Question

Under the utilization mgmt data model, what are care request items in practice?

A. Medication dosages.
B. Treatment protocols.
C. Patient demographics.
D. Diagnostic procedures.

Answer 1

Care request items under the utilization management data model usually refer to treatment protocols and diagnostic procedures. These items are key to ensuring necessary and cost-effective healthcare. Developing policies for health records must address the balance between costs, quality of life, and privacy.

Step-by-step explanation:

Under the utilization management data model, care request items refer to the specific components included in a healthcare request that can be analyzed for approval or denial in managed care settings. They typically represent the types of services that require authorization ahead of time. In practice, care request items could include B. Treatment protocols and D. Diagnostic procedures. These items help ensure that the provided healthcare services are necessary, appropriate, and cost-effective.

When developing policies concerning health records, it's vital to consider several factors. Three key questions that must be addressed are:

1. How can the policies ensure an optimal balance between the costs of treatments and diagnoses, the quality of life for the patient, and privacy risks?
2. What mechanisms will be in place to protect the privacy of individual patient health information?
3. How will the policies influence patient access to necessary and possibly life-saving treatments?