Emerging Issues in Health Care

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Table of Contents

Introduction
Global Competitive Forces
Medical Imaging Issues
Conclusion
Reference List

Introduction

New technological integrations in the health care sector are likely to exhibit different issues which will affect the delivery of service in the United States. One major area of interest is Medical Imaging. Medical imaging is likely to modify the conventional practices in imaging interventions in areas such as; informed consent, using contrast media for intravenous purposes, and applying invasive measures i.e. angiograms and image-directed biopsies.

However, contemporary trends in medical imaging interventions and techniques have given rise to new issues in the United States. The issues in question include cognizant, diagnostic procedures, teleradiology and filmless Imaging among others.

This paper will elaborate on global competitive forces contributing to ethical issues in medical care States. The paper will also fix issues resulting from medical imaging technology and outline the role of the United States in dealing with the same.

Global Competitive Forces

Global competition in medical imaging has surged to the scope of worrying policymakers, not only in the United States but across the world. Bielski (1996) argues that a link between industrial marketing and medicine has brought about “alliance of expediency and coercion”. Marketing has been viewed as, an indispensable aspect of the industrial process, physicians, as they play an indispensable component in decisive decision making in selecting and acquiring medical equipment for patients, have become a key role in influencing the acquisition of medical equipment. They have cut deals with suppliers of medical equipments with an intention of having their share (Bielski, 1996). Whereas medical companies may have their own moral standards, they tend to ignore the moral concern of physicians, thus, contravening procurement procedures and professional ethics.

Medical Imaging Issues

Cognizant

It is widely viewed that, a patient should be informed of the threat linked with a given diagnostic procedure. This is particularly important, noting the surging choice of current developments in the field of imaging technology. Uneven diffusion of information in regard to modern imaging possibilities and the choice of the doctor has, on occasions, disagreed on appropriate intervention deemed for a particular patient (Bielski, 1996). Failing in locating a particular intervention has caused challenges in advising patients, varying treatment decisions and result in contentious standards.

Informed consent in film-less and teleradiology has undergone milestones in imaging practice. Thus, Imaging consent procedures for imaging have changed from one hospital to the next. The challenges of patients unwillingly refusing to tolerate and corporate during the process have exuded obstacles in the technology. This has raised an ethical issue because, the patients are not informed adequately in matters relating to information such as; time to be spent in the radiology unit, waiting for or during the process (Bielski, 1996).

The Cost of Health Care

Borsellino (1997) notes that technology change has contributed to surging costs of health care. What has remained an enigma to the wider community is, to what extend have new technologies in a competitive environment contribute to physician behavior in contrast to patients’ wishes. According to Al-Damegh (2011), patient’s demands have created an ethical dilemma for a health care provider, this has been particularly important when the service is low priced. The conventional ethics of patient support has been endangered by the current ethics of cost control, which limit patient involvement and physician choice in the use of limited services available. Al-Damegh (2011), notes that physicians have increasingly embraced deception to woe third party payer endorsements for unspecified procedures. Thus, using the deception strategy, by physicians has been argued to infringe ethical issues in medical imaging, leading to high costs that restrict universality in its applications. The fact that Imaging practices are costly diagnostic tools especially if they are integrated with therapeutic interventions, the United States has done little to waive the treatment costs linked to its applications. Technology that saves costs, is fair and if equitably distributed enhances ethics besides contributing to access to medical service for the whole population.

Diagnostic Procedures

According to Borsellino (1997), some diseases such as the Coronary artery and its associated complications comprise 20% of deaths in the US. Besides, death resulting from acute myocardial infarction has shown no prior symptoms manifestation of Coronary artery disease; this has been slowly evolving in technologies. The technology in use has been computerized tomography and magnetic resonance imaging in screening patients posing a challenge in diagnosis (Al-Damegh, 2011). These technologies have brought new issues such as; rationale performance, potential values in relation to results of patients besides costs. The procedures for using any intervention strategy should be evaluated and updated because overuse of outdated technology may contribute to ethical challenges such as; poor delivery of quality service, high costs and ultimately deaths.

Teleradiology and Filmless Imaging

The rise of digital imaging technologies has been on the increase in the United States. The technology is viewed by medical practitioners has; cost effective, sufficient and reliable, thus, convincing the imagining providers to deviate from film based to filmless units. The technology has influenced broad spectrum of teleradiology with an intention of improving healthcare access, delivery and quality (Al-Damegh, 2011). However, this technology has resulted in complexity, new legal challenges and ethical implications. Problems such as; licensing and credentialing, deceit, misconducts, image holding have become common.

Role of United States

The United States has endeavored to establish standards and legal compliance in relation to retaining and accessing information contained therein. This has been to counter competitive forces witnessed in health care across the world. However, the situation has not addressed the issues fully. There has been state-wise bias for example; sabotage and hacking have made it impossible to fundamentally contain the issue. Hence, the United States is comprehensively instituting the, United State Medical Information Code; this will make it easier for providing least level privacy protection for interstate telemedicine (Al-Damegh, 2011). Individual States will play a vital role in complimenting the Act by enforcing local protection.

In addition, the united States have outlined that; images attained using non-digital formats will be retained. As in digitalization, where films are destroyed or tampered with, a patient has authority to hold an organization liable, he or she can make a claim in circumstances like when the original image was tampered. Though, verification stands as a major challenge. Film transmission radiography holds patient’s data making alteration a challenging factor. However, the United States government is assessing a fitting solution specifically tailored to fix this issue (Borsellino, 1997).

One solution in the offing is, the government has published a proposal for security in tele-radiology complying with legal procedures. In this case, procedures in tele-radiology, in contrast to ‘local domain radiology’, will not embrace tolerable publicity or a distant interpreter to make important clinical findings. However, in circumstances such as; when a new practice standard requires substantial images and data transfer, can constrain disclosure. Also, failure of a radiologist to seek a second “electronic” judgment will be regarded as a malpractice offence, and the patient may contest the diagnosis after ‘analyzing the tele-radiologist’s opinion’ (Borsellino, 1997). Similarly, if circumstances of a distant interpreter giving a misdiagnosis, the patient filing a negligence claim must verify that, a relationship between a physician and a patient occurred during the tele-radiologist and the patient, as current laws stipulates. Consequently, the United States has provided a clear framework in regard to licensure and credentialing. This has been through, the American College of Radiology. The guidelines endorse all practicing physicians provides a certified analysis of tele-radiography images. They should also be accredited at transmitting and reception ends and States (Borsellino, 1997). In addition, they must be credentialed by medical personnel of the directing hospital and have fitting rights in that organization.

Conclusion

The surging ethical issues in radiology may pose a serious concern in health care dissemination in United States. New trends and evolving technologies should continuously be assessed and be in tandem with ethical principles to warranty quality and professionalism. Besides, new laws should be enforced to ensure compliance and to avoid professional negligence thus improving health care sector.

Reference List

Al-Damegh, S.A. (2011).Emerging Issues in Medical Imaging, Indian Journal of Medical Ethics, VIII (1).

Bielski, L. (1996). Medical Imaging Meets Videoconferencing: Live High Resolution Imaging to Share” Advanced Imaging, 11 (4).

Borsellino, M. (1997). Health Care Reform Shouldn’t be a Political Issue, Medical Post 33(18).

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