Navigating the Changing Health Care System: Understanding the Challenges - Essay Sample

Introduction

Due to the dynamic nature of the health care system, the challenges facing the system are continually increasing. Health professionals, therefore, have to be prepared and stay up-to-date with the latest requirements in the delivery of health. The implementation of the Affordable Care Act (ACA) led to a significant modification of many sectors of the United States health care, including evaluation of patient care and delivery and advancement of research and technology. Challenges facing the health care sector range from crucial aspects such as legal or ethical issues, research technology advancement to more multifaceted areas such as the development of patient health care services, and protocols that ensure compliance of health organizations.

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One major legal or ethical issue affecting health care is the question of patient confidentiality. Information concerning the confidentiality of patients are considered private. Violating privacy causes harm to the patient at the same time have ethical consequences for the health practitioner. The types of information to be released and to which person, is stated in specific provisions of the Health Insurance, Portability, and Accountability Act (U.S. Department of Health and Human Services, 2018). HIPAA prohibits any kind of disclosure of patient's information to public spaces such as social media, no matter how unintentional such a practice can be.

Advancement in research and technology has had a significant influence in health care; however, they are associated with costly errors such as overlying on monitor data and failing to detect changes in clinical status. Nurses and other health care providers spend less time knowing their patients with confidence that they will find the information for the care they need on the computer. Despite the technologies making work easier around hospital settings, the nursing career pays little attention to the correct implementation of these technologies, such as their integration with the health care environment and patient condition. The implementation of advanced research and technology has had positive impacts; however, the significant influence is the adverse effects it has caused in the delivery of quality care.

Newer models continue to be adopted, replacing some of the traditional ones. At minimum effective care, some of the care models that have evolved from the traditional ones include freestanding emergency departments, digital diagnostics, remote patient monitoring, and patient-centered medical home. The patient-centered medical home model is an essential framework designed to help in transforming primary care. According to the Agency for Healthcare Research and Quality (2020), the patient-centered medical home is characterized by five functions, including comprehensive care, patient-centeredness, coordinated care, accessible services, and quality and safety.

Healthcare compliance is substantial because it helps clinical facilities tackle the ever-growing government regulations, which outline standards for privacy and usage for patient information, protect health care practitioners, and prevent fraud. According to Health and Safety Authority. (n.d.), the seven critical efforts and protocols for ensuring compliance of health care organization in a changing regulatory and economic health care environment include; Establishing written policies to promote commitment to compliance, identification, and appointment of a compliance officer responsible for supervising compliance efforts, creating reporting systems to encourage staff register complaints regarding compliance without fear, conducting formal education and training programs, adopting an ongoing auditing and monitoring systems to evaluate the effectiveness of compliance programs, enforcing standards with disciplinary measures for staff who fail to comply and conducting quick response to potential abuses where vulnerabilities are identified.

The Ultimate Impacts of the Key Elements on Healthcare Organizations

Ethical issues in health are a big concern that can lead to tragic outcomes such as loss of lives. For example, in 2016, NHS was accused of breaching doctor-patient confidentiality (Bulman, 2017). According to a memorandum of understanding published in January the same year, the Home office was given a right to access confidential patient information to help in the enforcement of immigration policies (Bulman, 2017). The information on patient information was published without consultation of NHS staff, healthcare organizations, the public, or the patients. Thus, the Human Rights Group took to court the Home office, claiming the breaching of patient data left people fearful of seeking help from medical centers. Dickert (2019) denotes that reform requires the moral decision making of leaders because they influence different relationships and lead to fundamental changes in healthcare. The success of a medical organization significantly relies on ethical and legal behaviors.

Technology advancement is another emerging healthcare issue that has created challenges in how providers practice medicine. The virtual doctor-patient interaction has led to costly errors in cases of chronic conditions that require visits. In connection with the ethical standards required, technology has led to the breaching of sensitive patient information (McBride et a, 2018). It is crucial that leaders understand and predict the working of the system to update on further development so that privacy is maintained.

Constant government regulations in healthcare lead to disruption of the whole system because it takes time for practitioners to adapt to new changes. Regulatory challenges affecting new patient-centered models lead to the high economic cost of providing the services. Research shows that healthcare managers are so much burdened to comply with different revised standards, including those of the Health Insurance Portability and Accountability Act (HIPAA). To tackles challenges with compliance, it is crucial for healthcare providers to engage in awareness creation and information sharing. According to Fiedler (2017), managers must device document control plans, training on compliance, address nonconformance incidents, and develop integrated healthcare reforms.

The evolution of patient care service models has helped reduce cost and produced a significant return on investment. The patient-centered medical home model (PCMHM), like other new models, faces the challenge of ensuring high levels of education to patients. According to this model, patients need satisfaction in the work their providers do and an assurance of safety. According to Budgen and Cantiello (2017). creating a good health infrastructure requires a significant investment of funds, making it an expensive process. In connection with the emerging issue of compliance in a changing economic environment, new models of care find it difficult to achieve accreditation.

Conclusion

In conclusion, as a result of the dynamic nature of the health care system, the challenges facing the system are continually increasing. Trends such as technology allow for more personalized medical records; however, overuse could lead to more diverse effects that are costly. Ethical considerations and compliance remain efficient in healthcare. The efficiency of the new trends in healthcare should be maintained at an equilibrium between value-added healthcare services, the cost of the solution, and maintain a healthy doctor-patient relationship.

References

Agency for Healthcare Research and Quality. (2020). The Patient-Centered Medical Home: Closing the Quality Gap. Agency for Healthcare Research and Quality (AHRQ). https://www.ahrq.gov/

Budgen, J., & Cantiello, J. (2017). Advantages and disadvantages of the patient-centered medical home: A critical analysis and lessons learned. The health care manager, 36(4), 357-363. doi: 10.1097/HCM.0000000000000178.

Dickert, N. W. (2019). Focusing on the Big Picture to Improve Ethical Decision-Making in ICUs. Critical care medicine, 47(12), 1804-1805. doi: 10.1097/CCM.0000000000004057

Fiedler, B. A. (2017). Challenges of new technology: Securing medical devices and their software for HIPPA compliance. In Managing medical devices within a regulatory framework (pp. 315-329). Elsevier. https://doi.org/10.1016/B978-0-12-804179-6.00018-6

Health and Safety Authority. (n.d.). Safety and Health Management System. https://www.hsa.ie/eng/Topics/Managing_Health_and_Safety/Safety_and_Health_Management_Systems/

McBride, S., Tietze, M., Robichaux, C., Stokes, L., & Weber, E. (2018). Identifying and addressing ethical issues with use of electronic health records. OJIN: The Online Journal of Issues in Nursing, 23(1). https://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-23-2018/No1-Jan-2018/Identifying-and-Addressing-Ethical-Issues-EHR.html

U.S. Department of Health and Human Services. (2018, July 26). Summary of the HIPAA Privacy Rule. HHS.gov. Retrieved May 1, 2020, from https://www.hhs.gov/hipaa/for-professionals/privacy/laws-regulations/index.html