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]]==
 +
[[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===
 
===Allergies & Adverse Drug Reactions===
−
===Behavioral Health===
 
−
* Addictions
 
−
* Behavioral Disorders (depression, anxiety disorders, schizophrenia, bipolar etc.)
 
−
* Substance Abuse
 
  
 
===Comorbidities===
 
===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
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* Osteoporosis
 
* Osteoporosis
 
* Stroke
 
* Stroke
−
===[[CMS-HCC Risk Adjustments]]===
+
 
−
===Designations===
+
===Demographics===
−
* Long Term Institutional Status (LTI Status)  
+
* Age
−
===Genome (DNA)===
+
* Sex
 +
* Disabled
 +
* Long Term Institutional Status (LTI Designated Status)  
 +
 
 
===Immunizations===
 
===Immunizations===
 
* Flu
 
* Flu
 
* Tetanus
 
* Tetanus
 
===Impairments===
 
===Impairments===
−
* Cognitive Impairments (Delirium "confused state", Dementia)
 
−
* Developmental Challenges (Autism)
 
 
* 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)
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* Surgeries
 
* Surgeries
  
−
===Microbiome===
 
−
* Proteome, viruses
 
−
===Pain===
 
 
===Physiological Metrics===
 
===Physiological Metrics===
 
* Blood glucose level
 
* Blood glucose level
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* Heart rate
 
* Heart rate
 
===Problem lists===
 
===Problem lists===
−
* Chest Pain
 
−
* Shortness of Breath
 
 
* Abdominal pain
 
* Abdominal pain
−
* Headache
+
* Acute asthma
 +
* Chest Pain
 
* Fever
 
* Fever
−
* upper respiratory tract infection
+
* Fractures
−
* sprains
+
* Headache
−
* fractures
+
* Pain (Chest Pain)
−
* wounds
+
* Rash or skin infection
−
* asthma
+
* Shortness of Breath
−
* Rash of skin infection
+
* Sprains
 +
* Upper respiratory tract infection
 +
* Wounds
  
−
===Wounds===
+
==[[Functional Conditions Factors|Functional Conditions]]==
 +
[[Functional Conditions Factors|Functional Conditions]] are elements of the [[Clinical Factors|clinical factors]] in [[Patient Recovery|patient recovery]].
  
−
==Functional Condition==
 
 
===Basic Physical===
 
===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:
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* Wheelchair - Travel via Wheelchair
 
* Wheelchair - Travel via Wheelchair
 
* Equipment Requirements - Oxygen, heart device, etc.
 
* Equipment Requirements - Oxygen, heart device, etc.
 +
 +
===Supportive Devices===
 +
* Pacemaker
 +
* Artificial limb
  
 
===Work===
 
===Work===
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* Fear, confidence in certain situations, etc.  
 
* Fear, confidence in certain situations, etc.  
 
===Functional History===
 
===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

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
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