01-02A - Introduction To Healthcare and Public Health in The US - Unit 02 - Delivering Healthcare Part 1 - Lecture A

Introduction to Healthcare
and Public Health in the US

Delivering Healthcare (Part 1)
Lecture a
This material (Comp1_Unit2a) was developed by Oregon Health and Science University, funded by the
Department of Health and Human Services, Office of the National Coordinator for Health Information
Technology under Award Number IU24OC000015.

Delivering Healthcare (part 1)
Learning Objectives
Describe the organization of healthcare at the
federal, state and local levels (Lecture a)
Describe the organization of the VA system and
Military Health System (Lecture b)
Describe the structure and function of hospital
clinical and administrative units (Lecture c)
Describe different types of long term care facilities,
with an emphasis on their function (Lecture d)

2
Health IT Workforce Curriculum
Version 3.0/Spring 2012
Introduction to Healthcare and Public Health in the US
Lecture a
Learning Objectives
Describe the organization of healthcare at the
federal, state, and local levels
Overview of the US Department of Health and
Human Services (HHS)
Role of state governments in healthcare
Local healthcare organizations

3
Lecture a
Purpose of the HHS
Provides essential healthcare for all Americans
Protects the needy or underserved
State, local, and tribal levels
Structure
Office of the Secretary
11 operating divisions
4
Lecture a
Organization of the HHS
1.1 Chart: (HHS.gov, ND)

5
Lecture a
Administration for
Children and Families (ACF)
Addresses the economic and social well-being
of children, families, individuals, communities
Vulnerable populations included
Programs are both national, regional
Well-known program: Head Start

6
Lecture a
Administration on Aging (AoA)
Adults 65 years of age and older will be 19% of
the US population by 2030
AoA funds non-medical programs to prolong
health and independence
Programs are both home-based and community-
based
Multiple needs served: nutritional, logistical,
legal, quality of life
7
Lecture a
Agency for Healthcare Research
and Quality (AHRQ)
Mission: Provide data on healthcare in the US
Quality, safety, efficiency, effectiveness, access
Measurable outcomes: illness, death, spending
All stakeholders are included
Focus areas of research:
Health information technology
Effectiveness of treatments
Quality improvement and patient safety
Illness prevention and care management
Healthcare value
8
Lecture a
Agency for Toxic Substances
and Disease Registry (ATSDR)
Mission: Prevent illness/disease from toxic/hazardous
substances
Examples: arsenic, asbestos, lead, mercury
Origins: environmental pollution, waste sites, disasters
Methods of intake: breathing, drinking, food, soil exposure
Identifies exposures, evaluates risk, recommends action
Prepares for emergencies/disasters
Educates about toxicology, environmental medicine, chemical
exposures
Issues public health advisories
Well-known example: Actions taken on and after 9-11-2001
9
Lecture a
Centers for Disease Control
and Prevention (CDC)
Responsible for health promotion, disease
prevention, reduction of injury or disability
Prepares for emerging health threats
Well-known example: Swine flu
Enacts prevention strategies, develops public
health policies, advocates for healthy
behaviors.
Works with national and international partners
Educates healthcare providers, consumers
10
Lecture a
Centers for Medicare
and Medicaid Services (CMS)
Medicare/Medicaid cover 25% of US population
Medicare
Largest health insurer in the US
For elderly or disabled people
Insured person pays premiums
Medicaid
For low-income patients and families
Specific guidelines are determined by each state
Insured person generally does not pay
Childrens Health Insurance Program

11
Lecture a
Food and Drug Administration
(FDA)
Responsible for the safety and effectiveness of
foods, drugs, and medical devices
Also veterinary drugs, cosmetics, radiologic
health, toxicology
Evaluates and approves new drugs
Regulates tobacco manufacture and marketing
Office of the Commissioner and 8 centers
12
Lecture a
Health Resources and
Services Administration (HRSA)
Mission: Improve access to healthcare
People with low incomes, no insurance
People with certain medical issues (such as patients
with HIV/AIDS and children with special needs)
People who are isolated (for example, in rural
communities)
Other services
Oversees organ, blood, bone marrow donations
Combats bioterrorism
Compensates people for severe vaccination reactions
13
Lecture a
Indian Health Service (HIS)
Mission: Improve physical, psychological, and spiritual
health of American Indians and Alaska Natives
Accessible public health services
Culturally sensitive; recognizes sovereign rights
564 federally recognized tribes in 35 states
Medical and social issues
Disparities in health and life expectancy
Higher mortality from diseases, social problems
14
Lecture a
National Institutes of Health (NIH)
Worlds largest source of funding for medical research
Funds universities, research institutions, its own
laboratories
27 institutes and centers with focus on:
Diseases (for example, cancer, heart disease,
alcoholism and drug abuse, arthritis, diabetes)
Specific groups (for example, children, the elderly)
Research issues (for example, nursing, alternative
medicine, information technology)
15
Lecture a
Office of the Inspector General
(OIG)
Protects the integrity of HHS programs
Protects the health and welfare of people who
benefit from HHS programs
Performs nationwide audits, investigations
Reports abuses to the Secretary and Congress
Recommends corrections
Examples of initiatives:
Stop Medicare Fraud program
Healthcare Fugitives list
16
Lecture a
Substance Abuse and Mental Health
Services Administration (SAMHSA)
Mission: Improve the health of people with mental illness/substance
abuse, while reducing healthcare costs and social costs
8 strategic initiatives:
Prevent substance abuse and mental illness
Reduce the impact of violence and trauma
Support military families
Support patients with housing, employment, education
Improve insurance coverage and access to treatment
Promote information technology and electronic medical records
Gather data to measure the success of programs
Educate the public about mental illness and substance abuse

17
Lecture a
State Healthcare
All states have a Department of Health
Organizational structures vary
Responsible for disease treatment, health promotion,
care of special groups
State governments partner with HHS
National Academy for State Health Policy
Mission: Improve healthcare access and quality
Encourages states to collaborate with federal
government, private companies, other states
Well-known example: national healthcare reform
18
Lecture a
Local Healthcare:
Private Healthcare Agencies
Independent healthcare providers
Single-provider practices
Group practices
Corporate healthcare
Employees, families, retirees
Some agencies operate community health
centers
Can have for-profit or nonprofit status
19
Lecture a
Local Healthcare: Hospitals
Profit or nonprofit
Government-supported or not
General or specialty
University-affiliated or community-based
Single or chain
Critical-access hospitals get Medicare
reimbursement

20
Lecture a
Summary - Lecture a
HHS
Multiple agencies
Oversight role: disease prevention, healthcare quality,
medical insurance for special populations, research,
mental health, food/drug safety, and more
State departments of health
Many of the same types of programs as HHS
Local healthcare
Private agencies
Clinics and hospitals
21
Lecture a
References Lecture a
References
Administration for Children and Families. http://www.acf.hhs.gov. Accessed April 5, 2011.
Administration on Aging. http://www.aoa.gov. Accessed April 6, 2011.
Agency for Health Care Research and Quality. http://www.ahrq.gov. Accessed April 4, 2011.
Agency for Toxic Substances and Disease. Agency for Toxic Substances and Disease Registry. http://www.atsdr.cdc.gov.
Updated March 23, 2011. Accessed April 4, 2011.
Alliance for Advancing Nonprofit Health Care. The value of nonprofit health care.
http://www.nonprofithealthcare.org/reports/5_value.pdf. Accessed April 5, 2011.
AmericanHospitals.com. Hospital locator: all hospitals are not created equal.
http://www.americanhospitals.com/hospitals/hospitalsequal.htm. Accessed April 5, 2011.
Centers for Disease Control and Prevention. http://www.cdc.gov. Accessed April 6, 2011.
Centers for Medicare and Medicaid Services. CMS programs and information. http://www.cms.gov. Accessed April 4,
2011.
Corporate Health Care Coalition. http://www.corporatehealthcare.org. Accessed April 5, 2011.
Health Resources and Services Administration. http://www.hrsa.gov/index.html. Accessed April 4, 2011.
HHS.gov. http://www.hhs.gov. Accessed April 4, 2011.
Indian Health Service. http://www.ihs.gov. Accessed April 4, 2011.
Indian Health Service. IHS fact sheets: Indian health disparities. http://info.ihs.gov/Disparities.asp. Updated January
2011. Accessed April 4, 2011.
Medicare.gov. http://www.medicare.gov. Accessed April 4, 2011.
Medline Plus. Medicare. http://www.nlm.nih.gov/medlineplus/medicare.html. Updated March 16, 2011. Accessed April 5,
2011.
National Academy for State Health Policy. http://www.nashp.org. Updated March 2011. Accessed April 4, 2011.
National Association of Community Health Centers. http://www.nachc.org. Accessed April 5, 2011.
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Lecture a
References Lecture a (continued)

National Institutes of Health. http://www.nih.gov. Accessed April 4, 2011.
Office of Inspector General. http://oig.hhs.gov. Accessed April 6, 2011.
Rural Assistance Center. CAH frequently asked questions.
http://www.raconline.org/info_guides/hospitals/cahfaq.php#whatis. Updated October 26, 2010. Accessed April 6, 2011.
Substance Abuse and Mental Health Services Administration. http://www.samhsa.gov. Accessed April 4, 2011.
U.S. Food and Drug Administration. http://www.fda.gov. Accessed April 6, 2011.

Images
Slide 5: US Department of Health and Human Services organizational chart. Available from
http://www.hhs.gov/about/orgchart/

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Lecture a

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