MEAS 225 - CCMA Workforce Development Prep

1. Demonstrate an understanding of the healthcare systems and settings.
   1. Roles, responsibilities, scope of practice, and titles of medical assistants
   2. Roles, responsibilities, scope of practice, titles, and credentials of medical providers and allied health personnel
   3. Licensing versus certification; maintenance of certification
   4. Types of health care organizations and delivery models (for example, outpatient/inpatient, patient centered medical home, collaborative care, accountable care organization, hospice, home health care, mobile health unit)
   5. Technology-based methods for providing health care and health information (for example, telehealth/virtual, patient portals)
   6. Health care payment models (for example, fee for service, value-based plans)
   7. General versus specialty health care and services
   8. Ancillary services and complementary therapies
2. Demonstrate an understanding of Medical Terminology
   1. Common abbreviations, acronyms, and symbols
   2. The Joint Commission’s (TJC) “Do Not Use” List
   3. Medical word building (roots, prefixes, suffixes, plurals)
   4. Lay terms and medical terms for common conditions, symptoms, and procedures
   5. Positional and directional terminology
3. Demonstrate an understanding of basic pharmacology
   1. Drug classifications (for example, diuretics, hypoglycemics, analgesics, over-the-counter), indications, commonly prescribed medications
   2. Drug classifications and schedules of controlled substances
   3. Differences between side effects and adverse effects; and between indications and contraindications
   4. Measurements (for both metric and standard systems) and dosage calculations, mathematical conversions/formulas
   5. Forms of medication (for example, tablets, patches, capsules)
   6. Look-alike/sound-alike medications
   7. Routes of medication administration
   8. Pharmacokinetics (absorption, distribution, metabolism, excretion)
   9. Rights of medication administration 
   10. Principles of storage and disposal
   11. Sources of drug/medication information and FDA regulations
4. Demonstrate an understanding of nutrition
   1. Dietary nutrients, suggested guidelines, and food labels
   2. Dietary needs related to diseases and conditions (for example, diabetes, kidney disease, celiac disease)
   3. Vitamins and supplements
   4. Eating disorders
5. Demonstrate an understanding of psychology
   1. Developmental stages
   2. Signs and symptoms of common mental health conditions (for example, anxiety, depression, PTSD, ADHD)
   3. Environmental and socioeconomic stressors
   4. Psychology of the physically disabled, developmentally delayed, and those who have diseases
   5. Defense mechanisms
   6. End of life and stages of grief
6. Demonstrate an understanding of anatomy and physiology
   1. Cell structure (for example, nucleus, cell membrane, cytoplasm, ribosomes, mitochondria, lysosomes)
   2. Anatomical structures, locations, and positions
   3. Structure and function of major body systems, including organs and their locations
   4. Interactions between organ systems, homeostasis
   5. Signs, symptoms, and etiology of common diseases, conditions, and injuries
   6. Diagnostic measures (for example, labs, imaging, biopsies) and treatment modalities (for example, infusion, chemotherapy, medication, surgery)
   7. Incidence, prevalence, risk factors, and comorbidities
   8. Epidemics and pandemics
7. Demonstrate an understanding of general patient care
   1. Ensure patient safety within the clinical setting.
   2. Identify patient. 
   3. Complete a comprehensive clinical intake process, including the purpose of the visit.
   4. Measure and obtain vital signs.
   5. Convert measurements of vital signs.
   6. Obtain anthropometric measurements.
   7. Identify, document, and report abnormal signs and symptoms
   8. Prepare examination/procedure room.
   9. Prepare and maintain a sterile field.
   10. Prepare patient for procedures, including providing education.
   11. Assist provider with general and specialty physical examination.
   12. Prepare and administer medications and/or injectables using nonparenteral routes.
   13. Prepare and administer medications and/or injectables using parenteral routes (excluding intravenous).
   14. Manage injection logs (for example, controlled substances, tuberculosis medications, immunizations).
   15. Perform staple and suture removal.
   16. Perform ear and eye irrigation.
   17. Administer first aid and basic wound care.
   18. Identify and respond to emergency/priority situations.
   19. Assist provider with patients presenting with minor and traumatic injury.
   20. Assist with surgical interventions (for example, sebaceous cyst removal, toenail removal, colposcopy, cryosurgery).
   21. Review provider’s discharge instructions/plan of care with patients.
   22. Follow guidelines for sending orders for prescriptions and refills electronically, by telephone, fax, or email.
   23. Order and obtain durable medical equipment (DME) and supplies (for example, CPAP, wheelchair, hospital bed).
   24. Document relevant aspects of patient care in patient record.
   25. Operate basic functions of an electronic medical record/electronic health record (EMR/EHR) system.
   26. Implement updates in EMR/EHR (for example, quality measures, alerts, telemedicine, population health reporting).
   27. Enter orders using computerized physician order entry.
   28. Conduct telehealth or virtual screenings in the context of a telehealth/virtual visit.
   29. Patient identifiers (for example, name, date of birth [DOB], medical record number, last 4 digits of Social Security Number [SSN])
   30. Elements of a patient medical/surgical/family/social history
   31. Screenings and wellness assessments (for example, tobacco cessation, alcohol use, HIV screening)
   32. Mental health screenings (for example, mini mental state exam; anxiety and depression screening tools
   33. Blood pressure-methods for obtaining (manual, palpating, electronic), in-range and out-of-range values, common errors, and trouble-shooting methods
   34. Orthostatics-methods for obtaining, common errors
   35. Pulse-methods for obtaining in various locations, abnormal rhythms, in-range and out-of-range values
   36. Respiratory rate-methods for obtaining, in-range and out-of- range values, types of abnormal patterns (for example, apnea, hyperventilation, dyspnea)
   37. Pulse oximetry-in-range and out-of range values, locations, and common errors
   38. Temperature-methods for obtaining in various locations, coordinating ranges, common errors
   39. Pain scale
   40. Menstrual status and last menstrual period
   41. Factors impacting vital signs (for example, age, medications)
   42. Conversion formulas for vital signs (for example, height, weight, temperature)
   43. Methods for measuring height, weight, BMI, and body and waist circumference; special considerations related to age, health, status, disability
   44. Pediatric measurements and growth chart
   45. Guidelines for establishing a sterile field
   46. Sterile techniques related to examinations, procedures, injections, and medication administration
   47. Positioning and draping requirements for general and specialty examinations, procedures, and treatments
   48. Equipment, supplies, and instruments required for general physical examinations
   49. Equipment, supplies, and instruments required for specialty examinations or procedures
   50. Patient instruction specific to procedures, including pre- and postprocedural instructions
   51. Modifications to patient care depending on patient needs (for example, assisting with ambulation and transfers for frail and disabled patients; using terms a child can understand for pediatric patients)
   52. Immunization schedules, requirements, and registries; adverse effects documentation and reporting
   53. Allergies (for example, medication, food, environmental); contraindications; type of reactions (mild, moderate, and severe); how to respond to allergic reactions or anaphylactic shock
   54. Dosage calculations related to injectables and oral medications
   55. Commonly used oral and parenteral medications, including forms, packaging, routes of administration, and rights of medication administration
   56. Methods of administration, techniques, procedures, and supplies related to eye and ear medications
   57. Storage, labeling, expiration dates, and medication logs
   58. Techniques (for example, needle angle, gauge, length) and injection site (for example, intramuscular, subcutaneous)
   59. Supplies and equipment related to injections
   60. Storage of injectables
   61. Techniques and instruments for suture and staple removal; types and sizes of sutures
   62. Instruments, supplies, and techniques related to eye and ear irrigation
   63. Commonly occurring types of injuries (for example, lacerations, abrasions, fractures, sprains, burns)
   64. Treatment for commonly occurring types of injuries (for example, bandaging, ice, elevation)
   65. Signs and symptoms of wound infection (for example, redness, pus, swelling, discharge) and wound stages
   66. Commonly occurring types of surgical interventions
   67. Signs and symptoms related to urgent and emergency situations (for example, diabetic shock, heat stroke, allergic reactions, choking, syncope, seizure)
   68. Emergency action plans (for example, crash cart, emergency injectables)
   69. Procedures to perform CPR, basic life support, and automated external defibrillator (AED)
   70. Legal requirements for content and transmission of prescriptions
   71. Electronic prescribing software, screening requirements for prescription refills
   72. Specialty pharmacies (for example, compounding and nuclear pharmacies; forms of medication available such as liquid, elixir, balm, ointment)
   73. Required components of medical records
   74. Prior authorizations for medication durable medical equipment (DME)
   75. Computerized Physician Order Entry (CPOE)
   76. Patient conditions appropriate for telehealth/virtual visit
   77. Modifications in care related to delivery of telehealth/virtual health care
8. Demonstrate an understanding of Infection Control
   1. Adhere to standard and universal precautions and guidelines related to infection control.
   2. Adhere to regulations and guidelines related to infectious diseases.
   3. Follow guidelines related to use of personal protective equipment (PPE), including donning and doffing.
   4. Adhere to guidelines regarding hand hygiene.
   5. Perform disinfection/sanitization.
   6. Perform sterilization of medical equipment.
   7. Perform appropriate aseptic techniques for various clinical situations.
   8. Dispose of biohazardous materials as dictated by Occupational Safety and Health Administration (OSHA) (for example, sharps containers, biohazard bags).
   9. Follow post-exposure guidelines (for example, needle safety guidelines, use of eyewash stations).
   10. Common pathogens and nonpathogens
   11. Organisms and micro-organisms
   12. Infectious agents, chain of infection, modes of transmission, and conditions for growth
   13. Signs and symptoms of infectious diseases
   14. CDC guidelines for infectious disease (for example, prevention, reporting)
   15. Guidelines for exposure to bloodborne pathogens (for example, OSHA, American Hospital Association [AHA])
   16. Approaches for the control of infectious diseases, epidemics, and pandemics
   17. Universal precautions
   18. Standard precautions (for example, personal protective equipment)
   19. Handwashing techniques
   20. Alcohol-based rubs/sanitizer
   21. Sterilization techniques (autoclave, instrument cleaner, germicidal disinfectants, disposables) and principles for maintaining sterilization equipment
   22. Techniques for medical and surgical asepsis
   23. Order of cleaning and types of cleaning products
   24. Safety Data Sheets (SDS)
   25. Cautions related to chemicals
   26. Disposal methods
   27. Exposure control plan
   28. Logs (for example, maintenance, equipment servicing, temperature, quality control)
9. Demonstrate an understanding of testing and laboratory procedures
   1. Collect nonblood specimens (for example, urine, stool, cultures, sputum).
   2. Perform CLIA-waived testing.
   3. Recognize, document, and report in-range and out-of-range laboratory and test values. 
   4. Match and label specimen to patient and completed requisition.
   5. Process, handle, and transport collected specimens.
   6. Perform vision and hearing tests.
   7. Perform allergy testing.
   8. Perform spirometry/pulmonary function tests (electronic or manual).
   9. Identify common testing errors leading to testing discrepancies or inaccurate results.
   10. Point-of-care testing
   11. Information required on completed requisition and/or form per provider order (for example, type of test, date, time, diagnostic code)
   12. Specimen collection techniques and requirements
   13. CLIA-waived testing regulations
   14. Quality controls (internal and external)
   15. In-range and out-of-range laboratory and test values
   16. Preanalytical and postanalytical errors that affect testing results
   17. Elements related to vision and hearing tests
   18. Peak flow rates
   19. Intradermal allergy test
   20. Requirements for transportation, diagnosis, storage, and disposal of specimens (for example, patient identifiers, site, test, chain of custody)
10. Demonstrate an understanding of phlebotomy
    1. Prepare patient for procedure.
    2. Verify order details.
    3. Select appropriate supplies for test(s) ordered (for example needle sizes, tubes).
    4. Determine venipuncture site accessibility based on patient age and condition.
    5. Prepare site for venipuncture.
    6. Determine order of draw.
    7. Perform venipuncture.
    8. Perform capillary puncture.
    9. Perform postprocedural care.
    10. Handle blood samples as required for diagnostic purposes.
    11. Process blood specimens for laboratory.
    12. Match and label specimen to patient and completed requisition.
    13. Recognize and respond appropriately to out-of-range test results.
    14. Prepare samples for transportation to a reference (outside) laboratory.
    15. Follow guidelines in distributing laboratory results to providers after matching patient to provider.
    16. Blood components (for example, whole blood, plasma, serum platelets)
    17. Bloodborne pathogens
    18. Patient identifiers, content of requisition (for example, site or test, diagnostic code, dietary restrictions)
    19. Patient preparation (for example, fasting/nonfasting, medication use, basal state, positioning)
    20. Assessment of patient comfort/anxiety level with procedure
    21. Considerations related to special patient needs (for example, need for support person or witness, use of restraints, chain of custody)
    22. Medical conditions or history and medications affecting collection of blood
    23. Blood vacuum tubes required for chemistry, hematology, and microbiology testing
    24. Phlebotomy site preparation, including cleansing, wrapping, order of draw with microtubes
    25. Anatomy, skin integrity, venous sufficiency, contraindications
    26. Order of draw for venipuncture
    27. Insertion and removal techniques
    28. Evacuated tube, syringe, and butterfly methods
    29. Types of tubes, tube positions, number of tube inversions, and fill level/ratios
    30. Additives and preservatives
    31. Bandaging procedures, including allergies and skin types
    32. Preanalytical and postanalytical considerations pertaining to specimen quality and consistency
    33. Special collections (for example, timed specimens, medication levels, blood cultures, fasting)
    34. Centrifuge and aliquot
    35. Expected and unexpected test values; control values
    36. Equipment calibration
    37. Storage conditions related to sensitivity to light and temperature
    38. Requirements for transportation, diagnosis, storage, disposal
    39. Processing and labeling requirements
    40. External databases (for example, outside laboratories, reference sources)
11. Demonstrates an understanding in EKG and Cardiovascular Testing
    1. Prepare patient for EKG or ambulatory cardiac monitoring procedure.
    2. Identify types of leads and proper anatomical electrode placement.
    3. Perform EKG tests.
    4. Recognize abnormal or emergent EKG results (for example, dysrhythmia, arrhythmia, versus artifact).
    5. Assist provider with ambulatory cardiac monitoring (for example, stress test, Holter monitoring, event monitoring).
    6. Transmit results or report to patient’s electronic medical record or paper chart and provider.
    7. Ensure proper functioning and storage of EKG equipment.
    8. Techniques and methods for EKGs
    9. Procedures and instructions to minimize artifacts
    10. Artifacts, signal distortions, and electrical interference (for example, fuzz, wandering baseline)
    11. Preparation, positioning, and draping of patient
    12. Considerations related to patient characteristics (for example, anatomy, adult/pediatric, medical condition)
    13. Supplies needed (for example, paper, correct leads, razor, tape)
    14. Placement of limb and chest electrodes
    15. Signs of adverse reaction during testing (for example, signs of distress, elevated blood pressure, respiration)
    16. Abnormal rhythms or dysrhythmias associated with EKGs
    17. Waveforms, intervals, segment
    18. Calibration of equipment
12. Demonstrate an understanding in Patient Care Coordination, Education, and Administrative Assisting.
    1. Review patient records prior to visit to ensure health care is comprehensively addressed.
    2. Ensure that documentation of preventative maintenance and screenings is included in patient record.
    3. Identify timelines and track recommendations for screenings and preventative maintenance (for example, mammogram, Papanicolaou (Pap) test, colonoscopy, immunizations).
    4. Assist provider with researching and supplying information on community resources for clinical and non-clinical services.
    5. Coordinate with health care providers and community-based organizations for continuity of care.
    6. Facilitate patient compliance (for example, continuity of care, follow up, medication compliance) to optimize health outcomes.
    7. Participate in team-based patient care (for example, patient-centered medical home [PCMH], accountable care organization [ACO]).
    8. Participate in transition of care for patients.
    9. Provide patient education via telehealth/virtual visit systems and processes.
    10. Provide education to patients on communicable disease prevention. 
    11. Schedule and monitor patient appointments using electronic and paperbased systems.
    12. Determine the type of appointment needed.
    13. Prioritize appointment needs based on urgency.
    14. Monitor patient flow sheets, superbill, or encounter forms.
    15. Verify insurance coverage/financial eligibility.
    16. Identify and check patients in/out.
    17. Confirm appropriate diagnostic and procedural codes.
    18. Obtain and verify prior authorizations and precertifications (for example, for prescriptions, procedures, radiology).
    19. Prepare documentation and billing requests using current coding guidelines.
    20. Ensure that documentation complies with government and insurance requirements.
    21. Perform charge reconciliation (for example, enter charges, post payments, make adjustments, process accounts receivable).
    22. Bill patients, insurers, and third-party payers for services performed.
    23. Resolve billing issues with insurers and third-party payers, including appeals and denials.
    24. Manage electronic and paper-based medical records.
    25. Process office mail and faxes to appropriate staff member.
    26. Facilitate/generate referrals to other health care providers and allied health care professionals.
    27. Follow up patient calls and appointment confirmations.
    28. Enter information into databases or spreadsheets (for example, electronic medical record [EMR], electronic health record [EHR], Excel, billing modules, scheduling systems).
    29. Participate in safety evaluations and report safety concerns.
    30. Maintain inventory of clinical and administrative supplies.
    31. Activate and facilitate use of patient portals.
    32. Provide technical instruction on the use of telehealth/virtual visits and troubleshoot issues.
    33. Types of office visits (for example, new patient, telehealth/virtual, annual wellness, specialty, sports/school physical), and requirements for each 
    34. Screening methods to identify type of appointment needed
    35. Practice management systems and software (for example, EMR/EHR, scheduling software, paper-based filing systems, office storage for archived files)
    36. Requirements related to duration of visits (for example, purpose of visit, physician preferences)
    37. Sections of the medical record (for example, administrative, clinical, billing, procedural, notes, consents)
    38. Required documentation for patient review and signature
    39. Chart review
    40. Electronic referrals (for example, creation, requirements, administration)
    41. Financial eligibility, sliding scales, and indigent programs
    42. Government regulations (for example, promoting interoperability/meaningful use, Medicare Access and CHIP Reauthorization Act of 2015 [MACRA])
    43. CMS billing and documentation requirements
    44. Insurance fundamentals, including revenue cycle and incentive models
    45. Insurance terminology (for example, copayment, coinsurance, deductible, tier levels, explanation of benefits, medical necessity)
    46. Referral and insurance authorizations, pre-certification requirements (for example, surgical, diagnostics, labs)
    47. Diagnostic and procedural codes
    48. Third-party payer billing requirements
    49. Advanced beneficiary notice (ABN)
    50. Aging reports, collections due, adjustments, and write-offs
    51. Online banking for deposits and electronic transfers
    52. Auditing methods, processes, and signoffs
    53. Data entry and data fields
    54. Equipment inspection logs, required schedules, and compliance requirements, including inspection by medical equipment servicers
    55. Telehealth/virtual visit technologies, barriers to access
13. Demonstrate an understanding of Communication and Customer Service
    1. Recognize the diversity of patient cultures and backgrounds when providing care.
    2. Recognize stereotypes and biases and interact appropriately with patients, colleagues, and others.
    3. Modify verbal and nonverbal communications with patients and caregivers based on special considerations (for example, pediatric, geriatric, hearing, vision, or cognitive impairment).
    4. Modify communications based on type of visit (for example, in-person, telehealth/virtual visits).
    5. Clarify and relay communications between patients and providers.
    6. Communicate on the telephone with patients and caregivers, providers, thirdparty payers using HIPAA guidelines.
    7. Prepare written/electronic communications/business correspondence.
    8. Handle challenging/difficult customer service occurrences.
    9. Utilize conflict management and complaint resolution to improve patient satisfaction.
    10. Engage in crucial conversations with patients and caregivers/health care surrogates, staff, and providers.
    11. Facilitate teamwork and team engagement.
    12. Demonstrate professionalism (for example, appropriate demeanor, clothing, language, tone).
    13. Cultural, religious, psychosocial, and economic considerations impacting provision of care
    14. Gender identity and expression, pronoun use
    15. Patient characteristics affecting communication (for example, language barriers, age, developmental stage, cognitive, sensory, and physical impairments)
    16. Communication styles appropriate to oral, telephone, email, text communications
    17. Nonverbal cues for in-person and telehealth/virtual communication
    18. Communication cycle (clear, concise message relay)
    19. Therapeutic communication
    20. Interviewing and questioning techniques, including screening questions, openended, closed-ended, and probing questions
    21. Scope of permitted questions and boundaries for questions
    22. Active listening techniques
    23. Coaching and feedback, positive reinforcement of effective behavior
    24. Telephone etiquette
    25. Email etiquette
    26. Business letter formats
    27. Patient satisfaction surveys
    28. Techniques to deal with patients (for example, irate clients, custody issues between parents, chain of command)
    29. Conflict management and dispute resolution methods
    30. When to escalate problem situations
    31. Incident/event/unusual occurrence reports; documentation of event
    32. Cause and effect analysis (for example, risk management related to patient and employee safety)
    33. Professional presence (for example, appearance, demeanor, tone)
    34. Modify verbal and non-verbal communication for diverse audiences (for example providers, coworkers, supervisors, patients and caregivers, external providers)
        1. Modify verbal and non-verbal communications with patients and caregivers based on special considerations (for example pediatric, geriatric, hearing impaired, vision impaired, mentally handicapped or disabled)
        2. Clarify and relay communications between patients and providers
        3. Communicate on the telephone with patients and caregivers, providers, third party payers
        4. Prepare written/electronic communications/business correspondence
        5. Handle challenging/difficult customer service occurrences
        6. Engage in crucial conversations (with patients and caregivers/healthcare surrogates, staff, and providers)
        7. Facilitate and promote teamwork and team engagement
        8. Recognize patient characteristics impacting communication (for example, cultural differences and language barriers, cognitive level, developmental stage; sensory and physical disabilities; age)
        9. Define all medical terminology and jargon, layman’s terms
        10. Demonstrate proficiency in therapeutic communication, interviewing and questioning techniques, including screening questions, open-, closed-, probing questions, and scope of permitted questions and boundaries for questions, active listening, communication cycle (clear, concise message relay), coaching and feedback, positive reinforcement of effective behavior
        11. Demonstrate professional presence (for example, appearance, demeanor, tone)
        12. Process patient satisfaction surveys
        13. Recognize when to escalate problem situations
        14. Perform techniques to deal with patients (for example, irate clients, custody issues between parents, chain of command)
        15. Prepare incident/event/unusual occurrence reports; documentation of event
        16. Understand Cause-and-effect analysis (for example, anxiety increases blood pressure or heart rate; risk management related to patient and employee safety [reviewing the design, setting/population, protocols, measurements of a facility to ensure overall patient and employee safety])
        17. Demonstrate Email etiquette and telephone etiquette
        18. Utilize Business letter formats
14. Demonstrate an understanding of Medical Law and Ethics
    1. Comply with legal and regulatory requirements.
    2. Obtain patient consent as needed.
    3. Adhere to professional codes of ethics.
    4. Obtain, review, and comply with medical directives (for example, advance directives, living will, health care proxy, medical order for life sustaining treatment).
    5. Protect patient privacy and confidentiality, including medical records.
    6. Adhere to legal requirements regarding reportable violations or incidents.
    7. Identify personal or religious beliefs and values and provide unbiased care
    8. Laws and regulations (for example, HIPAA, ACA, HERCA, Health Information Technology for Economic and Clinical Health [HITECH], 21st Century CARES Act, Controlled Substances Act)
    9. Patient’s Bill of Rights
    10. Informed (verbal or written) and implied consent, including consideration for minors and those unable to give consent
    11. Advanced directives (for example, living will, do-not-resuscitate/do-not-intubate [DNR/DNI], Medical Orders for LifeSustaining Treatment [MOLST] form)
    12. Power of attorney and legal guardianship
    13. Legal requirements related to maintenance, storage, and disposal of records
    14. Conditions for sharing information/release of information
    15. Criminal and civil acts; medical malpractice
    16. Mandatory reporting laws, sign and symptoms of abuse, triggers for reporting, and reporting agencies

• Function of the clinical medical assistant in a medical office
• Introduction to health care facilities
• Medical terminology
• Anatomy of each of the body systems to include the heart, conduction system, circulation of the heart & blood vessels
• Care & safety of patients, medical & legal aspects & work ethics
• Effective verbal and non-verbal communication
• Interpersonal skills and human behavior
• Phone in prescriptions to various pharmacies
• Confidentiality and HIPAA
• Take patient medical histories
• Update patient medical files
• Instruct patients on proper usage of medications
• Vital signs and documentation
• Prepare and assist with medical examinations
• Take blood pressure and body temperatures
• Apply sterile dressings
• Prepare patients for x-rays
• Perform various injections
• Administer oral medications
• Aseptic technique and infection prevention
• Assist with minor surgeries
• Proper use and disposal of biohazards and sharps

 
Course Addendum - Syllabus (Click to expand)