Benchmarking Assignment on Positive and Negative Impacts of the Affordable Care Act, Medicare, and Medicaid on Healthcare Operations

Big Data Analytics

McGuire, Manyika and Chui (2015) explains that in healthcare and life science, big data refers to electronic healthcare datasets that are complex and large, which are difficult to manage using traditional hardware, software, data management methods and tools. Big data are overwhelming in healthcare and life science not because of their volume but because of their data type’s diversity and the speed with which they are managed. Through the discovery of understanding and associations trends and patterns within the data, big data analytics saves live, lowers costs and improves care. Application of big data takes advantage of data explosion and removes previous analytical restrictions.

In public health, data analysis assists in analysis of disease patterns and tracking of the disease transmission and outbreak by improving speed response and public health surveillance. The big data analytics helps in turning large amount of data into actionable information that is useful in predicting and preventing crises, provides services and identify needs especially for the benefit of populations. It helps in analyzing patient records and ;                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          clinical trials to identify indications and discovering adverse effects that follow before the products reach the market. It helps in synthesizing and aggregating patient clinical records organizing datasets in real time for provision of data and services to third parties (McGuire, Manyika, & Chui, 2015).

Six-Sigma Benefits and Barriers

Willey (2003) explains that Six-Sigma is a customer driven quality- control program which is most commonly linked with different companies who are adapting the system with varying reference results to the product they are producing and its customer requirements. This principle is ideal in ensuring that an organization produces a quality product. This model addresses the entire process behind the production to completion of item or a service rather than the final outcome. When a health care organization which achieves the coveted Six Sigma quality certification stands out amid its competitors especially in companies where quality is the utmost customer priority it also expects the customers to bear the Six Sigma process.

However, the process has some setbacks too. It creates bureaucracy and rigidity as it applies to all aspects of the planning process and production creating delays and stifle creativity. It takes customer focus to the extremes, where internal quality control measures stop making sense to a company and are not considered because of the overlying goal to achieve customer satisfaction Six Sigma stipulated level.

Uses of Information Systems in Healthcare Operations

An information system is an establishment of consistent components that collect, control, and disseminates information and data to facilitate planning, control, coordination, analysis and decision making in organizations. Healthcare organizations require well-designed information systems to help them to make optimal use of the mounting health-related data supply. These health systems rely on these systems in improving operations and informing managerial decision making in areas like clinic administration, policy analysis, public health planning, health outcomes assessment,  program evaluation, performance measurement, and epidemiologic surveillance (Studnicki, Berndt, & Fisher, 2014).

According to Studnicki, Berndt and Fisher (2014) The key design considerations of information system in healthcare operations technology include selection and integration strategies, data linkage methods, data sources, units of analysis, service-based and population-based application objectives, and information privacy protections.  Health information system supports a wide variety of public health system objective like clinical research, public health policy analysis, quality assurance and performance measurement,                                                               health education and health information dissemination, program planning and evaluation, utilization analysis and demand estimation, facility and clinic administration, medical and public health outcomes assessment, and epidemiologic disease and risk factor surveillance. Health information systems explore implications and issues of public health management; privacy and security, operational models, available databases, information systems architectures and contemporary concepts and applications of HISs in public health.

The Uses and Benefits of EHR Systems

Studnicki, Berndt and Fisher (2014) explain that EHR helps a company to provide safer and higher quality care for patients while creating tangible enhancement of the organization. It achieves this by providing up-to-date, accurate and complete information about patients at the point of care. It reduces cost through improved health, reduced duplication of testing, improved safety and decreased paperwork. It enables providers to improve their efficiency as they meet the goals of a health care system. Another important benefit of the EHR is that it enhances security and privacy of patient’s data.

This system also promotes streamlined, legible, complete documentation, and accurate coding and billing. It assists health providers to effectively reduce medical errors, diagnose patients and provision of safer care. It is also a secure way of sharing electronic information with other clinicians and patients. It is a way of enabling quick access to the records of patients for more coordinated and efficient care. Last but not the least, EHR system enables a safer and more reliable prescribing.

Deployment of New Healthcare Information System

There is an existing misperception of HISs development due to expectations that these systems are analogous in comparison to their counterparts in IT intensive industries such as manufacturing and banking. However, health is a combination of many uncertain inputs ranging from the unique behavioral and biologic characteristics of the population and individual patients, to accessibility of health resources and health insurance characteristics. These inputs are generating millions of possibilities making the HIS used to be more costly and complex in building a HIS. The department of health informatics comprises of multidisciplinary core of expertise like specialist from the following fields; economics, sociology, finance and accounting operations research, medicine, nursing, and allied health management, electrical engineering, computer science, survey design, statistics and epidemiology. All health personnel should be trained on ways of using the HIS (Practice Fusion, 2016).

Privacy and Confidentiality of Patients

HIT (2015) explains that privacy and security is important as it increases a patient’s information integrity and trust through security and privacy. The Health Insurance Portability and Accountability Act (HIPAA) Rules provides the patient health information federal protections that are held by Business Associates (BAs) and Covered Entities (CEs), giving patients an array of right with respect to that information. The suite of regulations includes Breach Notification Rule that requires the BAs and CEs in providing notification following a breach of unsecured Protected Health Information (PHI), security rule that sets security for national standards of electronic Protected Health Information (ePHI) and privacy rule that is protecting the privacy of individually identifiable health information. CEs comply with the HIPPA Breach Notification, Security and Privacy Rules. BAs comply with the HIPAA Security Rule and Breach Notification Rule together with provisions of the HIPAA Privacy Rule.

No matter where the health information is stored, it gives the providers the responsibility of safeguarding this information as it meets the Rules requirements. The HIPAA protects most individually identifiable health information that are transmitted or held by a BA or CE in any form of media. The Privacy Rule calls this information “PHA” or “protected health information”. The disclosure and use of Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule standards addresses individuals’ Protected Health Information (PHI) by organizations subject to the Privacy Rule. In supporting patient’s care, electronic Protected Health Information (e PHI) is stored by providers in a variety of electronic systems, not just Electronic Health Records (EHRs).

Healthcare Environment

According to Hanna (2001), maintaining a safe environment replicates a level of vigilance and compassion for patient welfare which is important in all aspects of competent health care. It is important to clearly understand the organizational aspects that will promote a stable workforce. The healthcare environment consists of organizational culture, as well as safety climate and culture. A healthcare environment honors, exhibits and promotes the diversity of a person’ beliefs and outlooks through matters like, lack of discrimination and an employee cultural competence. The environment should understand, follow and support policies, programs, roles and responsibilities with activities that end nurse-doctor conflicts and ensure that patients understands what they want. A healthcare environment should treat and compensate employees fairly by giving great benefits.

References

Hanna, E. (2001). Thriving in a Changing Environment. Healthcare Management Forum, 14(1), 29-31. http://dx.doi.org/10.1016/s0840-4704(10)60390-0

HIT,. (2015). Guide to Privacy and Security of Electronic Health Information. The Office Of The National Cordinator For Health Information Technology. Retrieved from https://www.healthit.gov/sites/default/files/pdf/privacy/privacy-and-security-guide.pdf

McGuire, T., Manyika, J., & Chui, M. (2015). Why Big Data is the new competitive advantage. Ivey Business Journal.

Practice Fusion,. (2016). Benefits of switching to an electronic health record. Practice Fusion. Retrieved from https://www.practicefusion.com/health-informatics-practical-guide-page-1/

Studnicki, J., Berndt, D., & Fisher, J. (2014). USING INFORMATION SYSTEMS FOR PUBLIC HEALTH ADMINISTRATION (1st ed., pp. 353-383). Jones and Bartlett. Retrieved from http://www.jblearning.com/samples/0763738425/38425_ch13_353_380.pdf

Willey, J. (2003). The Six Sigma Book for Healthcare. Clinical Nurse Specialist, 17(5), 270. http://dx.doi.org/10.1097/00002800-200309000-00013

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