A Brief Note On The Health Care Advancement

1. Throughout history, a number of reformers have sought to improve the quality of medical care. What common thread connects them? Why did some fail? What were the successful able to see/do that others weren’t?

Health care is continuously changing. In the past several years there has been a large shift in the focus in hospitals. The focus has changed from the staff to patients, patient satisfaction, and cutting costs in order to budget more tightly (Tarrant & Sabo, 2010). Because of this, along with the extreme increase in a number of patients seen and the acuity of the patients, nurses are being overworked. As a result, role conflict and ambiguity is becoming an issue. The purpose of this paper is to discuss role conflict and ambiguity, its significance, and its application to nursing.

One of the greatest changes in healthcare in the past ten years has been the rise of managed care, much to the displeasure of many patients and physicians alike. Managed care arose out of concern about spiraling healthcare costs and was designed to encourage physicians to give patients treatments that were cost-effective out of their own financial interests. "The consumer strategy was directed at imposing some barriers to use by levying various forms of co-insurance. The most common approaches used either deductibles (where the consumer paid the first portion of the bill a technique familiar in other types of insurance) or co-payments (where the consumer paid a portion of the bill and the insurance company the rest) or a combination of both' (Kane et al 1994). Managed care has given health insurance companies an increasingly significant voice in how treatment is administered and allocated. Managed care has proliferated in the past decade despite considerable criticism of the practice of 'nickel and diming' patients as well as the considerable bureaucratic red tape it is has generated. Also, research indicates that healthy, well-insured patients tend to over-consume care without meaningful co-pays but poorer, sicker patients can be deterred even by moderate co-payments and suffer negative health consequences (Kane et al 1994). However, managed care has not gone away and is a reality that all healthcare

The future and direction of health care has been the topic of discussion amongst politician and U.S citizens today. There are several challenges surrounding the future and strategic direction in which health care should be heading. Accreditation, quality of health care and organization’s compliance; access to health care, maintaining a skilled workforce, information technology and pay for performance are some of the challenges that currently presenting itself in healthcare today. If health care is not dealt with appropriately it will have a significant effect an impact on the strategic direction in the future and direction of care.

Healthcare delivery in the United States has morphed through substantial changes over the years with most changes occurring as a result of technological advances in medicine. Though technological advances directly affect health care delivery in America, other factors affect it as well. As reported by Ball (2012), two of the earliest and most important technological advances that affected the system of health care delivery in the United States were the invention of the x-ray and the discovery of germs. These two advances drastically altered the health care delivery system and illustrate the way in which other technological advances may have bearing on the system. Further, these technological advances have drastically altered the public opinion with regard to the health care delivery system in the United States. Unfortunately, the resulting public opinion of the current health care delivery system is not necessarily a positive position. According to Jonas and Kovner (2008), this is probably due to the fact that health care in the United States remains a mystery to most. Additionally, the public opinion of the health care delivery system will continue to be affected by advances in technology as it was by the identification of germs and the use of x-rays in medical diagnosis.

When all of these factors are considered one could see how healthcare has an macroeconomic effect on the economy. Meaning that when an individual pays his or her premium, those premium dollars are invested back into the economy by the insurance companies to keep our economy strong. This is different from microeconomics. In a microeconomic system it’s more of a decision as to whether or not an individual can afford the premiums or if they’re even willing to pay the premiums.and whether or not they are willing to pay them.

I remember growing up when someone was diagnosed with cancer, HIV/AIDs as well as other critical diseases and illness, they were known to be a death sentence. We all know that the major changes that are taking place in world are technology, health care cost and coverage and research. This includes the healthcare sector. According to the text, “By far, the key driver of potential change in the health system is emerging technology and medical know-how” (Knickman, Jonas & Kovner, 2015, p. 335). With advance medical research through the use of technology, researchers continue to save numerous lives. I believe the Electronic health record and the patient engagement tools will continue to make a significant change in health care delivery. Individuals’ lifespan is expected to increase due to technology and research. With the advancement of medical research, prevention and interventions will prove to be a significant change and impact in the medical field. The text states, “Will patients be expected to pay for the prevention-oriented interventions themselves, rather than through insurance?” (Knickman, Jonas & Kovner, 2015, p. 335).

Over the year, the health care system in America undergo many changes; theses changes all focuses on how to deliver better care to the population while cutting hospital cost. The health care method of payments have changed, the hospitals are now getting paid for the services that they provide to the population based on a flat rate determined by Medicare and Medicaid. The patients have to receive proper care for the hospital to get paid and it's the hospital's job to find ways to provide the best care and at the same time find ways to lower hospital cost and make some profit (Kelly, 2012, p. 95). According to industry analysts "Most are seeking to reduce costs by 20 to 30 percent over several years" (Karash, 2013, p. 57 ).

Medical advancements have an overall goal to help save lives and allow people to live longer, but this can negatively impact our society. Our society will be impacted by overpopulation, moral issues and a divide in social classes.

Many factors you mentioned are considered responsible for the rising healthcare costs in our country. Numerous sources cite doctors, malpractice suits, health insurers, pharmaceutical companies, medical device companies, and hospitals all as instigators. You present a valid point about technology being a contributor, one which I had not considered before reading your post.

The Stand Alone ER "The Rapid Evolution of Health Care" By Steve Okhravi, MD, MBA, CPE July 16, 2012 Emergency care in the US is at a breaking point. Per data from The Institute of Medicine, over 1000 hospitals closed in the past few years because of the enormous cost associated with operation. There has been an increase in the number of visits to emergency rooms (ERs) to more than 120 million mostly due to those who are uninsured who, as a result, have a lack of access to primary care. As the number of those who are uninsured grows because of the recession so, too, does the community who turns to ER services for their health care needs. Clearly, ER provides a safety net for the medically underserved.

When a healthcare platform is designed based on specific trends, it is subject to the sometimes sudden and constant changes in those trends. Heath care and the delivery of health care services are always evolving with the introduction of new regulations, the advent of new technology and the fluctuation in reimbursement rates. Additional areas of variation include demographic composition and economic instability. In order for healthcare services to remain relevant, they must be willing to modify their model and design to meet the needs of the changing climate.

Thomas P. Conklin, MSW, is Executive Director of Catholic Family Service of the Diocese of Saginaw, Saginaw MI 48602. He is also Adjunct Faculty Member in the Sociology Departments at Saginaw Valley State University and Delta College, University Center, 48710. Electronic mail may be sent via the Internet to tpc517@aol.comreturn to text

I am truly excited and motivated to start the Online Masters in HealthCare Innovation from Arizona State University. If I were able to personally design a Master’s program that met the educational and professional needs of my career, this would be the program. I was excited as I reviewed the curriculum and the description for each class. My organization has placed a great deal of confidence and faith in my abilities by asking me to become the director over Imagine Perfect Care. Imagine Perfect Care is the innovation center for University of Utah Health Care and joins all three of our entities which include Health Sciences, the University of Utah Hospitals and Clinics and the University of Utah Medical Group. I have 31 years of clinical

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