Reforms in Healthcare Information Systems

In American society the health reforms that have been there have led to many issues. One of the reasons because of this is due to the fact that the reforms that have been made mainly address various concerns affecting different people. The country is faced with the issue of how the health care system in the country should be in future. There is great dissatisfaction with the health care system that has been there but even so there has not been any measures put forward on how to make reforms in the system. Reforms in the health care system were marked with the implementation of the act of patient protection which was the first step in the many reforms that have been made over the years. The fact that congress was able to pass the Affordable Care Act and the Patient Protection Act was a good strategy for dealing with some of the problems that were affecting the health system in America. In the world today, with the advancements of technology in the world it would be crucial if the government would consider the implementation of various systems of Information technology in the overall health system. The paper is intended to examine various reforms in the health care system that should be implemented in the world today and healthcare information systems that should be put in place.

Initiatives That Are Associated With Reforms in Healthcare

There are various reforms in the health care system that suit the situation in the country in regard to the period and the needs of the people. A number of initiatives have been put forward by the federal government in order to improve the health care system in the country. The planning and designing of information systems in health in the 21st century is associated with various initiatives which require evaluation and analysis. The initiatives that are associated with reforms in healthcare that are related to healthcare information systems include:

Telemedicine

Telemedicine in health is a relatively new concept and it is in line with health information systems. In the country the main purpose of telemedicine is in Medicaid and in this regard the role of telemedicine is to improve the health of patients in two ways. One of the ways is to provide real time communication that is interactive between patients, and health care practitioners or physicians who are in different areas. The form of electronic communication means that there is use of equipments for interactive communication that include equipments that enable audio and video coverage (Pruitt and Epping-Jordan, 2005).

In health, the way telemedicine is used for communication is a cost effective mode as compared to other traditional forms of communication such as face to face communication and other forms of communication used during provision of care (Crosson 2009). The states can choose to replace the use face to face communications or examinations between practitioners and patients with telecommunication. Telecommunication is closely associated with Medicaid because its definition is modelled from telehealth services which arose from Medicaid. However, the statute of the federal government in regards to Medicaid does not identify telemedicine as a separate service.

Telecommunication in health in very diverse and it ranges from doctors being able to link with patients over a long distance via phone, video such as webcam conversations or email to doctors being able to consult with each other electronically on urgent matters. Telecommunication in health care has helped in saving lives and providing care because in many situations it has been used by doctors in making fast decisions regarding various conditions that require emergency interventions. Another benefit of telecommunication is that patients can be able to use new forms of technology such as devices that can relay the heart rate, blood pressure and other vital signs of the patients that require regular monitoring (Kongstvedt, 2012). This helps in managing some of those conditions at home. Telemedicine is also very important because through its use there can be provision of care by medical experts in areas where the experts cannot easily get to physically. Telemedicine has also been very helpful in the relay of crucial medical questions to real-time problems for doctors without borders. In this aspect the doctors in distant areas such as South Sudan, Niger and other country faced with difficulties relay questions on serious medical question to teams of doctors around the world and then solutions are sorted (Chaudhry et al. 2006). Due to all the benefits that have been brought about by telemedicine it is important to encourage more use of other advanced health information systems that can transform health in many more countries. Telemedicine is expected to greatly in the next 5 years according to the COI’s analysis because the mission is to have in operational and implemented in all states within the period using consumer marketing as the main strategy (Bodenheimer, Wagner and Grumbach, 2002).

Physical Order Entry That Is Computerized

Medicine has been digitally transformed in many ways and one of the computerization of order entry. The system allows clinicians to place orders directly through electronic means. The order is then directly transmitted to the recipients who then serve the patient without being physically at the same location to transmit the information. About a decade ago, just before the implementation of electronic transmission the data was hand written and then physically transmitted to the areas where it was required (Kongstvedt, 2012). The HITECH Act by the federal government in 2009 spurred the use of the electronic methods. The Act was then accompanied by the program that ensured Meaningful Use which also boosted the use of electronic means of relaying medical information and entry of data (Chaudhry et al. 2006). Through this, computerised provide order entry (CPOE) was rapidly used in the outpatient and inpatient setting in order to provide better health services to the patients. Currently, many hospitals have embraced the use of CPOE and in it used in one form or the other to provide care. Initially the CPOE systems were developed in order to safer ways of placing order on the mediations for patients. This is because the physical methods that were used to order medication were faced with many challenges such as alteration and loss of the records (Pruitt and Epping-Jordan, 2005). The orders could also be physically changed and there would be no way of knowing since it was difficult to keep the records safe. Since CPOE systems were put up the records are now safer and it is also easy and fast to transmit the information. Through the use of the systems the patients are also provided with better care because their information is protected and there is a reliable method of data storage for reference in future and follow ups. If the practitioners make mistakes regarding patient prescription the information can be quickly recovered with all the information in place. It is now possible to even use the electronic methods for ordering procedures, tests and consultations as well (Crosson 2009). The widespread use of CPOE has greatly helped the patients and health care providers thus effectively transforming the health care systems of information as accordance to today’s era. CPOE is expected to be in all hospitals in the next 5 years having improved storage system and security of the patient information and thus this can be properly implemented if the state removes hand written forms of order entry (Bodenheimer, Wagner and Grumbach, 2002).

Expansion of Medicaid

Expansion of Medicaid is crucial if the country is to achieve universal access to health and hence it is important incorporate it with the current systems that are used for health delivery. This is why Medicaid expansion was incorporated with health information technology systems and hence the existence of IT systems for Medicaid. The importance of the systems is to help states in developing, designing, operation and implementation of technology as well as various other systems that are related to the improvement of patient coverage (Pruitt and Epping-Jordan, 2005). The systems are also important in the establishment exchanges for insurance in order to improve the number of people covered under Medicaid. The federal government provides guidelines that are very helpful in terms of how they link Medicaid services with information technology in health and thus speedy expansion of the services to the patients (Kongstvedt, 2012). The IT services that are used for the expansion of Medicaid are meant to be seamless and simple so that people can be easily identified. The people that are identify by the systems are the ones that qualify for coverage of Medicaid through tax credits, exchange, CHIP, Medicaid and cost sharing reductions (Crosson 2009). The IT systems worked well in 2014 during the exchanges which were very helpful in qualifying small employers and other individuals select, pay or shop for affordable and high quality plans that could fit their needs individually. The prices for the exchanges were competitive and hence many individuals could easily find the once that suited them with no great difference in the charge (Chaudhry et al. 2006). This way very important in the expansion of the number of people in the country who used Medicaid. IT systems provide a place where individuals could shop for insurance options and exchanges of insurance thus making purchase of health insurance more understandable and easier. In order for Medicaid to have all the success it did there had to be a suitable IT system and the system being consumer friendly was crucial (Bodenheimer, Wagner and Grumbach, 2002).

Patient Portals

Technology in the world today has greatly improved the access of health to patients. In majority of the health facilities in America and the world over patient’s access to health information is what has led to the great success that has been achieved by such facilities. Patient portals have been put up in order to improve the confidence of the patients towards the type of care that they receive. The patient portal is mostly and online website that has individual patient information (Chaudhry et al. 2006). The information in the portal is secure and patients can only see some of their personal information if they log in with personal usernames and passwords. Some of the information that patients can view in their portal after logging in is like the most recent visit to the doctor, medications, immunizations, discharge summary, lab results, allergies and any other information that may be helpful to the patient (Pruitt and Epping-Jordan, 2005). Some portals are also very helpful to the patients because they allow patients to actively communicate with their health care providers on matters of health. The patient can also request of their prescriptions through the portals, plan and make a schedule for appointment that are not very urgent, make payments on health services provided, update information that is used to contact the patient, complete and download medical forms and other services that affect the patients (Kongstvedt, 2012). Communication between the health care providers and the patients has been greatly improved and through the systems the patients are empowered which eventually leads to the improvement of patient outcomes in the health facilities (Bodenheimer, Wagner and Grumbach, 2002). Patient portal come up and filled the need of patients to take charge of their personal health needs. This has come about due to the education that patients have gotten over the years and they now understand that they have a right to their information in terms of health. Patients have also understood that in order to deal with the emerging health problems, it is no longer just a personal fight but a national problem and actively participating in their health care will go a long way in improving personal and national health care (Crosson 2009).

Health Insurance Exchanges

The Affordable Care Act made it a requirement to states that they had to set up health insurance exchanges so as to give small business owners and individuals a level field in the access to affordable health care (Bodenheimer, Wagner and Grumbach, 2002). The people who owned small businesses could make the insurance exchanges so that they could afford to pay for insurance for their employees (Crosson 2009). It was not possible for some of the states to set up their own exchanges and thus the insurance exchanges they used were from the federal government. In order for the federal government and the states that put up the insurance exchanges to do it successfully they had to rely on the health information systems (Chaudhry et al. 2006). In order for the reforms to be implemented the healthcare information systems had to be adjusted in a way that they could fit with the health insurance exchanges that were required and hence from there it was not very difficult to achieve the set requirements (Pruitt and Epping-Jordan, 2005). When the information systems were well set for their users it became very easy for individuals who required health insurance exchange to view the options and make exchanges that best suited them.

Challenges Facing the Initiatives

The major challenge facing initiatives put forward to improve healthcare reforms and information technology in health is its uptake in the hospitals around the states. The only way to encourage uptake is educating both patients and the practitioners on its benefits and its cost effectiveness in the long run (Crosson 2009). The other challenge is the cost because new technology has to be put up in order to ensure the full implementation. This will require money from either the federal government and partly from the state (Chaudhry et al. 2006). Funds will also be required for educating and marketing individuals on the new methods of technology that may be used to advance the health reforms (Pruitt and Epping-Jordan, 2005). The challenges may be overcome by the effective distribution of funds by the federal government and the perspective that the changes would ensure that eventually the cost would be low (Bodenheimer, Wagner and Grumbach, 2002).

References

Bodenheimer, T., Wagner, E. H., & Grumbach, K. (2002). Improving primary care for patients with chronic illness. Jama, 288(14), 1775-1779.

Chaudhry, B., Wang, J., Wu, S., Maglione, M., Mojica, W., Roth, E., ... & Shekelle, P. G. (2006). Systematic review: impact of health information technology on quality, efficiency, and costs of medical care. Annals of internal medicine, 144(10), 742-752.

Crosson, F. J. (2009). 21st-century health care—the case for integrated delivery systems. New England Journal of Medicine, 361(14), 1324-1325.

Kongstvedt, P. R. (2012). Essentials of managed health care. Jones & Bartlett Publishers.

Pruitt, S. D., & Epping-Jordan, J. E. (2005). Preparing the 21st century global healthcare workforce. Bmj, 330(7492), 637-639.