Below is a summary of Rob’s EHR activity during his five day stay in the hospital. As an oncologist, you are responsible for examining the patient, ordering tests and procedures, interpreting and analyzing test results and confirming Rob’s diagnosis. Using his EHR and Internet research, answer the questions and be prepared to discuss the responses with the rest of Rob’s healthcare team.

1. Review Rob’s Inpatient EHR: The result of Rob’s CT scan is posted to his EHR. What do his test results reveal?



2. Internet Research: After ordering the CT scan and viewing the results, you order a sputum cytology test and a lung biopsy. Why do you order these tests?
   
   Review Rob’s Inpatient EHR: What do these tests reveal?



3. Internet Research: The results of Rob’s tests are not encouraging and you explain the possible treatment options; which include surgery, chemotherapy, radiation or all of the above. What are the four options in lung surgery? Provide a brief explanation of each.
   
   Internet Research: Also, provide a brief explanation of chemotherapy and radiation.

Below is a summary of Rob’s EHR activity during the first day of his five day stay in the hospital. As a nurse, you are responsible for gathering Rob’s family and health history and obtaining, reading and monitoring his vital signs. Using this EHR and Internet research, answer the questions and be prepared to discuss the responses with the rest of Rob’s healthcare team.

1. Internet Research: You see that the physician has ordered a lung biopsy and sputum cytology. Because the physician only talked to Rob for a short time, it is your responsibility to explain these procedures to Rob. What information do you provide him?
   
   Review Rob’s Inpatient EHR: What do Rob’s tests reveal?



2. Internet Research: Rob knows that a mass has been found on the right lobe of his lungs and that it could be cancer. What will you tell Rob about the disease and treatment that could include surgery, chemotherapy and radiation?



3. Review Rob’s Inpatient EHR: Listed on his EHR, what is Rob’s blood pressure when he is admitted as an inpatient?
   
   Internet Research: Should Rob need chemotherapy, how can the chemotherapy medications and having high blood pressure impact his health?

Below is a summary of Rob’s EHR activity during his five day stay in the hospital. You have the results of his chest X-ray and see several other tests are to be performed. As a laboratory or radiology technologist, you are responsible for obtaining and providing test results to assist the physician in diagnosing Rob’s condition. One of those tests is an interior inspection of the lung called sputum cytology. Using his EHR and Internet research, answer the questions and be prepared to discuss the responses with the rest of Rob’s healthcare team.

1. Internet Research: List four types of lung cancer biopsy procedures and explain what each entails.



2. Internet Research: Why was a sputum cytology performed?



3. Review Rob’s Inpatient EHR: Laboratory results, shown in blue or red, indicate abnormal results. Which tests of Rob’s are abnormal?
   
   On Your Own: Why do you think it helps the healthcare team to see the lab results this way?



4. Internet Research: You meet with the physician and review all the tests he has ordered. How does a spirometry test (also known as a pulmonary function test), a PET scan and a Complete Blood Count (CBC) help determine Rob’s treatment options?
   • Spirometry (Pulmonary Function) test
   • Bone or PET scan
   • Complete Blood Count

Below is a summary of Rob’s EHR activity during his five day stay in the hospital. As a pharmacist, you are responsible for ensuring Rob receives the proper medications ordered by the physician. You are also responsible for reviewing any adverse reactions Rob might have. If he were taking any medications currently, you would have to know about possible interactions with new medications, both now and in the future. Using his EHR and Internet research, answer the questions and be prepared to discuss the responses with the rest of Rob’s healthcare team.

1. Review Rob’s Inpatient EHR: You review Rob’s EHR and notice that he is currently taking a medication (listed under home medications). What medication is he taking?
   
   Internet Research: What is this medication and what condition does it treat?
   
   Internet Research: If Rob needs chemotherapy, how can the chemotherapy medication and having high blood pressure, treated with medication, impact Rob’s health?



2. Review Rob’s Inpatient EHR: The oncologist has prescribed additional medications to fight the lung cancer. List each medication.
   
   Internet Research: Provide Rob with a brief explanation of each.



3. Internet Research: You realize that Rob’s test results indicate lung cancer and prepare information for him regarding chemotherapy and radiation – two possible treatments. What can you tell him about how the drugs/treatments are administered and their side effects?

Below is a summary of Rob’s electronic health record (EHR) activity during his five days in the hospital. As the medical and health services manager, you are responsible for making sure he receives excellent care. You will also figure Rob’s bills, consisting of his tests, procedures, room charges, supplies and medications. Using his EHRs, Virtual Physical Exam (VPE) and Internet research, fill out the billing statements and be prepared to share this information with the rest of Rob’s healthcare team.

• MHSM – Bill (which includes both a ED and inpatient statement)
• MHSM – Bill Reference
• Rob’s EHR – PCP Chart
• Virtual Physical Exam
• Rob’s EHR – Inpatient Chart (link below)

1. Use the blank copy of Rob’s PCP and Inpatient bills and the Bill Reference to calculate his costs. In his EHRs, look for the number of times a test is administered, number of days a cost is incurred or the units per day a medication is administered. You may need to do additional Internet research. Some helpful sites are www.healthcarebluebook.com, www.fairhealthconsumer.org and www.pharmacychecker.com.

Below is a summary of Rob’s EHR activity during his five day stay in the hospital. As the health coach, you will recommend lifestyle changes to prevent symptoms from recurring and decrease the need for future emergency care or hospitalization. Rob’s lungs have been permanently damaged and he will need to understand to what extent and what lifestyle changes he will need to make. You will provide the education he needs to understand his diagnosis and the risk factors that may have caused his condition. Using his EHR and Internet research, answer the questions and be prepared to discuss the responses with the rest of Rob’s healthcare team.

1. On Your Own: At an average national cost of $8.39 per pack of cigarettes if Rob quits smoking, as advised, how much could he save each year?



2. Internet Research: There are two main types of lung cancer associated with tobacco use – small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC). NSCLC is subdivided into squamous cell carcinomas, adenocarcinomas and large-cell carcinomas. Explain these type of cancers to Rob – what they are and which is the most common?
   • SCLC
   • NSCLC
     • Squamous cell carcinoma
     • Adenocarcinoma
     • Large-cell carcinoma



3. Review Rob’s Inpatient EHR: Besides educating Rob about his lung cancer, you also want to help him make other lifestyle choices that can impact life expectancy. In his EHR you notice a few areas in his Vital Signs and, Measurements and Weights sections that are borderline high and could be improved. What are those areas and his results?