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A healthcare ecosystem involves doctors, nurses and staff, patients, labs, pharmacists, insurance providers and the family. A healthcare ecosystem, like any other, is affected by internal factors such as poor staff, inadequate or even lack of medicine and staff among others. It is also affected by external factors such as, federal legislation, accreditation standards and government regulations. In trying to provide proper health care to its people, the US federal government developed the Nationwide Health Information Network (NHIN), where healthcare providers, organizations and consumers can access exchanged health information. In this network, specialists and healthcare organizations are able to exchange information across the nation, thus providing higher quality healthcare to consumers, reduced costs, more efficient control and ease access to health services.
In this text we will analyze three issues involved in health care provision in the US and how they are affected by licensure, certification and accreditation. They are; increasing coverage, decreasing the cost of health care and insurance coverage. Licensure involves issuance of licenses to professionals while certification refers to the acknowledgment of their work through giving a certificate of practicing. Accreditation on the other hand refers to review of healthcare providers by Non-Governmental Organizations by comparing their performance standards to previously set ones.
To increase coverage of healthcare provision, the federal government has gone as far as providing healthcare via the internet, through the NHIN, where organizations and other healthcare providers register and exchange information that is accessed by consumers. State governments have made it easier for medical professionals to get licenses by coming up with online licensing systems. One is the Iowa Department of Public Health (2013) that has an online system where medical professionals can acquire licenses, renew them, change names and addresses and also attach documents to their licenses. The Health Licensing Board also made its licensing procedures favorable so that it could enable mobility of the work force. These factors will lead to the increased coverage of health care provision. Certification of Electronic Health Records by the Office of the National Coordinator for Health Information Technology (ONC), has led to an increase in coverage of healthcare as there is increase patient access to information. If a healthcare provider is positively accredited, he or she is able to reach more people as they trust his or her professionalism.
The federal government has been seeking to reduce healthcare costs, but in reality, they have been on the rise. This had led to the middle class American straining to get proper medical care. According to Patricia Danzon (2002), medical costs have been on the rise due to several reasons. They are; increase in intensity of resources which refers to changes in resources due to technology, thus making their use expensive. Another reason Danzon talks about a increase in medical prices which consequently increases medical costs for Americans. The last reason is the increase in volume of services per head. According to Skinner (2013), the cost of medicine and healthcare services in the US has been on the rise due to American professionals’ willingness to buy machinery at any cost not considering its economic value. Over-treatment, fraud, burdensome rules, administrative complexity of health care systems and failure to coordinate care led to increased medical costs. Certification of Electronic Health Record would reduce healthcare costs. Accreditation would also reduce costs and increase the quality of services thus improving healthcare delivery.
Insurance coverage is another issue in health provision in the US. Although a good number of US citizens are covered by a medical insurance policy, there are a big number of citizens who pay for healthcare bills out of their pocket. This makes it expensive for them. Some insurance policies are expensive and that is why a poor American can’t pay premiums. Those who are insured are under the constant torture by increasing premiums. Through licensure of insurance companies to expand their policies, they could help people access better healthcare services.
The above three elements discussed affect clinical quality, reimbursement and patient access. According to Brennan, Cafarella et al (2009), increased coverage not only means physical coverage, but also access to the right care at the right time and in the right setting. This means that there will be increased patient access by them, and patient’s access good health care, as well as improved clinical quality thus leading to the proper delivery of healthcare services. Healthcare organizations get reimbursed according to the number of patients they have attended to.
Reduced costs of healthcare services will impact differently on clinical quality, reimbursements and patient access. With reduced costs, healthcare providers will be willing to provide lower quality services to patients. On the other hand, patients will have increased access to healthcare services, and since the government gives reimbursements on the quantity of patients, healthcare organizations will have increased reimbursements. As for insurance coverage, if there is increased insurance cover among citizens, there will be an increase in patient access, the increased quality of services and reimbursements as well.
The NHIN was a development of the US federal government. With the discussed elements above, they have been able to support the NHIN as they are increased coverage and reduced costs of healthcare services. Insurance companies also support the NHIN as they are able to provide and receive relevant information to and from healthcare organizations that are treating patients they have covered.
Health informatics professionals are people who deal with devices, methods and resources that are used to optimize acquisition, storage, use and retrieval of information in health. They have helped reduce costs incurred by patients to access healthcare services as they have uploaded information on NHIN that is used by patients. The have also-enabled communication between health professionals concerning a patient easier and also provides clinical guidelines to them, and also ease insurance coverage as patients get to learn about available medical insurance companies. According to AHRQ (2002), the role of health informatics professionals is to effectively manage and organize information on websites, therefore making it easier for it to get retrieved. They also analyze information before uploading it for use by medical professionals, patients and other stakeholders. They help in effective use of information on the website by all parties. Due to their roles, they extend healthcare provision coverage and reduce costs, including transport and communication costs as there are minimal movements.
Increased coverage of healthcare services, and reduced costs have some impacts on the health informatics workforce. Due to increased coverage, there has to be an increase in the work force of health informatics so that they are able to efficiently and effectively organize, manage, analyze and ensure the proper and meaningful use of information on their websites. They may also have to work at night since people access the websites at any time of the day, thus they work for long hours. Increased insurance coverage will have no effect on the health informatics work force. Reduced costs on the other hand will impact on them. People will prefer medical help from doctors online and from websites, meaning that the health informatics workforce will have to increase and work for longer as well. They also will have to constantly revise the information to keep up with current trends.
A healthcare ecosystem is definitely a large one. It requires every party to play its role for its sustenance. With changing technology and need for healthcare provision, the US government has gone as far as advocating for provision of healthcare via the internet. The healthcare ecosystem is faced by various factors, both internal and external such as government interference, inefficient staff among others. As discussed in the text, increasing the healthcare provision, insurance coverage and reducing costs is not an easy task although the three elements would lead to better healthcare services.
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