sponsored ambulatory health services

Urgent and immediate care centers

Office-based surgery centers and practices Pain management clinics Podiatry offices

Networks
Mobile clinics Nurse managed centers Groups of ambulatory care organizations

SINGLE SPECIALTY PROVIDER OFFER CARE IN SETTING SUCH AS:

Birthing centers Cardiac catheterizations centers Dental clinics Dialysis centers Endoscopy centers Imaging centers Podiatric clinics Radiation/ oncology clinics Rehabilitation centers Sleep centers Urgent/ emergency care centers Womens health centers

Infusion therapy services

Laser centers Lithotripsy services MRI centers

Ophthalmology practices
Oral and maxillofacial surgery centers Pain management centers

Plastic surgery centers

ISSUES FOR AMBULATORY CARE

Increased accountability

The need for continuous and documented service improvements

Pressures to control utilization Protection of confidential information Integration and support to the other system

APPLICATIONS NECESSARY IN THE AMBULATORY ENVIRONMENT

Ambulatory care information systems, usually computerassisted, are designed to store, manipulate, and retrieve information for panning, organizing, directing, and controlling administrative and clinical activities associated with provision and use of ambulatory care services and facilities.

MAJOR APPLICATIONS AREAS NEEDED IN THE AMBULATORY ENVIRONMENT:

Registration Billing Accounts receivable Accounts payable

Patient and staff scheduling

Managed care functionality

BENEFITS THAT CAN BE ACHIEVED BY USING ELECTRONIC RECORDS

Financial
Administrative Clinical areas

FINANCIAL BENEFITS OF AUTOMATED INFORMATION SYSTEM

Cost effective and timely bill submission process resulting in decreased days in accounts receivable and the reduction of rejected claims. Larger ambulatory care organizations use electronic data interchange (EDI) to automate the exchange of data such as claims, submittals, and remittances and health plan eligibility information. Some organization provides integrated credit card payment applications so that patients may use credit cards, which are processed immediately In the ideal electronic system, claims are edited rejected which necessitates further processing, costing, time, and money.

THE ROLE OF NURSE USING INFORMATION SYSTEM IN THE AMBULATORY CARE SYSTEM
The very basic objective of the automated ambulatory care information system is to easily integrate the data to the other data and easily translate these data into information. The effective transformation of data can be integrated to the other processes to transform it into knowledge. The ambulatory care nurse and other health care provider should be capable enough to implement the process effectively.

MEMBER ASSOCIATIONS INVOLVED IN AMBULATORY CARE

American Academy of Ambulatory Care Nursing (AAACN) An organization specifically for nurses that offers networking opportunities for the membership by geographic location through local networking groups and by specialty practice through SIGs (special interest group) American Medical Informatics Association (AMIA) -has physicians and nurses whose working groups include the Primary Care Informatics Working Group

-Spring 2005 meeting was dedicated to Best Practices for ACPOE and Population management with EHR

MEDICAL GROUP MANAGEMENT ASSOCIATION (MGMA)

-founded in 1992 -based In Colorado A major organization in U.S representing physicians in group practice nationwide -19,00 individuals are members, representing more that 237,000 physicians. The organization supports : Networking Job recruitment Research Political action - associated with the American Hospital Association. -an organization of management professionals across the continuum of healthcare services They offer, networking opportunities, education, publications and legislative advocacy

Society for Ambulatory Care Professionals

Federated Ambulatory Surgery Association (FASA)

Non-profit association representing the interests of ambulatory surgery centers in the united sates. It represents physicians nurses, and administrative staff, congress, legislatures and regulatory bodies

American Association of Ambulatory Surgery Centers (AASC)

An association that promotes advocacy at the national level through relationships with the CMS and Congress, networking and educational opportunities.

Association for Ambulatory Behavioral Healthcare

Is an international organization of ambulatory mental healthcare providers dedicated to the delivery of high-quality psychiatric and chemical dependency treatment within a continuum care.
Started in 1975 based in Fairfax, Virginia

American Health Information Management Association (AHIMA)

Its purpose is to foster the professional development of its members through education, certification and lifelong learning thereby promoting quality information ot benefit the public, the healthcare consumers, providers, and other users of clinical data in any health care setting

Healthcare Information Management Systems Society It formed the ambulatory care committee HIMSS ambulatory care Initiative was created in response to trends such as the aging population, the increasing prevalence of chronic diseases and development of minimally invasive procedures.

Accreditation Organizations -validate standards of practice and promote quality care.

Accreditation Association for Ambulatory Care

COLA

A not-for-profit organization formed on 1979

Its mission is to develop standards and conduct a survey and accreditation program Headquartered In Columbia, Maryland Non-profit, physician directed and national accrediting organization Its purpose is to promote excellence in medicine and patient care through programs of voluntary education, achievement, and accreditation A private, not-for profit organization dedicated to assessing and reporting on the quality of managed care plans

National Committee for Quality Assurance

JOINT COMMISSION ON ACCREDITATION OF HEALTHCARE ORGANIXATIONS

Published management of information standards for ambulatory care.

Journals and conferences: Journal of Ambulatory Care Management

Issue focuses on one topic of interest related to ambulatory care.

Ambulatory Pediatrics is a publication of the ambulatory Oediatric Association, it started in 1999. Journal for Healthcare Quality a publication started in 1979 by the national association for healthcare quality

CONFERENCES THAT FOCUS ON INFORMATION TECHNOLOGY NEEDS OF THE AMBULATORY CARE ARENA:
Medical group Management Association which provide a wide range of educational programs on topics that medical group practices need to be aware of
American Medical- Informatics Association primarily discusses hospital and clinic use of technology

FUTURE DIRECTIONS FOR THE ADOPTION OF INFORMATION TECHNOLOGY IN AMBULATORY CARE

Ambulatory practices:
-use of electronic mail -computer interviewing -voice recognition

-handwriting
-recognition smart card technology -wireless devices -BIOMETRICS