definition of patient+type by Medical dictionary

Patient+type | definition of patient+type by Medical dictionary
Patient+type | definition of patient+type by Medical dictionary

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Patient Identifier Type | Interoperability Standards Advisory (ISA)

Data used to categorize individuals for identification, records matching, and other purposes.

• USCDI V1
• USCDI V2
• USCDI V3
• Draft USCDI V4
• Level 2
• Level 1

Data Element

Information from the submission form

Patient Identifier Type

Description Identifies the type of identifier payers and providers assign to patients Submitted By: Mark Roberts / Leavitt Partners Data Element Information Use Case Description(s) Use Case Description Administrative and financial transactions are a critical part of health care provisioning and management. There is a need for health care consumers to get access this health data to be able to make better care decisions and manage their health care journey. Making Member data available to consumers will enable them to have greater visibility into the costs associated with their health care, identify potential errors, and enable them to plan for their future health care needs taking financial costs into account. Consumer-directed exchange occurs when a consumer or an authorized caregiver invokes their HIPAA Individual Right of Access (45 CFR 164.524) and requests their digital health information (adjudicated claims and encounter data) from a HIPAA covered entity (CE) – health insurance company or payers via an application or other third-party data steward. Estimated number of stakeholders capturing, accessing using or exchanging All health care insurers (>1,800), third-party application developers, and all consumers of the health care system (>320M) Link to use case project page http://hl7. org/fhir/us/carin-bb/ Healthcare Aims Improving patient experience of care (quality and/or satisfaction) Improving the health of populations Reducing the cost of care Improving provider experience of care Maturity of Use and Technical Specifications for Data Element Applicable Standard(s) NUBC, CPT, HCPCS, HIPPS, ICD-9, ICD-10, DRGs, NDC, POS, NCPDP codes, and X12 codes. http://hl7.org/fhir/us/carin-bb/artifacts.html#5 Additional Specifications HL7® FHIR® US Core Implementation Guide v3. 1.1 based on FHIR R4 Current Use Extensively used in production environments Supporting Artifacts This was part of the CMS Patient Access and Interoperability Rules, which went into effect July 1, 2021. CMS has suggested that industry consider using the CARIN for Blue Button Implementation Guide for the Patient Access API. https://www.cms.gov/about-cms/health-informatics-and-interoperability-group/faqs Number of organizations/individuals with which this data element has been electronically exchanged 5 or more. This data element has been tested at scale between multiple different production environments to support the majority of anticipated stakeholders. Supporting Artifacts While it is not known how many consumers have requested this data electronically, this information is communicated broadly today through other forms. This data is now being required to be communicated electronically through the CMS Patient Access API for which the regulation has suggested that industry consider using the CARIN for Blue Button Implementation Guide for the Patient Access API, we expect this data will be exchanged broadly throughout the health care sector. https://www.cms.gov/about-cms/health-informatics-and-interoperability-group/faqs Potential Challenges Restrictions on Standardization (e.g. proprietary code) Some codes, but not all, are linked to proprietary code standards that may require a license. Restrictions on Use (e.g. licensing, user fees) Licensed Industry Standard Code Systems This IG includes value set bindings to code systems that reference industry standard codes which require implementers to purchase a license before the coded concepts can be used. The following information summarizes the set of licensed Code Systems required by this IG and provides links to the information about where to go to obtain a license: • AMA CPT: The CPT procedure and modifier codes are owned by the American Medical Association. • X12: CARC (Claim Adjustment Reason Codes are owned by X12.. • NUBC: The NUBC secretariat is the American Hospital Association.. • NUCC: National Uniform Claim Committee (NUCC) is presently maintaining the Taxonomy code set. The codes are free and publically available for download and use. If the use however is “For commercial use, including sales or licensing, a license must be obtained”. It would be appropriate for an app developer to file the license form just like they would for any other code set; however, there is no fee. • NCPDP: Retail Pharmacy data standards are defined by the NCPDP . • 3M APR-DRG: AP-DRGs and APR-DRGs are owned by 3M. Use of AP-DRGs and APR-DRGs require a license. Code Systems Not Requiring Licenses This IG includes value set bindings to code systems that are industry standard codes available for use without licenses. The following information summarizes the set of Code Systems required by this IG that are available for use: • ICD-CM Diagnosis Codes (ICD-10-CM): International Statistical Classification of Diseases and Related Health Problems (ICD). This IG will use version 10. The ICD-10-CM code set is maintained by the National Center for Health Statistics (NCHS) of the Centers for Disease Control and Prevention (CDC) for use in the United States. It is based on ICD-10, which was developed by the World Health Organization (WHO) and is used internationally a medical classification. • ICD-Procedure Codes (ICD-PCS): The ICD-10-PCS code set is owned by CMS.. • DRGs.:MS-DRGs are owned by CMS. MS-DRGs are used for the Medicare population. • HCPCS Level II Procedure and Modifier Codes: Primarily include non-physician products, supplies, and procedures not included in CPT. They are owned by CMS and are available for use. • NDC (National Drug Codes): The US Federal Drug Administration (FDA) Data Standards Council assigns the first 5 digits of the 11 digit code.. • RARCCodes: The RARC codes are owned by CMS. Privacy and Security Concerns This data, like any patient data should be exchanged securely. Current processes exist, governed by CMS and ONC, to securely transfer this data. Estimate of Overall Burden The data elements in this class are already held by health care payers, anticipated burden of collection of data would be negligible. The CMS rule and Patient Access API already require CMS covered payers to share this data electronically. Many payers covered by the CMS rule have or are already considering making this data available in the same fashion for other lines of business. ONC Evaluation Details Each submitted Data Element has been evaluated based on the following 4 criteria. The overall Level classification is a composite of the maturity based on these individual criteria. This information can be used to identify areas that require additional work to raise the overall classification level and consideration for inclusion in future versions of USCDI Maturity – Standards/Technical Specifications Level 1/2 – Must be represented by a vocabulary standard or an element of a published technical specification Maturity – Current Use Level 2 – Used at scale in more than 2 different production environments Maturity – Current Exchange Level 2 – Demonstrates exchange between 4 or more organizations with different EHR/HIT systems Breadth of Applicability – # Stakeholders Impacted Level 2 – Used by a majority of patients, providers or events requiring its use

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Psychological reactions of the patient to illness

Psychological consultations for oncologists, anonymity is maintained
Phone: 8-800 100-0191
(call within Russia is free, consultation is available around the clock)

The reflection of the disease in a person’s experiences is usually defined by the concept of the internal picture of the disease (VKB). It was introduced by the domestic therapist R.A. Luria is still widely used in medical psychology. This concept, according to the definition of the scientist, combines everything “that the patient feels and experiences, the whole mass of his sensations, his general well-being, self-observation, his ideas about his illness, about its causes – all that huge world of the patient, which consists of very complex combinations of perception and sensation, emotions, affects, conflicts, mental experiences and traumas.

As a complex structured formation, the internal picture of the disease includes several levels: sensitive, emotional, intellectual, volitional, rational. VKB is determined not by a nosological unit, but by a person’s personality, it is also individual and dynamic, like the inner world of each of us. At the same time, there are a number of studies that reveal the characteristic features of the patient’s experience of his condition.

Thus, the concept of V. D. Mendelevich (“Terminological foundations of phenomenological diagnostics”) is the idea that the type of response to a particular disease is determined by two characteristics: the objective severity of the disease (determined by the criterion of mortality and the likelihood of disability) and the subjective severity of the disease (the patient’s own assessment of his condition).

The idea of ​​the subjective severity of the disease is made up of social and constitutional characteristics, which include sex, age and profession of the individual. Each age group has its own register of the severity of the disease – a kind of distribution of diseases according to socio-psychological significance and severity.

So, in adolescence, the most severe psychological reactions can be caused not by those diseases that are objectively threatening the safety of the body from a medical point of view, but by those that change its appearance, make it unattractive. This is due to the existence in the mind of a teenager of a basic need – “satisfaction with one’s own appearance.”

Persons of mature age will react more psychologically to chronic and disabling diseases. “This is connected with the value system and reflects the aspiration of a person of mature age to satisfy such social needs as the need for well-being, well-being, independence, self-sufficiency, etc.” In this respect, the strongest experiences are associated with oncological diseases. For the elderly and the elderly, the most significant are diseases that can lead to death, loss of work and performance.

Individual psychological characteristics that influence the specifics of experiencing a disease include temperamental features (in relation to the following criteria: emotionality, pain tolerance as a sign of emotionality, and restrictions on movements and immobility), as well as features of a person’s character, his personality (ideological attitudes, level of education).

There is a typology of how a patient responds to an illness. Knowing the type of patient’s response helps to choose an adequate strategy for interacting with him and his family, to use appropriate methods of communication, motivation for treatment.

Types of psychological response to a severe somatic illness

Typology of response to illness A.E.Lichko and N.Ya. Ivanova (“Medical and psychological examination of somatic patients”) includes 13 types of psychological response to a disease, identified on the basis of an assessment of the influence of three factors: the nature of the somatic disease itself, the type of personality in which the most important component determines the type of character accentuation and attitude to this disease in the reference (significant) group for the patient.

In the first block there are those types of attitude to the disease in which there is no significant violation of adaptation: light, but without underestimating the severity of the disease. The desire to actively contribute to the success of treatment in everything. Unwillingness to burden others with the burdens of self-care. In the case of an unfavorable prognosis in the sense of disability – switching interests to those areas of life that will remain available to the patient. With an unfavorable prognosis, attention, worries, and interests are concentrated on the fate of loved ones, their business.

Anosognosic : active rejection of thoughts about the disease, its possible consequences, denial of the obvious in the manifestation of the disease, attributing them to random circumstances or other non-serious diseases is characteristic. Refusal of examination and treatment, the desire to manage their own means.

The second block includes types of response to the disease, characterized by the presence of mental maladaptation:

• Anxious : for this type of response, continuous anxiety and suspiciousness regarding the unfavorable course of the disease, possible complications, inefficiency and even the danger of treatment. The search for new methods of treatment, the thirst for additional information about the disease, possible complications, methods of treatment, the continuous search for “authorities”. Unlike hypochondria, more interested in objective data about the disease (test results, expert opinions) than their own feelings. Therefore, they prefer to listen more to the statements of others than to endlessly present their complaints. The mood is primarily anxious, depression – as a result of this anxiety).
• Hypochondriacal : focus on subjective painful and other unpleasant sensations. The desire to constantly talk about them to others. On their basis, the exaggeration of the real and the search for non-existent diseases and suffering. Exaggeration of the side effects of drugs. A combination of desire to be treated and disbelief in success, demands for a thorough examination and fear of harm and painful procedures).
• Neurasthenic : behavior of the “irritable weakness” type is characteristic. Outbursts of irritation, especially with pain, with discomfort, with treatment failures, adverse examination data. Irritation often pours out on the first person who comes across and often ends with repentance and tears. Pain intolerance. Impatience. Inability to wait for relief. Subsequently – repentance for anxiety and incontinence.
• Melancholic : characterized by depression by the disease, disbelief in recovery, in a possible improvement, in the effect of treatment. Active depressive statements up to suicidal thoughts. A pessimistic view of everything around, disbelief in the success of treatment even with favorable objective data.
• Euphoric : characterized by unreasonably elevated mood, often feigned. Neglect, frivolous attitude to the disease and treatment. Hope that “it will work itself out”. The desire to get everything from life, despite the disease. Ease of violation of the regime, although these violations may adversely affect the course of the disease.
• Apathetic : characterized by complete indifference to one’s fate, to the outcome of the disease, to the results of treatment. Passive obedience to procedures and treatment with persistent prompting from the outside, loss of interest in everything that previously worried.
• Obsessive-phobic : characterized by anxious suspiciousness primarily concerns fears of not real, but unlikely complications of the disease, treatment failures, as well as possible (but poorly justified) failures in life, work, family situation due to the disease. Imaginary dangers are more exciting than real ones. Signs and rituals become protection from anxiety.
• Sensitive : characterized by excessive concern about the possible adverse impression that knowledge of one’s illness may make on others. Fear that others will avoid, consider inferior, dismissive or wary, spread gossip or unfavorable information about the cause and nature of the disease. Fear of becoming a burden for loved ones due to illness and hostility on their part in connection with this.
• Egocentric : “Departure into illness” is characteristic, showing off one’s sufferings and experiences to relatives and others in order to completely capture their attention. The requirement of exceptional care – everyone should forget and drop everything and take care only of the sick. The conversations of others are quickly translated “on themselves”. In others, who also require attention and care, they see only “competitors” and treat them with hostility. Constant desire to show his special position, his exclusivity in relation to the disease.
• Paranoid : characterized by the belief that the disease is the result of someone’s malicious intent. Extreme suspicion of drugs and procedures. The desire to attribute possible complications of treatment and side effects of drugs to the negligence or malice of doctors and staff. Accusations and demands for punishments in connection with this.
• Dysphoric (characteristically sad and embittered mood).

Interaction with some of these patients can bring significant psychological discomfort to the physician. But knowing the psychological foundations of this type of patient behavior will help the doctor better understand his needs, expectations, fears and emotional reactions, optimally organize the process of interaction with him, and use certain tools of influence. It is important to understand that, even while demonstrating complete indifference to the outcome of treatment, the patient most of all wants to hear words of hope and needs to strengthen his faith in the best. Patients who are constantly worried about their condition need a calm, optimistic and attentive conversation with the doctor, and patients who demonstrate reactions of aggression towards others and the doctor need an authoritative confident position of the doctor, which will help to cope with the strongest fear hidden in the soul for their lives.

Thus, understanding the type of patient’s response to the disease will help to make the relationship between the doctor and the patient more effective, contributing to the psychological well-being of both participants in the treatment process.

Personality types: main differences and their characteristics

Contents of the article . Since ancient times, scientists and philosophers have been interested in the topic of personality classification, many theories have been developed, some of which have become part of modern psychology. In this article, we will briefly analyze the psychological types that the Soviet scientist A. E. Lichko developed while observing adolescents. It is in adolescence that individual character traits and psychological characteristics are quite strongly manifested, which are smoothed out during growing up, but can manifest themselves at a moment of crisis. Even more types of personality classifications can be found in the free online course “Typology of Personality” on the platform “Russia – a country of opportunities”.

Asthenoneurotic type

People with a weak nervous system who are characterized by low stamina, irritability and overwork. They get tired more from psychological stress than from physical exertion. When working for a long time, they need frequent breaks, in general they like to work at their own pace. Such people are hard to switch from one activity to another, it is better not to distract them from the process once again. Any unforeseen situations cause them irritability and anxiety. But these people are very careful and disciplined, they can spend hours doing monotonous work that does not require speed.

Unstable type

Complex personality type, which is characterized by irresponsibility, idleness and addiction, for example, from alcohol, drugs, games. Such people strive for pleasure, they want to constantly relax and have fun. They often have problems with work, they do not want to study and grow professionally. This type of personality can be called a real hedonist who sees entertainment and enjoyment as the main goal of his life. The positive features include openness and sociability.

Conformal type

People who strive to live like everyone else and do not want to stand out from the crowd once again. The opinion of others is very important to them, they try to earn the praise and approval of others. Basically, the way of life of such people directly depends on the society in which they live. If there are religious people around them, then the conformist will be a believer to the point of fanaticism. It is also difficult for them to change something in their lives, it is difficult to pull them out of their comfort zone. Positive features include low conflict, friendliness, devotion and diligence.

Labile type

Empathic people who can feel the mood and feelings of others well. They often make outstanding psychologists and social workers. They are open and always ready to help and support with a kind word. But this type is very sensitive and touchy, does not tolerate criticism in his address, cannot stand loneliness and changes in life.

Cycloid type

People who are prone to drastic mood swings experience strong emotions – either they are overly happy, or they feel sad on the verge of depression. They cope with internal experiences for a long time, they are distinguished by excitability and irritability, sometimes aggressiveness. The positive traits include sociability and friendliness.

Sensitive

People with excessive impressionability, vulnerability and openness. They can get excited about simple things that most people don’t notice. They also keep pleasant and unpleasant memories for many years, which flash in memory as if in reality. This type of personality is difficult to tolerate public criticism, is very afraid of being ridiculed. Positive traits include increased morality, compassion and sociability.

Psychasthenic type

People who are prone to introspection and reflection like to delve into themselves and criticize for shortcomings. They have an excellent memory, so they remember their mistakes well and often engage in self-flagellation. Hence, they have a lack of confidence in their abilities, they take too long to make decisions, doubt and are afraid to stumble again. The positive features include loyalty and reliability, they will never betray loved ones and will always stand up for their own.

Schizoid type

Closed and unsociable people who do not know how or do not want to build close relationships with others. But they do a great job of maintaining business relationships. They have a rich inner world, into which they prefer not to let anyone in. Many people have high intelligence and out-of-the-box thinking.