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Related Concept Videos

Methods of Documentation V: CBE01:23

Methods of Documentation V: CBE

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Charting by Exception, or CBE, is a method of documentation used in healthcare, particularly in nursing, that focuses on documenting only significant or abnormal findings rather than recording every detail. This approach aims to streamline the documentation process, improve efficiency, and ensure that healthcare providers can quickly identify deviations from normalcy in patient assessments.
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Documentation in Long-Term and Home Healthcare Setting01:29

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Documentation in long-term care facilities and home healthcare settings is crucial for ensuring continuous, coordinated, and comprehensive care for patients. Each setting has its specific documentation processes and tools:
Long-Term Care Facilities
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Methods of Documentation VI: Case Management Model01:15

Methods of Documentation VI: Case Management Model

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The case management model is a multidisciplinary approach that involves healthcare professionals from diverse disciplines, such as physicians, nurses, therapists, social workers, and pharmacists, working collaboratively to address the various needs of patients. Each healthcare professional brings unique expertise and perspectives, contributing to a more comprehensive understanding of the patient's condition and tailoring treatment plans accordingly.
For example, a patient with a chronic...
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Nursing Clinical Information System01:27

Nursing Clinical Information System

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Nursing Clinical Information System (NCIS)
A Nursing Clinical Information System (NCIS) is a specialized type of healthcare information system tailored to meet the unique needs of nursing practice. It incorporates the principles of nursing informatics to streamline information management and improve the quality of care delivery.
Critical attributes of NCIS include:
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Health Information Technology and Healthcare Information System01:30

Health Information Technology and Healthcare Information System

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Health Information Technology (HIT)
Health Information Technology, commonly called HIT, integrates advanced information systems and technology in healthcare settings. Its primary functions include:
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Methods of Documentation III: PIE01:21

Methods of Documentation III: PIE

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Problem-intervention-evaluation (PIE) is a systematic approach to documentation used in healthcare settings for clinical decision-making and patient care planning. It is a structured approach to organizing patient data based on problems, interventions, and evaluations. Here's a breakdown of its key features and considerations:
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Related Experiment Video

Updated: May 7, 2025

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Assessing Medicare's Coverage With Evidence Development Program.

Maryam Mooghali1, Osman Moneer2, Guneet Janda3

  • 1Maryam Mooghali (maryam.mooghali@yale.edu), Yale University, New Haven, Connecticut.

Health Affairs (Project Hope)
|January 6, 2025
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Summary
This summary is machine-generated.

The Centers for Medicare and Medicaid Services (CMS) coverage with evidence development (CED) program could be strengthened. CMS often relies on lower-quality studies for coverage reconsiderations, missing opportunities to use robust CED-approved evidence.

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Area of Science:

  • Health policy
  • Medical economics
  • Clinical evidence evaluation

Background:

  • The Centers for Medicare and Medicaid Services (CMS) coverage with evidence development (CED) program allows Medicare coverage for items/services lacking "reasonable and necessary" status, contingent on clinical study participation.
  • CMS periodically reevaluates CED decisions based on emerging evidence.

Purpose of the Study:

  • To analyze the characteristics of studies cited by CMS in CED reconsiderations.
  • To assess the quality and representativeness of CED-approved versus non-CED-approved studies used in coverage decisions.

Main Methods:

  • Review of 235 publications cited by CMS for reconsideration of 10 out of 26 CED-approved items/services since 2005.
  • Comparison of study design robustness, sample size, and patient demographics between CED-approved and non-CED-approved studies.

Main Results:

  • CMS reconsidered 38% of CED items/services, citing 235 publications.
  • CED-approved studies (24% of cited evidence) featured more robust designs (67% RCTs vs. 13%), larger enrollment (median 1,000 vs. 125), and greater US patient inclusion (93% vs. 44%) compared to non-CED-approved studies (49% of cited evidence).

Conclusions:

  • CMS's reliance on non-CED-approved studies for reconsiderations, despite their lower quality and representativeness, indicates potential areas for CED program enhancement.
  • Prioritizing higher-quality, CED-approved evidence could improve the rigor and relevance of Medicare coverage decisions.