WFM1 Task 2 Trends in the Ecosystem

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1 Trends in the Healthcare Ecosystem Kechia Mignault Western Governors University Course number: C799 Pam Borsum July 15, 2022
2 Federal Government Payer Program Historic events such as government changes, economic fluctuations, and social movements have had significant implications on today’s healthcare. Because of this shift in how healthcare is delivered, the government is encouraging healthcare providers to embrace new technology to find ways to deliver quality care accessible to more people at reduced cost. A. Analysis of Key Historic Events and the Implication on Healthcare Delivery There are many historical events that had an impact on medicine. Time will not permit listing all events that have impact medical history, but some events will be mentioned here. A1. Evolution of Medicine The first medical book, the Ebers Papyrus, was written in 1500 BC (Wagner, 2021). Between 384-322 BC, Aristotle said the body was made up of four liquids: phlegm, blood, yellow and black bile. From 400-1000 AD, medical advancement progressed in the Middle East. By 1628, William Harvey published a discovery of how blood circulates within the body. In 1865, Joseph Lister developed antiseptic surgery. This changed the world of medicine. In some cases, the surgery was more dangerous than the actual injury or disease that caused the need for the surgery, because of the lack of sterile treatment and potential for infection. It is only within the last hundred years that the practice of medicine began to develop more along with science. Prior to that, there were some advancements in medicine, but those were largely unscientific. Wars such as the Civil War and World Wars I and II stimulated new development in treatment of injury and disease, as healthcare providers see care issues in war and then adapt them to general society (Wagner, 2021). A2. Roles of Healthcare Professionals
3 Between 1792 and 1750 BC, the Code of Hammurabi was written. This code provided laws to govern medical practice, establishing the very early beginnings of medical practice. From 1100-1200 AD, schools of medicine began to be founded in Europe. Barbers that also operated as surgeons started to work in towns and churches ran local hospitals. This was the initiation of providers starting to receive formal training as healthcare providers. Starting in the late 1800s, physicians took a more prominent role in healthcare. The growth of cities in the United States caused healthcare to move away from homes to physician offices located in urban areas. (Wagner, 2021). Prior to this time period, many people received care at their own homes and often went to hospitals with the expectation of dying there. Due to urbanization, people began to go to doctor’s offices or hospitals to receive treatment. For healthcare professionals, this increased their productivity by reducing their travel time (Journal of Health Politics, Policy and Law 2004; Starr 1982; Wailoo, Jost, and Schlesinger 2004 as cited in Wagner, 2021). A3. Technology in Healthcare In 1816, Rene Laennec, a physician and inventor, invented the stethoscope, which is still used in doctors’ offices to this day (Roguin, 2006, as cited in Wagner, 2021). This allowed providers to listen to the heart and evaluate unhealthy sounds made by the heart, which helped doctors diagnose and treat patients. In 1895, Wilhelm Conrad Rontgen accidentally discovered X-rays. X-rays are an important diagnostic tool in medicine, since they enabled doctors to see inside the human body for the first time without having to subject the patient to a risky surgery (Concorde, 2017). B. Components of a Healthcare Delivery System
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4 Three components of a healthcare delivery system are organization, funding, and delivery. Ideally, these components will work in accord to provide easily accessible, quality healthcare at a reduced cost to patients (Wagner, 2021). Integrating these three key components has been challenging and the components often do not work together harmoniously (Bennett, 2012; Bodenheimer, 2008, as cited in Wagner, 2021). These components include many different types of facilities such as hospitals, long-term care and rehabilitation facilities, and noninstitutional providers like doctors, pharmacists, nurse practitioners and physician assistants (Wagner, 2021). B1. Patient Care Access Access to high-quality healthcare in the United States is often affected by a patient’s location. A patient living in a rural location, 100 miles from the nearest town or doctor, will have more limited access to care than someone who lives in an urban area with multiple multi-system organizations (Wagner, 2021). Different approaches have been taken to address these kinds of issues to make healthcare more accessible for patients. One approach is the minihospital, which has a smaller number of beds than a larger, more urban facility but still can provide the care that the local rural population requires. If more advanced care is needed, the minihospital has transport services such as helicopters, fixed-wing aircraft, and ambulances to take patients to affiliated hospitals. B2. Patient Care Cost Funding is another component of a healthcare delivery system that affects patient care. After the Affordable Care Act (ACA) was introduced, accountable care organizations (ACOs) began to rise in prominence. This organization is a group of providers who share responsibility for a patient population. Their goal is to improve the health and experience of the patient population while reducing the total cost (Wagner, 2021). This group works with different insurers
5 and often receive financial incentives for reducing patient cost. One way they do this is to focus on preventive care, so that more complicated illnesses caused by neglecting preventive services can be avoided or mitigated. B3. Quality of Patient Care The Medicare Shared Savings Program (MSSP) was established by the ACA. This program encouraged the formation of ACOs. One goal of the MSSP was to encourage coordination and cooperation between providers to improve the quality of care for Medicare beneficiaries by providing more quality care for individuals and improving health of populations (Wagner, 2021). This program rewards ACOs that reduce expenses while meeting standards for quality of care. C. Analysis of Healthcare Trends and Emerging Technology Federal government initiatives and emerging technology have influenced the practice of medicine and changed the way healthcare data is used. C1. Federal Government Initiatives Related to Health Informatics One federal government initiative related to health informatics is the Medicare Recovery Audit Contractor (RAC) program. This program aims to reduce improper payments by Medicare by examining coding data for accuracy, detecting and collecting overpayments, and implementing action plans to prevent future inappropriate payments (Oachs & Watters, 2020). C2. Effects of Emerging Technology on Medical Practice Telemedicine and telemonitoring are types of technology that have improved access to specialty services in rural areas. Telemedicine also enabled people to stay in touch with their primary care providers during the COVID-19 pandemic. These types of services minimize the need for travel and allow people to access medical care despite geographic limitations (Wagner,
6 2021). Patient portals have also affected medical practice. A patient portal is described as a secure website where a patient can access their personal health information (PHI) such as their current medication list, lab results and immunizations. In some cases, they can also send their doctor a message, request a prescription refill, and schedule appointments that are not urgent. These advancements have improved access for patients.
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7 References Concorde Career Colleges. (2020). A short history of X-rays. https://www.concorde.edu/about- us/blog/health-care-insights/health-care-awareness-history-x-rays Lemelson-Massachusetts Institute of Technology (n.d.) Rene Laennec. https://lemelson.mit.edu/resources/rene-laennec Oachs, P., & Watters, A. (2020). Health information management, concepts, principles and practice (6 th ed). American Health Information Management Association (AHIMA). https://wgu.vitalsource.com/reader/books/9781584267577/epubcfi/6/44%5b %3Bvnd.vst.idref%3Dchapter009.xhtml%5d!/4/2%5bdiv1%5d/390/7:193%5baud %2Cule%5d Wagner, S. L. (2021). The United States healthcare system: Overview, driving forces, and outlook for the future . https://ebookcentral.proquest.com/lib/westerngovernors- ebooks/reader.action?docID=6180928&ppg=22