Health Care Reform for Improving our Quality of Care

Global Healthcare Outlook's viewpoint on Healthcare for 2018 is to bring into play more technology centered medical system. The use of smart should ease the difficulties that providers have when scheduling appointments, maintaining health records, and avoid procedure and machine malfunctions, correct diagnosis, and efficacy. The Outlook continues to find new ways for providers, patients, and the government to deliver cost-friendly, quick, and maintained services for all.

In this year's report, there are six viewpoints that highlight how to solve these issues. Health systems are seeing declining margins because of straining finances due to the population aging faster than expected. This means more people will need special services, prescription drugs and these procedures can be costly. Insurance companies are having difficulty keeping client's costs at bay, as stated, health care costs increase, affordability and insurance coverage remain problematic. In the United States, deductible cost increases are far outpacing increases in costs covered by insurance (Cooper, 2018). Soon patients will not be able to afford to take care of themselves. Besides, the insurance companies, the workforce is taking a hit as well in India, for example, medical workforce shortage means available doctors command a high price structure, further eating into hospital margins (Cooper, 2018). Cost reduction is high on the list of ways to solve these problems and healthcare providers are teaming up to combine organizations so there are more providers in the network. That means more patients can choose them for services.

Another issue is preventing wasteful spending by adding more value to the coverage and services. As part of defensive medicine, providers run every lab they can think of on a patient. This is a preventative measure for the provider, so a patient does not sue or create a conflict because they were diagnosed with an illness that could have been protected with early prevention and testing. While there is some benefit to these measures, some of the labs and scans are costly. Programs such as the ABIM Foundation's Choosing Wisely Initiative36 (the European Federation of Internal Medicine has also launched its own Choosing Wisely campaign),37 which seeks to advance a national dialogue on avoiding wasteful or unnecessary medical tests, treatments, and procedures, aim to reduce low-value health care services (Cooper 2018).

Risk management is a practice performed across the globe in healthcare. Stakeholders use this to prevent data breaches and review quality care assessments. Cooper mentions in the report that organizations should perform a thorough assessment to understand how recent and upcoming policy changes will impact organizational priorities and explore strategies to reduce exposure (2018).

Exponential Technology has boomed through the past few years and improve care by reducing costs. This technology ranges from AI robotics, 3-D printing of human like organs, companion diagnostics that help doctors prescribe treatment and drugs correctly to avoid error, biosensors. These practices and inventions are important because the world is constantly updating with the newest trends. People want faster services and quicker recovery times. If the equipment can reach developing countries, global health would improve. Even in the United States, many facilities are aging and under reconstruction because they are outdated. Providers are Rethinking how to optimize inpatient and outpatient settings and are planning how to integrate digital technologies into traditional hospital services to reduce costs. in the future (Cooper 2018).

Improving patient experience is probably one of the top issues in healthcare. If the patient is not satisfied with the provider or insurance organization, they will give poor reviews, and even be discouraged to try and seek help for any illness. In the report, apps for phones or tablets, self-check in machines, and improved hospital website can help patients get smoother care and encourage them to continue to use that facility.

The Institute of Medicine's viewpoint for changing the quality of healthcare services in the 21st century is to continually provide safe and effective care, to reduce the burden of illness, injury, and disability, and to improve the health and functioning of the people of the United States (Institute of Medicine 2001). In order to achieve these foals, the institute brings in different case studies on how to improve provider service, in case these scenarios were to happen again. The goals for improvement are to be Safe, Effective, Patient- Centered, Timely, Efficient, and Equitable. Throughout the readings, there a recommendation on what the movement and citizens should do, for example quality assurance programs. The readings suggest that congress should provide more funding for these programs, so that way providers and insurance companies can see where along the health process, from first doctor visit to recovery at home, is the care lacking. Patients should be able to trust that the system will take care of them, by keeping track electronically of their records, the doctors will treat them with respect and autonomy, the hospital experience, for any reason they are admitted, is not a scary ordeal.

The effectiveness discussed is improving the methods of research for diseases that do not have cures, or little knowledge about it. The IOM says that it is important for ensuring that if there ever is a public outbreak of a certain disease or epidemic, there are funds and means of finding a cure. Not all doctors should provide their medications and treatments solely on this because every person will react different, but we can do better at monitoring results and data. To get results and cure others, providers must react quickly to emergencies as well as in the waiting room at outpatient centers. Timeliness was stressed as an area that needs improvement in 2001, and it translates to 2018 still. Appoints are mostly necessary at physician offices, but what happens to those who need medical help but it's not an emergency? Lack of timeliness also signals a lack of attention to flow and a lack of respect for the patient that are not tolerated in consumer-centered systems in other service industries. It suggests that care has not been designed with the welfare of the patient at the center (Institute of Medicine, 2001). Nowadays, people wait three weeks to three months to see a physician. In the emergency rooms, some claim to have 5-minute wait times, but that is only to check in, not be seen, so it can last up to 5 hours.

Being effective is a vital in any industry. The IOM focused on ability of the organization to reduce quality waste and administrative or production cost. Some methods to accomplish this is through the process of elimination such as, tests, multiple entries (such as clerical reentry of physicians' prescriptions and laboratory orders), classifications that add complexity without adding value (such as types of appointments and job classifications), and layers of control (such as approvals and sign-offs) (Institute of Medicine, 2001). Defensive medicine is on the rise for fear of lawsuits in undetected illness, but it costs money to run the machines to test that a patient probably does not need. Paper and medical equipment waste is additional area in which facilities can cost reduce. It may be expensive to contract companies to clear biohazardous wastes.

We take a look at chapter nine, Preparing the Workforce, covering clinical training and education, regulation of the health professions, and legal liability issues. According to the Occupational Employment Statistics of 2000, over 6 million people were in the health care industry and by now, that number has raised. It emphasized how not just doctors and nurses, but all personnel be educated in different skills. These skills can be training in information technologies to maintain records of visits and medical history, how to educate others in after care, and knowledge of other departments in the organization. When a patient is sick, they pass through many members of the health care team in that facility. If a nurse can do medical billing and coding, it can save an office money, so they don't have to hire another person. Teamwork is accentuated in every work place and there will always be a chain of command in any industry. The IOM accentuates that learning can happen at any time in life and we should continue to train new clinicians and the current ones. Seminars, and classes should be available to educate clinicians of new technologies and medicines that could be beneficial to their population of patients. These techniques can also ensure that clinicians get reaccredited in their field and keep up their licensures. Making sure that providers do this is crucial, so no liability and lawsuits appear. A provider can lose their careers if they practice without a license or certification.

Several similarities are formed between these two viewpoints of healthcare reform. The Institute of Medicine and the Global Outlook both have six ways or goals, that can aid in reforming healthcare for the 21st century as well as maintaining it for the future. Both views want to provide beneficial services to the patients and educate the public on how to stay healthy and live longer lives. A main point we can take away from Crossing the Quality Chasm on page 40 is, The committee believes substantial improvements in safety, effectiveness, patient-centeredness, timeliness, efficiency, and equity are achievable throughout the health care sector. This opportunity for improvement is not confined to any sector, form of payment, type of organization, or clinical discipline. Problems in health care quality affect all Americans today, and all can benefit from a rededication (Institute of Medicine, 2001).

Both ideas focus on taking care of not only the patients, but the providers as well. Society is finding ways to improve the productivity of providers in multiple disciplines, for example the AI robots. If we can create robots of this high functioning, we can improve our machinery to test earlier for cancers, strokes, or diabetes. Research was highlighted to find cures for past epidemics and promoting public health to prevent any communities from getting sick.

A contrast I noticed between the two reform plans was Global Outlook's focus on not only the United States of America, but multiple countries as well. The outlook used the other nations to compare to the U.S. and how to do better in our administration, insurance organizations and quality care. The focus was mostly on cost reductions and risk management for providers. There was a section how to improve the patient experience by using social media and kiosks to check in when you enter a medical facility. Using those methods differ from the Institute of Medicine's approach to patient care. The six goals were face to face and hands on with the client and making sure good reviews and results come from the services provided as to where the Outlook only focused on the problems the world is facing with trying to keep the population healthy. Mainly statistics were shown on how many people do not have access to health care in 2018 and the consequences of that. But, quality of care should not falter just because insurance plans and hospitals are costly or non profit.
To bring in a personal opinion on the two points, I agree most to the Global Outlook's research because it is up to date for the year 2018. This view also focuses as discussed earlier on the administrations of healthcare and how cost reductions are a must. Americans as well as other countries today cannot afford health care anymore. I feel that in today's society, the government will only help you is you're, barefoot, pregnant, disabled or an addict. But what about Americans that are working 2 to 3 jobs, and still cannot afford the Marketplace insurances? Because the Institute's view was written in 2001, Americans did not have the presidencies and administrations we have today. It is a mess in Washington D.C. as it always is, but the introduction of the Affordable Care Act really stirred people around. According to Health Markets, There are now 20.1 million Americans without health insurance than when the Affordable Care Act was enacted in 2010, according to data released by the Centers for Disease Control and Prevention (Healthmarkets 2018).

In 1993, President Clinton tried to reform health care, but failed. President Bush tried to work through it but the tragedy of September 11th happened so not much attention was paid. On eHealth's website, they explain 'Trumpcare versus Obamacare and our current commander in chief is paying no attention to any reforms of any kind. His health reform allows states to create their own prices on health insurance and this can be difficult for many already struggling for example, One of the things a state can do is charge people who go uninsured for an extended period of time, and have a pre-existing condition, a higher rate for their health insurance, for a certain time period that is generally expected to be up to 12 months (eHealth 2017). In my opinion, America didn't see as self-destructive as it was in the early 2000's, and that was only 17 years ago. So how did America fall behind with other countries in improving our quality of care for our citizens?

Reference:

1. Cooper, T. (2018, August 27). 2018 Global health care sector outlook. Retrieved November 10, 2018, from https://www2.deloitte.com/global/en/pages/life-sciences-and-healthcare/articles/global-health-care-sector-outlook.html (Cooper, 2018)
2. EHealth. (2018, October 31). Trumpcare (AHCA) vs. Obamacare (ACA). Retrieved November 16, 2018, from https://www.ehealthinsurance.com/resources/uncategorized/trumpcare-vs-obamacare
3. Healthmarkets. Healthcare Reform News Updates. (2018, November 15). Retrieved November 16, 2018, from https://www.healthmarkets.com/resources/health-insurance/trumpcare-news-updates/
4. Institute of Medicine. (2001 February 28) 2001. Crossing the Quality Chasm: A New Health System for the 21st Century. Washington, DC: The National Academies Press. Retrieved November 10, 2018 from https://doi.org/10.17226/10027. (Medicine, 2001)

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