Tag: Healthcare

An Evaluation of Healthcare Workforce Labor Costs

 Three Key Drivers of Labor Costs within A Specific Health Care Service, Facility, Or Other Health Sector-Related Occupation

For the past decade, the labor share of hospital total expenses has been increasing. According to the Healthcare Financial Management Association (HFMA), hospitals in the US have created 586,500 new jobs in the past decade, significantly increasing cost pressure (Daly, 2019). Some of the factors driving labor costs within hospitals include new staff needed to fulfill their missions embarked in the past decade, labor supply, and productivity improvement efforts.

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            Over the past decade, hospitals have created new job positions to fulfill the missions they have adopted in response to increasing quality requirements. This includes staff needed to implement electronic health records (EHRs), tracking social determinants of health, and other information technology initiatives (Daly, 2019). The additional staff required to implement these initiatives has considerably contributed to the increased labor cost. Hospitals can control this cost driver by fully leveraging technology. Automating most information technology functions can help minimize the number of staff required to oversee the initiatives.

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            The tightening labor market has also contributed to the increased cost of labor within hospitals. Due to population increase and increasing competition from private hospitals, the tightening labor market has led to higher wage demands. Hospitals, therefore, have more staff than they used to have, and these employees are demanding relatively higher wages. Besides the high salaries, the hospitals are compelled to offer attractive personnel benefits to retain their staff (Aksenova et al., 2020). Thus, decreased labor supply has contributed to the increased cost of labor. Hospitals can address this factor by investing in strategies aimed to improve employee retention. This starts in the recruitment process by identifying employees who will stay the course and providing a favorable working environment undergirded by the organizational culture.

Rea also Key Drivers of Labor Cost within a Hospital

             Due to the increasing competition in the healthcare industry, hospitals have been compelled to find ways to bolster their productivity. Consequently, hospitals have spent considerable amounts of money and time enhancing employee productivity in the past decade. Some of the strategies used to improve productivity include employee training, giving perks, and other bonuses (Emanuel, 2018). A solution that can help address this factor is focusing on intrinsic motivators instead of extrinsic motivators when designing frameworks for attracting and retaining employees.

Future Changes that Might Accelerate or Exacerbate the Solutions ro Labor Costs

            Whereas the proposed solutions have a high potential to slow down the increasingly growing cost of labor costs within hospitals, various trends deter the proposed solutions from achieving the desired outcomes. To start with, the growing trend of consumerism can prove challenging to the solutions. Hospitals will be forced to respond to consumerism by adding staff as navigators to guide patients requiring by answering non-clinical questions and guide patients requiring cosmetic surgery, among other needs driven by consumerism. Additionally, the increasing entry of Generation Z into the workforce means that Generation Z and Millennials will soon constitute most of the workforce. Notably, the two generations have unique employee needs that will require organizations to devise new strategies for attracting and retaining them as well as motivating them to enhance productivity. Lastly, the shrinking labor market means that the labor supply will continue to shrink, causing wages to rise. Nonetheless, through proper planning, the healthcare industry can counter these threats.

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Global Healthcare Strategy in Boldly Go Case Study

Problems/Issues Facing the Organization as Regards to Global Healthcare Strategy in The Boldly Go Case Study

Providence Healthcare has been through a transformation process that focused on improving quality of care, reduce cost and enhance general performance. The transformation process was led by Josie Walsh and has since its planning in 2009 has experienced a great level of achievement commendable by all stakeholders in the organization. After attaining the organization’s transformation and innovation goals, Walsh now needs to sustain its momentum and build the future. The main problem of the organization is determining the best strategy to sustain change and innovation momentum and to build the future (Reddin, 2015).

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Possible Solutions Global Healthcare Strategy

To attain sustainable change, quality improvement initiatives need to become the novel way of working instead of something included in routine operation. The organization needs to develop performance metrics that will set performance standards in every unit. Each unit needs to set ambitious but attainable performance short-term and long-term goals. The organization also needs to keep monitoring the performance on regular basis to determine where the units are attaining their goals. If not, the organization and unit leaders will need to determine the cause of failure and address it effectively. This performance monitoring and improvement strategy will help in ensuring that the organization maintains a high performance throughout. It will also play a great role in fine-tuning every member of the organization to work towards maintaining high performance. According to Silver et al. (2016), an organization can employ tools to aid in sustaining improvement. These tools include standard work, performance board, process control board, and improvement huddles. These tools will help in recommending improvements when required and communicate improvement results to leadership and staff. They will also help in ensuring regular review routines to be able to diagnose problems before they negatively impact an organization, and suggest possible solutions to address them. This process can include having regular review meetings with staff and leaders to collect views, ideas, and recommendations.

Another way to ensure the sustainability of organizational change is by creating an organizational culture that reflects the current transformation in the organization. In this case, Walsh will need to define a new organizational culture that will capture the new ways of doing things, the new organization’s mission and vision, and the new transformation and performance goal in the organization. Organizational culture is perceived as the DNA of the organization. It is a powerful tool that molds what happens in an organization. It acts as the organization’s personality. It is therefore one of the best ways in which organizational leadership can employ to maintain change. The organization’s leadership should create an organizational culture that captures the current way of doing things. This by ensuring that those ways are adopted as norms and that they resonate in the executors’ minds. The organization leaders should also ensure that all workers share the organization’s beliefs, mission, vision, and values to be able to buy in the new culture (Willis et al., 2016). By embracing the new change into a new organizational culture, Walsh will be able to ensure that the organization maintains the same momentum it had generated through change. This will ensure that the organization embraces high performance, quality patient care, exceptional patient care experience, and innovation as the organization’s routine and culture. 

The organization can also sustain change by keeping workers motivated. The organization should consider developing an effective workers management program that ensures effective workers’ training, mentorship, and coaching. The organization should also have a leadership development program that will aid in preparing workers to move to the next level when the need arises. Other measures include ensuring competitive compensation, recognition, performance-based incentives and bonuses, and provision of a good work environment characterized by open communication, good work-life balance, promotions, and opportunity for career growth and development (Hamadamin & Atan, 2019).

Recommended Solution to the Global Healthcare Strategy Problems in The Boldly Go Case Study

The best solution to sustain change for Providence Healthcare and to ensure the future is by integrating the three proposed strategies. Each strategy plays a part in enhancing sustainability. In this regard, Walsh should consider developing the right organizational culture that would complement the employed change. She should also develop performance improvement initiatives that will aid in ensuring the organization maintains high performance, quality patient care, and innovativeness all through. The organization should also develop effective workers and talent management programs that ensure the development of a favorable work environment, workers’ development, knowledge transfer, and general workers’ satisfaction. This integration will eventually ensure that the organization can maintain its change momentum and remain among the best healthcare organization even in the future.

Expected Outcomes

The anticipated results from the adopted strategy will be the maintenance of high performance by embracing transformational and innovative culture characterized by quality patient care, cost management, and high performance. The strategy will also ensure continuous improvement of processes, general operations, and management. This will result in a sustainable high level of performance all through. Effective workers and talent management will ensure that the organization promotes effective knowledge transfer and reduction of turnover. This will ensure that the organization maintains high talents that can uphold its operation standards.  It will also ensure workers’ development to ensure no knowledge gap in the organization even as more experienced workers retire or leave the organization for any reason. Workers will be more committed to their work and willing to invest in ensuring the organization’s success. Overall, this will ensure a high organizational competitive advantage in the healthcare industry, high performance, and high profitability in the long run.

Healthcare Leadership Through The lens of The Research

Definition of Leadership Through the Dominant Leadership Theories in the Research

Leadership is an essential element of society. Whenever any type or form of society exists, leadership is fundamental. Leadership refers to the process through which a person mobilizes people and resources to achieve a shared vision or desired goal (Barr & Dowding, 2019). According to Barr and Dowding, leaders inspire, motivate, challenge, and encourage their followers. Sfantou et al. (2017) concurringly elucidate that leadership entails persuading and influencing others while showing resilience and persistence. Leaders focus on the big picture, whereby they motivate their followers to aspire to achieve the vision of what could be by making them believe it is possible. Bottom line, leadership is a relationship between those who inspire and provide direction (leaders) and the followers, whose role providing their input and commitment to achieve the desired goal.

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Personal Experience that Informed My Thoughts about Healthcare Leaders Through the Lens of the Research

Having worked in the health care industry for a few years and being a beneficiary of the health care system my entire life, I have experienced various eye-opening events that have shaped my perspective about health care leaders. As a beneficiary of the healthcare system, I have seen the sector undergo many reforms to promote the efficient delivery of high-quality, effective, and safe care. The health care system is characterized by constant reforms geared towards improving the quality and accessibility of care and minimizing the cost of care to promote much-needed efficiency (Sfantou et al., 2017). Indeed, health care leaders are necessary to lead the changes effectively. On the other hand, working in the health care sector has allowed me to see the rationale of effective leadership in all of the healthcare system’s levels. Leaders in the health care sector not only implement necessary reforms but also inspire and motivate health care workers to strive towards optimal performance and, as such, facilitate enhanced patient outcomes. Thus, leadership is essential to the success of the healthcare sector. The sector needs effective leaders to lead and drive necessary reforms at all levels of the system to ensure quality provision of medical care and optimal patient outcomes.

Read also Leadership Theories in Practice

Traits of an Authentic Leader Through the Lens of the Research

Authentic leadership is undergirded by the philosophy that leaders can demonstrate their legitimacy by cultivating sincere relationships with their followers and involving them in the decision-making process by giving importance to their input. According to Malila, Lunkka, and Suhonen (2018), an authentic leader encourages their followers to embrace openness in a manner that promotes both individual and team performances. Key traits defining authentic leaders include self-awareness, solid values, the ability to establish robust and meaningful relationships, self-discipline, and leading with the heart (Makhmoor, 2018). Thus, authentic leadership is based on an individual’s character as opposed to their style.

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Authentic leaders have a strong sense of self-awareness which gives them an understanding of their purpose. They also ensure that a well-established set of values and principles inform their behavior and decisions. Notably, authentic leaders understand that they are not perfect and do not try to be. As a result, they admit when they make mistakes and make sure to learn from their errors. Additionally, they are considerate of other people’s needs, allowing them to develop and maintain meaningful relationships. Moreover, they match their behavior to their context, which allows them to uphold self-discipline and lead with their hearts (Makhmoor, 2018). These traits enable authentic leaders to be genuine.

Exercise to Aid in the Development of the Skills/Habits of an Authentic Leader

An exercise that can help one develop the skills/habits of an authentic leader is introspection. The process entails self-analysis, whose objective is to look inwards to facilitate self-awareness. To develop the traits of an authentic leader, one must examine different aspects, including their feelings, behaviors, and attributes. The reflective process facilitates the development of self-awareness, leading to self-consciousness (Chon & Sitkin, 2021). With improved self-consciousness, one can effectively enhance the understanding of their purpose, establish connected relationships, practice solid values, demonstrate self-discipline, and lead with the heart. Thus, introspection can help an individual develop the skills/habits that characterize an authentic leader.

There are various benefits associated with introspection. First, it will allow a leader to ensure that their behavior matches their context precisely in terms of values and principles that inform their approach to leadership. Secondly, self-awareness will enable one to become sensitive to other people’s emotions and, as a result, develop meaningful relationships. Thirdly, introspection allows a person to constantly grow since it facilitates an ongoing enhancement of emotional intelligence. Lastly, the self-awareness developed from the introspection process allows a person to understand their purpose. As a result, their leadership approach becomes genuine since it is based on their character instead of style, which makes it genuine (Chon & Sitkin, 2021).

U.S. Drug Prices, Why Are they so High?

Drug Prices in The United States

Nearly one in four Americans who take prescription drugs say they struggle to afford the medication they need. A recent report from RAND Corporation found that US prescription drug prices are 256% higher than other countries; averaging the prices seen in 32 other countries (Light & Caplan, 2018). The ratio of sales to volume weight is significantly higher in the US. Zolgensma, a drug that treats spinal muscular atrophy, is the most expensive drug in the U.S. It has an estimated annual cost of $2,125,000. Unbranded generics account for approximately 12% of prescription drug spending at manufacturer prices (Walker, 2015). The branded drugs make up 11% of the US prescription volume and 82% of expenditure. Therefore, brand drugs are the primary driver of the higher prescription drug prices in the country. These prices, in fact, have been exponentially increasing for a while.

Why Are Drug Prices so High In United States?

The simple explanation of this excessive drug prices is monopoly pricing. By using the patent protection and FDA marketing exclusivity, the government gives pharmaceutical companies a monopoly on brand-name drugs. Monopolies are the highest risk factors for excessive prices.

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It is very difficult to note the actual out-of-pocket cost to consumers for a prescription because of the consumer rebates and price adjustments to insurers. Thus, the true cost of these prescription drugs is difficult to determine (Berman & Thomas, 2017). These prices are engrossed in a web of price adjustments and middle managers from the gross price to the actual price that the consumer pays. Patients’ out-of-pocket costs continue to grow while net costs to insurers keep declining, meaning that the insured patients are bearing a disproportionate share of the costs relative to the terms of their insurance agreements (Bollyky & Kesselheim, 2017). Clearly, the health insurance system in the US is so unique to any other developed country.

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Another reason for the higher prices in the country is because the government does not set ceiling prices in the US as other countries do. Also, there are marketing exclusivity periods for patented innovator drugs. There is a group of middlemen known as Pharmacy Benefit Managers (PBMs) that negotiates prices with pharmaceutical companies for inclusivity of health insurance coverage lists (Berman & Thomas, 2017). These groups often promote implementation of direct discounts or rebates that lead to higher prices to the consumer. This results in a war of internal pricing where manufactures are given incentives to increase list prices while increasing discounts to keep PBMs happy.

Read also Challenges Facing Health Profession

Has The Government Done Anything To Lower Drug Prices?

In mid Sep 2020, the Trump administration signed an executive order to lower prescription drugs by “putting America first.” A Most Favored Nation strategy to drug pricing creates a trading opportunity among states making originally bilateral agreements multilateral (Bollyky & Kesselheim, 2017). The implication of this is that the drugs covered under the most favored nation pricing scheme will be expanded. This initiative will allow Medicare to use the lower prices of the other developed countries than paying higher for the same drugs.  Also, Trump announced the end of the Unapproved Drugs Initiative program that was responsible for major shortages of vital medicines (Light & Caplan, 2018).

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This implies that the drug prices may be five times less expensive than before if the Biden administration implements this policy. The true cost of a drug depends on who’s paying, and everyone involved is pushing costs up. There should be fundamental rebate reforms to fix both the cost-shifting problems in the US and develop a more open and reliable net price. Medicare should be allowed to negotiate drug prices in order to help drive costs down and end the monopoly in pricing. Also, it is important for every citizen to have health coverage to benefit from negotiated pricing.

Key Stakeholders in The Nursing and Residential Care

The Nursing and Residential Care

I work in the health care services and facilities sector of the health care industry. The industry is composed of many subsectors, including hospitals, nursing and residential care facilities, ambulatory health services, and medical practitioners and healthcare professionals. Notably, I work in the nursing and residential care facilities subsector. The subsector provides residential care combined with supervisory, rehabilitation, nursing, or other types of care as needed. The category incorporates home health care services, urgent care centers, nursing care facilities, in-home senior care, mental health and residential developmental facilities, community care facilities for the elderly, et cetera (Pool, 2018).

Who are the Key Internal Stakeholders in the Nursing and Residential Care?

            Key internal stakeholders in the nursing and residential care facilities include care providers, representatives of nursing homes, medical directors, directors of nursing, medical practitioners, licensed nurses, geriatric nursing assistants, and other staff who work in the nursing home facilities such as cleaners and cooks. These internal stakeholders are responsible for ensuring that residents of the nursing and residential care facilities receive high-quality care designed to facilitate healthy aging, maximum functioning, and quality of life. Another key internal stakeholder is policymakers responsible for establishing the framework with which care is provided to the residents of the nursing and residential care facilities.

Who are the Key External Stakeholders in the Nursing and Residential Care?

            Key external stakeholders include nursing home residents, insurance companies, pharmaceutical companies, the government, and the education system. The nursing home residents are the clients of the nursing and residential facilities. Insurance companies provide medical coverage to the residents of the nursing home facilities. Besides formulating and implementing policies related to health care provision, the government subsidizes health care for the elderly and the disabled. Pharmaceutical companies supply medicine to nursing and residential care facilities. Lastly, the education system is responsible for training practitioners who offer their services to the nursing and residential care facilities sector.

Strategies for Developing Relationships with the Key Stakeholders

            Strategies for developing relationships with internal and external stakeholders include clearly communicating with them regularly. This requires a well-developed communication framework for building positive relationships with the stakeholders (Andriof, Waddock, Husted, & Rahman, 2017). Notably, the communications should be tailor-made to suit each group of stakeholder’s unique needs. Another strategy entails gaining stakeholders’ trust through implementing an effective two-way communication (Seifi & Crowther, 2018). According to Seifi and Crowther, the key to stakeholders engagement starts with building trust trough remaining trustworthy, reliability, and transparent. Management of stakeholders involves communicating with key stakeholders on a timely fashion and ensuring they fully understand the scope of their responsibilities. Thirdly, always stay consistent with the messaging. Inconsistent messages can lead to stakeholders’ outrage, loss of trust, and negative reputation (Andriof, Waddock, Husted, & Rahman, 2017).

Meeting up with key stakeholders and involving them in the decision-making process facilitates the development of robust relationships. When key stakeholders are involved in the decision-making process, they feel appreciated and part of the sector and, as such, strengthens the relationship (Derakhshan, Turner, & Mancini, 2019). It is also imperative to keep surprises to a minimum. Stakeholders like to have information on what is going on to give their input or adequately prepare themselves for the risks and issues involved with action plans. Last but equally important, nursing and residential care facilities can use data management systems to map stakeholders to inform the communication framework that outlines how to engage with each customer (Andriof, Waddock, Husted, & Rahman, 2017). These highlighted strategies keep the stakeholders informed and satisfied.

Long Term Care Sector – Healthcare Principles and Practice

Introduction

The following research paper will focus on the Long Term Care Sector which is part of the health care delivery system. It will look at the historical development of the sectors and the challenges and issues facing it prior to health care reform. It will also look at the specific challenges in the sector, and the benefits and risks it faces in the future associated with health care reform. Despite the US having one of the best medical care services in the world, it is only accessible to those who have health insurance plans or resources. It is has not been universally accessible to all American citizens. The Affordable Care Act ensures that all Americans have access to affordable health care.  Current health reform has focused on the key issues of those who are uninsured, and has not looked critically at long term care especially for the future.

Long term care users fall into two categories; the frailed elderly and the disabled. The long term care sector is a crisis in the horizon as the 77 million baby boomers enter retirement. The number of people requiring long term care in future will increase including the non-elderly persons with disabilities. Policy makers need to look at the key issues affecting the sector in order to come up with health reforms that will assist avert the crisis that will happen with long term care in the next 30-40 years. The costs of long term care are high and the existing systems do not have clear mechanisms for payment and delivery.

Historical Development and Current State of Long Term Care Health Care Delivery

In order to understand the historical development and current state of long term care in health care delivery one must look at the US Health Care Delivery system as a whole. The Health Care Delivery system consists of major components and processes that enable people to receive health care. Most developed countries have a National Health Insurance programs that enables all citizens to receive health care services. However, in the US not all citizens are entitled to routine and basic health care services. Despite the US Health Care Delivery System having evolved, there are concerns on access, cost, and quality as the system does not provide a universal basic health care package at an affordable cost. Organizations, individuals involved in health care include educational and research institutions, medical insurers, suppliers, claim processors, and health care providers.

The US health care delivery system has various subsystems that include managed care, military medical care system that caters for vulnerable populations, and the integrated system that consist of various forms of ownership between hospitals, physicians, and health insurers. Long term care is normally provided through managed care. Long term care is any arrangement where a Medicaid program contracts an organization to provide benefits which will include some level of long term care benefits.

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The following are the main characteristics of the US Health Care System. The system has no central governing agency, and has little integration and coordination. The health care costs under the system are high and there is unequal access. Legal risks influence practice behaviors, and there is conflict through the health care system in terms of market justice vs. social justice. The access to health care under this system is selectively based on insurance coverage. There is a quest for integration and accountability.  The US expenditure on primary health care is the highest in comparison with other developed countries and is almost 13% of the Gross Domestic Product.

The US has a unique Health Care system, but it lacks universal access to all American Citizens. Health care in the US is compromised by disintegration in delivery limited access and high costs. The two groups of patients that suffer under this system are those with complex long term care needs and those with low income or no health insurance. Access is restricted to those who have health insurance through their employer; those covered under a government health care program; those who can afford to buy health insurance using their own funds; and those who are able to pay for services with their own funds. In most developed countries the Government plays a central role in the provision of health care to its citizens. In the US this is different where the private sector plays a leading role.

In 2003, managed long term care market was expected to grow dramatically. However, only 2.3% of this market using public long term care is receiving these services. Managed long term care is provided mainly through large local non-profit plans or those that have progressed due to responses from particular states. The growth of long term care services has been very slow due to several factors. These include complex programs that take a relatively long time to plan, startup periods, and resistance of long term care providers, federal policies, and inadequate infrastructure. However, despite these challenges long term care is popular in the states where it is well established and has the potential to grow in the future (Fronstin, 2010).

In the 1970’s long term care services was mainly through nursing homes. This brought about large increases in nursing home expenditures and raised the issue of whether the long terms services system was sustainable. In the 1980’s there was the introduction of home and community based waiver (HSBC) so that states would create flexible community based services. The HSBC waiver program grew rapidly, however the nursing home expenditures continued to increase. This meant that the HSBC waiver could not control the growth of institutional care.

In the 1990’s several states planned initiatives on long term care based on Medicaid managed care. Different states had different legislation on long term care. In 2003, 3.1 million elderly persons and persons with disabilities received long term care through Medicaid financed long term care. Of these, over half a million were in nursing homes and half a million went through community based waiver services program. Examples of managed long term care programs include Arizona’s Long Term Care System, Florida’s Frail Older Option, and San Francisco’s On Lok Program. Minnesota, Colorado, and Wisconsin are among the leading states providing innovative models on long term care.

Types of Long Term Care

  • Formal and informal caregivers – this refers to unpaid family members and unpaid persons such as friends, neighbors, family members and partners. The individuals can be primary or secondary care-givers, live with the aging individual or separately, and can work full time or part time. This category comprises of the largest number of caregivers in America.
  • Home and Community Based Care – thevast majority or about 80 percent of people receiving aid include those with functional limitations and stay in private homes in the society and not in institutions. The ageing population aged 65 years and above with functionality impairment receives 9 hours of assistance daily while those who are aged more than 85 years have 11 hours of support daily. Hospice care can also be given at home for the terminally ill persons.
  • Nursing Home Care – There are many old people that resides in institutions mostly those who are above 85 years of age. However, the price of a room in nursing home caresgrowing over time. This is due to the surge in the number of people who seeks a long-term solution in this home care while the facility does not expand with demand.However, the nursing homes provide a cost-efficient technique to permit patients with injuries to recuperate in an environment outside a sanatorium. The nursing homes attend to two types of clients. The first group is those that have been discharged from clinics for rehabilitative upkeep. The Medicare recompenses for a limited time for this type of nursing home care. Secondly, it also caters for those who suffer from mental disorders and chronic physical ailments that they are unable to move about, provide their own meals, and clean themselves by taking a bath. This kind of care is paid by Medicaid and the kind of people who suffers from chronic physical diseases and mental disorders are referred to as long term care residence.
  • Supportive Housing programs – this kind of program offer low cost housing to the older people earning low to moderate incomes. The responsibility of developing such housing is under the state or local governments. They assist the client with tasks such as shopping, laundry, housekeeping, and meals. Further, they also assist with help such as eating, bathing, transportation, toileting, taking medicines, and dressing.
  • Continuing Care Retirement Communities – This type of long-term care provides a full variety of services and care based on what every occupant requires over time. This kind of arrangement provides care in three key stages namely: skilled nursing, assisted living and independent living(Crocker, Forste, Young, Brown, Ozer, Smith & Greenwood, 2013).

Challenges and Issues In Long Term Care Sector Prior to Health Care Reform

The major challenges and issues facing long term care prior to health care reform relates to access, cost and quality. Prior to health care reform, states had showed interest in using managed care models to purchase Medicaid benefits for those populations that required long term care. In developing these programs, States needed businesses that had managed care plus expertise in clinical, social management of long term care populations. Traditional health plans prior to health care reform did not have this expertise. On the other hand, those that had expertise to provide services for long term care did not have any experience in managed care. For the long term care market to succeed, it required the merging of managed care expertise with experience in long term care populations. Due to this the managed care institutions expanded into long term care or long term care institutions expanded into managed care. The market before health care reform was dominated by long term care businesses expanding into managed care (Baer & O’Brien 2010).

The role of the aging network advocates was another challenge facing long term care. Advocacy from aging networks has a huge impact on various long term care programs. For example, the aging network advocates were opposed to long term care reforms based on partnership models that involved integration of acute and long term care. This was because such plans would be dominated by medical HMO’s thus reducing the role of the aging network.

The other challenge is that there are not many private long term care businesses to offer long term care to the aging populations.  Prior to health care reform law, there were two major for profit players in the long term care market; Amerigroup and Evercare which is the leading player. Evercare has long term investment plan and it targets frail elders and all persons with disabilities. The company is working across the country and is also active at federal and state levels. Amerigroup on the other hand is Evercare’s major competitor, but long term care is not its core business. Most providers of long term care have developed a managed care service (Fronstin, 2010).

Another challenge is whether managed long term care can offer more value in comparison to HCBS services. HCBS or fee for service programs depend on the case manager who coordinates the long term care. Managed long term care increase the use of home and community based services, and reduces the use of institutional services. They also have high customer satisfaction levels. In addition preventable admissions and high death rates are not a concern.

Policy issues and complex program designs are a challenge to managed long term care. The managed long term care programs that have been implemented are very diverse across different states. Differences exist in payment methods, managed care suppliers, competition, and whether enrollment is mandatory or voluntary. Most states do not have a clear picture of which program models they should replicate. However, Arizona stands out as one of the most successful long term care programs (Grabowski, 2006).

Legal authority over managed long term care has advanced positively, however difficult policy issues often emerge that complicate program development. Payment challenges will always remain controversial and technical for most managed long term care programs. These need to be refined in the future. Constituents are concerned about political resistance to managed long term care from the established fee for service systems. Infrastructure is a challenge which affects access, and it is does not exist in some states where the target population for long term care lives. Managed long term care was in its infant stages prior to health care reform, where only 3% of the potential market has enrolled in managed long term care plans.

Challenges in the Long Term Care Sector

The biggest challenge that the long term care sector will face in the future is that baby boomers are set to retire and the number of citizens seeking long term care will increase. In addition new technology and medical advances are increasing life longevity. It is estimated that there are about 77 million baby boomers. Most of this population prefers to receive medical care from home or their community and not in nursing home. Very few of them have prepared for long term care either through insurance or savings. Majority of the baby boomers have fewer children and will most likely be divorced. It is therefore unlikely that they can have family to informally take care of them (Johnson, & Wiener, 2006)

Currently health care reform laws and associated regulations are concerned with the populations that are uninsured and the rising health care costs. However, long term care need to be considered as it may soon become a crisis in the future. Many elderly people live in fear that chronic diseases will drain them financially. This aging population may have to depend on their children or welfare, and this will limit how they want to live at the end of their lives. Long term care will soon become the issue after the health reforms on acute health care systems.

Policy makers need to reform the health care system to ensure that this aging population can access affordable long term care in the future. The current system does not meet the demands of the frail and elderly who require assistance in normal daily life tasks such as bathing, toileting, dressing, cooking, transportation, housekeeping, and managing finances. Long term care is expensive and the cost will continue to rise in future. Long term care is currently funded through Medicaid and Medicare (63%), with out of pocket expenses covering 22%, and the remaining 15% from private sources. Medicaid covers long term care, but Medicare only covers some level of long term care for short durations after hospitalization. Most of the people approaching retirement are unaware of this fact (Johnson, & Wiener, 2006).

Private financing of long term care is through long term care insurance. Currently about 8 million Americans have some form of long term care insurance. These policies vary as long term care insurance is a relatively new product in the health insurance market. Cases of difficulty in getting long term care benefits under some of these policies have been reported. The market for long term insurance is small because families, who can afford to but it earlier in life, do not because they are in denial about ending up in a nursing home when they retire. Other families do not have the necessary information to make a decision and sometimes they do not understand the insurance technical language. High premiums is also another factor that deters families from purchasing long term care insurance (Baer & O’Brien 2010).

As the baby boom generation approach retirement, most of them do not have financial plans for their retirement. This leaves them with insufficient savings to take care of their expenses in retirement. The average nursing home costs about $ 80,000 a year, whereas some of this generation end up with about $70-75,000 in savings when they retire. Additional policy effort is required to deal with the challenges that the long term care sector will face in future. Medicaid and Medicare are already facing huge financial strains due to high health care costs and an increase in demand for services (Calmus, 2013).

Potential Risks and Benefits

As discussed earlier the number of people requiring long term care will increase as baby boomers grow older and the number of non-elderly persons with disabilities increase. The Patient Protection and Affordable Care Act also known as the ACA or Obama care makes long term care services more affordable and protects the rights of consumers. All citizens are entitled to health care until they retire.  The law ensures that people can receive long term care services and support in their homes or community. It provides existing tools, new options and financial incentives for States to provide home and community based services. The aging population will have increased access to health care and the law will ensure quality of service (Gruber, 2011).

The health care reform provides enhance federal funding to states for the provision of person centered and home and community based attendant services. This will increase the ability of individuals with disabilities to live within their community. The law increases access to non-institutional long term services support (LTSS). The Money Follows the Person (MFP) was extended under the law for a further five years. The MFP allows for individuals who are provided with long term care to move out of institutions into their homes and other community based environments. In the area of quality, the law provide for a grant program (TEFT), demo grant for testing experience and functional assessment to test quality measurement tools and ensure quality of long term care services (Gruber, 2011).

The possible risks to long term care associated with health care reform are that the current health reform laws have not critically looked at the future. Long-term care should be part of efforts to improve health care for all Americans. It is believed that long term care affects only a small percentage of the population. 70 percent of people turning age 65 will need long-term care as they age, and about 33% will spend some time in a nursing home  (Wiener, 2009)

There are four critical factors that need to be considered when looking at the possible risks for long term care associated with health care reform. The first one is that the aging population and people with disabilities is going to grow dramatically in the future. The financial burden for long term care will be much greater than before. Health reforms need to consider how this part of the population will access long term care. Reforms need to consider the demographics or characteristics of the people who will require long term are in future as this is very different from those receiving long term care today (Wiener, 2009).

Secondly, federal and state governments are spending huge amounts of money on long term care. Public spending on long term care will increase substantially in the next 20-30 years. Long term care is one of the health sectors that is dependent on public funding. Thirdly, most of the older people with disabilities also incur high acute care expenses as these are related to their underlying chronic diseases. Fourthly, the current health care system under the existing reform laws does not have a proper financing and delivery system. There are no proper mechanisms in place to help people plan and pay for long term care as they grow older (Calmus, 2013).

Conclusion

In conclusion long term care is an important sector of the health care delivery system. Policy makers need to develop health reform laws and regulations that can deal with the growing number of people that will require long term care in the future. This is especially because of the baby boomers that are soon to retire and live longer due to medical advances. The focus has been on acute care services and the uninsured, but the focus should now shift to long term care. The Affordable Care Act benefits long term care in certain aspects but it does not look at the future.

Recent Information Technology Failure In a Healthcare Organization

Healthcare Information Governance Assignment Instructions

Research health care organizations / providers that have recently had a significant information technology failure, and complete this assignment. Write a seven to eight (7-8) page paper in which you:

  • Determine the key factors contributing to the failure in question. Next, analyze how the failure impacted both the organization’s operations and patient information protection and privacy.
  • Analyze the leadership team’s reaction to the failure, and indicate whether the leadership took sufficient measures to deal with various stakeholder groups impacted by the failure. Provide support for the rationale.
  • Take a position on whether the health care provider that you identified should either develop a custom application or select a proprietary system. Provide support for the rationale.
  • Recommend at least three (3) best practices that any organization could adopt in order to avoid such a failure in the future.
  • Provide support for the recommendation. Suggest how health care leaders can use project metrics and portfolio management to ensure operational efficiency and effectiveness. Provide specific examples to support the response. Analyze a government intervention into health care businesses, meant to ensure that health care and patient information is secure and thus to minimize information breaches and technology failures.

Read also Developing An Information Assurance Policy

Health Care Organizations That Had a Significant Information Technology Failure – Sample Paper

Information Governance

            Good information technology must enhance cognitive function, provide user experience, can be customized easily and effectively to the needs of the subspecialists and specialists, must effortlessly put the essential information to the hands of the physicians, should keep eHealth information securely, help facilitate better practice of medicine and outcomes and protect patient privacy. All these attributes point to the importance of maintaining an effective information technology in the healthcare setting. The information technology with no doubt has brought improvements in the healthcare setting and has improved the level of outcomes.

Read also Issues Surrounding Personal Health Information (PHI) Ownership

However, a poorly designed information technology can bring huge loss of patient data and sometimes can cause patient data breaches as witnessed in the Health Net, which lost a hard drive that had information of close to 1.5 million members. Numerous healthcare providers have experienced information technology breakdowns in the United States.

Read also Health Information Technology In Mayo Clinic

Health Care Organizations That Had a Significant Information Technology Failure

Network Glitch at Florida Health System

            In 2014, IT network failure at Florida Health system paralyzed health operations in its MHS facilities (Stuart, 2014). According to the hospital officials, the failure in the hospital hardware system paralyzed operations for about two days. A hardware failure in the three-hospital Martin Hospital in Stuart caused an unexpected downtime in the hospital’s Epic EMR and other applications. In fact, the breakdown affected thirteen of the hospital MHS facilities.

Read also Capital one Bank Data Breach – Article Analysis

            Although the breakdown occurred in the evening of Wednesday, the hospital officials reported that the IT department resolved the problem and restored the services by Friday (Stuart, 2014). The hospital officials asserted that although the problem affected the Epic EMR, the cause was attributed to the hardware breakdown. The hospital spokesperson, Scott Samples asserted that the hospital had to resort to manual patient documentation and charting system, as the patient care was their priority. In the same hospital during the launch of its Epic MRC in 2011, Samples had asserted the development of proper processes to ensure patient safety and proper documentation in such processes of downtime. He pointed that the health system would follow due processes in order to ascertain the causes of the glitch and prevent such events in future.

Read also How to Address Employees to Report Privacy and Security Breaches

Sutter-Health in Northern California

            As more hospitals ditch paper work for electronic record systems, more downtime glitches are reported in the United States. The other recent occurrence of a downtime on patient care is the Sutter Health in Northern California that occurred in August 2014, (Stuart, 2014). In an event similar to that of the Florida Health system, the hospital’s $1 billion Epic EMR experienced downtime that paralyzed hospital operations for a whole day. According to a press response from Sutter nurses, the glitch caused a compromise on the patient care.

            The problem extended to the hospital patient data backup system and when the hospital nurses resorted to printing the patient data using the hospital’s Pyxis system, the data print out was outdated by two to three days. According to a RN at Alta Sates Summit Medical Center and California Nurses Union representative for the hospital, the patients were concerned for failure to receive their medications for a whole day. Although the downtimes were from Citrix glitch, the hospital officials denied naming the vendor (Stuart, 2014). However, they issued a statement to regret the inconvenience that was caused to the patients.

How the Failures Impacted Both the Organization’s Operations and Patient Information Protection and Privacy

            The failure of the hardware in the Florida Health system paralyzed operations in its MHS. Although the hospital was able to resort to manual chart and documentation of patient data, there was likelihood that it caused many patient inconveniences due to time taken to offer medication. In addition, given that the glitch took two days to rectify, explains the extent of inconvenience and the risks it exposed the electronic medical data.

Read also A Violation of Ethical Principles Related To Managing Healthcare Information

            According to (Johnson & Willey, 2011), healthcare data loses can result in social stigma and privacy violations. The failures of the Epic EMR in Florida Health system opened an avenue for consequential changes in the patient medical information. For example, changes in information such as blood type or allergies can affect patient health. Therefore, the downtime in Florida Health system exposed patient data to possible privacy breaches and improper diagnosis.

            The Sutter Health in Northern California case caused a lot of patient inconvenience, although it just occurred for a day. The fact that the retrieval of patient data from hospital backup system produced data that was outdated by two to three days, meant the system failure exposed the patients to wrong diagnosis. In addition, the system opened up loopholes for data loss in the hospital electronic data storage. The reliance of the Sutter Health in Northern California in its Epic EMR meant that many of the patients were not able to receive their medications for most of the day and almost paralyzed the operations in the hospital.

Read also Impacts of Electronic Health information on Nursing Process – Presentation

The Leadership Team’s Reaction to the Failures

            The reactions of the leadership in the failures that affected Florida Health system and Sutter Health in Northern California were almost similar. Both leaderships failed to own responsibility for the failures. In addition, the hospitals response failed to give comprehensive information regarding the steps the hospitals took in order to secure patient information during the time of the failures. The spokesperson for Sutter Health in Northern California just issued a statement expressing the regret for the inconvenience caused by the downtime in the hospital EMR. In addition, the hospital leadership declined to name the vendor of the Epic EMR, only for the medical representative to name it.

            However, the leadership of the Florida Health system reacted by ensuring the patient care experienced minimum inconvenience, when it resorted to the manual patient data documentation and charting. The numbers of the patients in both hospitals, whose data was exposed was huge and it could easily have led to a breach of the HIPAA regulations. According to (Gamble, 2012), a number of regulations govern the Electronic Medical Records. The first legal aspect covers the risks of medical malpractice. The Florida Health system in the case above was concerned with patient care and the hospital leadership worked to ensure that minimum inconvenience was caused and that patient care was not compromised due to the failure of its Epic EMR. Its use of the manual system worked and patient care experienced minimal inconveniences.

            However, the Sutter Health in Northern California use of the Pyxis system produced outdated data, which would have exposed the hospital to the breach of the HIPAA regulations governing EMR. The reactions of the Sutter Health in Northern California to resort to Pyxis system exposed the physicians against risks of medical malpractice claims, likelihood of medical errors and vulnerability to fraud claims.  In addition, the failure of the hospital leadership to provide detailed information of the cause of the downtime and the steps it took to secure patient data as well as ensure patient care was not compromised, was insufficient.

Position on Whether the Health Care Providers Should either Develop a Custom Application or Select a Proprietary System

            As the healthcare system in the United States adopts more electronic healthcare records (EHRs), the numbers of vendors have narrowed. In 2013, about ten EHRs vendors accounted about 90% of the HER market in the hospital sector in the country. These vendors include Epic, Cerner, Healthland, MEDITECH, Siemens, CPSI, McKesson, NextGen Healthcare, Allscripts and Healthcare Management Systems (Gregg, 2014). However, only three of the ten vendors expanded their market in 2013. These vendors include Epic, MEDITECH and Cerner. Although there are national efforts to improve safety, effectiveness and quality, there is need for the healthcare organizations to be prepared for the failures that occasionally come up with the adoption of the EHRs applications.

            In regard to the failures that occurred in the Epic EMRs in Sutter Health in Northern California and Florida Health system, there is need to adopt custom applications. When an organization adopts proprietary system, there is likelihood of the laxity from the supplier company and this poses great risk in the event of any system failure. Most of the proprietary applications are one company owned and once the companies sell the copies of its software to cover its development costs, every other unit sold generates pure profit and this reduces company emphasis on innovation or efficiency (Muir, 2011). As seen in the case of Sutter Health in Northern California, the presence of the Pyxis system would provide an alternative when the Epic system failed. Therefore, there is need for Sutter Health in Northern California and Florida Health system to integrate multiple disparate systems in order to have comprehensive custom applications for their EMRs (Vest & Gamm, 2010).

Recommendation of Best Practices That Any Organization Could Adopt In Order To Avoid Such a Failure In The Future

            The failures of hospital EHRs causes inconveniences to the patients and can hinder patient care (Terry, 2013). In order to avoid such occurrences as witnessed in the Sutter Health in Northern California and Florida Health system, there is need for healthcare organizations to adopt a number of strategies. The following are the recommendations, which when adopted, can help in avoiding such failures in future.

Read also NR-512 – Safeguarding Health Information and Systems

            First, avoid proprietary and adopt custom applications in order to ensure the healthcare information system is interfaced with the available information technology infrastructure. As witnessed in the case of the Florida Health system, there was no backup for the healthcare records, due to dependence on the proprietary Epic application in its EMRs. The presence of backup system in Sutter Health in North California allowed an access of patient data. However, lack of interfacing with the existent hospital information technology, led to retrieval of out dated data. Therefore, there is need to interface the HIT with the existing hospital information technology in order to ensure continuity of patient care in case of a glitch.

            Second, identify and mitigate risks before they occur. The hospital information and technology department should conduct system updates and regular checks in order to troubleshoot and prevent major downtimes that can derail the operations in the hospitals. The regular checks should also take into consideration the security checks in order to ensure that appropriate measures are in place in order to prevent any data loss in case of any system failure. As noted in the case of the Sutter Health in North California, the hospital patient information is very vital and it goes a long way in enhancing the work of the physicians. Making such information available all the time is very important in ensuring the continuity of patient care.

            Third, exercise good governance, learn from others and past events in order to benchmark on the best practices. There is need for the senior management should ensure the organizational mission and vision are focused on efficiency, increasing quality and delivery of services in organized and cost effective way. It is with no doubt that EMRs play a critical role in enhancing vision and mission. However, there is need for the top management to support the EMR in order to realize successful implementation (Cellucci, Wiggins, & Trimmer, 2011). Most EMR failures result from its poor implementations.

How Health Care Leaders Can Use Project Metrics and Portfolio Management to Ensure Operational Efficiency and Effectiveness

            The project portfolio involves the maximization of use of the available resources and organizational capabilities in order to ensure the meeting of the desired outcomes, within the constraints of technology, finance, vision and mission (van Angeren, Blijleven, & Batenburg, 2014).  The project metrics are data that give a measurement of the projects. The healthcare organizations can use a combination of shrewd resource allocation and project metrics in ensuring that its operations are effective.

            An organization in analysis the costs of project, selecting the project that is cost effective and providing good control measures, it can ensure a project that is efficient and affordable. In addition, the evaluation and controls in portfolio management help in prevention of inconveniences caused by failures in projects. Besides, the use of metrics ensures that the right projects are selection and implemented.

Government Intervention into Health Care Businesses, Meant To Ensure That Health Care and Patient Information Is Secure and Thus To Minimize Information Breaches and Technology Failures

            The federal government through the HIPAA act has enacted a number of regulations that govern the safety of patient data (DesRoches & Miralles, 2010). The federal government through its federal stimulus package of 2009, the American Recovery and Reinvestment Act 2009 has a number of provisions as drafted in the Health Information Technology for Economic and Clinical Health Act provide an encouragement for the hospitals to adopt electronic medical records. It is evident that as much as the government provides framework for adoption of the EMR, it exercises also it other core responsibility of regulation.          

The most important aspect of the healthcare security is the security of the patient information, which includes the medical information. Any lose of the patient information is not like lose of a financial card, which can be re-issued and another one issued. When patient data is lost, it can be used for impersonation or to solicit for money. Therefore, the government through the HIPAA has provided a number of regulations that protects the patient against risks associated with loss of their medical information in case of security breaches or system failures.

Trend and Issues in Healthcare Presentation

“I will begin by welcoming all of you to today’s presentation. The topic of this presentation is “How the practice of nursing is expected to grow and change.” The mode of healthcare delivery today is very different from the one used in the past centuries. The healthcare delivery system is now changing to meet the health needs of the current and future generations. In the coming years, we as nurses are expected to contribute positively to the restructuring of the healthcare delivery system of the United States. For example, it is anticipated that very few nurses will be required to serve in acute care hospitals while a large percentage of them are expected to work in the community. This means that future nurses must be equipped with the knowledge and skills required for quality healthcare delivery in the community. In order to produce competent nurses who can offer both community-based and hospital-based healthcare services, the educational sector must make relevant changes that match the anticipated growth and changes in the health sector.

The community is faced with the challenge of dealing with new infections that are affecting society today. With close guidance and advice from nurses, the community will be able to know the right actions that they must take in order to avoid deaths that may occur from such infections. According to Kovner and Walani (2010), there is an increasing need for health education and prevention in the community. The best way through which the community can receive relevant health education is when healthcare delivery systems are brought close to them. This explains why nurse-managed clinics should be created out in the community. An advanced practice nurse must be deployed in every nurse-managed clinic to help provide health education and to deliver care to the community (Kovner and Walani, 2010). This clearly indicates that more nursing jobs will be available in the community in the near future following the creation of nurse-managed clinics.

Apart from the anticipated change in the role of nurses in the near future, another aspect of growth in nursing practice that is expected to change is the manner in which nurse performance is rewarded. In a few years to come, nurses will be rewarded on the basis of the quality of care delivered and their ability to manage costs. In nursing, this new system is known as Accountable Care Organizations (Deloitte, 2009). Various healthcare organizations will transform into accountable care organizations that compensate physicians and nurses based on health care quality delivered. Successful implementation of this new system will completely change the manner in which healthcare organizations reward nurse performance. This calls for an immediate realignment of the nursing sector such that nurses must be in a position to deliver quality care to their patients both in the hospital setting and the community (Deloitte, 2009).

We as nurses are charged with the responsibility of ensuring that rates of disease occurrence in the community remain low. In order to achieve this, the community should be given an opportunity to make medical consultations whenever they need to (Dardani and Lyles, 2010). Patient-Centered Medical Homes is a new health care delivery system that seeks to provide the community with constant access to their personal healthcare providers and to unlimited medical consultations. According to Dardani and Lyles (2010), it is anticipated that Patient-Centered Medical Homes will change nursing roles from the provision of indoor medical services to serving community-based roles in the medical homes.

We must also remember the fact that many deaths that occur in the community today are caused by chronic diseases such as high blood pressure, cancer, and diabetes. Many people succumb to these diseases because they lack adequate knowledge on how to effectively manage them back at home after they have left the hospital. Faster recovery from chronic diseases can be enhanced if the nurse continues to guide the patient even after acute care (Haggerty et al., 2003). This is known as Continuum of care and it is one of the new systems that are likely to change the face of healthcare delivery in the near future. Under Continuum of care, more nurses will be deployed in the community to offer continued care to community members who are suffering from chronic infections (Haggerty et al., 2003). Nurses who will offer a continuum of care and who will be required to serve in nurse-managed clinics, accountable care organizations, and patient-centered medical homes will be chosen at random. I, therefore, urge each and every one of us to acquire the necessary skills that will enable them to continue working as nurses in a sector characterized by rapid growth and change. Thank you!”

According to nurse 1, many people in the community acquire certain infections due to a lack of knowledge about how such diseases can be prevented. This compels the health sector to spend a lot of finances purchasing drugs that can be used to treat diseases that could have been avoided. For instance, a high percentage of the population is currently infected with HIV merely because they were not conversant with various preventative measures. Such infections can be avoided if only members of the community were taught in advance on how to avoid them. Nurse 1 supports the idea that the health care delivery system is likely to change in the near future where nurses will be required to deliver care in nurse-managed clinics and patient-centered medical homes (Kovner and Walani, 2010).

According to nurse 2, the nursing profession requires all workers to offer high quality of care to all patients. A system that assesses the quality of care can help nurses enhance their performance levels and to ensure that they offer quality care. Both modern and future hospitals are incorporating a new system that will assist them to reward nurses and physicians based on performance. Nurse 2 has an impression that in a few years to come, healthcare organizations will not reward nurses based on their academic qualifications but on the quality of care they deliver. She believes that accountable care organizations will not retain nurses who cannot meet their quality standards (Deloitte, 2009).

According to nurse 3, the healthcare conditions of people who are suffering from chronic infections normally worsen after they leave the hospital. This is attributed to either side effects of drugs or non-adherence to medication. In order to reduce rates of deaths that occur from chronic infections, nurses must be deployed in the community to deliver continuum care to patients who are suffering from such infections. This means that in the near future, the number of nurses working in the community will exceed those offering indoor services. Nurse 3 feels that the nursing sector is expected to grow and change at a rapid rate in the near future and nurses must be prepared for those changes in order to fit in the future job market (Haggerty et al., 2003).

Understanding of Child Mortality and Advancements in Healthcare Outcomes

Child mortality refers to the death of an infant before their first birthday. Notably, infant mortality is widely used to measure both population health and the quality of health care. According to World Health Organization (2020), infant mortality highlights a longstanding, growing concern of public health. Public health not only sees the factor as a measure of infant death risk but uses it more broadly as a crude indicator of availability and quality of medical care, community health status, and poverty and socioeconomic status level in a given community. Thus, the health and wellbeing of children and communities across the globe can be measured using child mortality rates.

Understanding child mortality is, therefore, essential to describing advancements in health care outcomes. Infant mortality comparison between time periods can help determine whether the quality and accessibility of health care in a particular area is improving or deteriorating. Increased infant mortality points out declining health care outcomes and vice versa (World Health Organization, 2020). Therefore, by analyzing infant mortality rates across time periods and regions, health care policymakers are able to determine which communities need improvements in their health care system as well as prioritize based on urgency.

To sum up, infant mortality comparison serves as a needs assessment to help public health evaluate the quality and accessibility of health care. The variable is also essential for assessing the impact of public health programs. The essentiality of infant mortality in describing advancements in health care outcomes stems from its ability to paint a picture of the availability and quality of medical care, community health status, poverty, and socioeconomic status level in a given community.

Predictive Informatics, Healthcare and Genomics

What are some of the ethical and social implications of predictive informatics in health care?

Over the past decade, predictive informatics has emerged as the potential future of healthcare globally. Yet, it still remains imperative to consider key ethical and social implications of this new reliance upon predictive informatics. A major ethical concern associated with this new development is the privacy and confidentiality of patient data. This typically includes issues surrounding the granular control over data provided to a specific healthcare provider, evaluation of the data, and social networking reliance (Meek, 2016). Similarly, decision support is also a key social implication of predictive informatics in healthcare. This is primary due to the fact patients have previously been known to access such data devoid of any qualified clinical intermediaries within a healthcare setting.

Is predictive informatics that uses genomics racist, sexist, or homophobic?

            Although predictive informatics using genomics has recently been criticized for being racist, sexist, or homophobic, I firmly contend that this assertion is erroneous and unfounded. Predictive informatics essentially seeks to address medical actualities of the day with the primary aim of introducing viable solutions through new developments in personalized medicine. This now involves identifying the susceptibility of a particular race, ethnic group, sex, or gender with the primary objective of bolstering disease prevention and reducing specific risks associated with a particular. For instance, susceptibility to cardiovascular disease and obesity varies starkly from one individual to the next based solely on biological and sociocultural factors (Srivastava et al., 2020). Thus, predictive informatics through genome-based knowledge is responsible for a deeper comprehension of distinctions within a given population and bound to ultimate result in positive outcomes for vulnerable individuals.      

How can genomics and data analytics change how healthcare and coverage could be approached?

Genomics and data analytics represent a revolution undoubtedly bound to have far-reaching impacts on healthcare and an alternative approach to coverage. This is mainly because their application increases the accuracy rate of diagnoses. The subsequent application of predictive algorithms will play a central role in informing a physician’s decision concerning whether a patient should be discharged as opposed to relying solely on their clinical judgment (Yoshihashi & Hoyt, 2017, p. 56). Furthermore, it will also bolster preventive medicine within the healthcare sector through early intervention and health promotion through well-living. Predictive analytics is also bound to transform coverage by according healthcare providers with accurate predictions of individual costs associated with insurance products. This may also go a long way in allowing employers to make accurate future predictions of healthcare costs likely to be incurred by employees covered by the organization.

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