Healthcare management at an institutional level is not only extremely complex but also rapidly advancing and evolving as it adjusts to internal and external factors. Many modern ethical or legal dilemmas, for example, involve balancing between the right decisions from an entrepreneurial perspective which may differ from the right decisions as per nursing or other professional affiliation (Grady, 2015). There has also been a lot of advancement in technology which has become a major bearing factor and indispensable component of healthcare. The need to constantly better the best processes in healthcare has also resulted in the development of a variety of patient care and service delivery models. Finally, healthcare is one of the most regulated professions in America, a fact that has led to the development of many compliance protocols ( Talukder et al., 2018 ) . As this research paper reveals, the combination of the different advancements, ethical or legal provisions, and protocols have exponentially complicated the processes involved in healthcare management to the benefit of the patient but to the plight of the professionals involved.
The healthcare management is ravaged by many ethical/legal issues, key among them coming to the fore when the professionals and the patients differ on what needs to be done. The traditional clinician was like a firefighter who solved the problem first and discussed the implications later. The modern patient, however, has been given a say on what should or should not be done to them while being assisted in a healthcare institution. When the patient is not in a position to make that decision, the loved ones of the patient, who in some cases may not agree with one another are called upon to make the decisions for and on behalf of the patients (Grady, 2015). The issue of informed consent has become a complex limiting factor in the efficacy of clinical personnel more so when medical emergencies occur. Instead of focusing purely on the clinical issues at hand, doctors and nursing officers have to consider legal and ethical implications too. For example, the resuscitation of patients now depends on patients will as expressed before the emergency occurs or as communicated by the loved ones. Blood transfusions even in an emergency situation or in surgeries are also dependent on patient consent. As clinicians try to solve healthcare problems, their effectiveness is also hampered by the ethical/legal issues.
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A Key Advancement in Technology Affecting Health Care
A lot of technology has been developed to assist in health care with the most prominent being information technology that has literally taken over operations in healthcare institutions. All hospital records are now stored in a computer network system that is updated in real-time and availed all over the institution (Holmgren, Patel, & Adler-Milstein, 2017). The impact of IT in the clinical setting has been to save time and resources which in the healthcare sector also means saving of lives. However, a manifest complication arose when the IT networks took over healthcare institutions, all of which complicated operations for professionals. The first complication lies on the ability of one set of data to be accurately interpreted by the different professionals who operate together in a hospital. For example, the same patient could be under the care of a physician, an APN, an oncologist, a physiotherapist, a radiographer, and a chiropractor. All these professionals have to use the same set of data that is being updated in real time from different nodes. To solve the impasse created by the professional variances, hospitals have had to invest in expensive data integration and interoperability systems (Holmgren, Patel, & Adler-Milstein, 2017). Healthcare professionals have also had to study IT in order to deal with the complexities of data sharing and the use of IT in their day to day activities. As reflected above, technology advancements favor patients but to some extent complicate the operations of professionals.
Patient Care and Service Delivery Model Example
The healthcare sector has been seeking to go above and beyond in bettering its best in service delivery, a good example being the Minneapolis Heart Institute’s New Ulm Project (Sidebottom et al., 2018). The New Ulm project is an example of the new holistic approach to healthcare where clinicians do not just wait for patients to come to the hospital and be treated. Under the new approach, clinicians seek out patients long before they even get sick so as to mitigate the causes of disease. The New Ulm Project has undertaken this approach to the issue of cardiovascular disease in New Ulm Minnesota (Sidebottom et al., 2018). The project combines the management and treatment of current cases of cardiovascular disease while contemporaneously seeking to reduce future incidences. Mitigation processes include educating the people on proper lifestyles such as diet and exercise, and early treatment of cardiovascular disorders. The impact of the New Ulm Project on the populace has been the exponential reduction of cardiovascular disorders instances in the present and based on projections, even in the future.
A Key effort and A Protocol for Regulatory Compliance
The words protocols or regulatory compliance in the healthcare sector have become almost synonymous with the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and patient confidentiality. Clinicians are trained professionals who are competent and capable of handling most regulatory issues, but information technology has remained a major challenge. For a start, IT is extremely malleable and keeps on changing almost in real-time (Takyi et al., 2017). For example, airplanes manufactured half a century ago are still making intercontinental flights, but some components of IT become obsolete within a year of their introduction. To mitigate the complications and vagaries caused by HIPAA rules in healthcare, one major effort, and one major protocol has been developed.
The major effort has involved the creation of the position of privacy and security officers in the senior management of most hospitals (Takyi et al., 2017). The privacy and security officer can be considered as the healthcare version of the Chief Security Officer (CSO), a position that has risen to the top echelons of the corporate sector. The CSO’s impact in the healthcare sector has been positive for the patients but an inordinate complication for the professionals. The patients stand to benefit from the services of a professional whose sole role is to protect their privacy. Conversely, the already professionally diluted health care sector that has to deal with the professional balance of powers between administrators, doctors, advanced practice nurses, and other specialists, now has to deal with the addition of another senior professional. From the perspective of protocols, an email policy has been developed where patient data cannot be transmitted through private gadgets, servers, or networks ( Talukder et al., 2018 ) . Clinicians, therefore, have to separate their private communication from their professional communication in adherence to this new protocol. Once again, the protocol benefits patient but inordinately complicates the obligations of professionals who now have to have two lines of communications akin to intelligence officers.
Conclusion
The healthcare sector is gradually evolving and changing, with the changes exponentially benefiting the patient, but to some extent, making the work of professionals harder. Indeed, the healthcare sector generally and specifically at an institutional level such as hospitals and nursing homes is both fluid and dynamic as it keeps adapting to external and internal factors. Conversely, management in healthcare also has to factor in both professional and entrepreneurial perspective which in most cases differ exponentially. The professional side of the equation involves seeking to obey and respect the oaths taken by the different professional and also adhering to professional ethics. The entrepreneurial perspective involves seeking to ensure patient satisfaction and adherence to all laws, rules, and regulations. Balancing between the two perspectives improves services but complicates the work of managers and professionals. This complication is exacerbated by the fact that the healthcare sector keeps on advancing in technology, processes, and protocols.
References
Grady, C. (2015). Enduring and emerging challenges of informed consent. New England Journal of Medicine , 372 (9), 855-862
Holmgren, A. J., Patel, V., & Adler-Milstein, J. (2017). Progress in interoperability: measuring US hospitals’ engagement in sharing patient data. Health Affairs , 36 (10), 1820-1827
Sidebottom, A. C., Sillah, A., Vock, D. M., Miedema, M. D., Pereira, R., Benson, G., ... & VanWormer, J. J. (2018). Assessing the impact of the heart of New Ulm Project on cardiovascular disease risk factors: A population-based program to reduce cardiovascular disease. Preventive Medicine , 112 , 216-221
Takyi, H., Watzlaf, V., MATTHEWS, J. T., Zhou, L., & DeAlmeida, D. (2017). Privacy and Security in Multi-User Health Kiosks. International Journal of Telerehabilitation , 9 (1), 3-14
Talukder, S., Witherspoon, S., Srivastava, K., & Thompson, R. (2018). Mobile technology in healthcare environment: Security vulnerabilities and countermeasures. arXiv preprint arXiv:1807.11086
