Document (#34522)

Author

Pajarillo, E.J.Y.

Title

¬A classification scheme to determine medical necessity : a knowledge organization global learning application

Source

Knowledge organization for a global learning society: Proceedings of the 9th International ISKO Conference, 4-7 July 2006, Vienna, Austria. Hrsg.: G. Budin, C. Swertz u. K. Mitgutsch

Imprint

Würzburg : Ergon Verlag

Year

2006

Pages

S.339-347

Series

Advances in knowledge organization; vol.10

Abstract

The use and application of knowledge organization concepts and designs is pervasive in this current global learning society. Individuals, groups and organizations benefit from these knowledge organization tools to improve and enhance learning and system workflows. Practitioners in many disciplines deal with conflicts and problems encountered in managing and enhancing information with solutions and strategies that are inherent and unique in their respective domains, yet germane to the Information Science field. Classification theory is one such Information Science concept that plays a crucial role when organizing the body of knowledge in all disciplines, including Nursing. Determining the medical necessity of clients who require home care nursing is often onerous to prove. Nurses can use a classification scheme to establish nursing care that is reasonable and necessary for potential home care clients. This classification mechanism can be useful when determining the criteria for skill need required for reimbursement by Medicare and other health insurance payors. This research is an exploratory attempt at developing this practical tool. Nurses with home care experience were surveyed and interviewed using home care scenarios. The focus was on how nurses qualify home care clients' appropriateness for services and their medical necessity. The result was a tri-level classificatory scheme to outline this process and its ontological representation.

Content

Vgl.: http://www.ergon-verlag.de/isko_ko/tocs/0497f79b0c0b3ed06/0497f79b0c0c7c33f/index.php.

Field

Medizin

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