Clinical Integrated Networks (Cin)

This ensures that all organisations under their watch are working to a set of rules and regulations that apply to them. They regulate the care given and inspect institutions to ensure that optimal care that conforms to

Making the health information available, reducing duplication of tests, reducing delays in treatment, and patients well informed to take better decisions.

To guarantee that its members receive appropriate, high level quality care in a cost-effective manner, each managed care organization (MCO) tailors its networks according to the characteristics of the providers, consumers, and competitors in a specific market. Other considerations for creating the network are the managed care organization's own goals for quality, accessibility, cost savings, and member satisfaction. Strategic planning for networks is a continuing process. In addition to an initial evaluation of its markets and goals, the managed care organization must periodically reevaluate its target markets and objectives. After reviewing the markets, then the organization must

“An Integrated Physician Model is the result of a series of partnership between hospitals and physician develop overtime” (Harrison, 2016). Primarily, it is a joint venture that has become many joint ventures. In addition, all of this joint ventures are connected through congruent goals, and that is to provide different level of care to all the patients. Integrated physician model also organizing themselves to improve the cost and quality by operating under a clinical guideline. This could include acute care hospital, home care, nursing homes, affiliated medical group, primary care clinics, employed physician and any independent medical groups.

Clinical integration is the overall purpose of an integrated physician model. Clinical integration provides an opportunity to coordinate services through centralized scheduling, electronic health records, clinical pathways, management of chronic diseases, and innovative quality improvement programs (Harrison, 2016). This needs to be a major factor in the planning process. When you have the capability and access to an patients care plan because of greater resources and having all of the necessary silos to provide such care, well then it becomes a much smoother process and as a result this can play a factor into timely care and quality of care, as well it can contribute to cost reducing factors such as outpatient care. The electronic health records allow each silo to have access to treatments and testing that has already been done, this further improves quality, timely, and costly care. The clinical pathways allow creating a standardized care plan for patients that over time become more effective and efficient. The management of chronic diseases before clinical integration could be very costly and painful, requiring the patient to see multiple facilities and doctors with limited communication between the different facilities. With success in clinical integration these patients can have easy access to their providers and information because it would all be tied together, it can reduce the stress of knowing everything themselves because the information would already be

Providing EMR, this will provide accuracy for the patients. They may have better check points when the goes into the hospital and they are having surgery the files are provided with plus medical history.

Why is the skill, concept, procedure, or tool necessary for accurate record keeping, operational efficiency, excellent patient services, employee management, regulatory compliance, reducing costs, forecasting, and so forth?

Making sure the needs of the patients are met. Making sure everyone is on the same page when it comes to making things better for the patients. Making sure the employees are happy, this will help them to give excellent care to the patients.

to enhance patient care by providing prescription monitoring information that will ensure legitimate use of controlled substances in health care

Preferred provider organizations offer flexibility in benefit design and allow patients flexibility to choose from a list of in-network providers for their care. Care provided in-network typically is discounted with out of network services resulting in higher out of pocket expenses to the patient (Hirth, Grazier, Chernew and Okeke, 2007). Clinically integrated networks are a more recently developed managed care structure. In this model, independent practitioners form a virtual network as a means of increasing capacity for contracting with payers of healthcare whether commercial insurance or for self-insured organizations. Physicians recognize advantages to collaborative contracting and the increase in coordinating care of patients through the network (Kaplan and Guest, 2012). Commercial insurance companies are looking to clinically integrated networks as another mechanism to control the costs of healthcare delivery. Accountable care organizations, as with clinically integrated networks, are fairly recent phenomenon with similar but more formalized characteristics. An accountable care organization is a structured network of healthcare entities which have united and are responsible for the health of an identified population. The accountable care organization shares the risk of meeting the health needs of

In addition, to protect the public resources that fund the Medicaid programs and maintain balance by paying claims and eliminating burdens on the providers while preventing and detecting fraud.

Why the skill, concept, procedure, or tool is necessary for accurate record keeping, operational efficiency, excellent patient services, employee management, regulatory compliance, reducing costs, forecasting, and so forth

The purpose of this paper is to discuss how true clinical integration of hospitals and physicians is impacted by The Federal Trade Commission policy statements. In this context, the term true clinical integration is used to describe engagement and alignment among hospitals and physicians to achieve meaningful clinical process redesign that can change culture and lead to lasting differences in the way care is delivered. This is to differentiate the term clinical integration as an alignment vehicle principally for antitrust liability avoidance purposes.

health issues , to enhance public health , and to help support ill patients both physically

Networking is cultivating relationships with others in a meaningful way so that you have people to turn to when you need information and support. And people you can help when they need someone to turn to (Tullier, 2004). Building connections to other powerful, intelligent people is crucial for a successful nursing career. Nurses can and will continue to learn the important aspects of career networking for themselves, other nurses, and their patients (Never underestimate the importance of networking: an ... n.d.). We can obtain our information and by sharing it to become an influential leaders. This will require breaking out of our zones of comfort and becoming players on the health care stage. Nurses, patients, and the public will all be beneficiaries