Difference between revisions of "Clinical Factors"
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These are the [[Clinical Factors]] that are a component of the [[Patient Recovery Factors]]. | These are the [[Clinical Factors]] that are a component of the [[Patient Recovery Factors]]. | ||
| − | + | ==[[Clinical Conditions Factors|Clinical Conditions]]== | |
| − | + | [[Clinical Conditions Factors|Clinical Conditions]] are elements of the [[Clinical Factors|clinical factors]] in [[Patient Recovery|patient recovery]]. Medicare has developed a model to categorize the [[Clinical Conditions Factors|clinical conditions factors]] in order to risk [http://www.cms.gov/Medicare/Health-Plans/MedicareAdvtgSpecRateStats/Risk-Adjustors.html '''risk adjust'''] health insurers that are covering patients. The [[CMS-HCC Risk Adjustments]] model adjust for patient demographics (i.e., age, disabled) and disease (i.e., diabetes, congested heart failure). | |
| − | + | ||
| − | + | ||
| − | + | ||
| − | + | ||
| − | ==== | + | ===Allergies & Adverse Drug Reactions=== |
| + | |||
| + | ===Comorbidities=== | ||
| + | Comorbidities are chronic disorders (or diseases) that need to be managed. Most comorbidities do not get cured. | ||
| + | Comorbidities include behavioral or mental disorders. | ||
* Alzheimer's disease | * Alzheimer's disease | ||
* Arthritis | * Arthritis | ||
| Line 21: | Line 20: | ||
* Osteoporosis | * Osteoporosis | ||
* Stroke | * Stroke | ||
| − | + | ||
| − | === | + | ===Demographics=== |
| − | * Long Term Institutional Status (LTI Status) | + | * Age |
| − | + | * Sex | |
| − | + | * Disabled | |
| + | * Long Term Institutional Status (LTI Designated Status) | ||
| + | |||
| + | ===Immunizations=== | ||
* Flu | * Flu | ||
* Tetanus | * Tetanus | ||
| − | + | ===Impairments=== | |
| − | + | ||
| − | + | ||
* Physical Impairments (Use of limbs, arthritis, amputation, birth defects, Epilepsy) | * Physical Impairments (Use of limbs, arthritis, amputation, birth defects, Epilepsy) | ||
* Sensory Impairments (Blind or Visually Impaired, Deaf or Hard of Hearing, loss of taste and smell) | * Sensory Impairments (Blind or Visually Impaired, Deaf or Hard of Hearing, loss of taste and smell) | ||
| − | + | ===Medical History=== | |
* Adverse events | * Adverse events | ||
* Family Medical History | * Family Medical History | ||
| Line 39: | Line 39: | ||
* Surgeries | * Surgeries | ||
| − | + | ===Physiological Metrics=== | |
| − | + | ||
| − | + | ||
| − | + | ||
* Blood glucose level | * Blood glucose level | ||
* Blood pressure | * Blood pressure | ||
* Cholesterol level (HDL, LDL, etc) | * Cholesterol level (HDL, LDL, etc) | ||
* Heart rate | * Heart rate | ||
| − | + | ===Problem lists=== | |
| − | + | ||
| − | + | ||
* Abdominal pain | * Abdominal pain | ||
| − | * | + | * Acute asthma |
| + | * Chest Pain | ||
* Fever | * Fever | ||
| − | * | + | * Fractures |
| − | * | + | * Headache |
| − | * | + | * Pain (Chest Pain) |
| − | * | + | * Rash or skin infection |
| − | * | + | * Shortness of Breath |
| − | * | + | * Sprains |
| + | * Upper respiratory tract infection | ||
| + | * Wounds | ||
| − | ==== | + | ==[[Functional Conditions Factors|Functional Conditions]]== |
| + | [[Functional Conditions Factors|Functional Conditions]] are elements of the [[Clinical Factors|clinical factors]] in [[Patient Recovery|patient recovery]]. | ||
| − | + | ===Basic Physical=== | |
| − | + | ||
The ten variables addressed in the [http://en.wikipedia.org/wiki/Barthel_scale '''Barthel scale'''] are: | The ten variables addressed in the [http://en.wikipedia.org/wiki/Barthel_scale '''Barthel scale'''] are: | ||
* presence or absence of fecal incontinence | * presence or absence of fecal incontinence | ||
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* help needed with bathing | * help needed with bathing | ||
| − | + | ===Basic Life Activities=== | |
* Clean home or setting | * Clean home or setting | ||
* Drive | * Drive | ||
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* Use Public Transportation, | * Use Public Transportation, | ||
| − | + | ===Logistic Capabilities=== | |
* Walk - able to walk, ride in car, ride bus or taxi | * Walk - able to walk, ride in car, ride bus or taxi | ||
* Assisted Walking - walker, cane | * Assisted Walking - walker, cane | ||
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* Equipment Requirements - Oxygen, heart device, etc. | * Equipment Requirements - Oxygen, heart device, etc. | ||
| − | ==== | + | ===Supportive Devices=== |
| + | * Pacemaker | ||
| + | * Artificial limb | ||
| + | |||
| + | ===Work=== | ||
Physically able to go back to work or enough functional ability to find a new job | Physically able to go back to work or enough functional ability to find a new job | ||
| − | + | ===Passion=== | |
Physically able to go back to work or enough functional ability to find a new job | Physically able to go back to work or enough functional ability to find a new job | ||
* Volunteer, watch grand kids soccer games, etc. | * Volunteer, watch grand kids soccer games, etc. | ||
* Golf, weekly lunches with friends, etc. | * Golf, weekly lunches with friends, etc. | ||
| − | + | ===Mental=== | |
Not prevented from working, pursuing passion and functional activities because of mental health challenges | Not prevented from working, pursuing passion and functional activities because of mental health challenges | ||
* Fear, confidence in certain situations, etc. | * Fear, confidence in certain situations, etc. | ||
| − | + | ===Functional History=== | |
| + | |||
| + | ==[[Genomic Factors|Genomic]]== | ||
| + | [[Genomic Factors|Genomic]] are elements of the [[Clinical Factors|clinical factors]] in [[Patient Recovery|patient recovery]]. | ||
| + | |||
| + | ===Human Genome=== | ||
| + | [http://en.wikipedia.org/wiki/Human_genome '''Human Genome''']] - complete set of genetic information encoded as DNA sequences within the 23 chromosome pairs. It includes the genomes of [http://en.wikipedia.org/wiki/Tumor '''tumors'''], the abnormal mass of tissue from abnormal growth or division of cells. | ||
| + | |||
| + | ===Microbiome=== | ||
| + | [http://en.wikipedia.org/wiki/Microbiome '''Microbiome'''] - the collective genomes of the microorganisms that share our body | ||
| + | * Bacteria | ||
| + | * Viruses ([http://en.wikipedia.org/wiki/Human_virome '''virome''']) | ||
| + | * [http://en.wikipedia.org/wiki/Eukaryote '''Other microbes with genomes''']. | ||
| + | |||
| + | ===Non-Genomic Profiles=== | ||
| + | * [http://en.wikipedia.org/wiki/Metabolome '''Metabolome'''] - are small molecules with metabolism functions of fuel, structure, signaling, stimulatory and inhibitory effects on enzymes and other catalytic activities. | ||
| + | * [http://en.wikipedia.org/wiki/Proteome '''Proteome'''] - set of proteins expressed by a genome, cell, tissue or organism at a given time, under defined conditions. | ||
| + | * [http://en.wikipedia.org/wiki/Transcriptome '''Transcriptome'''] - set of all molecules use to create new cells with genomes. | ||
| + | |||
| + | ==[[Mental Health Factors|Mental Health]]== | ||
| + | [[Mental Health Factors|Mental Health]] are elements of the [[Clinical Factors|clinical factors]] in [[Patient Recovery|patient recovery]]. | ||
| + | |||
| + | ===Comorbidities=== | ||
| + | Mental Health comorbidities (or mental health disorders diseases) that need to be managed. Most comorbidities do not get cured. | ||
| + | ===Disorders=== | ||
| + | * Anxiety Disorder, | ||
| + | * Attention Deficit Hyperactivity Disorder (ADHD), | ||
| + | * Autism, | ||
| + | * Bipolar Disorder, | ||
| + | * Depression | ||
| + | * Eating Disorder, | ||
| + | * Obsessive Compulsive Disorder (OCD), | ||
| + | * Panic Disorders, | ||
| + | * Post Traumatic Stress Disorder, | ||
| + | * Schizophrenia | ||
| + | ===History=== | ||
| + | ===Impairments=== | ||
| + | * Cognitive Impairments (Delirium "confused state", Dementia), | ||
| + | * Developmental | ||
Latest revision as of 12:33, 17 August 2014
These are the Clinical Factors that are a component of the Patient Recovery Factors.
Clinical Conditions
Clinical Conditions are elements of the clinical factors in patient recovery. Medicare has developed a model to categorize the clinical conditions factors in order to risk risk adjust health insurers that are covering patients. The CMS-HCC Risk Adjustments model adjust for patient demographics (i.e., age, disabled) and disease (i.e., diabetes, congested heart failure).
Allergies & Adverse Drug Reactions
Comorbidities
Comorbidities are chronic disorders (or diseases) that need to be managed. Most comorbidities do not get cured. Comorbidities include behavioral or mental disorders.
- Alzheimer's disease
- Arthritis
- Asthma
- Cancer
- COPD
- Diabetes
- Congestive Heart Failure
- High Blood Pressure
- High Cholesterol
- Obesity
- Osteoporosis
- Stroke
Demographics
- Age
- Sex
- Disabled
- Long Term Institutional Status (LTI Designated Status)
Immunizations
- Flu
- Tetanus
Impairments
- Physical Impairments (Use of limbs, arthritis, amputation, birth defects, Epilepsy)
- Sensory Impairments (Blind or Visually Impaired, Deaf or Hard of Hearing, loss of taste and smell)
Medical History
- Adverse events
- Family Medical History
- Medical Conditions
- Surgeries
Physiological Metrics
- Blood glucose level
- Blood pressure
- Cholesterol level (HDL, LDL, etc)
- Heart rate
Problem lists
- Abdominal pain
- Acute asthma
- Chest Pain
- Fever
- Fractures
- Headache
- Pain (Chest Pain)
- Rash or skin infection
- Shortness of Breath
- Sprains
- Upper respiratory tract infection
- Wounds
Functional Conditions
Functional Conditions are elements of the clinical factors in patient recovery.
Basic Physical
The ten variables addressed in the Barthel scale are:
- presence or absence of fecal incontinence
- presence or absence of urinary incontinence
- help needed with grooming
- help needed with toilet use
- help needed with feeding
- help needed with transfers (e.g. from chair to bed)
- help needed with walking
- help needed with dressing
- help needed with climbing stairs
- help needed with bathing
Basic Life Activities
- Clean home or setting
- Drive
- Laundry
- Prepare food and/or cook
- Shopping (Food, Medicines, necessities, etc.)
- Use Public Transportation,
Logistic Capabilities
- Walk - able to walk, ride in car, ride bus or taxi
- Assisted Walking - walker, cane
- Wheelchair - Travel via Wheelchair
- Equipment Requirements - Oxygen, heart device, etc.
Supportive Devices
- Pacemaker
- Artificial limb
Work
Physically able to go back to work or enough functional ability to find a new job
Passion
Physically able to go back to work or enough functional ability to find a new job
- Volunteer, watch grand kids soccer games, etc.
- Golf, weekly lunches with friends, etc.
Mental
Not prevented from working, pursuing passion and functional activities because of mental health challenges
- Fear, confidence in certain situations, etc.
Functional History
Genomic
Genomic are elements of the clinical factors in patient recovery.
Human Genome
Human Genome] - complete set of genetic information encoded as DNA sequences within the 23 chromosome pairs. It includes the genomes of tumors, the abnormal mass of tissue from abnormal growth or division of cells.
Microbiome
Microbiome - the collective genomes of the microorganisms that share our body
- Bacteria
- Viruses (virome)
- Other microbes with genomes.
Non-Genomic Profiles
- Metabolome - are small molecules with metabolism functions of fuel, structure, signaling, stimulatory and inhibitory effects on enzymes and other catalytic activities.
- Proteome - set of proteins expressed by a genome, cell, tissue or organism at a given time, under defined conditions.
- Transcriptome - set of all molecules use to create new cells with genomes.
Mental Health
Mental Health are elements of the clinical factors in patient recovery.
Comorbidities
Mental Health comorbidities (or mental health disorders diseases) that need to be managed. Most comorbidities do not get cured.
Disorders
- Anxiety Disorder,
- Attention Deficit Hyperactivity Disorder (ADHD),
- Autism,
- Bipolar Disorder,
- Depression
- Eating Disorder,
- Obsessive Compulsive Disorder (OCD),
- Panic Disorders,
- Post Traumatic Stress Disorder,
- Schizophrenia
History
Impairments
- Cognitive Impairments (Delirium "confused state", Dementia),
- Developmental
