The Establishment of an Integrated Unit to Regulate the Paramedics of the Legal Health System - Example

Hard system methodology approach

Hard systems methodology is a rigid techniques and steps that provide solution to a stated problem and processes the problem based on computer implementations. The method provides a comprehensive approach through which appropriate solutions can be developed to address the challenges in the legal health system.

Stage 1: Systems Description

There exist disparities in regulation of the health system. The rules established by the federal, local, and government agencies results to the high costs of health care services, which are not affordable. This results in the loss of many lives due to sickness and injuries (Trochim et al., 2006). The various regulatory agencies include the Office of the National Coordinator for Health IT (ONC), Office of Civil Rights (OCR), Centres for Medicare and Medicaid (CMS), which are tasked with providing government subsidised medical services and ensure compliance with Health Insurance Portability and Accountability Act (HIPAA) (FitzGerald and Bange, 2012). There are also other Non-governmental organisations and public organisations like theEnvironment Protection Agency (EPA), Centre for Disease Control and Prevention (CDC) and Food and Drug Admission (FDA) which looks at the medical devices and distinguish them according to the level of risk they pose to the users.

The presence of diverse regulations reduces the efficiency of the operations conducted by the paramedics. The emergency health services to patients in critical condition are slowed down. In addition, there is increased liability, which the paramedics are exposed to. These regulations provide high levels of documentations and thus high costs for the health care services.

Influence Diagram

Spray Diagram: Related factors

Analysis of the Existing Situation

The regulations in place ensure transparency during transactions, promote equal access to health care, ensure correction of the market failures, and improving moral norms and individual behavioursfor example by regulating consumptions of bhang and tobacco. The regulations are developed by private bodies, as well as the local, state and federal governments. The regulatory bodies ensure compliance and adequacy of these services to the public (Trochim et al. 2006). They also ensure that the quality of the services provided is up to standard. They achieve this by certification of the doctors, nurses and paramedics.

Stage 2: Identification of Objectives and Constraints

The main objectives are as below:

• To improve visibility on health care to ensure that people’s information does not fall to the wrong hands. This will make it easier for the paramedics to obtain information about a patient who is in a critical condition.
• To have uniformity in the regulations; this is, whereby, all the stakeholders are using one set of regulations with a central storage of information with restricted access at different levels.
• To reduce documentations and the process of acquiring licence and to ensure low operation costs.
• To provide efficiency in the operations within the health care industry; overlapping responsibilities and duplicated efforts are identified and bottle necks in the supply chain omitted.
• To facilitate the decision making process by ensuring a complete view of the environment, the inputs and outputs of the whole system

In order to achieve the above objectives, there are constraints that should be overcome. These include:

• Less funds available
• Inadequate infrastructure
• Illiteracy of the public on technological advances
• Political support
• Resistance from the stakeholder

Stage 3:Generation of Routes to Objectives

Researches should be conducted on the regulations from various agencies. This will help in developing strategies to be employed in coming up with a simple integrated unit of rules and regulations. This research will involve heavy data gathering from the various agencies. Methods employed may include collection of existing records and constitution, research and development data (Burge, 2015). Analysis of data follows to come up with the selected important information from each agency, which cumulatively forms a simple integrated unit of the health care services.

Representation of the Approach Used

Stage 4: Formulating Measures of Performance

By successfully overcoming the following challenges, it will mark the beginning of the implementation process (Bergrath et al., 2013).There is a high cost and complexity of integration. The complexity is due to the huge researches that have been conducted by the various regulatory agencies to come up with their own rules and regulations. This makes it difficult to merge all the rules to come up with an integrated unit. There should be regulation of the various levels of liabilities facing the paramedics. This is as a result of the tremendous changes in national and international laws (Gostin and Taylor, 2008). This affects the various sectors, including private, non-government ambulance services, and other mobile services in between international boundaries in which the paramedics work in (Gayton and Lovell, 2012).

It is necessary to control the loss of jobs by the majority of people during the transformation process and the resulting strikes and resistance from the employed. Availing enough resources is important to deal with the challenges faced. Financial resources are crucial during the last stages of the transformation process.Political challenges brought about by political leaders during the integration process. These leaders may use this process as avenues to promote their career and agendas. As a result, the time frame for completing the implementation process is jeopardised.

There is limited accessibility to other areas due to inadequate infrastructure in some parts of the country. This would lead to only a percentage of the people in the country to enjoy the fruits of the integrated unit. Awareness should be done country wide using internet sources to ensure that everyone would benefit from the technology applied in the use of the integrated unit. The technologies used in the integrated unit should be made affordable to everyone, including poor communities within the country.The equipment available should be maximised on their use to avoid rendering most of them obsolete. This would improve the advantages of the integrated unit.

Stage 5: Modelling

A Control loop diagram will be used to ensure that the performance measures will work effectively.

Stage 6: Evaluation

This involves evaluation of the objectives and expected consequences to ensure that the set objectives to solve the problem of many regulations are achieved. The goal is to obtain efficiency of the paramedics in offering the health care services.

Stage 7: Choice of Route(s) to Objectives

There are various ways that will enable the set goals to be achieved. The government can maintain peaceful agreement with other nations in order to obtain loans and the funds needed for the transformation, ensuring there is full cooperation of the stakeholders and seeking public opinions on the transformation.

Stage 8: Implementation

The implementation of the integrated unit comes with rapid changes in technology. This will enable the government to integrate case laws, federal laws, state laws and other rules and regulations formulated by the non-government organisations into one (Stewart, 2014). The process will also provide a chance to access response from the public about the services they are getting. This way, improvements can be made to provide efficient services. Furthermore, people can pay for the services through master cards and PayPal account owing to the advanced technologies.

It will also ensure that the practitioners are certified and are very competent in providing the health care that is required by the patients. This is due to the centralised information that enables the paramedic to reach important information about the laws and regulations that affect their operations.They can also get updates on ways that they can deal with legal situations or how to react in moments of crisis.The integrated unit benefits from the opportunities presented by the international markets (Noone, 2009). For example, the government may sign agreements with other nations in order to receive loans and necessary finance to facilitate the implementation process. The quality of the integrated regulations that govern the health care industry may be improved by borrowing necessary regulations from other countries.

Stakeholder Analysis

The individuals to be considered are the professionals like the doctors, nurses and the paramedics. They conduct the actual work in the healthcare industry and are thus affected by the regulations established (Stewart, 2014). They are exposed to legal liabilities which affects their operations. The members of the society should also be considered since they are affected by improving the technology. They should be enlightened on internet and other new technologies that will accompany the integrated unit regulations. This is to ensure that everybody can benefit from the project. The members of the various regulatory agencies who can be interviewed during the data gathering stage to provide sufficient information for the integration process. The political leaders should sign an agreement before the onset of the process so as to avoid delays in implementation later on.

Reflection

The formulation of an integrated unit to control the paramedics of the legal health system is very important and should be done as early as possible. This is because of the benefits that come with it such as the increased levels of efficiency in the operations within the health care system. It will also reduce the level of documentation and hence low costs of operation. An integrated unit will also improve visibility throughout the health care industry and enhance uniformity in the applications of the various laws and regulations throughout the country. An integrated system will also centralise data and information and this will enable the general public and the practitioners to access relevant information regarding the laws and regulations which affect their operations (Bergrath et al., 2013). Other benefits of an integrated unit are as follows: An integrated unit also facilitates decision making by ensuring a complete view of the environment, the inputs and outputs of the whole system. It will also allow for an efficient allocation of resources and hence improved efficiency in operations and harmonised set of rules throughout the healthcare system. There is also reduced documentation and increased awareness and interaction for quality improvement purposes (MUE-25 project partners, 2009).

Although this process has all the above benefits, it will face a number of challenges such as: inadequate infrastructure, which may limit access to these services by a percentage of the public, high cost, and complexity of the integration process, rapid changes in the international and national laws, inadequate resources and resistance from employees within the regulatory bodies,the political parties may also use this process to enhance their political agendas and as a result, mess with the integrity of the whole process. In order to curb these challenges, the government should seek opinions from the public and other experts before embarking on the integrated unit of regulations (Pronovost and Goeschel, 2010). Although the benefits in the long term are high, it should consider the stakeholders within this industry so that it does not end up spending more money paying for repairs in future. The government should also maintain peaceful treaties with other nations so that they are able to obtain the necessary financial and expert knowledge in implementing the whole unit (Taghavi et al., 2012). Successful implementation of this project will also require Full Corporation of all stakeholders in the healthcare industry. The government should consider consolidating all regulations and still try as much as possible to maintain a great percentage of the employees in the industry. This will limit the possibility of strikes and other forms of resistance.

The long term benefits of integrating the rules and regulations outweigh the challenges and threats facing this process. The Health Systems Management system will be helpful in this integration process as it will provide a framework within which the integration process will be implemented. Therefore, the HSM should be applied in the integration of laws and regulations (Burge 2015). Challenges faced by this process will be met as time goes by. However, there is need to give a provision for uncertainties and emerging risks.

Conclusion

In conclusion, an integrated unit to regulate the paramedics is important as it will enhance efficiency in their operations and limit cases of legal liabilities that they are exposed to. An integrated unit will also improve visibility throughout the health care industry and enhance uniformity in the applications of the various laws and regulations. It will also reduce the level of documentation and hence low costs of operating. The rapid changes in technology have presented a great opportunity to facilitate the implementation of this unit through the internet which has numerous advantages as discussed above. The international markets also present an opportunity for financing and borrowing of loans in order to finance this process. The government can also use international markets to learn and borrow legislations from other nations, which may be incorporated into the nation’s laws.

The implementation of an integrated unit also faces some challenges such as inadequate infrastructure which may limit access to these services by a percentage of the public. Other challenges include the high cost and complexity of the integration process, rapid changes in the international and national laws, inadequate resources and resistance from employees within the regulatory bodies. The political parties may also use this process to enhance their political agendas and as a result, mess with the integrity of the whole process.

The government should therefore seek opinions from the public and other experts before embarking on the integrated unit of regulations. Although the benefits in the long term are high, it should consider the stakeholders within this industry so that it does not end up spending more money paying for repairs in future. The government should also maintain peaceful treaties with other nations so that they are able to obtain the necessary financial and expert knowledge in implementing the whole unit. Successful implementation of this project will also require Full Corporation of all stakeholders in the healthcare industry. The government should therefore consider consolidating all regulations and still try as much as possible to maintain a great percentage of the employees in the industry. This will limit the possibility of strikes and other forms of resistance.

Client Report

With regulations from the federal, local and state government which also oversee other agencies in the health care industry, the health care services are very expensive. These regulations expose the medical practitioner to the risk of professional liabilities if they fail on one side of the laws. This shows how hard it is for them to learn and understand all the regulations they are required to strictly follow. Besides, it influences how they administer treatment in the field (afraid to provide full treatment). Thus it is necessary to develop an integrated unit regulation.

It is recommended that the government should consult with the public and other stakeholders. Their opinion before the implementation matters a lot. This will avoid overspending on repairs in future and thus long term benefits of the integrated unit. An intensive research should be conducted before deciding on the regulations to be adopted in the new integrated unit. This will ensure efficiency of the paramedics and the related professionals in their operations (Bergrath et al. 2013). Awareness on internet technology and other new technologies should be enhanced to the public. This will ensure that everyone will enjoy the benefits of the integrated regulations. The public can easily access emergency treatment at subsidised costs.

The government should sign agreement with other nations in order to obtain loans and necessary funds to complete the transformation process (from disperse regulations to an integrated unit). It should also borrow important regulations. This will improve the quality of the integrated unit and make it diverse. Also, all the stakeholders in the healthcare industry are required to cooperate to ensure that the implementation process is successful. This is because the strike wave and resistance will have been prevented.

The integrated unit has more advantages as compared to the disperse regulations. It makes the health care services affordable to the public due to re reduced costs. It also helps the medical practitioners to easily learn and understand the regulations. This results to improved operations in the health care industry. There will be improved visibility since the information is secured which will make it easier for the paramedic to obtain necessary information about a patient in a critical condition. The process of obtaining certification and licence by the paramedics is reduced, this reduce the ratio of the paramedics to the public, meaning that the public will receive unlimited emergency health services easily.

The integrated unit also enhances the uniformity in the established rules and laws since all the stakeholders are using one set of rules, which has several facets. Additionally, it facilitates decision making by ensuring a complete view of the environment, the inputs and outputs of the whole system.It allows for an efficient allocation of resources and hence improved efficiency in operations and harmonised set of rules throughout the healthcare system.The centralised storage of information will save on time and space. It will also make it easier for the paramedics to get updated information on how to deal with certain legal situations such as quarantined places (Noone 2009).

In conclusion, it is justified that changing from the many regulations to an integrated unit provides more benefits both to the public and the government. The fruits of the transformation include, more lives saved and reduced disabilities due to the accidents and injuries, efficiency of the health care services administration due to reduced costs and the increased number of the medical practitioners who are easily reached. The above recommendations will help steer the transformation process and yield quality services from the health care industry.

Reference List

Bergrath, S., Czaplik, M., Rossaint, R., Hirsch, F., Beckers, S.K., Valentin, B., Wielpütz, D., Schneiders, M.T. and Brokmann, J.C., 2013. Implementation phase of a multicentre prehospital telemedicine system to support paramedics: feasibility and possible limitations.Scandinavian journal of trauma, resuscitation and emergency medicine, 21(54), pp.1-10.

Burge, S., 2015. An overview of the Hard Systems Methodology Stuart Burge. [online] Available at:< https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=2&cad=rja&uact=8&ved=0ahUKEwjS8_3co7XMAhWDWBQKHamhAqEQFggpMAE&url=http%3A%2F%2Fwww.burgehugheswalsh.co.uk%2FUploaded%2F1%2FDocuments%2FHard-Systems-Methodology.pdf&usg=AFQjCNFJ_6Bbq3INlhHreAM1s4o61UuCfA&sig2=imlH9tJpok6UXvOUCEbZ2g> [Accessed 29 April 2016].

FitzGerald, G. and Bange, R., 2012. Defining a regulatory framework for paramedics: a discussion paper. Australasian Journal of Paramedicine, 5(2), p.7.

Gayton, S.D. and Lovell, G.P., 2012. Resilience in Ambulance Service Paramedics and Its Relationships With Well-Being and General Health. Traumatology, 18(1), pp.58–64.

Gostin, L.O. and Taylor, A.L., 2008. Global Health Law: A Definition and Grand Challenges. Public Health Ethics, 1(1), pp.53–63. [online] Available at:< http://phe.oxfordjournals.org/content/1/1/53\nhttp://phe.oxfordjournals.org/content/1/1/53.full.pdf\nhttp://phe.oxfordjournals.org/content/1/1/53.short> [Accessed 29 April 2016].

Noone, M.A., 2009. Towards an integrated service response to the link between legal and health issues. Australian Journal of Primary Health, 15(3), pp.203–211.

Pronovost, P.J. and Goeschel, C.A., 2010. Viewing health care delivery as science: Challenges, benefits, and policy implications. Health Services Research, 45(5 PART 2), pp.1508–1522.

Stewart, R.B., 2014. Regulation, Innovation, and Administrative Law : A Conceptual Framework. California Law Review, 69(5), pp.1256–1377.

Taghavi, M., Simon, A., Kappus, S., Meyer, N., Lassen, C.L., Klier, T., Ruppert, D.B., Graf, B.M., Hanekop, G.G. and Wiese, C.H., 2012. Paramedics experiences and expectations concerning advance directives: a prospective, questionnaire-based, bi-centre study. Palliative medicine, 26(7), pp.908-916.

Trochim, W.M., Cabrera, D.A., Milstein, B., Gallagher, R.S. and Leischow, S.J., 2006. Practical challenges of systems thinking and modeling in public health. American Journal of Public Health, 96(3), pp.538-546.