Shortell and Kaluzny’s Healthcare Management

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Impact of the consumer-driven health movement on health care service delivery

This movement has seen a shift from the acute-care to the chronic-care model which has translated to people living longer with more chronic diseases as a daily part of their lives. More health care consumers are rejecting the traditional ‘paternalistic’ approach to health care delivery and are demanding greater choice and control over health care treatment choices and decisions. Third-party administrators, health insurance plans, financial institutions, and providers have to realign their products and services to accommodate this market transformation.

Impact of Bachman’s “five building blocks of healthcare consumerism”

The success or failure of consumerism highly depends on whether these five “building blocks” are developed using creative approaches; efficiently delivered; and successfully integrated. Studies have shown that those people who adopt the first generation consumerism plans at an early stage are already experiencing positive results from the use of preventive care services and that their health costs are now lower than before.

How HIPAA regulations protect the public’s privacy in regards to EMRs, PHRs, and health information used in social health networking groups

HIPAA rules have limited the use and disclosure of personal health information by “covered entities” (e.g. Health plans-group, government insurance, etc) who qualify on a “need to know” basis according to HIPAA criteria. HIPAA also has Administrative Simplification (Title 2, subtitle 1) which stipulates that the U.S. Department of Health and Human Services (HHS) should adopt national standards for the use of electronic health information e.g. code sets, health identifiers.

How CDHPs and HDHPs have changed health care service reimbursement and health insurance expectations

The Consumer Driven Health Plan has played a big role in changing the health care service reimbursement system into one that gives the consumer economic purchasing power and leaves him/her with the responsibility of making decisions. Likewise, High Deductible Health Plans have revolutionized the health care reimbursement service by providing comprehensive coverage for high-cost medical events and a tax-advantaged way to help individuals build savings for future medical expenses.

Difference between HSAs, MSAs, FSAs, and HRAs

Pertaining to eligibility: HRA’s are for employees (current and former), MSA’s are for self-employed and small employers, HSAs – individual (who can contribute until eligible for Medicare) while FSAs are for employees in general. HRAs and FSAs are notional account types whereas MSAs and HSAs are accounts that are funded in a trust. MSAs and HSAs are fully portable accounts, HRAs are not portable (but plan sponsor may permit retirees to continue account). FSAs are not portable. When it comes down to funding mechanisms, MSAs are individually funded, HSAs: employer and/or individual, FSAs are not funded (employee salary reduction and/or employer credits). HRAs-not funded (employer “credits” only).

Retail medicine and whether it should be of concern to health care managers and leaders in for-profit and not-for-profit environments

Retail medicine is a phenomenon that illustrates health care which is provided in clinics which are usually formally known as convenient-care clinics. Health care managers and leaders in for-profit and not-for-profit environments should keep a watchful eye on this phenomenon because of its rapid growth and the fact that it is a useful adjunct to the menus of primary care services. However, in the same breathe; they do not serve as the sole source of care because they are not sufficiently equipped.

Why retail medicine has become popular with consumers and how health care managers and organizations can leverage their concepts to enhance current service delivery practices in a non-retail environment

Over time, retail medicine has grown to become popular with consumers seeking healthcare services because it offers these individuals suitably well-located and relatively affordable access to a restricted range of medical services. It has been observed that healthcare managers and other practitioners can connect with these convenient care clinics in a collaborative bid to expand themselves as well. This will lead to increased health care delivery because the clinics can be used as a “first aid” center, where more demanding ailments can be referred to as practitioners in health care organizations.

Difference and similarity between EMRs and PHRs

The main difference between Electronic Medical Records (or Electronic Health Record) and PHRs is where the control lies. PHR is under the control of the consumer whereas doctors and hospitals use EMRs to track clinical information about their patients, meaning the hospital or the health care center has control over the documents. However, the two are similar by virtue of their data being documented electronically.

Pros and cons of Google Health and Health Vault as consumer health applications. Foreseeable future barriers to the expansion of this concept

Google Health focuses on wellness goals and it has a wide variety of functions like importing medical records, exploring medications and treatments, converting paper records. However, unlike some Public Health Records, Google Health doesn’t have many tools of its own to permit users to evaluate their health.

Health Vault offers specificity for sharing. E.g. you can invite someone to view parts of your records; allow them to act as a custodian. Another pro is that it gives one the flexibility to import and export documents in two main industry formats to avoid formats from clashing. However, Health Vault’s chief sharing short-coming is that it doesn’t have a function for printing your health record.

How consumers can become more involved in their own health care. Products and resources are available

Consumers can become more involved in their healthcare by researching their health problems to be more knowledgeable about their current status and needs, seeking information and second opinions on diagnosis and the treatment options available so as to make informed decisions, and through active involvement in their own health care decisions and treatment choices. The resources and products available for consumers who wish to monitor their health from home include online support groups such as PatientsLikeMe, social networking sites like Facebook and Twitter, disease-specific associations, public service, and government websites and alternative medicine.

5 key ethical principles (and their examples) that impact the health care environment

The key ethical principles that impact health care are respect for autonomy, privacy, confidentiality, fidelity, and veracity. Conflicts in autonomy arise in ethical dilemmas concerning competence, informed consent, or assumptions of control over others due to certain family and organizational situations. Privacy issues are common in areas like abortion and family planning due to public controversy. Issues of confidentiality occur in the disclosure of personal health information due to the consumer’s choice of forms of health record maintenance. Conflicts infidelity arise in instances of divided loyalties due to multiple allegiances. Issues of veracity occur in the nondisclosure of pertinent health information since physicians are required to deal honestly with patients.

Difference between nonmaleficence and beneficence and their importance to health care

Nonmaleficence is an obligation to intentionally refrain from participating in actions that would harm others, it may provide reasons for legal punishment and is required to be followed impartially while beneficence is the obligation to do good, prevent or remove harm, and to act in a kind manner, and does not have legal implications. Nonmaleficence and beneficence are important in health care since it is essentially a helping profession in which physicians care for others and as such should refrain from causing them harm.

Why IRBs exist and their impact on biomedical, behavioral, and clinical research activities

IRBs exist to protect the ethical rights of human subjects who participate in research conducted by institutions. They impact biomedical, behavioral, and clinical research activities by reviewing their research protocols, requiring modifications or disproving their research activities according to federal and institutional policy. They also determine whether the situations presented constitute research and if they involve human subjects.

Whether or not all health care organizations and providers need to comply with the Patient’s Bill of Rights

All health care organizations need to comply with the Patient’s Bill of Rights. This is because health care organizations are essentially there to take care of the patients and act for the well being of the patients. Health care organizations should therefore see to it that the patients receive all the information pertaining to their diagnosis, considerate treatment and that all their rights are upheld.

Whether or not health care providers should always tell the truth to their patients even if the truth will cause them pain or distress

Yes, health care providers should always tell the truth to their patients since their relationship is based on trust and the assumption that the provider will act in the best interest of the patient. Physicians should deal honestly with patients and colleagues in all their professional interactions and interrelationships.

References

Burns, L. R., Bradley E. H., & Weiner B.J. (2011). Shortell and Kaluzny’s Healthcare Management: Organization Design and Behavior. Albany, NY: Delmar.

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