Other Findings. Based upon information gathered from the subject matter expert (SME) from the EHR company, linking EHRs to EDRs electronically is technologically feasible, data is connected through data mapping and linked via a patient identifier. Interoperability can be supported through a query-based, and push-based approach. Data standards such as Health Level 7® (HL7®), Clinical Data Architecture® (CDA®), and Systemized Nomenclature of Medicine (SNOMED), Fast Healthcare Interoperability Resource® (FHIR®) and Digital Imaging and Communications in Medicine® (DICOM®) is also used for interoperability. Systemized Nomenclature of Dentistry (SNODENT) can be used, however, it requires importing into the system with additional licensing terms and fees for support. Figure 4 below depicts a high-level overview of electronic health and dental record systems linkage. Figure 4 Data Mapping Via Patient Identifier Research also found that Xxxxx Hospital’s ED currently has a very effective dental referral system in place. Patients that present to the ED for non-traumatic dental problems are either referred to Xxxxx’x Oral Surgery Clinic for the treatment of dental infections and extractions, and the remaining patients are referred to dental clinics that perform dental treatment on a sliding scale. Many of the patients that present to the ED for dental problems lack health literacy and the financial resources to pay for treatment. Referring such patients to low-cost dental clinics appears to be a cost-effective solution for the patients and cost-saving solution for Xxxxx’s ED. Patients that return to Xxxxx’s ED are between three to five percent, therefore, it was concluded that Xxxxx currently has an effective solution in place, and linking their EHRs to private-practice EDRs would not be a cost-effective and practical solution for Xxxxx, or private-practice dentists. Further policy measures would need to be put into practice before moving forward with systems integration. Summary Based on the research, there are patient benefits for linking EHRs to EDRs. Oral health disparities would be lowered, provider communication would improve, and better patient treatment decisions could potentially arise from linking the data sources. From a technology standpoint, linking the data sources is feasible and interoperability can be supported. Although linking the data would improve patient outcomes and provider communication, it appears to have its limitations due to indirect provider communicatio...
Other Findings. In response to what increases risk to my patients, 41% said none of the provide options applied to their employment situation, 32% responded that I am required to care for patients with excessive risk, 32% said I am required to manage the care of too many patients in the office, 26% answered my patients regularly request unnecessary interventions, 17% said my practice protocol are not evidence-based, 15% are required to manage the care of too many patients on call, 13% said physicians do not support the plan of care developed by myself and my patients, 8% said patients declined needed interventions, 6% are not currently taking care of patients, 4% selected other, and 2% said back-up physicians do not respond as quickly as I need them to respond. Chapter 5: Discussion/Conclusion Study results show that the restrictions placed on the scope of practice of CNM vary at the practice level. What CNMs are allowed to do at their practices are dependent on the practice agreement/protocol, and the development of these agreement/protocol involve more physicians than CNMs (64% vs. 47%, respectively); these practice protocols/agreements do not allow much room for negotiation (only 39% of CNM were able to negotiate their practice agreement/protocol and 29% did not have the option to negotiate even though they wanted to). Close to half of CNMs (45%) are allowed to order screening mammograms independently (without a physician signature and 31% were not allowed). It is surprising, albeit refreshing that this CNMs can order screening mammograms independently because Georgia status limits the situations in which APRNs can order diagnostics tests such as MRI without physician authorization, specifying that APRNs who are delegate this authority can only do so in life-threatening situations (Xxxxxxxx, 2015). Yet, screening mammograms are used as part of breast cancer prevention. The U.S. Preventive Task Force recommends biennial mammography screening for breast cancer for women age 50-74 (Siu, 2016), and breast cancer screening is within the education and skills of CNMs. Therefore, for the 31% of CNMs in this sample that are not allowed to order such screening mammograms independently, it imposes restriction on their scope of practice. Majority of CNMs in this study order prescriptions under GA APRN prescriptive authority for APRNs. In Georgia, the physicians who delegate prescriptive authorities to APRNs cannot have a written protocol agreement with more than four APRNs (Xxxxxx...
Other Findings. The results for the prize redemptions and misses again emphasizes the difference between loyalty programs and gamification procedures. The immediate impact of streak redemption is found to be negative and significant for the middle and high state (b = -.64 p < .01 for the middle state and b = - .14 p < .01 for the high state). Although redeemed prizes in the reward system serve as positive feedbacks on performances, it is also worth noting that by redeeming a streak players also finish one “round” in the game. The psychological benefits for winning comprise a significant part of enjoyment in playing a game. Repeating the game by starting new rounds will generate decreased level of thrill since players have already experienced the game mechanism in full and this could be the reason why players are less motivated after streaks are redeemed. On the other hand, losing in games or gamification procedures may not necessarily be a negative event. The coefficients of Value of Streak Reset are positive and significant for the low and middle state (b = .53, p < .01 for the low state and b = .29 p < ,01 for the middle state). Losing may render players the feeling of incompletion and make prizes from winning more salient, thus pushes players to start a new round. These results further set gamification procedures apart from traditional loyalty programs. The time trend is in general negative suggesting players lose interest gradually over time.
Other Findings. The Parties acknowledge that any Customer Satisfaction Benchmark might result in the discovery of continuous improvement opportunities separate from cost competitiveness issues. Any such opportunities identified by the Benchmarker will be the subject of analysis and review, including without limitation, the preparation by Supplier of a formal gap and root cause analysis, as well as a written plan detailing the actions of the parties as may be required to close any such identified gap or opportunities. [***] Confidential treatment has been requested for the bracketed portions. The confidential redacted portion has been omitted and filed separately with the Securities and Exchange Commission. Amendment 1 to Bxx.xxx/xXxxxxxxx Master Services Agreement This Amendment Number 1 (the “First Amendment”) to the Master Services Agreement, Effective Date of April 5th, 2004 between Bxx.xxx and vCustomer (the “Agreement”) is effective January 1, 2005 (“Amendment Effective Date”), and modifies, amends and changes the Agreement as set forth below. This Amendment is entered into by and between Bxx.xxx and vCustomer, who are the current parties to the Agreement (the “Parties”). Unless expressly modified here, all other terms and conditions in the Master Service Agreement remain in full force and effect.
Other Findings. The results showed that surgery type is a protective factor from experiencing complications post-bariatric surgery, suggesting that it lowers the risk of complications. SUMMARY Characteristics of the sample are shown in the Box 1. The mean age of the patient sample was 44 years old. No significant correlation was found between bariatric patients who received PNC by an RD and those that experienced complications post-bariatric surgery (Xxxxxxx’x Correlation ρ = 0.193; P = .139) as shown in Table 3. The chi-square and the significance under the omnibus test of model coefficients as shown in Table 7 indicates that the overall model is not significant (p = 0.130). Surgery type appears to be a protective factor from experiencing complications post-bariatric surgery, (Point Estimate/Exp (B) = 0.848) suggesting that it lowers the risk of complications post-surgery. Counseling done by an RD and surgery approach does not prove to be protective factors from experiencing complications post-bariatric surgery. After adjusting for surgery type and approach, the association between patients who received PNC by an RD and experiencing complications persisted (β = 1.039; 95% confidence interval, 0.807– 9.904; P = 0.104) as shown in Table 8. Disclaimer: It should be noted that of the 60 patients reviewed, 22 were seen by an RD, one was seen by a primary care physician (PCP), and 37 were seen by an unknown practitioner for PNC. Given that the majority of counseling was done by an unknown practitioner, it is not possible to make conclusions on RD effectivity. It is possible that the unknown practitioners were RDs at a location outside of the Xxxxx Xxxxxxx Health System.
Other Findings. The process of analyzing the resources set forth by organizations similar to Global
Other Findings. Baseline, intervention and post-intervention proportions of due and overdue Pap screenings in the Muscogee County office and in the satellite clinics were also reviewed. The P chart for the Muscogee County clinic (Figure 7) shows the baseline UCL and LCL set at 39% and 16% respectively. The process average is approximately 28%. First quarter results show the proportion of women without current Pap screenings between 20% - 21%. An increasing trend is noted in the proportion of women due or overdue during the second quarter. The proportion rises from about 24% to 35%. The third quarter demonstrates an increase to 42%. During the intervention a shift in the UCL and LCL occurs. The values are now 42% and 19% respectively with a process mean of 31%. Figure7. P chart of Muscogee County clinic cervical cancer screenings. A decline in the proportion of due or overdue Pap screenings from 42% to 24% occurs during this four month period. The post-intervention period shows an overall increase in delinquent Pap screenings with a high of 43% being reached. The UCL, LCL, and process mean remain stable. One data point, December 2013, is identified outside of the control limits indicating a Test 1 failure. See possible explanation below. The P chart for the satellite clinics (Figure 8) shows the baseline UCL and LCL set at 75% and 38% respectively. The process average is 56%. During this baseline period, the proportion of women attending the county clinics without a documented Pap screening is consistently >50%. During the intervention, a shift in the UCL and LCL can be seen. The values are 55% and 19% respectively with the process average at 37%. A decline from 65% to 21% in the proportion of due or overdue screenings is demonstrated during these four months. From January 2013 to December 2013, the UCL and LCL remain close to the intervention values. This period has a UCL of 58%, LCL of 21%, and process mean of 39%. Following a low of 18%, a gradual but steady increase in women in need of Pap screening is demonstrated. The post-intervention period culminates in a high of 78%. Four data points, one in the intervention stage (September) and three in the post-intervention phase (January, November, and December), are identified as Test 1 failures. If not for the intervention effect, September 2012’s proportion would have been well within baseline control limits. Immediately after the intervention, an all-time low of 18% is achieved. Again, this is most likely due to patient c...
Other Findings. S. The Sale does not constitute a de facto plan of reorganization or liquidation or an element of such a plan for any of the Debtors, as it does not propose to: (a) impair or restructure existing debt of, or equity interests in, the Debtors, (b) impair or circumvent voting rights with respect to any future plan proposed by the Debtors; (c) circumvent chapter 11 plan safeguards, such as those set forth in sections 1125 and 1129 of the Bankruptcy Code; or (d) classify claims or equity interests, compromise controversies or extend debt maturities.
Other Findings. There are some issues regarding the variables and parameters of the study that require explanation. Those are the absence of sealants as a treatment option for the teledentistry program and the selection of a one-year time frame for the CEA, as opposed to a school year. In addition, some of the results of equations and analysis necessitate explanation. These include the negative value for the ICER calculation including the intangible cost and the results of the one-way sensitivity analysis of the probability for participation in teledentistry. The teledentistry Dental Supervisor, Xxx Xxxxxx, DMD opted not to provide sealant treatments during the teledentistry clinics. According to Xx. Xxxxxx, the most recent studies indicate that sealants are currently not as clinically indicated as they were at one time, especially for a population who, for the majority, already showed signs of tooth decay (X. Xxxxxx, personal communication, October 9, 2011). For this reason, sealant costs and benefits were excluded from the CEA. A time frame of one year (October 2010 through September 2011) was selected for the analysis instead of the 2010 - 2011 school year teledentistry program period (October 2010 through April 2011), as previously stated. Although this may overestimate the cost for the teledentistry program, the change is justified. Even though children may not have received services during the expanded period, the cost of the equipment, facility, utilities and wages of salary and contract staff were on-going. In addition, the Dental Supervisor and Telehealth Coordinator were conducting meetings with school staff, case management continued and support staff provided services to the program. The ICER calculation including the intangible cost resulted in a positive value, implying teledentistry was cost-effective but not cost saving. The researcher expected the inclusion of the intangible cost to enhance the cost savings of the teledentistry program. In fact, when the decision tree was created in TreeAge Pro 2.0 for models including and excluding the intangible cost, results were more closely in line with the researcher’s expectations. TreeAge Pro 2.0 selected traditional dentistry as the intervention with the most utility when the intangible cost was excluded and selected teledentistry as the intervention that provided the most value when the intangible cost was included. The one-way sensitivity analysis results for the probability of obtaining teledentistry services ...
Other Findings. While a qualitative analysis of tweets related to the illegal selling and purchasing of prescription drugs was outside the scope of this study, it was observed that multiple tweets from indivduals (as opposed to organizations or companies) included content soliciting prescription opioids for sale. More research may be useful to determine whether Twitter could serve as a platform to help identify illegal drug traffickers in specific states, especially considering many individuals tweeting about buying and selling prescription drugs also included a self-identified location.
