International Public Health Policy Essay example -- Graduate Admission

International Public Health Policy    As a student of international public health, I intend to obtain an essential part of my instruction overseas. My formal education, with the potential to undermine more culturally appropriate knowledge and practices considering its decidedly Western perspective, is still incomplete. The Harvard Public Health Program will allow me the flexibility to learn Asian public health policy and programming, the benefit of which is undeniable. Asia has dealt admirably with the effects that rapidly changing socioeconomic conditions have had on health, particularly the emergence of chronic diseases that characterize industrialized nations side by side with infectious diseases that characterize still developing nations. All of this has been made even more complex by the emergence of new diseases such as AIDS. The decision to pursue public health was not a haphazard one, but the result of a thoroughly thought out estimation of my interests, concerns and capabilities. When I was seventeen, I wrote an essay for college that described my motivation and commitment to learning a subject well for a purpose. Sitting under covers in a small, poorly lit room, listening to my father swear at the walls during a cocaine high, I wanted to understand substance abuse and addiction. The purpose then was to "grow up and learn why people become addicted to things that hurt them, their bodies. . . and their children," and my intent was to use that information in my work as a substance abuse rehabilitation counselor. During my undergraduate years, I participated in numerous and rigorous courses related to my interest in substance abuse, one of which led to my involvement with a university-sponsored program called... ..., considering the World Health Organization's revised definition of health: "...a state of complete physical, mental and social well-being, and not merely the absence of disease," and one that cannot be accomplished with too narrow a perspective. Similar to when I was seventeen, I am still learning for a purpose, having recognized that I will always feel the obligation to do so. Yet it is now with the blessing and encouragement of an international community with whom I attempt to bridge the growing inequity between our countries, actualizing that obligation through the transfer of the knowledge and experience that I am fortunate enough to receive. Most importantly, I wish to apply, on their terms, the theory, methodology, and technology that I have been taught, thereby fulfilling the responsibility that I have to use this knowledge in the most beneficial manner.

Rape fantasies :: essays research papers

Written in 1977, "Rape Fantasies" appears to be a recap of a conversation among several women during their lunch hour, a few of them playing bridge, one--Chrissy the receptionist--reading aloud from a tabloid. When Chrissy asks the question, "How about it, girls, do you have rape fantasies?" the story unfolds with each woman's response, all retold from the perspective of Estelle, who's doing her best to deflect the entire conversation by concentrating on her bidding. The conversation is tragically ironic, moving from woman to woman, Darlene calling the entire subject "disgusting," Greta describing a Tarzan-like scenario, Chrissy describing hers in a bubble bath, when Estelle, ever the voice of reason, reminds them that what they're describing are sexual fantasies: "Listen . . . those aren't rape fantasies. I mean, you aren't getting raped, it's just some guy you haven't met formally who happens to be more attractive than Derek Cummins . . . and you have a good time. Rape is when they've got a knife or something and you don't want to" (104.) Estelle then describes her rape fantasy where she deflects her attacker by squirting juice from a plastic lemon in his eyes ("You should hear the one about the Easy Off Cleaner"), but also includes the one where "this short, ugly fellow comes up and grabs my arm . . . [and] I say, kind of disgusted, 'Oh for Chrissake,' and he starts to cry," which prompts a wave of sympathy in Estelle (106). And there are more, each with Estelle warding off her attacker through outsmarting him ("I've just found out I have leukemia"), or talking him out of it. As the narrative continues, the reader becomes aware that Estelle is addressing someone in addition to the reader--"I hope you don't mind me holding my nose like this . . ." (107) and that person is probably a man (twice Estelle says, "But I guess it's different for a guy"). As the story ends, we realize that Estelle all along has been in a bar, speaking to a man she has just met, worrying about the possibility she will be raped by him. "Like, how could a fellow do that to a person he's just had a long conversation with, once you let them know you're human, you have a life too, I don't see how they could go ahead with it, right?

Mgt/230 Week 1 Assignment

Mgt/230 Week 1 Decision Making Process Paper University of Phoenix People should make decisions every day, some of those decisions are easy to make, while others are quite difficult to implement. An appropriately combined and organized decision-making process will help to control this issue and bring a positive outcome for those involved. The decision-making process may become challenging for people due to â€Å"the lack of structure and entail risk, uncertainly and conflict† (Bateman and Snell, 2012, p. 86).That is why people trying to make important personal or professional decisions should have an appropriate model to follow in order to avoid these challenges. Bateman and Snell identified six steps or stages of decision-making process which may be attached to any problem or decision. First, it is necessary to identify and analyze the problem. The problem at hand for me was the necessity to purchase my own home. In 2002 I was renting a home in a small city with my husband an d son living there as well. The house was also shared with my Mother-in-Law, and it was too small for all four of us to share.My husband and I realized after a short period of time that this living situation was not going to work out and that we should start looking for a place of our own. Since I am an animal lover and was the owner of one horse and one dog at that time, finding a home that also had a small amount of acreage was also necessary to accommodate us all. Generating and evaluating alternative solutions (steps 2 and 3 in the decision making process) was really not an option for us as we knew exactly what we would have to do if we were to obtain the right place for all of us to live.The only alternative solution in this situation would have been to rent a large piece of property with a larger home and we had come to a point in our lives where purchasing seemed like the better investment. Step 4 in the decision making process is, making the choice. We searched around for ju st the right place to purchase. It took several months of searching before we happened upon the home we ultimately chose. The house wasn’t quite as big as we were hoping for but we thought we could build an addition and do some remodeling to make it perfect.The property attached to the house was large enough to house my horse and our dog, and for my son to play. The decision was made, we were purchasing this house. Step 5 in the process is implementing the decision. After the decision was made to purchase our new home, we set up meetings and appointments with the realtor, our bank and our lawyer to finalize paperwork on the loan and other necessities. All paperwork was signed and keys were handed over to us about a month later. Once the house was ours we quickly made the necessary changes so that it would accommodate our entire family, by adding an extra room and re-painting the entire house.We built a barn to house the horse and put in a shed for storage. We thought it was p erfect. Step 6 in the process is evaluating the decision. Shortly after purchasing our home and property everything was going well, and this continued for many years to come, even though it was probably more work than we had initially expected, we were happy with our decision. Living in the country on our own farm with barely a neighbor to be seen was definitely the way to go. Looking back on this decision some 10 years later, I still believe I made the right decision even though my life has completely changed since that time.The house and property suited us very well up until about 4 years ago after my divorce. I see now that the house is not nearly large enough for my even larger family. Since my divorce I have had two more children and am getting re-married and this home is not nearly large enough for five people, especially if we have guests over for holidays or birthdays. We are currently in the decision making process once again, that being the possible purchase of yet another , larger, home and more acreage as the number of farm animals has grown over the past 10 years as well.Having the information that I do now, in our readings, I am going to go through the steps one by one and be sure that my ultimate decision will be the right one and that this new place (if we purchase one) will be perfect for more than 10 years. References Bateman, T. S. , & Snell, S. A. (2010). Management: leading & collaborating in a competitive world (9th ed. ). Retrieved from The University of Phoenix eBook Collection database.

Epitaph and Dreaming Black Boy

a) Compare the ways in which these two poems deal with the experience of oppression and racism. b) State which of the two poems you find more disturbing, and give reasons to support your answer. c) Identify and comment on TWO poetic devices used in each poem to highlight the workings of oppression or racism. â€Å"Dreaming Black Boy† and â€Å"Epitaph† are two poems which address the issues of oppression and racism. though they both deal with the same problem, it is handled and discussed differently. In † Dreaming Black Boy†, the persona, a young black boy in school, talks about his aspirations and dreams. He hopes for an end to racism. The persona tries to use his education to try to escape the harsh reality of racism. He not only mentions what is going on around him now, but also the past and even how he would like things to be in the future. He longs for acceptance, a good education, success, to travel and a break from mental slavery. He fails to grasp that despite his intelligence and physical maturity, the racist treatment will continue, thinking that what he experiences as a young boy is the worst, he has yet to find out how it is in the future. On the other hand, â€Å"Epitaph†, a significantly shorter poem, is about a black slave who was hanged, people stop what they are doing to watch the sight, yet the rest of the world continues to go on. The sugar cane continues to grow, unlike in â€Å"Dreaming Black Boy†, the persona in â€Å"Epitaph† is an adult, looking on a past occurrence and commenting on how these types of events have impacted on our lives today. â€Å"Epitaph† appears to be the most disturbing as it suggests that many of these slaves' deaths are forgotten. The idea or notion that life goes on after you die and all you are awarded is a â€Å"pause†. The images in â€Å"Epitaph† are also more graphic. In â€Å"Dreaming Black Boy†, the poet uses euphemism to down play the harsh reality of the young black boy. For example, â€Å"plotters in pajamas† is used to refer to the KKK, a group infamous for the terror they caused on the black race. The main literary device used in â€Å"Dreaming Black Boy† is allusion. The persona alludes to white supremacy groups, a famous singer etcetera, to express the things he would like to change about his reality. â€Å"Epitaph† uses the â€Å"apostrophe† to give a visual image f the black slave hanging and swinging as he is hanged. This metaphor is effective in showing also how the slave has taken on the problems of the black race as his own. And his death belongs to the blacks. It is their history. Racism and slavery are two of the most controversial and oppressive elements in human history. Though both poems differ in style and technique, both successfully describe the physical and emotional effects of racism and oppression (slavery). This success is achieved through the use of allusions, vivid images, symbolic language and even euphemism. ) Compare the ways in which these two poems deal with the experience of oppression and racism. b) State which of the two poems you find more disturbing, and give reasons to support your answer. c) Identify and comment on TWO poetic devices used in each poem to highlight the workings of oppression or racism. â€Å"Dreaming Black Boy† and â€Å"Epitaph† are two poems which address the issues of oppression and racism. though they both deal with the same problem, it is handled and discussed differently. In † Dreaming Black Boy†, the persona, a young black boy in school, talks about his aspirations and dreams. He hopes for an end to racism. The persona tries to use his education to try to escape the harsh reality of racism. He not only mentions what is going on around him now, but also the past and even how he would like things to be in the future. He longs for acceptance, a good education, success, to travel and a break from mental slavery. He fails to grasp that despite his intelligence and physical maturity, the racist treatment will continue, thinking that what he experiences as a young boy is the worst, he has yet to find out how it is in the future. On the other hand, â€Å"Epitaph†, a significantly shorter poem, is about a black slave who was hanged, people stop what they are doing to watch the sight, yet the rest of the world continues to go on. The sugar cane continues to grow, unlike in â€Å"Dreaming Black Boy†, the persona in â€Å"Epitaph† is an adult, looking on a past occurrence and commenting on how these types of events have impacted on our lives today. â€Å"Epitaph† appears to be the most disturbing as it suggests that many of these slaves' deaths are forgotten. The idea or notion that life goes on after you die and all you are awarded is a â€Å"pause†. The images in â€Å"Epitaph† are also more graphic. In â€Å"Dreaming Black Boy†, the poet uses euphemism to down play the harsh reality of the young black boy. For example, â€Å"plotters in pajamas† is used to refer to the KKK, a group infamous for the terror they caused on the black race. The main literary device used in â€Å"Dreaming Black Boy† is allusion. The persona alludes to white supremacy groups, a famous singer etcetera, to express the things he would like to change about his reality. â€Å"Epitaph† uses the â€Å"apostrophe† to give a visual image of the black slave hanging and swinging as he is hanged. This metaphor is effective in showing also how the slave has taken on the problems of the black race as his own. And his death belongs to the blacks. It is their history. Racism and slavery are two of the most controversial and oppressive elements in human history. Though both poems differ in style and technique, both successfully describe the physical and emotional effects of racism and oppression (slavery). This success is achieved through the use of allusions, vivid images, symbolic language and even euphemism.

Dystopian Societies-1984 vs Fahrenheit 451

Dystopian Visions An imaginative society consisting of oppressive squalor in which all are heavily restricted by the absolute superiority of the ruling party. A society where repression and restrictions seem boundless, while the individual liberty of the citizen seems boundlessly obstructed. A society where mental deprivation and deception is the goal of the guardian; a society where misery and poverty are thrust upon the unsuspectingly loyal citizens; a society where the well- being of the people are of imperceptible acknowledgement, yet its inhabitants have been manipulated into perceiving such as utopian. Contrary to their deceit induced perceptions, these characteristics are quite the opposite of utopian, they are dystopian! Many authors portray their own vision of a dystopia through novels. Two highly intriguing dystopian novels are George Orwell’s, â€Å"1984,† and Ray Bradbury’s, â€Å"Fahrenheit 451. † Their visions were strikingly similar as the themes were both based on totalitarian governments maintaining control through propaganda and mental/social deprivation (mostly corporate and bureaucratic controls, although technological control was utilized). The protagonists find themselves in almost identical situations, for they have become enlightened of the misery, sacrifice, and evil that their society possesses. But they must conceal their knowledge, leaving them trapped, although they could not keep it hidden forever. In both novels came the mental sheltering of the society to thwart contradicting or rebellious thought that would come with the enlightenment of the sacrifices the society was withstanding. This social and mental control would render the majority of society incapable of independent thought, allowing the injustices to proceed. Forced ignorance masked the evil the government had laid upon them and if one were to unveil the ignorance, they had to conceal it with their lives. In both novels, those who could not shield their enlightenment would fall victim to the strong and cunning police forces of the society. These forces would brutally murder and vanquish the existence of those free of the government’s mental sanitation. As shown by the â€Å"thought police† in â€Å"1984†. This shows the extent to which the extinction of information and individuality was pursued. Another shared characteristic, although much more obvious in â€Å"1984,† is the use of propaganda in manipulating the people. In ‘Fahrenheit 451,† the propaganda came in the form of death. They would publically kill those who disobeyed, just as you see in the end of movie when they murder â€Å"Montag†. In â€Å"1984,† the society was infested with â€Å"Big Brother† propaganda. With posters, â€Å"Two Minutes Hate†, inflated numbers, and constant reassurance of â€Å"Big Brother† being the flawless and great protector of everyone, they deceived the people. I would like to point out the fact that they didn’t share the same figurehead type worship. In â€Å"1984,† everything and everyone was focused and revolved around â€Å"Big Brother†, whereas in â€Å"Fahrenheit 451,† there wasn’t as much as the singular idol to worship and direct praise towards. These societies painted by Bradbury and Orwell both utilized mental and social hindrance, through strong regulations. This type of control is otherwise known as the bureaucratic control. In â€Å"Fahrenheit 451† they put heavy restrictions on literature, and would incinerate all books they could locate. In â€Å"1984,† they were absolutely relentless with their regulations, even the wrong facial expression could get you killed. Corporate control was also highly utilized in these societies. Specifically, they would brainwash you as a daily routine called â€Å"Two Minutes Hate† in the, â€Å"1984,† novel. Here is an example of the Two Minute Hate’s effect on the people, â€Å"a desire to kill, to torture, to smash faces in with a sledge hammer, seemed to flow through the whole group of people like an electric current†¦Ã¢â‚¬  (Orwell14). The government successfully manipulated the inhabitants into loving and feeling completely dependent to â€Å"Big Brother† and the government, while completely despising whoever â€Å"Big Brother† portrayed as the enemy. Big Brother† altered everything to make him seem absolutely flawless and created a false sense of superior and improving living conditions. All of this advertising and false media was not unique to, â€Å"1984,† though. In â€Å"Fahrenheit 451,† the government would use the media to show the deaths of those who broke regulations in place. Technological control was a third control used, as Telescreen monitors were implanted everywhere in â€Å"1984,† to ensure complete surveillance to avoid any risk of conspiracies or deviation from their norms. In â€Å"Fahrenheit 451,† they had robotic dogs that could sniff out and locate any human needed. The protagonists in these novels, Montag and Winston, are both unique to their society for they had the power to unveil the mask of ignorance and be enlightened to the true colors of the society they lived in. They both felt trapped and desperately needed to escape or alter their society. The differences between them and the others are made even more apparent by their wives and how they end up feeling about them. Winston mentally nicknamed his wife, â€Å"the human sound track,† (Orwell66) during their relationship. This being very similar to Montag’s feeling towards his bland and uninteresting wife as well. They both are overwhelmed by the now painfully visible misery and evil their society consists of, but must protect such thoughts with their lives. A significant difference between the two characters is the fact that Guy Montag was successful with his attempt to better society, for his city was destroyed leaving it up to him and some others to rebuild society. This unlike Winston, who was captured, tortured, and then allowed back into society with a new conformist attitude. These novels are criticizing the paths and patterns that human governments tend to take. With governments concealing/censoring information from the people and corruption being so widespread and apparent; these authors are presenting a possible outcome of our chronic blunder. Orwell was even directly criticizing the rule of Stalin in his day and how horrible such a society is and can be. These societies reflect the negatives of our society in a bloated and extreme way and if these relevant evils are not eliminated, our society is at risk of being reduced to a dreaded dystopia.

Client Paper Essay

In society today, there are numerous issues facing human services clients. Homelessness, services having their funding cut, and the association of stigmatization that one might receive while accepting services are just a few issues. Many of those who face these issues may always face substance abuse issues or may be in domestic violence situations. Due to the additional factors, clients may not feel as though they deserve to receive help, and therefore may not seek out the needed help to get their life back on track. One of the largest problems facing society today is substance abuse. The individuals that face this issue are able to receive services from several agencies, whether they need medical health care, mental health care, or drug or alcohol rehabilitation services. They are also able to receive services in all three areas if the individual requests it. (Samet, Friendmann, & Saitz, 2011). While seeking these services, some individual may face the burden of not having health insurance, lack of funds and transportation, or providers may lack the ability to make the best referrals for the individuals. For instance, if a man with a history of methamphetamine abuse who has been incarcerated is released from prison, he may not have family nearby that can house him, may have no where to turn if there is no agency that can take him and house him. In his case, he will need to secure treatment in an inpatient substance abuse program that will be aggressive enough to help him with his addiction. This will help alleviate him being on  the street in search of food, water and shelter which is state in â€Å"Maslow’s Hierarch of Needs† (Woodside, 2011). In recent studies, it has been shown that approximately two thirds of homeless adults would meet the criteria for substance dependency. An additional 20 percent of homeless persons meet the criteria for having severe mental illnesses. Many of these individuals have received dual diagnoses, suffering from substance abuse and also having a mental illness. (Krogel et. Al, 1999). Not only can these clients suffer from substance abuse and mental illness, there can be many other issues they face. Physical disabilities, homelessness, and health issues can be rampant among individuals. Different situations can be the cause of these issues, such as environmental influence or societal changes (Samet, Friedmann, & Saitz 2001). Traditionally, providers would only focus on the issues which are specific to their scope of practice, however, when treating the â€Å"whole client† it is important to remember these issues can go hand in hand. In order to treat one of the issues, a provider must look at how the client got to the point where they are. Treatment, then, would need to be from all models so it would be effective (Samet, Friedmann, & Saitz 2001). For this to take place appropriately, all providers would need to work together with effective and extensive to treat all aspects of issues the client is facing. If this is not executed correctly, the client cannot succeed and may fall through the cracks, or wind up in the same place they were in previously. For example, the gentleman discussed earlier that was incarcerated and has a substance abuse issue may suffer from a mental illness as well as a substance abuse issue. In this instance, a primary provider would need to find a provider who works with addictions, and a provider who works with mental health. Together, the three professionals would need to form a plan with the client and communicate with every party involved in order for the treatment to be effective. If the primary provider could not provide a professional for the substance abuse and a professional for the mental health, the client could easily fall back into old habits and lose all progress that may have been made. This could result in the client injuring himself or another person,  additional jail time, or even death. The gentleman in this example gives us a perfect example of where the treatment provider has been previously aware of issues concerning the client and is able to find the resources and agencies needed to make the community referrals. Unfortunately, there is a commonality that each treatment provider is faced with a client that only has one single issue. However, in this example, the client has more than one issue ranging from substance abuse to mental illness to homelessness. The provider will then need to determine if the client will need additional assistance with other issues that may be outside our scope of practice. For example, if the provider is working in a substance abuse treatment program the primary focus is helping the client to stop using drugs and/ or alcohol. As the client is no longer supposed to use substances or drink, the client can no longer reside in an environment where substances and/or alcohol are being used; this can become a trigger for the client and risk t he client’s sobriety and recovery. This client is now homeless and will need assistance with housing. As the client continues in sobriety the treatment provider may notice that the client appears to be struggling with mental health issues that have not been previously diagnosed; this client will now need to be referred to a mental health provider for further evaluation and possible medication management. The provider has been made aware of these arising situations through communication and effective listening skills while interacting with the client in the group and individual therapy process. The provider will need to be aware of the client’s verbal and non-verbal cues as the clients’ affect may be incongruent with the current situation. The provider will also need to be aware of the client’s cultural issues as treatment may cause the client to have stigmatization within his or her family unit. The treatment provider will also have to work with resistant clients, clients who are over demanding, and clients that are unmotivated. Often times these clients have hidden issues that need to be uncovered and addressed in order to move forward in their recovery process. Working with these clients can be a difficult process however if the provider can find a way of working with these clients in non-traditional manners we will help to uncover these issues and move them forward in their recovery process. Working with  client’s who have substance abuse issues is a very challenging job that poses many challenges not only for the client, but also for the treatment provider. We have chosen to work in a field that is extremely broad and which spans across many scopes of practice. Our clients face a wide range of issues that can be ever changing. Our jobs as Human Services workers will be to help identify and treat these clients and their individual needs to improve the client’s level of functioning within the community and his or her family unit needs to provide the client with the best treatments and solutions. References Samet, J, MD, Friedman, P, MD, Saitz, R, MD (2001). Benefits of Linking Primary Medical Care and Substance Abuse Services: Patient, Provider, and Social Perspectives. http://archinte.jamanetwork.com/article (Retrieved on 8 April 2013). Koegel, P, Ph.D, Sullivan, G, MD, Burnam, A, Ph.D, Morton, S, Ph.D, Wenzel, S, Ph.D. (1999). Utilization of Mental Health and Substance Abuse Services Among Homeless Adults in Los Angeles. http://journals.lww.com/lww-medicalcare (Retrieved on 8 April 2013). Woodside, M. (2011). An Introduction to Human Services, 7e. www.ecampus.phoenix.edu (Retrieved on 7 April 2013).

Evolution of health care information system Essay

In this paper, we will compare and contrast Skilled Nursing Facilities from 20 years ago to today. Skilled Nursing facilities of today are both similar and different from what they were like two decades ago. Similarities comprise of the organizational structure, including different departments, and the various roles within those departments. The roles of nurses, doctors, administrators, and therapists have not changed much in the last 20 years, and it is still the same hierarchical approach where a top down approach to administration and management is used . The differences outweigh the similarities as many changes have taken place over the years. Most of the changes have been as a result of the advances in information technology in health care. Some of the differences include utilization of information systems such as e-mail for communication, documentation using electronic medical records (EMR), and utilization of advanced medical equipment. Two significant advances in health care information system over the last two decades has been the use of EMR and the advances in medical devices. These two advances have changed how care is being delivered in health care in general and more specifically, in skilled nursing facilities. Two decades ago, majority of documentation was done by hand, often resulting in disjointed, redundant documentation without the ability to extrapolate meaningful data for analytical and benchmarking purposes. By contrast with the current EMR documentation, there is very little duplication of documentation, and internal and external benchmarking is available for quality improvement purposes. Today’s skilled nursing facility is dependent upon computer and information systems to run practically every aspect of the organization. Billing systems, pyxis systems for medication dispensing, minimum data set documentation and transmission to The Centers for Medicare and Medicare Systems are just some examples of the use of computer technology used in nursing facilities of today. Skilled Nursing Facilities using outdated technology, hand- written documentation, and outdated medical equipment will have to adapt to and invest in technology and equipment if they want to stay competitive with the market. Information System in Skilled Nursing Facility of Today The skilled nursing facility that I currently work at is a long-term care facility founded in 2001 and is affiliated with a local nonprofit hospital. This 150-bed state-of-the-art facility has 40 sub-acute beds, 30 dementia beds, and the remainder, are long-term beds. The sub-acute unit has all private rooms. All beds are Medicare and Medicaid certified. This modern facility has electronic medical records and uses internal and external benchmarking data to track and trend data. They use this data to improve clinical and financial outcomes and as a result of this, have been able to improve their financial viability and have a five-star rating on the CMS Nursing Home Compare website. The physicians and nurses can access lab results, and x-ray results online via a secure connection. The admissions department can cost out patients medications and the rehabilitation department, in collaboration with the MDS coordinators can determine reimbursement based on patient needs, prior to the patient being admitted. Data is stored in a data warehouse (server) where it can be mined by authorized personnel only. The advanced medical equipment use has resulted in high level of job satisfaction and resulted in staff retention. Analysis of Data Used: 20 Years Ago to Now Twenty years ago, skilled nursing facilities did not have the ability to collect and analyze data. The need to collect data was there, and some manual data collection was done, but it was impossible to collect significant clinical and financial data and use it for analytical purposes. Fast forward 20years to the present and we now have the ability to have access to significant data that can be used to improve systems and processes for better outcomes. Of significance has been the minimum data set in nursing homes. The Minimum Data Set (MDS) is part of the federally mandated process for clinical assessment of all residents in Medicare and Medicaid certified nursing homes. This process provides a comprehensive assessment of each resident’s functional capabilities and helps nursing home staff identify health problems. Care Area Assessments (CAAs) are part of this process, and provide the foundation upon which a resident’s individual care plan is formulated. MDS assessments are completed for all residents in certified nursing homes, regardless of source of payment for the individual resident. MDS assessments are required for residents on admission to the nursing facility, periodically, and on discharge. All assessments are completed within specific guidelines and time frames. MDS information is transmitted electronically by nursing homes to the national MDS database at CMS. National and regional benchmarking is available through reports and government rates nursing homes based on these benchmarks. Examples of available benchmarking are percentage of restraints used, facility-acquired wounds, infection rates, falls, and decline in activities of daily living. Two Major Technological Advances influencing Health Care Information System (HCIS) Health care information systems are a prerequisite for coordinated, integrated, and evidence-informed health care. Introduction and use of EMR has changed how health care is delivered across the spectrum and will continue to change. It has allowed us to collect clinical data and use it to use evidence-based best practices. It has given the ability to decrease redundancy in documentation and increase patient safety by flagging medications that may be contraindicated if given in combination with another medication. Another major technological advance has been in the area of medical devices and equipment. Advanced medical devices used for diagnosis has helped detect diseases more rapidly and as a result, saved lives. The use of telemedicine is for patients who wish to remain in their homes versus a nursing home have been significant. Nurses can check patients’ vital signs frequently and collaborate with the physician to monitor patients and change treatment as needed before patient becomes acutely ill. This has lessened the need for the patients to be re-hospitalized, hence, better outcome for the patient as well as lesser financial impact. Formally defined, telemedicine is the use of medical information exchanged from one site to another via electronic communications to improve a patient’s clinical health status. Telemedicine includes a growing variety of applications and services using two-way video, e-mail, smart phones, wireless tools, and other forms of telecommunications technology. Conclusion There are some similarities and vast differences between the operations of a long-term care facility of today versus one from 20 years ago, specifically as it relates to information systems and how data was used than in comparison with the way it is used today. Today, every process, and system in a long-term care facility is dependent upon information technology to function. Financial and clinical outcomes are measured and compared with other organizations, both, nationally, and regionally to gauge and improve processes. One major technological advance has been in the area of use of EMR and access to patient information, such as lab results being readily available, enabling providers with quick decision-making ability. Another major technological advance has been in advanced medical equipment and telemedicine, allowing exchange of information for improved patient health status. Future advancement in information technology will change the way health care is delivered and facilities that embrace this change and use it to their advantage will come out ahead. References www. americantelemed. org/learn www. cms. gov www. lse. ac. uk