Healthcare Ecosystems

Healthcare Ecosystems

Healthcare ecosystems

A healthcare ecosystem refers to all the factors involved in healthcare provision and the internal and external factors that affect the quality and quantity of healthcare services provided. A healthcare ecosystem includes the Medicine’s resources, physicians and staff members working in it. It also includes the patients receiving the services and the payers, which may be the sponsors (Hinde & Shaikh, 2012). Another important inclusion in the ecosystem is the government as the laws and regulations they make affect the ability of the healthcare provider to provide required services. The administrative sector in the Medicine is also a contributor in the healthcare ecosystem. The function of the ecosystem is to ensure that quality healthcare is provided hence all the factors should be geared towards achieving that aim.

John Hopkins Medicine

One healthcare provider that would act as a good example in explaining the ecosystem in healthcare is John Hopkins Medicine in Baltimore. It specializes in both pediatric and adult healthcare provision, and in the past twenty-one years, it has been ranked as the best healthcare provider in the state (USNews HEALTH, 2012). The Medicine has a wide array of units, each specializing in the treatment or improvement of specific health problems. It invests greatly in technology to ensure that there is greater safety assurance and comfort for the patients and smoothened workflow for physicians (John Hopkins Medicine, 2012). The Medicine has been in existence since 1889 hence has seen tremendous growth and changes during that period, these being as an effect of the changing economic, social and legislative factors.

Discussion on how legislative, social, or economic event impacted the growth of John Hopkins Medicine

 

In past years, there has been a gradual increase in health problems affecting people and this has resulted in more people-seeking healthcare. This has especially been evident in the increase in the number of individuals being treated for chronic diseases. It is estimated that chronic diseases account for an average of 70% of all health related deaths in the states. Most of the chronic diseases result from the kind of lifestyle that the people in the state lead. Studies show that cancer, heart disease and stroke are the leading chronic diseases with one out of every three adults being obese (Centers for Disease Control and Prevention, 2012). The main cause of these diseases is poor diet and lack of exercise resulting from social lifestyles that promote this unhealthy lifestyle. For example, long working hours, increase in technological gadgets that limit physical strain and availability of cheap and convenient junk food stores are examples of reasons for reduced physical activities and deteriorating health.

Consumption of junk food and genetically modified foods reduces the amount of nutrition people gain from food and increases consumption of harmful cholesterol. This lowers the strength of the body’s immune system hence making it easier for people to fall ill. Harmful cholesterol is the main contributor of obesity resulting to heart disease as it deposits itself on the artery walls therefore narrowing the arteries. This in turn limits the amount of blood passing through the arteries to the heart hence reducing the amount of oxygen reaching the heart muscles. In heightened cases, it results in heart attacks. This therefore shows that a change in lifestyle would result in a decline in health problems facing individuals.

Another major chronic disease facing individuals caused by socially influenced lifestyle is cancer. Lung cancer is mainly caused by smoking of tobacco; cancer of the liver is mainly caused by excessive consumption of alcohol, hence it shows that lifestyle choices affect the health of an individual (CDC, 2012). The increasing number of individuals seeking treatment for chronic diseases each year has resulted in the expansion of John Hopkins Medicine. Therefore, one of the factors indirectly influencing the growth of the Medicine are social factors that result in increased health hazards. The Medicine is constantly expanding its resources with the increase in the number of patients to ensure that it meets rising demand for services required. For instance, the Medicine recently embarked on expanding the cancer center to increase its ability to tackle the increasing cancer cases it receives. In the new center, the Medicine will incorporate the latest technology and resources available in tackling the cancer cases it receives.

Comparison of John Hopkins Medicine mission statement and value statements to services provided

John Hopkins Medicine mission is the improvement of health in the surrounding community and in the world where they aim to achieve this by setting an excellence standard where healthcare is concerned (John Hopkins Medicine, 2012). The Medicine has set out to be the world leading healthcare institution in service provision, illness management and in research development in matters concerning human health, a task it has achieved consistently for the past two decades. Yet another mission that the Medicine strives to attain is the recruitment of healthcare providers of the highest integrity and best performance. It aims at providing facilities that ensure high quality service provision and aid in achieving high success rates in prevention, diagnosis and treatment of diseases and illnesses. The Medicine has a number of values that helps it in meeting its objectives in terms of serving the patients and the community at large. The John Hopkins Medicine values include; Leadership and integrity, excellence and discovery, diversity and inclusion and respect and collegiality (Johns Hopkins Medicine. 2012, p. 2). John Hopkins Medicine appreciate that the community in which they work need to benefit. In line with the mission and the values, the Medicine is devoted in uplifting the community through provision of various services (John Hopkins Bloomberg. 2012, para. 2). The Medicine has established John Hopkins medical campus aimed at training the community members and other members of society. The campus has transformed many lives of students in the community and the society in large.  This training has impacted good leadership skills among students helping many students acquire, skills and knowledge in healthcare.  The Medicine has also engaged in research and development on various issues affecting healthcare. The research findings that have been useful in improving the healthcare of the community and the society. Furthermore, the Medicine has established Children Safety Center (CSC), which has a home like environment that provides an opportunity for families in the society and in the community with a variety of safety products.  The home further, provides these families within the community with personalized safety education that helps them to make good decisions pertaining to the food they eat and on the benefits of seeking medicals attention.   The community has also benefited from the low-cost safety products sold by the Medicine. These products include cabinet locks and latches, carbon monoxide and smoke alarms, stair gates among many others (John Hopkins Bloomberg. 2012, para. 2). The Medicine is also instrumental in providing the entire family of the Medicine and the community with injury prevention needs through the Center for children society.

The hospital has also partnered with John Hopkins Heart and Vascular Institute to hold heartfest celebrations where local restaurants in the community prepare  heart-healthy foods  and wines aimed at creating awareness about the right diets to feed on to prevent heart related disease. The celebrations are also going to be graced by “the heart attackers” a rock band that consists of local cardiologist and other medical specialists.   These celebrations demonstrate the commitment of the John Hopkins Hospital to provide quality services to the community members.

Furthermore, apart from musical entertainment and food, the celebrations will educate and provide interactive displays created by the John Hopkins Heart and Vascular institute and other organizations to sensitize the community on how to prevent  chronic diseases such as heart and stroke diseases. Many of the citizens in USA succumb from these diseases and by the, hospital collaborating with the local community through such celebrations; the prevalence of such diseases is likely to decrease.

 

Explanation on how John Hopkins Medicine promotes current or future quality improvement initiatives

John Hopkins Medicine is one of the hospitals that has continued to embrace change and appreciate any improvements in its operations. Some of the current initiatives that the hospital has initiated this year is the electronic health record database (John Hopkins Medicine, 2012). The hospital has come up with software called epic that is able to integrate the patient’s records into one system. This platform will improve service delivery, as all medical practitioners working at various departments will be bale to access to patient information and provide amicable solutions.  The efficiency of service delivery will also be improved since time taken to retrieve information will be reduced since t medical practitioners will not be required to move from one office to another to look for information on the patients. Records will also be well kept for reference purposes hence enhancing service delivery.

JHH is one of the six major hospitals that is committed in developing curriculum for the office of the National Coordinator aimed at teaching physicians on how to use this electronic health records. This training is an important venture that is aimed at instilling knowledge and skills in its employees to improve their service delivery. This training will impact positively on the health service provision in the hospitals.

The hospital is also considering using robotics in dispersing bleaching in order to kill bacteria. This development is aimed at reducing infections during surgical procedures. This is a positive development in the health industry as it will, drastically reduce the rate of infections during surgery.

The hospital is also using Pap test fluid in detecting ovarian and endometrial cancers. In this test, cervical fluid is obtained through this pap tests that helped in detecting these kinds of cancer.  To prove that this test was accurate, a pilot study was conducted named papGene Test that relied on genomic sequencing of specific cancer mutations and it detected 100% presence of endometrial cancers. These are some of the initiatives that have improved the health care provision and are projected to impact on the future service delivery.

 

Interpretation of trends and future development of John Hopkins Medicine

            Analysis on how John Hopkins Medicine uses health informatics technologies to impact its healthcare delivery.

In the modern days, health informatics technologies have become important components in ensuring that best services are delivered to the patients. John Hopkins Medicine is one of the Medicines in the country that has embraced informatics technologies in ensuring that it delivers better services to the patients. In healthcare provision, complications in upcoming diseases render communication and information sharing quite important in that one unit or Medicine can share its knowledge with another in helping to come up with a solution to a disease. John Hopkins Medicine has greatly incorporated informatics in how it runs as it understands the importance of research and communication in achieving the goal of elimination or containment of illnesses. For instance, it works hand in hand with John Hopkins University in the study and research of certain illnesses. In this research, it utilizes advanced techniques and technology, providing competent solutions to illnesses, which they then share with other healthcare providers.

The Medicine utilizes computer technology and other technologies in running of certain treatment machinery such as chemotherapy and x-rays. The Medicine is strategically designed with workstations between patient rooms for consistent monitoring of the patient’s progress (John Hopkins Medicine, 2012). The Medicine has computerized documentation and storage of patient information and provides contact information that is easily accessible, therefore enabling patients to easily contact them. The doctors are each provided with pagers for easy communication of emergencies and communication lines are always open. The emergency sector is fitted with the appropriate technology and resources for quick communication and smooth handling of the cases brought in.

In its future initiatives, the Medicine is planning to come up with individualized health initiative. This initiative is aimed at developing and implementing appropriate methods and tools that can be intelligently used to ensure that individual wellness is achieved, ensure early diseases detection, and ensure that the healthcare is affordable and effective. Therefore, this initiative would see the healthcare improve and become an effective model for the entire nation. Hence, it is apparent that the quality of healthcare in the Medicine will improve in future as the Medicine has embraced technology in keeping the patients records.  This information concerning the patients will play a major role in helping the Medicine provide quality healthcare services to its patients.

Evaluation on how John Hopkins Medicine uses emerging trends in technology to support its projects and initiatives.

In the recent past, technology has advanced at a fast pace.  Many organizations have been at the forefront to embrace these new technologies in their system to keep up with the entire world. Technology has revolutionalised the way tasks are done and the most important thing about these technologies is that they have facilitated service delivery and at the same time ensured quality. The advancement in technology has to greater level impacted on the entire department of Medicine. For instance, the department in charge of ensuring safe customer records has received a boost. Information technologies adopted in the Medicine system has ensured quality and effective healthcare provision services. For instance, individualist health initiatives has enabled improved provision of healthcare service as every patients information can  be retrieved at all the departments (John Hopkins Medicine, 2012).

Information Technology has helped in providing effective and quality treatment such as determination of psychology and behaviors of individuals. Such developments have boosted health care provision. Research facilitated by advancement in IT has helped the medical specialists at the hospital to come up with new ways of detecting cancer through pap fluid tests (Gantz, 2012). Theretofore, these technologies will see patients undergo safe and successful surgeries followed up by check ups to ensure continuous positive response to treatment.

The hospital has used emergence trends in technology to improve its service provision. For instance, the hospital has set up an electronic health record database by use of epic software. This software is as a result of the advancement in technology.  The electronic health record is a great improvement in this current period. The electronic health records will impact positively on the hospital capacity to keep accurate information pertaining to their patients.  Furthermore, use of robots in surgeries is as a result of emergence of new technologies. This technology will help to reduce rates of infections.  This implementation has been in line with the requirements of the Health Information Technology for Economic and Clinical Health Act (HITECH Act) such as recovery in non-functional areas in the healthcare system and reinvestment in the electronic and technological aspect with the aim of increasing efficiency and customer service. In addition, the act purpose of supporting the utilization of electric health recording by providing funding and incentives to healthcare providers for utilization of electronic health records in a meaningful manner has also been achieved (Kudyba, 2010).

Influences of the healthcare ecosystem

The healthcare ecosystem is influenced by external forces including; government regulations, accreditation standards, and federal legislation. The federal government established a goal of developing the National Health Information Network (NHIN). Using information technology, healthcare organizations will be increasingly linked across the nation. The seamless exchange of health information provides healthcare consumers with a higher quality of care, improvement in patient access, and more efficient control of the cost of healthcare services. The healthcare ecosystem is one of continual change.

Analysis of the three current federal government programs related to health informatics How each current program is impacted by licensure, certification or accreditation standards.

The federal government realizes the importance of implementation of health informatics hence has established programs by setting up regulatory bodies to achieve the realization of a complete and functional informatics system. Therefore, the federal government seeks to achieve this goal of realization of the health informatics by the implementation of Health Information Technology for Economic and Clinical Health Act (HITECH Act) (DerGurahian, 2010). This Act involves recovery in non-functional areas in the healthcare system and reinvestment into the electronic and technological aspect with the aim of increasing efficiency and customer service. The main purpose of this Act is to support the utilization of electric health recording by providing funding and incentives to healthcare providers for utilization of electronic health records in a meaningful manner (Kudyba, 2010). The government sets a time frame where if in that period some healthcare providers fail to implement the informatics system, they are penalized. This is because of failing to show meaningful use of the incentive grants allocated for achieving this. This program results in the realization of the electronic health recording and exchange of health information among the various constituents in the healthcare ecosystem.

The programs set up by the federal government involve different bodies, each being differently influenced by licensure, certification and accreditation standards. These bodies are set up to regulate the application of the HITECH Act by determining what meaningful use of electronic health data records entails, and how it can be demonstrated (SearchHealthIT, 2010). They also determine which certified electronic health records technology is appropriate and determine who will be in charge of certifying this technology. The federal government programs are also in charge of ensuring that there is protection of electronic data records to avoid misuse or the data falling into the wrong hands. The development of the data exchange standards is also under the scrutiny of the federal government.

One of these programs is the temporary certification program that is responsible for the certification of health IT. This program has been put into action to determine the relevance and impact of certain technology in Health IT. Two bodies will jointly run the certification programs and these are the Certification Commission for Healthcare Information Technology, which will certify the software, and the Joint Commission that will generally examine Health IT to ensure quality healthcare provision. The second and permanent phase of Health IT certification will be run by several bodies to attain comprehensiveness in systems to be implemented (SearchHealtIT, 2010). Hence, by setting up certification programs the federal government ensures security and privacy in data transfer.

The other program set up by the federal government is the Centers for Medicare and Medicaid Services. This is a regulatory body set in place to govern the issuance of grants and incentives. This is the body responsible for the determination of what meaningful application of electronic health records represents hence determines the system used in awarding of incentives (SearchHealthIT. FAQ, 2010). The CMS, by determining the meaningful use of electronic health records by healthcare providers, forms a basis for accreditation to determine the providers who are eligible for Medicare reimbursement. This will result in Medicaid being reimbursed based on merit of implementation and proper utilization electronic health records and information exchange.

The third program set up by the federal government in relation to the digitization of data management and sharing is the Health IT Standards Committee. This committee is made up of members from various components of the ecosystem such as healthcare providers, federal agents, health insurance companies and Health IT technology vendors. Members of the Health IT Standards Committee program come up with recommendations on standards and certification of data exchange systems, which they submit to the body responsible for the authorization of the use of health IT (DerGurahian, 2010). This program ensures that the accreditation standards set are competitive and will ensure protection of health information.

 Predict how each current program will impact the following:

  1. Clinical quality
  2. Reimbursement for services
  3. Patient access to care

All the three programs are bound to have a significant impact on clinical quality in their own unique way. The health IT certification program, for instance, is responsible for certification of IT to be applied or utilized in clinical data storage and sharing. By ensuring that only quality and certified technology is installed in the clinical setting, this will result in secure and reliable data source. It will also ensure that all the clinics work towards implementing the HITECH Act by embracing IT in healthcare. Since the guidelines towards the required technology will already be in place, IT utilization will become more efficient and reliable. The program will ensure reliable health information exchange in that the software necessary for such purposes will be trustworthy, as it will have undergone certification. Hence, with the exchange of healthcare information and the sharing between various healthcare providers, there will be improvement in the quality of healthcare that is provided to the public. This program will influence reimbursement since this will be dependent on the level of meaningful application of Health IT by a healthcare service provider. Hence, by setting quality standards in the technology that will be implemented in healthcare systems, this program will end up affecting how healthcare providers will make meaningful use of electronic data by implementation of the certified technology (Haux, 2010). This program regulates the technology used in data storage and exchange, certifies both the software and hardware, and hence allows easy access of healthcare data while at the same time maintaining privacy and security. This enhances patient access to healthcare information and simplifies the entire process.

The centers for Medicare and Medicaid services are responsible for identification and governance of the issuance of incentives. This is based on the healthcare providers showing commitment in the meaningful utilization of electronic health records. The electrification of data management by healthcare providers is bound to bring great benefit to clinical quality in that retrieval of required data will be easier and less time-consuming, hence faster delivery and service provision to the patient. The CMS will impact reimbursement of Medicare and incentives to healthcare providers, as they will judge the healthcare’s dedication towards achieving the HITECH Act’s goal of utilizing electronic health records and healthcare information sharing.

Reimbursement will be awarded based on the extent to which the healthcare embraces Health IT hence this will be the program with the greatest impact on reimbursement. By motivating healthcare providers to implement health IT into their systems by basing reimbursement on the incentive shown by the provider, the CMS will successfully increase the patients’ access to healthcare since there will be less communication barriers. Information sharing between patients and healthcare providers will be easier and faster enabling the public to access help in a timely manner. With electronic healthcare information sharing, the public’s knowledge of symptoms of certain illness will grow hence they will be able to identify an illness early and seek medical help.

The third program set up by the federal government towards achievement of the HITECH Act goals is the Health IT Standards Committee. This committee consists of members of the healthcare ecosystem representing every aspect of the system. Hence, the decisions made by this committee are bound to be non-biased and to represent the interests of every party in a beneficial manner. Thus accreditation standards, licensing standards and guidelines recommended by this committee will ensure that electronic health data is represented in a safe and secure manner and incentive standards set are attainable and relevant (Gardner, Overhage & Steen, 2009). It will also ensure that the technology authorized for use is applicable in a healthcare setting and is specifically tailored for the healthcare requirements. This program will attain clinical quality in that the decisions made will emanate from healthcare providers hence the set standards will be achievable. They will be geared towards quality improvement hence the technology certification standards will be agreed upon only when they fulfill the purpose of quality improvement.

This committee will also have an influence over reimbursement in that they will determine the quality of Health IT expected in healthcare centers and will have a hand in setting the expected standards for incentive to be provided. This committee provides recommendations for the licensure, certification and accreditation bodies hence their decisions play a major role in influencing the final decisions as their recommendations represent the interests of everybody involved. This committee influences patient access to healthcare by regulating the kind of technology to be implemented and determining the standards on which the software will be set.

Explanation on how each current program supports the NHIN.

The Nationwide Health Information Network (NHIN) aims at improving the healthcare system by increasing the quality level in healthcare centers. This represents improvement in all sectors of service provision and information management. Another aim is the reduction in disparities arising from poor information systems. It seeks to reduce the costs incurred by healthcare providers due to inefficiencies and errors through the implementation of an information system that is reliable and systematic, one where there is complete information and easier management of data hence correct data is easily retrievable. The NHIN also seeks to improve coordination between healthcare providers, technicians, physicians, and other entities involved in the health ecosystem. This ensures that the environment created allows better healthcare provision and ensures rapid communication of information. It also ensures that there is timely response to emergencies and threats by ensuring fast connectivity and communication between the public and the healthcare providers (Al Gallant, 2010). This can also be achieved by the easy communication between different healthcare services providers, which will ensure that there is sharing of information that may be helpful incase of an emergency.

The three federal government programs work towards supporting the NHIN by ensuring that utmost benefit is gained from the healthcare information networks created. One of the programs is the health IT certification program. It supports the NHIN in that it ensures certification of quality technology by allowing only the software that will result in the highest efficiency and easy transfer and access to health data. By certifying the technology, it ensures little or no occurrence of errors and increases accessibility of healthcare information. It also increases efficiency in the coordination of the users of the data transfer through electronic sources and in general lowers occurrences of errors. In that way, this program is able to achieve the key benefits for the intended use of the IT system.

The second relevant program is the CMS, which is responsible for determining whether a healthcare provider shows motivation in implementing HITECH Act goals and hence determine whether the provider should receive incentives and reimbursement. This motivates the healthcare providers to implement electronic health records, a move that simplifies the process of data sharing and retrieval. Implementation of electronic health records reduces errors and inefficiencies, improves coordination as data retrieval and data exchange becomes simplified and faster and data storage becomes more manageable (Al Gallant, 2010). Electronic health information makes it easier for the public to contact the Medicine in cases of emergencies hence resulting in increase in the quality of healthcare provision.

The third program is the Health IT Standard Committee, which is responsible for forwarding the recommendations for licensing, certification and accreditation standards. This committee represents the interests of the healthcare providers, which usually involve the increase in customer care quality. By so doing, the standards set in technology certification of technology and incentive provision standards will be aimed at the overall improvement in services provided by the healthcare provider (Al Gallant, 2010). Thus, the set standards will ensure that only the best technologies that fully satisfy the needs of the healthcare system will be authorized and the attainment of a more efficient and comprehensive healthcare system will occur.

The roles of health informatics professionals in operationalizing each of the selected federal government programs

            The roles health informatics professionals have performed in each federal       government program.

Health informatics program members are experts in health informatics who ensure that the health IT system set meets the standards required for complete actualization of its purpose in improvement of the healthcare system. In certification programs, they ensure that the certified software programs are compatible with the running of the healthcare system. They ensure that the systems can bring about efficiency in storage of large amounts of data and allow retrieval without errors. They also ensure that the systems allow data sharing between individuals in a discrete manner and they adapt to changing trends in healthcare. Professionals calculate the cost of installation and maintenance of the system to ensure that it is manageable. This task is usually carried out by the Office of the National Coordinator in conjunction with the National Institute of Standards and Technology (U.S Department of Health and Human Services, 2010).

In the Centers for Medicare and Medicaid, health informatics professionals perform the role of developing rules and guidelines that govern the context of meaningful use of incentive programs. They determine the capacity to which a healthcare provider can implement Health IT and utilize it meaningfully. In this regard, they set the standards at which a healthcare service is eligible for Medicare reimbursement. The healthcare information professionals in this case are the member of the Joint Commission as they are responsible for setting these standards.

In the Health IT Standards Committee program, the role of the health professionals is the recommendation of standards that are applicable in the healthcare setting. The professionals are inclusive of healthcare professionals, IT professionals and research professionals where together they come up with solutions that are applicable in the healthcare setting while at the same time providing the best that information technology can offer. With the health informatics professionals being involved in every step of the creation of the system, the end product ensures comprehensiveness hence ensuring that the goal of quality improvement is achieved.

Analysis of how each federal government program could impact the health informatics workforce.

Every program implemented by the federal government has an impact on the final health informatics program. The main purpose of the processes of licensing, certification and accreditation is the activation of a system that is comprehensive and serves every required purpose effectively hence minimizing the occurrence of errors. The program that results in certification of the system is quite important in attaining a system that is free of errors. This is what will bring about efficient running of operations in the healthcare center hence the health IT certified should allow efficiency and smoothness in operations of the informatics system (Rouse, 2009). This will result in better coordination between all the factors of the ecosystem hence ensuring that efficient healthcare provision takes place.

The CMS is responsible for accreditation of the healthcare based on its incentive in achievement of electronic health records. This program will result increased efficiency in terms of storage of electronic data, hence making the staff more vigilant when it comes to electronic data usage. The Health IT Committee will be responsible for decisions made as their opinions count. This means that the standards set will be compatible will the healthcare system and its environment; hence the healthcare providers will be able to achieve the benefits from implementation of NHIN. This will increase interactions between healthcare practitioners thereby enhancing the general efficiency in the healthcare system.

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