Category: Health & Medicine

Conclusion

Therefore, it should be stressed that two main approaches to insanity developed in the 20^th century: biological/neurological (insanity has organic or physical origins, for instance, abnormal brain functioning) and Freudian (insanity originates from psychological causes). However, completely curing insanity with medication has been impossible so far; it has only been possible to manage some of the symptoms of mental disorders.

This corroborates the statement that insanity may have not only organic causes but also psychological ones. Noteworthy, the studies conducted by Freud and Freudians revealed that mental illnesses often originated from numerous restrictions imposed on the members of the society.

The institutionalization of insanity has rather a grim history. While it began in the Muslim world in the 8^th century, Western Europe adopted a stance according to which insanity needs to be institutionally addressed as late as in the 18^th century.

However, the first Western madhouses resembled prisons in which torture was used to their patients rather than institutions of healing and rehabilitation. Such a harsh situation was the result of the widespread beliefs about and perceptions of the nature of insanity; it was often thought that it has supernatural, demonic origins. Also, the insane were often regarded as wild animals, dangerous deviants that ought to be isolated.

However, there also exists a theory according to which the emergence of the asylum was a result of the social structure in which the ruling class built madhouses to better control the lower classes. The asylums also served as businesses, allowing its owners to generate profits; the lunatics, for instance, were sometimes used to amuse the crowd.

At the end of the 18^th century, however, several bills were passed that led to a change in the manner in which asylums worked. Gradually, the practice of viewing the insane as dangerous beasts became less and less widespread, while the mad-doctors started being perceived as psychiatrists. In the 19^th century, the mental hospitals flourished thanks to the popularization of a theory according to which the mentally ill would benefit from beautiful surroundings.

However, in these institutions, the patients still often remained isolated and mistreated due to several reasons (such as the fear of the personnel, and the remote locations of these hospitals because of which the control was minimal).

The history of insanity treatment is also rather grim. At first, the mentally ill were considered retards; they were made to pray and were subjected to solitary confinement, physical restraints, and various forms of physical abuse and torture. Later, when science began cooperating with the mental hospitals, the methods of treatment, ironically enough, became crueler; electroshock and insulin shock therapy, hot and cold water application was used in the 19-20^th centuries; in the middle of the 20^th century, a new method that led to dire consequences for the patients, lobotomy, was introduced.

It is paramount to stress that diagnosing insanity was (and, in many cases, remains) based on the cultural constructs such as the perceptions of the norm dominant in the society. For instance, before the last quarter of the 20^th century, homosexuality was viewed as a deviation, and homosexuals were put into madhouses. Harshly strict perceptions of womens sexuality led to the development of hysteria in women; females demonstrating sexual desire also were capable of being put into asylums. Even over the last few decades, social constructs influenced the mental health sphere, leading to the hospitalization of individuals who had, for instance, a gender identity disorder.

On the whole, it might be stated that the history of insanity is mostly comprised of dark, blatantly cruel facts. Nowadays, it is important to adhere to the approach according to which mental illnesses should be handled with caution, and the treatment ought to be aimed at the rehabilitation and management of the disorders. Care must also be taken while defining a certain state as a mental illness, for cultural bias might lead to diagnosing mental disorders in persons simply due to the dominating perceptions in society.

Executive Summary

This report provides an analysis of current issues related to medical assistance programs. Attention is mostly devoted to factors that have led to an increase in spending. Scholarly sources will be examined to collect the data on this subject matter. A set of recommendations that should be considered by policymakers will also be provided. All of the findings will be summarized in the final section of the paper.

Spending

One of the core factors that lead to an increase in Medicaid spending is caused by changes in policy. The Affordable Care Act has had an enormous influence in this case, and the number of enrollees has increased dramatically. It is possible to identify a particular connection with the approach that has been utilized in China. The government has recognized that individuals that are most vulnerable cannot gain access to necessary services, and have tried to remove barriers that were present (Wagstaff, Lindelow, Wang, and Zhang 38). However, the initiative has led to many complications in the United States.

Researchers found that expenses have grown by eighteen percent in the states that expanded, and only by six percent in the rest (Galewitz par. 2). This difference is quite significant and should be acknowledged. It would be reasonable to examine enrollment and spending data to get a better understanding of the issue. It is possible to state that the figures seem reasonable, but the number of enrollees is quite intriguing (Policy Basics: Introduction to Medicaid par. 3). Close to fifty percent of them are children, and only eight percent are elderly (see Table 1).

Table 1. Medicaid enrollment and spending in 2012.

The data is quite outdated, but should be analyzed when developing a strategy that would help to decrease budget shortages. The government has to provide full support for individuals that enrolled recently throughout the whole year, according to the health law. However, close to ten percent of the costs have to be picked up by the states. The process is rather gradual, but the impact on the budget is enormous (see fig. 1).

It should be noted that such changes are hard to predict because of numerous economic and political factors. Moreover, the situation is likely to be complicated by the presidential election in 2016, and changes in the policies could be enormous. Another factor that has led to an increase in spending is online insurance. The process became much easier, and eligible individuals could enroll without having to worry about difficulties they had to deal with previously (Galewitz par. 9).

Possible Solutions

Pratt is a certified professional and is quite experienced in this area. She suggests that it would be beneficial to consider a replacement for Medicaid because the program has numerous issues that are hard to resolve (Pratt 12). This approach may be viewed as questionable, but should be taken into consideration because some of the ideas suggested are quite comprehensive. Changes to the expansion should also be considered because the increase in expenses associated with this initiative has been dramatic. Markel, Sauer, and Blasier state that the introduction of additional taxes may be helpful, but the situation will not be improved until the causes of budget shortfalls are addressed (261).

Conclusion

In summary, it is an enormous issue that should not be overlooked because spending is growing at rapid rates, and a financial crisis may follow because the current debt is tremendous, and it could damage the economy in the long-term. The introduction of new policies and an increase in enrollment that followed were determined as the primary causes of the problem. It is quite evident that approaches need to be changed at this point, and it is possible to resolve the situation that has occurred if necessary measures are taken.

Works Cited

Causes of Enrollment and Spending Growth n.d. Web.

Galewitz, Phil. Medicaid Spending Soars  Mostly In Expansion States. Kaiser Health News. Kaiser Family Foundation. 2015. Web.

Markel, David C., Peter J. Sauer, and Ralph B. Blasier. Is a Physician Provider Tax the Solution to Michigans Medicaid Woes? HSS Journal: The Musculoskeletal Journal of Hospital for Special Surgery 9.3 (2013): 257-263. Print.

Policy Basics: Introduction to Medicaid 2015. Web.

Pratt, Lindsay L. Lets Fix Medicare, Replace Medicaid, and Repealthe affordable Care Act: Here is Why and How. Sun City Center, FL: Author House, 2012. Print.

Wagstaff, Adam, Magnus Lindelow, Shiyong Wang, and Shuo Zhang. Reforming Chinas Rural Health System. Washington, DC: World Bank Publications, 2009. Print.

Medical imaging techniques have helped improve clinical practices. Medical imaging is the process or technique used in medical practice to create images of the body or different body parts. Doctors and physicians use the images obtained from medical imaging to reveal various conditions or diseases in the body. Medical imaging is a critical aspect in biological study today. There are different techniques in medical imaging. The common techniques include radiography, computed tomography (CT scan), magnetic resonance imaging (MRI), sonography, and positron emission tomography (PET scan). These imaging techniques have made it possible to diagnose various diseases and conditions affecting human beings today. This paper presents a brief description of these medical imaging techniques. Students interested in healthcare practice will find the descriptions useful towards making appropriate career choices.

Radiography

Radiography is one of the common imaging techniques used in medical practice today. Radiography entails the use of different imaging techniques such as X-rays to examine materials of different compositions. A good example of such materials is the human or animal body. The x-rays are produced using an X-ray generator. The nature of the body explains why different parts tend to absorb different amounts of x-rays during radiography. The rays are recorded as an image using a digital detector. Sometimes a photographic film is used as a detector. The photographic film usually provides a two-dimensional (2D) image of the examined body parts. Radiography is used for both industrial and medical practices. Radiographic examination of animals or human beings has helped treat different conditions and diseases.

Computed Tomography (CT scan)

Modern technologies have made it easier to produce three-dimensional (3D) images using a technique known as tomography. Computed tomography is a new imaging technology that utilizes computer-generated x-rays to produce virtual slices or images within an object or body. The x-rays produced using tomography makes it possible to examine the interior of an object without dissecting it. Computed tomography utilizes a principle known as digital geometry processing. The approach makes it possible to produce three-dimensional (3D) images. The important thing about X-ray CT scans is that it gives the viewer (or doctor) an opportunity to examine the images from a single axis. The images are usually cross-sectional, thus making it possible for clinicians and doctors to use them for therapeutic, diagnostic, and treatment purposes. The use of computed tomography has helped doctors provide quality care and treatment in different medical practices and disciplines.

Magnetic Resonance Imaging (MRI)

One of the best imaging techniques today is magnetic resonance imaging (MRI). This type of medical imaging is widely used in nursing practices to investigate the function or anatomy of the human body. The technique uses equipment known as MRI scanners. These scanners use radio waves and magnetic principles to form accurate images of different body parts. The magnetic fields and waves form images that can be used to improve medical practices. Magnetic resonance imaging (also called magnetic resonance tomography) is widely applied in health care institutions for diagnosis and disease staging without the use of harmful radiations. Magnetic resonance tomography is widely used in many hospitals and health care organizations because it is effective. The method helps produce 3D images, thus improving the quality of services provided to patients without exposing them to ionizing X-rays and other harmful radiations.

Sonography

Diagnostic sonography (also called ultrasonography) is an imaging technique that uses ultrasounds. The imaging technique examines the subcutaneous structures in the body, such as vessels, lesions, muscles, tendons, and joints. The imaging method uses high-frequency sound waves. The technique produces ultrasound images known as sonograms. These sound waves are produced using special equipment called a transducer. Sonography uses ultrasonic devices to produces scans, videos, and images of human body parts. One thing about this type of medical imaging is that it requires special skills and experience. Sonographers should be competent because of the extraordinary levels of diagnosis and image analysis. It is also necessary for professionals to have a wide knowledge of physiology, anatomy, and sound physics. Such skills are necessary to ensure the technique is successful.

Positron Emission Tomography (PET scan)

Positron emission tomography (PET) is another modern imaging technique used widely today. The imaging technique produces 3D pictures of various body functions or processes. The imaging method uses a system capable of detecting rays emitted by a tracer (also called a positron-emitting nuclide). The important thing to consider is that a positron emission tomography helps doctors examine different body functions, organs, and tissues. The method uses small amounts of gamma rays. The doctor should choose the best radioactive material depending on the tissue or body organ under study using PET scan. Patients or individuals can inhale or swallow the radioactive material for the scan to take place. A positron emission topography (PET) scan is, therefore, useful because it makes it possible for physicians to evaluate several conditions affecting people today. Some of these conditions include cancer, heart disease, kidney failure, and various neurological problems.

Introduction

Fall prevention refers to the application of copious measures in minimizing the number of accidental falls which elderly persons mostly suffer. Recent studies in health care have confirmed that falls and the associated injuries rank top the list of the most common and serious medical problems suffered by the aged and the aging persons (Benson, 2010). At their stage of life, the aged people are usually weak and unstable compared to when they were youths. Accordingly, these persons are prone to falls in such places and situations as doorsteps, washrooms and other areas with slippery floors. They may also slip when alighting from automotive, especially motorcycles. Several outcomes are common with falls. For instance, according to Pignolo (2012), the results may include bone fracture and even death in some extreme cases.

Falls endanger the lives of the aged (Cripps, 2012). With the society, and especially the healthcare team keen to ensure that the elderly individuals lead a healthy life, there is a need to think of and explore the appropriate measures, which will ensure the safety of the aged people. This task is what this project seeks to accomplish. The task explores the effective ways of preventing falls. Its outcomes will benefit the efforts of the society particularly that of the clinical practice area of ensuring that the aged people remain safe and healthy. Principally, this project anticipates providing such parties with the appropriate measures to curb falls among the elderly people and improve their overall health.

Review of Literature

This project is not the initial one to explore falls among the elderly in the society. Downton (2013), for instance, played a very big role in describing falls as one of the threats to the healthcare of the elderly. In his work Falls in the elderly, Downton (2013), other than describing falls and presenting some illustrations opined that they greatly risk the lives of the old adults. Falls, gait and balance disorders in the elderly: From successful aging to frailty, is another work on falls. In the book, however, Lafont (2006), the author, tried not to be plain on the subject matter and decided to explore the cause of falls among the elderly. Diseases according to him were a perfect example.

Principally, the literature explored simply provide the basics about falls among the elderly. It seems like they were just reporting to the community about the fact that aged adults are exposed to the risk of falling given that they do not have sufficient energy to fully support their bodies. While these works greatly contributed to the knowledge and experience about falls among the elderly, none of them tried to offer practical ways in which these falls could be curbed. It is the fact that the prevention of the falls is more imperative than just the knowledge about them that influenced the decision to carry out this project.

Project Plan

This topic was selected because of its relevance. Actually, it is everyones responsibility to keep the elderly healthy and this certainly commences with keeping them away from falls (Benson, 2010). This topic was inspired by an existing knowledge gap on falls. Most of the studies have discussed the basics of this issue and even about its course. Nonetheless, even the works, which have had an opportunity to explore the measures of curbing falls among the elderly, have not been comprehensive enough and this gap is what this paper seeks to exploit.

Implementation

The plan for the project included engaging the elderly from one of the worlds largest home of the elderly in various fitness practices while keen on the activities that were performed well so that they would be considered as part of the strategies for curbing falls. The project was time-consuming taking up to six months. Although it met its objectives, it encountered numerous barriers. The general handling of the elderly itself proved difficult. What Tremblay (2015) calls the ugly thing about the elderly is that some could not talk and as such, understanding them was a problem. However, all these were overcome through the support of specialists in elderly health affairs that were around. Other than just offering the society with the strategies of preventing falls among the elderly, this project also provided a different experience for the researchers.

Evaluation

Assessing the program after the completion, various specialists in issues to do with the elderly approved several of the measures, which the plan came up with. A case in point, ensuring that they take simple steps to stay safe was mentioned as the greatest move that can help reduce falls. Given this validation, the project seemed to have fulfilled its goals. It had provided the society with the means of curbing the falls among the elderly. Although there were no serious barriers, which affected the results, there is a need to modify the plan to reduce the time involved.

Recommendations/Implications for Practice

Since the measures of reducing the falls have been made out by this plan, future projects need to focus on assessing the suitability, the efficiency, and applicability of these measures to ensure that they remain relevant.

References

Benson, K. (2010). Preventing falls in the elderly. Albuquerque, NM: Hartman Pub.

Cripps, R. (2012). Falls by the elderly in Australia: Trends and data for 1998. Canberra, Australia: Australian Institute of Health and Welfare.

Downton, H. (2013). Falls in the elderly. London, England: Springer.

Pignolo, R. (2012). Fractures in the Elderly: A Guide to Practical Management. Ann R Coll Surg Engl, 94(1), 70-72.

Lafont, C. (2006). Falls, gait and balance disorders in the elderly: From successful aging to frailty. New York, NY: Springer.

Tremblay, R. (2015). Preventing falls in the elderly. Fort Collins, Co: Colorado State University.

Health Insurance and Quality

One of the approaches that will be applied to the urgent care center to increase patients satisfaction is the consolidation of repetitive processes during service delivery. Most patients who visit the urgent care center are concerned about their time during any visit and hence having a long wait time can lead to increase frustration and dissatisfaction with the services provided. Patrick and Puterman (2008), indicate that consolidation of duplicative processes ensures that time as a resource is maximized while still guarantee quality care for the patients. Eliminating repetitive processes ensures that the center can operate with less staff hence cutting on the cost of operation (Berwick, 2009). For example collection of patient data during triage, history taking, and billing leads to repetition and hence requires to be streamlined. To reduce the repetitive processes, the personnel who triage patients can also be responsible for billing which reduces the need to document the patient information (Patrick & Puterman, 2008). Other processes such as the recording of patient bills can be completed once the patient leaves the center to avoid unnecessary delays.

Skills training of the staff in the urgent care center will also be carried out to improve patient satisfaction and reduce operating costs. The training will focus on improving the history-taking skills of the staff to improve the delivery of service at the center (Patrick & Puterman, 2008). The training will also focus on empowering the staff to be in a position to communicate better with the patients in the center. For example, when staff can deal with arising issues such as patients agitation due to delays at the center the patient satisfaction will significantly improve. The training will also enable the clinical personnel to ask targeted questions that will enhance the quality of the information obtained during the visits. Collecting adequate information will improve the diagnosis made during patients visits and in essence increase their satisfaction while lowering the costs of care by avoiding misdiagnosis (Berwick, 2009).

The third initiative that will be implemented to increase patient satisfaction and reduce the cost of operation will entail scheduling patient visits. Rather than having a large number of patients sit in the waiting bay, the center will endeavor to schedule patient visits especially the return cases (Patrick & Puterman, 2008). For example, the scheduling will allow the center to allocate the repeat clients to visit during the off-peak hours to prevent them from experiencing delays that characterize the normal operations at the center. The scheduling will ensure that the staffing numbers match several patients hence ensuring that human resources are well utilized preventing unnecessary operational costs (Berwick, 2009).

Pay Source

The clinic will only be accepting Medicare as the pay source for the services provided at the clinic. The decision was informed by various advantages that are associated with Medicare as a source of pay for both the clinic and the patients. For example, the scheme has provisions for financing health promotion for the patients hence working to reduce the overall burden of the healthcare for the clients. The Medicare program requires minimal paperwork when serving the clients. As a result, the clients will spend less time in the clinic during their visits. Using Medicare will also reduce the amount of manual paperwork for the staff hence improving service delivery.

References

Berwick, D. (2009). What patient-centered should mean: Confessions of an extremist. Health Affairs, 29(19), 4-7.

Patrick, J., & Puterman, M. L. (2008). Reducing wait times through operations research: Optimizing the use of surge capacity. Healthcare Policy, 3(3), 7588.

Abstract

The purpose of this essay was to demonstrate nurse expertise as a critical element of meaningful nursing experience. Nurse expertise remains a significant factor that influences the quality of patient care and patient outcomes. Many nurses, however, are not able to become experts in their profession. Nurses can become experts by attaining the right education, experience and working in a professional, supporting environment.

Introduction

Nursing education and expertise are critical to improved quality of care. Well-educated, clinically expert nurses differ from other nurses because of their decision-making abilities while managing a clinical issue effectively. Education and expertise significantly affect nurses clinical decisions and in turn, quality of care for patients and clinical outcomes. Thus, nurses should strive to be experts in their areas of specialization.

Expertise

Expert nurses have abilities to identify unanticipated clinical situations and proactively engage others to control such situations. Such nurses possess intuitive advantage of the prevailing situations in clinical settings, and they can accurately determine the condition, respond immediately and achieve intended outcomes. Expert nurses have always demonstrated superior performance and therefore, other nurses and nurse educators normally consult them. According to McHugh and Lake (2010), many nurse professionals will progress and attain competencies in their practices, but a significant number will never become nurse experts.

Nursing expertise is imperative because of its influences on clinical judgments, patient quality of care and potential outcomes. Nurses can only acquire expertise when they test and refine both theoretical and practical knowledge in actual clinical situations (McHugh & Lake, 2010, p. 276). Through education and experience, nurses undergo through five potential levels to become experts, including novice, advanced beginner, competent, proficient, and expert (McHugh & Lake, 2010, p. 276).

Experience

Experience in a nursing setting is imperative but different from expertise. Experience reflects period spent in practice and self-reflection outcomes that ensure that nurses can confirm, review, refute and refine their ideas and expectations in a given clinical setting. A mere interaction with patients in various circumstances does not constitute experience. Instead, nurses can develop experience by reflecting various aspects of patient care and developing effective decision-making skills spontaneously (McHugh & Lake, 2010). Nurses must recognize that experience is important but not satisfactory for attaining expertise. Moreover, not all nurses who have experiences can become experts. This implies that time spent, events and interactions with patients do not necessarily make one an expert in nursing.

Education

Nursing education has significant impacts on nursing expertise. Nurses must have theoretical background information and practical knowledge to develop their expertise levels. Didactic nursing education alone, however, cannot develop nursing expertise. Nursing education must always promote further learning and evidence-based learning to help nurses to develop their clinical expertise. That is, a sound nurse education can assist in developing nursing skills and expertise through experience.

Work environment

McHugh and Lake (2010) observed that clinical settings have profound impacts on nursing expertise. On this note, the authors argued that social involvement with other like-minded nurses, conformity with expected norms, and information flow systems could help educated, experienced nurses in a professional working environment to develop nurse expertise.

Conclusion

While many nurses may achieve competency levels in their practices, it remains difficult for them to become experts in nursing. However, with the right education, experience and a supporting work environment, nurses can develop fundamental attributes to help them to become nurse experts and improve quality of care and patient outcomes.

Reference

McHugh, M. D., & Lake, E. T. (2010). Understanding Clinical Expertise: Nurse Education, Experience, and the Hospital Context. Research in Nursing & Health, 33(4), 276287. Web.

Data Analysis

This subsection presents the information regarding the results of discussing observations related to the issue of preparedness for the emergency in the EDM Department of the HAAD. The information regarding the observations, as well as the data regarding the EDM standards, the associated risks, and the performance management in the EDM Department, was retrieved with the help of reviewing the HAAD documentation and contacting the EDM personnel.

Sampling

Since the study utilizes the review of the literature and the organizations documentation, as well as the results of the previous studies conducted in the organization, as its methodology, it is irrelevant to discuss the sampling strategy for this research. Still, it is important to note that the HAAD involved 101 employees in the performance management and development survey that is discussed in this paper.

Data to Be Collected

To analyze the emergency preparedness capability of the staff working in the EDM Department of the HAAD, as well as the relevance of the EDM standards and criteria which were proposed for the healthcare workers operating in cases of emergency, it was necessary to contact the EDM personnel and obtain the required data for the further analysis. The secondary qualitative data are collected for this study.

This type of data allows utilizing the information presented in the previously conducted surveys for the current study while saving them time and costs and receiving access to the wide qualitative and quantitative data important for the analysis (Bryman, 2015). The focus was on collecting the feedbacks regarding the observations criticality in the EDM Department, the data regarding the EDM standards and predicted risks and the information regarding the results of the performance management and development survey conducted in the organization.

Perceptions of the Staff regarding Performance Management to Address Emergency Preparedness

The managers of the HAAD and the EDM Department surveyed to analyze the employees perceptions regarding the provided performance management and training to develop their professional skills, including capabilities associated with the emergency preparedness. Figure 2 presents the employees perceptions of the guidance provided in the HAAD in terms of emergency preparedness, standards, and criteria.

Only about 11% of employees noted that they agree with the provided guidance when about 7% and 6% of employees completely disagree or somewhat disagree with this statement. About 22% of employees somewhat agree with the idea, and the largest proportion (about 28%) is neutral regarding the question. Therefore, it is possible to state that the provision of guidance requires further improvement to satisfy the employees needs.

Figure 3 presents the results of the employees perceptions regarding the training courses provided to improve competencies. 23% of employees agree that the department provides enough training, but about 10% of respondents somewhat disagree with this statement. Still, 15% and 11% of employees even strongly and completely agree with the statement. Therefore, the department seems to provide emergency training, but there are also areas for improvement.

Figure 4 shows the employees visions regarding the convenience of in-house training. The majority of employees agree that the environments for the training are comfortable, but some workers are neutral or disagree with this idea (26% and about 16% accordingly). It is possible to speak about the high efforts made by the HAAD to improve the provided training.

Figure 5 demonstrates the reactions to HAAD managements communication with employees regarding training and guidance. Almost 10% of employees completely disagree that any communication is observed, and about 10% of employees support this vision. However, the majority of workers are neutral regarding the question (about 30%). From this point, employees require the improvement of the communication regarding training with the HAAD managers.

In this study, the literature review means not only the discussion of scholarly articles but also the analysis of the organizational documentation and findings of the studies and surveys conducted in the HAAD. Managers of the HAAD need to improve their approaches to training employees regarding the EDM standards and criteria of behaving in critical situations.

Abstract

The paper discusses the challenges associated with emergency preparedness in the Emergency and Disaster Department of the Health Authority Abu Dhabi. The frequency of emergencies in the Middle Eastern region supports the necessity of discussing the issue of preparation enhancement for preventing and eliminating emergencies. The analysis of the secondary data is applied in this study to examine the capacities and training regarding emergency preparedness in the Health Authority Abu Dhabi.

The study reveals the lack of employees skills in addressing emergencies and the need for improving emergency preparedness using the manpower, staff training, and using the innovative equipment. The research results suggest some appropriate solutions to the problem, including the system of the employees training and changes in the organizational structure of the regulator.

Background Information

The Yakima Regional Medical and Cardiac Center is a 214-bed facility that is found in Central Washington in the USA. The hospital provides a full complement of healthcare services to the residents of Yakima region. It is mainly known for its open-heart surgery, comprehensive robotics, advanced imaging, and neurosurgery services to the inpatients rehabilitation (Rau, 2012). The hospital is a Level I Cardiac and Level II Stroke center with inclusion of Level III trauma designations. It also undertakes pediatric and maternity services among others (Rau, 2012). The staff capacity is above 700 comprising both full and part-time employees.

Yakima Residents

The people of Yakima County in the USA have been the target of the Yakima Regional Medical Cardiac Center. The facility focuses on alleviating health-related issues including lifestyle diseases such as obesity and cardiac problems. Data provided by the Washington State Department of Health indicates that about 30 percent of the population living in Yakima is said to have lifestyle-related problems. Approximately 22 percent of the residents are below the poverty level (Mokadam et al., 2011).

Lifestyle diseases have been noted in both adults and children in the region. For example, obesity has been a major health problem in this region, especially amongst children. In fact, the Washington Department of Health (2011) reveals that 30 and 35 percent children who fall in the eighth and tenth graders are overweight and obese respectively. Other health facilities that offer services in conjunction with the Yakima Medical Regional Medical and Cardiac center include the Yakima Health District (YHD) among others. These health facilities are striving to provide medical services together with community-based education on healthcare with a view of promoting the prevention of diseases rather than treatment (Washington State Department of Health, 2011).

Emerging Role of Computerization

Technology in the current healthcare programs has laid emphasis on medical information systems to ensure that doctors and nurses are successfully supported to provide quality services whilst reducing expenditures and improving the health statuses of patients. In the case of the Yakima Regional Medical and Cardiac Center, the management has introduced computerized medical systems that are supported by the cloud computing technology (Wan et al., 2013).

The healthcare services are currently performed using programmed equipment such as telemedicine, electronic medical records, medical imaging, and automated patient management. The systems offer an array of Infrastructure-as-a-Service (IaaS) to the stakeholders during activities such as registration, billing, scheduling, and reimbursement of various payments (Wan et al., 2013). This state of affairs has been deemed to provide cost-effective and efficient healthcare services to the Yakima residents (Rostrom & Teng, 2010).

IT Security and Patient Privacy

Computerization has led to cloud technology that is highly provisioned for the improvement of security levels in the healthcare facilities. It can be effectively monitored to precise endpoints to ensure accuracy in areas such as billing, storage, and retrieval of patient information (Jacob et al., 2011). Security and patients privacy is currently a regulatory compliance issue in the healthcare systems. Matters about data movement across borders and ownership of such information have become critical. About 30 percent of the healthcare system in the USA is implementing various cloud technology models that heavily rely on emails and Microsoft Live Meeting.

The information available in the healthcare systems such as the electronic health records (EHR), diagnostic imaging, and the health analytics and information equipment of the Yakima Regional Medical and Cardiac Center is on the increase. Such storage mechanisms are deemed more secure, especially in ensuring patient privacy based on the sensitivity of the health information (Rostrom & Teng, 2010).

The hospital is striving to prevent the violation of patients confidentialities by imposing heavy fines and cost recoveries on the handlers of health information besides notifying the patients of the instances. The hospital has built a private cloud model technology where data resides on the patients data center. The organization also allows some degree of managing the patients privacy issues guided by the stipulated set of standards that govern the data center (Rostrom & Teng, 2010).

The health facility has significantly benefitted from the use of cloud technology in various ways. For instance, computerization has increased the access to resources that are difficult to be attained. The hospital has also deployed cloud technology security experts that provide the latest patches and software to the center with a view of promoting the protection of patient data (Rostrom & Teng, 2010). The physical access to the facility is also guarded by relevant policies and procedures that are in place to boost the overall security. The hospital computers are secured using encrypted passwords that are known by various trusted personnel to avoid any leakage of data in case the equipment are stolen from the facility. Cloud technology has also provided feasible solutions to the instances of information loss that can occur during the loading of documents and/or physical damages to the equipment (Jacob et al., 2011).

Conclusion

The analysis of the Yakima Regional Medical and Cardiac Center reveals that the embracement of e-healthcare models based on cloud computing is important due to the possibility of storing mass data and increased speed of retrieving patient information. Besides, such systems also enhance the security and sharing of information depending on the available resources. Therefore, the cloud computerization concept is effective in ensuring the security, efficiency, and fast delivery of information that ensures the delivery of quality healthcare services.

Reference List

Jacob, N., Pillai, V., Nair, S., Harrell, D., Delhommer, R., Chen, B.,&Gopalan, S. (2011). Low-cost remote patient monitoring system based on reduced platform computer technology. Telemedicine and e-Health, 17(7), 536-545. Web.

Mokadam, N., Melford Jr, R., Maynard, C., Goss, J., Stewart, D., Reisman, M.,&Aldea, G. (2011). Prevalence and procedural outcomes of percutaneous coronary intervention and coronary artery bypass grafting in patients with diabetes and multivessel coronary artery disease. Journal of cardiac surgery, 26(1), 1-8. Web.

Rau, J. (2012). Medicare to penalize 2,211 hospitals for excess readmissions. Web.

Rostrom, T., & Teng, C. (2011). Secure communications for PACS in a cloud environment. Engineering in Medicine and Biology Society, 2011(1), 8219-22. Web.

Wan, J., Zou, C., Ullah, S., Lai, C., Zhou, M., & Wang, X. (2013). Cloud-enabled wireless body area networks for pervasive healthcare. Network, IEEE, 27(5), 56-61. Web.

Washington State Department of Health. (2011). Healthy Youth Survey. Web.

Discussion

It is imperative to note that medical assistance programs are actively discussed by many scholars, and they have recognized that the current approach has several weaknesses. Moreover, some of the policies were frequently criticized, and most think that they should be altered. It is hard to argue with the fact that the initiative was incredibly helpful for many individuals, and many lives were saved as a result.

However, the argument is that changes are required in this case because the government is not in control of the situation. It would be reasonable to examine peer-reviewed articles and the literature on this subject matter. It is necessary to identify primary areas of spending and get a better understanding of the reasons it increases at rapid rates. Some of the solutions will also be reviewed and discussed.

Spending

Eligibility has been expanded on numerous occasions to cover various groups of people. The situation was quite similar in China, and the government understood that many individuals do not have access to healthcare because of their financial status. However, it was recognized that several limitations are required to ensure that the program stays sustainable in the long-term. The focus on efficiency was vital.

The number of eligible individuals has increased dramatically, but an increase in spending did not damage the economy as much (Wagstaff et al. 38). Changes to income requirements could be viewed as especially interesting because such factors as marital status and earning capabilities of the family are not taken into account. The population of the country has aged, and expenses have skyrocketed in the last few years. The same trend can be identified in all the sectors, and the cost of Medicaid is going to increase rapidly from 2010 forward (see fig. 1)

Such services as home care are incredibly costly, and they are mostly covered by Medicaid. It is necessary to understand that it was hard to predict that the cost of care would increase at such rates. Available data suggests that most resources were spent in California, and the figures seem disproportional when compared to the situation in Wyoming (Kaiser Family Foundation par. 1). A significant percentage of enrollees are children, and the Medicaid spending they require is relatively small.

The amounts of money used to support impoverished and blind individuals are justified but must be monitored to ensure that funds are used efficiently (Policy Basics: Introduction to Medicaid par. 3). The data should be examined to identify particular trends or areas where unnecessary spending may be minimized. Alterations to the policies have an enormous impact on this case and have led to many complications.

Many suggest that the Affordable Care Act is especially problematic, and several aspects were overlooked by the administration. The biggest problems of the approach were not addressed, and the number of enrollees was increased without the consideration of possible consequences. Some of the projections that are being made are quite shocking, and should not be disregarded. The number of enrollees has increased significantly. One of the aspects that should be considered is that it is believed that they are healthier than the individuals that were previously enrolled, and expenses of care would be lower, but it is hard to make such predictions in the long-term.

Growth rates are quite worrying, and it is not expected that the situation is going to change anytime soon if necessary measures are not taken. A fourteen percent increase in 2014 should be highlighted because it is the highest number in twenty years (Galewitz par. 1). The states that accepted the expansion were affected the most. On the other hand, one of the studies suggests that federal payments could be bigger if all the governors decided to expand because the number of uninsured individuals is statistically significant, and alternative options do not help to mitigate the losses (Price and Eibner 1030). It is quite evident that the difference in philosophies is quite significant, and Republicans think that such support should not be provided to individuals that are healthy and are capable of work.

Another aspect that should not be overlooked is that there used to be numerous instances when the system was abused in the past. Improper payments are quite problematic because they are hard to track and affect the quality of care. Therefore, it leads to worse outcomes. One of the studies suggests that mortality rates were much higher. Understandably, access to professionals should be limited because the governments are trying to minimize the expenses, but the quality still needs to be improved.

Any changes to the policies would be quite slow because negotiations with numerous organizations are required. It is not surprising that it leads to enormous tension. The role of modern technologies also should not be overlooked. The process of enrollment became much easier, and individuals that were previously incapable of dealing with numerous barriers can now apply safely. Understandably, this was the primary goal of the initiative, but damage to the economy was overlooked.

States have to spend such enormous funds to support Medicaid that it is nearly impossible to focus on infrastructure and other vital areas. The states that did not support the expansion can prioritize schools, police, and they believe that such functions are much more beneficial. It is necessary to understand that taxpayers have to pay for the expansion of the program, and it makes an enormous percentage of the population unsatisfied. Moreover, it is nearly impossible to maintain a particular level of spending because the costs of healthcare are always increasing, and it does not seem to be sustainable. Davis suggests that it will cost close to 4,2$ trillion in the next ten years (par. 9). Such numbers are shocking, and the fact that federal taxpayers would help to pay them is an enormous issue.

Possible Solutions

One of the approaches that should be considered is the modernization of the pharmacy. Networks should be improved to avoid unnecessary fees, and the need to minimize waste also should not be overlooked. Some of the items that are purchased by Medicaid have no market value and could be used more efficiently (Pratt 15). Such approaches have proven to be useful but are still not utilized by most states.

One of the most significant benefits of this method is that no changes to access are expected, but the government will save up funds that could be used efficiently in other areas. The most focus should be devoted to evidence-based practice because some of the approaches are quite outdated, and they must be replaced with more useful ones. The idea that it would be reasonable to eliminate the current system, and establish a new one is intriguing and some of the points that are made are quite comprehensive (Pratt 12). The problem is that many view free healthcare facilities as outdated, but this perspective is not based on evidence.

The problem is that Medicaid has established over many years, and most policymakers would be reluctant to accept such dramatic changes. Moreover, enormous resources would be devoted to the development of new guidelines, and it is entirely possible that unexpected complications could occur. Many individuals think that it is not the responsibility of the government to provide free healthcare, and it is only a burden on the economy.

They are not satisfied with the way policymakers handle this situation, and it leads to tension. The lawsuits are also quite problematic because the funds are used on attorneys, and such expenses are hard to handle for most states. The introduction of additional taxation is another solution that should be considered. However, most believe that this approach is not reasonable, and does not address the cause of the problem. Moreover, taxes will have to increase continuously, and Medicaid spending is going to require an enormous percentage of tax revenue according to the alternative fiscal scenario (see fig 2).

It can be seen that Medicaid is not the only problematic area that the government has to address, but it would be reasonable to focus on this program because growth rates are enormous. One of the primary issues is that healthcare professionals are paid less if they must take care of Medicaid patients, and it reduces their satisfaction levels. One of the studies has found out that such individuals will be forced to wait much more time even when children are involved (Grady par. 1).

Such results are not surprising, and the government should not expect doctors to do what is morally right if their pay is affected. The expenses could be reduced if the quality of services has improved because it would lead to positive outcomes. However, policymakers are reluctant to make such changes because the situation is already problematic and budgets cannot handle additional expenses.

The range of benefits associated with the initiative has also expanded, but its efficiency was not increased. Some of the services that the program covers are viewed as the most expensive, and it makes the situation much harder to resolve. Long-term care accounts for close to forty percent of the spending and only fifteen percents of individuals need it (Klein par 6). Therefore, it would be reasonable to focus on this area because expenses are disproportional, and the problem can be resolved with better management. The lack of coordination between the facilities is also a critical issue because they do not share vital information that could help to reduce the length of stay (Klein par. 7).

The utilization of community-based service initiatives should be considered, and it is expected that it would help to reduce the expenses by nearly 70 percent (Xerox 4). The experience of other countries also should be analyzed, and some of the strategies may be utilized. Current methods should be simplified, and the need to cooperate with organizations specialized in this area should not be disregarded. It is necessary to examine the factors that lead to readmissions and take appropriate measures to ensure that some risks are eliminated. Such aspects as financial stress, housing instability, and others are quite problematic, and most attention should be devoted to guidelines that would help to increase adherence levels.

Conclusion

In summary, it is possible to state that medical assistance programs have an enormous impact on the economy of the country. Understandably, they make the population much more satisfied. However, it would be reasonable to consider the introduction of several limitations because states have to deal with resource shortages. It is quite evident that care should be much more efficient. Understandably, the program has achieved its primary task, but the complications that were introduced are not acceptable, and the harm that has been caused by several policies is enormous. It is expected that presidential elections would also have an impact on Medicaid, and changes to the policies are also likely.

The population will not be satisfied with an increase in taxation, and other solutions should be examined. Therefore, it is paramount to focus on this problem and review all possible options because the economy of the country is at risk, and it is evident that the current approach is not sufficient. The fact that some of the ideas suggested by scholars are overlooked is worrying. However, the system may become sustainable if some of the most significant issues are addressed, and complications are prevented. An enormous effort is required in this case. The government and healthcare organizations should cooperate to develop strategies that would eliminate the problem.

Works Cited

Davis, Sean. 12 Reasons Why Medicaid Expansion is a Terrible Idea. The Federalist. Web.

Elderly Population Growth n.d. Web.

Entitlement Spending Projections n.d. Web.

Galewitz, Phil. Medicaid Spending Soars  Mostly In Expansion States. Kaiser Health News. 2015. Web.

Grady, Denise. Children on Medicaid Shown to Wait Longer for Care. The New York Times. 2011. Web.

Kaiser Family Foundation. n.d. Total Medicaid Spending. Web.

Policy Basics: Introduction to Medicaid 2015. Web.

Pratt, Lindsay L. Lets Fix Medicare, Replace Medicaid, and Repeal the Affordable Care Act: Here is Why and How. Sun City Center, FL: Author House, 2012. Print.

Price, Carter C. and Christine Eibner. For States That Opt Out Of Medicaid Expansion: 3.6 Million Fewer Insured and $8.4 Billion Less In Federal Payments. Health Affairs 32.6 (2013): 1030-1036. Print.

Wagstaff, Adam, Magnus Lindelow, Shiyong Wang, and Shuo Zhang. Reforming Chinas Rural Health System. Washington, DC: World Bank Publications, 2009. Print.

Xerox n.d., Eight Ways to Reduce State Healthcare Costs. Web.

Introduction

Medical professionals and firms must act ethically in order to address the changing health needs of their patients (Basu 12). The medical field is guided by powerful codes of conduct and ethical principles. Such regulations make it easier for caregivers to act ethically and support the goals of medical practice. Similarly, companies involved in the medicine field should promote the best practices capable of maximizing the health outcomes of the members of the population. Unfortunately, there are various scandals and scams that continue to affect the health sector. This essay gives a detailed analysis of medicinal scams as something that affects the United States medical field.

The Medicinal Scam

The American healthcare system is characterized by private and government-sponsored institutions. Some programs such as Medicaid and Medicare make it easier for more people to have quality healthcare in the country (Cohen 79). The sector has attracted many pharmaceutical companies in order to support the health outcomes of different citizens. Cohen believes strongly that the health sector cannot succeed without the role played by different pharmaceutical corporations (79). Most of these firms offer therapeutic services and curative medicines to the targeted citizens.

These companies have adequate financial resources to engage in research and development (R&D). The activities play a critical role towards producing quality medicine. This fact explains why such firms support the health sector of every country. However, corruption has become a critical aspect of many pharmaceutical corporations. The wave of corruption has affected the quality and quantity of medicines available to different patients. Some officials might accept kickbacks for purchasing medicines (Cohen 77). Consequently, the expenditures of these firms are reduced and eventually affect the quality of drugs available to the people.

Past studies have indicated that the American pharmaceutical industry has continued to attract both honest and dishonest players (Cohen 78). The emergence of dishonest businesspeople is something that continues to undermine the quality of health support available to the United States citizens. Unscrupulous dealers in the industry engage in inappropriate drug production processes (Toebes 19). The malpractice results in ineffective or substandard drugs that might not address the health needs of the countrys population. The situation affects the quality of drugs available to different patients. More often than not, the players in the industry manufacture ineffective drugs in an attempt to make money.

Some pharmaceutical companies collude with physicians and nurses. This malpractice is initiated in order to dictate the kind of drugs to be used in specific hospitals. This process occurs without considering the quality of drugs available to the targeted patients. It is agreeable that physicians and pharmacists should ensure their clients receive the best drugs that can maximize their health outcomes (Toebes 19). The interface between physicians and these drug companies is a critical area that is affected by rampant corruption. This kind of collusion is embraced in order to ensure the companies and physicians make money. Unfortunately, the malpractice is executed without addressing or considering the health needs of different patient.

Toebes indicates that many pharmaceutical companies engage in unethical practices in an attempt to maximize their profits (19). For instance, some firms in the industry have been observed to use aggressive pricing policies (Toebes 20). Commercially successful drugs face the challenge of product liability problems (Toebes 20). Such firms tend to increase prices for such drugs in an attempt to make money. Consequently, every targeted patient finds it hard to realize his or her health outcomes.

More often than not, pharmaceutical firms engage in unethical medical research works in an attempt to produce specific drugs. This process is executed without considered the needs and expectations of different stakeholders in the industry. Conflicts of interest emerge between physicians and pharmaceutical firms. Some companies might decide to produce ineffective drugs. Such medicines fail to address the health needs of the clients. It is also agreeable that the issue of corporate social responsibility (CSR) has been ignored by many pharmaceutical companies in the industry. This happens to be the case when the firms are expected to support the welfare of their communities (Basu 16). This is a clear indication that some firms engage in business malpractices in an attempt to make money.

This challenge affecting the health goes further to include insurance companies. Toebes indicates that some insurance companies liaise with hospitals in order to receive finances for services that were not actually provided (2). The insurance industry in the United States has been observed to have numerous financial resources (Potter 19). Studies have indicated clearly that such companies have the potential to transform the health outcomes of many American citizens.

However, some companies in the health insurance industry have outlined new unethical ways of making money. They do so by failing to pay claims (Potter 19). Several insurance companies have been observed to engage in corrupt practices in the United States. Some of these companies include Unum, American Insurance Group (AIG), and State Farm (Potter 29). For instance, Unum has been considered as one of Americas leading provider of disability insurance. Unfortunately, the company is known to deny claims or delay compensations. The company is known to have inappropriate strategies for handling customers claims (Basu 17). This analysis shows conclusively that the malpractices of these insurance companies affect the effectiveness of the United States healthcare sector.

Many American doctors have been using unethical methods to amass wealth. For instance, addiction to prescription drugs has become a major problem in many countries across the world (Chapman et al. 2). For instance, the number of deaths arising from prescription drug overdose increased almost 300% between 1995 and 2012 (Chapman et al. 2). This means that more people are dying from prescription drugs in the country than ever before. According to recent studies, such deaths surpass those associated with road accidents (Chapman et al. 2).

The most interesting fact is that many doctors have been responsible for this health problem. For instance, physicians and doctors prescribe more drugs to their patients especially those with terminal conditions. Individuals suffering from migraines, persistent pains, and schizophrenia are misguided by their doctors to continue taking prescription drugs. This malpractice has led to increased cases of drug addiction. Some doctors embrace the malpractice in an attempt to increase profits. More often than not, such physicians start their drug businesses and prescribe medicines to the targeted patients (Chapman et al. 14). The ultimate goal is to maximize sales and profits.

Unless new measures are put in place, the American citizens will be unable to realize their health outcomes. This happens to be the case because many people fail to receive positive medical support. Patients with serious medical conditions are forced to take specific drugs that might not address their health needs. The malpractice is associated with drug dependence. It also affects the patients quality of lives (Basu 21). This scenario is very unfortunate because doctors and healthcare workers are always expected to support the diverse needs of their clients (Basu 22). This challenge will continue to pose numerous threats to many people across the nation.

My Personal Stand

The above discussions show conclusively that medicinal scam is a major challenge affecting the American healthcare sector. This malpractice brings together many stakeholders such as physicians, pharmacists, healthcare workers, pharmaceutical corporations, and insurance companies. These stakeholders engage in illegal practices in an attempt to make more money (Chapman et al. 13). This is a major problem that continues to affect the health outcomes of many communities in the country.

The government should consider some of the best measures and policies in order to monitor the manner in which pharmaceutical companies engage in drug production and marketing. This should be the case because the companies have corrupted the countrys medical field. Instead of supporting the health and medical sectors, these firms promote specific malpractices in an attempt to make profits. This kind of corruption attracts many caregivers, hospitals, government agencies, and doctors (Potter 41). These players collude in an attempt to amass wealth.

Insurance companies have also been engaged in similar corrupt practices. These companies have corrupted the medical sector by failing to honor their customers claims. The level of trust in the health insurance sector has been affected significantly. That being the case, new policies should be implemented to ensure each and every insurance company engages in ethical business practices (Cohen 81). The approach will support the health needs of many American citizens and eventually improve their lifestyles.

Doctors should be monitored in order to act ethically and professionally. Physicians who prescribe inappropriate medicines with the aim of making money should be prosecuted. This is the case because such doctors are responsible for the current problem of prescription drug addiction. Such doctors operate pharmaceutical businesses and use them to market more drugs to different patients (Chapman et al. 18). They engage in unscrupulous practices in an attempt to maximize their sales. Consequently, more deaths associated with prescription drugs are recorded in the United States every single day.

Conclusion

This discussion shows conclusively that the American health sector faces numerous challenges. It is agreeable that many pharmaceutical and insurance companies have corrupted the United States medical field into money-making business. Additionally, doctors have contributed a lot to the problem of drug addiction. These malpractices affect the health outcomes of many citizens in the country. Similar problems have been recorded in more countries across the globe. That being the case, the American government should be on the frontline to implement powerful policies capable of monitoring the performance and businesses of these stakeholders (Basu 49). Legal procedures should be used to deal with every corrupt insurance and pharmaceutical company in the United States. Doctors should act ethically in order to maximize the outcomes of their patients. These measures will play a critical role towards addressing these issues affecting the countrys medical field. Consequently, more people in the United States will find it easier to pursue their health goals and eventually have healthy lifestyles.

Works Cited

Basu, Rituparna. The Broken State of American Health Insurance Prior to the Affordable Care Act: A Market Rife with Government Distortion. Ayn Rand Institute, 2013.

Chapman, Meg, et al. Research on Illegal Prescription Drug Market Interventions. Abt Associates, vol. 1, no. 1, 2015, pp. 1-47.

Cohen, Jillian. Pharmaceuticals and Corruption: A Risk Assessment. Corruption and Health, vol. 1, no. 1, 2015, pp. 77-85.

Potter, Wendel. Deadly Spin: An Insurance Company Insider Speaks Out On How Corporate PR is Killing Health Care and Deceiving Americans. Bloomsbury Press, 2010.

Toebes, Brigit. Human Rights, Health Sector Abuse and Corruption. Working Paper, vol. 1, no. 1, 2011, pp. 1-39.