Computerization in Healthcare Practices - Coursework Example

Organizations in today’s world are forced to face many difficulties. The ongoing recession is only making the situations worse. In addition to it, recent health care reforms from the federal government call for change in care practice administration. To facilitate that change, this paper attempts to answer two basic questions: 1. Will computers and new technology improve efficiency and reduce costs? 2. Discussion of legislative and regulatory factors affecting the reimbursement and care practices in an organization. Will computers and new technology improve efficiency and reduce costs? From past 60 years, health care benefits have formed a part of compensation which was tax free. This benefit can be examined from three sides: Employers: Employers used it as a means to retain their best employees. They never cared to maintain any medical records. This job was outsourced to the practicing physicians in the government hospitals. There was hardly any documental evidence of the patient in the organization. Employees: Citing the lapse from the part of employers, employees made sure that all their health costs get reimbursed through their employers. It was also an encouragement to unhealthy practices. They never bothered to have to pay for costly medicines and also for their fitness. The service providers: These were also the price setters. As such, they ensured to extract neat profit from the employers after all subsidies. They ignored to provide non-profit services like trauma care etc. As they were also the record maintainers, they could easily cover up the lapses. On the whole, the pricing mechanism was dependent on some arbitrary algorithms and not on market forces. The main disadvantage was that it never encouraged innovative treatments as they were difficult to administer. This increased the cost of health care without any corresponding increase in its value. Introduction of Computers and new technology into health care will improvise the system in two ways: 1. It will provide paperless documented evidence and any person can access his record at any place. This improves patient involvement in updating the records of the system. The evolution of internet will also help practitioners to exchange valuable insights. 2. Patient involvement will foster Electronic medical record (EMR) maintenance. This will transform into Electronic Health Record (EHR). This standard formats help in innovative medicine discovery through network interface. One successful case has been the reduction of number of HIV transmission cases from mother to child in Africa. That means computer introduction into the health care system will facilitate patient involvement. This involvement will encourage them to follow best practices and pave way for better health on the one hand. On the other, it also opens doors for administration of innovative medication. However, this transition may not be possible in a day or two. This needs continuous efforts from all three abovementioned parties. The transition can be illustrated into three stages of: Fostering of EMR’s: Here the data is stored and used. Naturally, as training and performing activities is a bit difficult, the activity would be more centralized in nature at the beginning. The physicians only may maintain difficult records with profit motive. This calls for high cost of maintenance but improved quality of medication. Stabilization through EHR’s: Maintenance of health records will be done by the patients themselves for convenience sake. This will gradually reduce the maintenance costs. The physicians will have more time to concentrate on innovations. Increase of affordability: As health records are already established and case studies give standard diagnosis, efficient methodologies can be evolved. The cost of existing medication tends to become lower. New innovations and patient involvement also kindles health improvement. The company can bet on value for lower incurrence of health care costs. At present, we are in the first stage of transition. With the passage of Health reform act on November, 7th, 2009, around 95% of Americans would be covered under insurance. This calls for higher record maintenance. But, the transition of introducing computers into health care should not be avoided on the basis of costs. In fact, it is unavoidable. Maintaining such huge number of records without any proper documentation will only reap inefficient returns. Proper records have to be built up and updated regularly. It will lead to reducing costs and efficiency improvement in future. But, for now, it will be improved quality of maintenance coupled with cost increase (Christensen.C ., Grossman. J., Hwang. J., 2009). Discussion of legislative and regulatory factors affecting the reimbursement and care practices in an organization. Shoe mart ltd., our organization, based in Florida specializes in manufacturing and selling of shoes. It employs around 200 employees. To learn about the effects on its re-imbursement and care practices due to regulatory factors, we need to have a look at the main points of health care reforms in the Patient Protection and Affordable Care Act (PPACA). The excise tax to be imposed on high cost coverage will be implemented from 2018. Coverage age for dependent children irrespective of their pre-existing conditions has been increased from 18 to 26 years. There is also a ban on life time dollar payment limits. New hires have to be automatically enrolled into the coverage. Part time workers who work for more than 30+ hours a week should be given coverage. 28% subsidy on retiree drugs is not tax deductible. Differentiation of health care and job. (Anon., May, 2010). To accomplish the compliance of above reforms, it is expected that the company will have to shell out 3% more of its original projected health costs this year. In addition to it, the regular hike in insurance premiums is around 6% per annum. The number of people covered is also undoubtedly on a rise. This may result in a double digit % rise in health care expenditure if it is left unprecedented. A sharp hike to that extent may jeopardize the reimbursement process. As such, some strategic decisions need to be taken to reduce the cost pressure. These decisions have to be taken on the fronts of: Reimbursement and Care Practices. Reimbursement: The excise tax on high cost plans which would be implemented from 2018 would be a major expenditure to the company. At the same time, it is unavoidable in order to retain the talent pool. As such, the compensations of the executives need to be redesigned to reduce the coverage and compensate them alternatively. Increase in the coverage age for dependent children implies additional burden for the company. This has to be reduced by opting for insurance schemes from companies which offer child plans as a complementary to the policy. A wait period of 90 days before enrollment and offering a default low cost plan to the new hires may reduce the cost to the minimum. Part time workers timings have to be redesigned to ensure that they do not work for more than 29 hours a week. Early retirees who are below 65 have been given an option to access re-insurance program in case of high cost claims. This can reduce the retiree claim cost by 25-30%. By 2013, employees have to be notified of state insurance plans. However, to retain the employees, it is better that the company compares between existing insurance coverage and state coverage and opt for the best one. This means a lot of strategic administration for the firm. If not done, it may have to shell out $2,000 per employee as penalty. To avoid this high cost, default good coverage has to be proposed as a payment reduction and people retention strategy. In this way, well thought out reimbursement actions have to be implemented to reduce the rise in contingent health costs. These are strategies for the short run. In the long run, care practices have to be changed. Change in care practices can be possible by: Training of employees: The administrators will have to assign the employees their personal record maintenance work. For that training on systems and change management seminars is very important. Regular checking of whether the records are duly updated has to be taken up. Preventive methodologies: As everyone knows, it is better to prevent an ailment rather than curing it after it is too late. Our organization has realized this concept and it has provided gym and exercise facilities to all the employees. It needs to ensure that the workers use the facilities and take benefit of it. Maintenance of practitioners: Smaller ailments can be done of by minimum medication. For that sake, a medical department has been employed. His job will also be to regularly check the records of the employees and initiate prevention of big diseases. Illegitimate abuse of patients: This needs to be curbed and measures need to be taken to ensure that they are treated with due respect. Implementation of these care practices means a lot of administrative burden on the organization. But, to reap commercial benefits in the long run through active employees, these measures need to be taken up. Conclusion: Thus, the legislative and regulatory factors are influencing the age old established reimbursement and care practices in our organization. But, the legislation has enforced this law. We have to go with it without any immediate benefit to the costs incurred now. So, the only way is to adapt to this change and try for improved health practices. Book References: Christensen. C., Grossman. J., Hwang. J. 2009. The Innovator’s Prescription: A Disruptive Solution for Health Care. U.K. Mc. Graw-Hill. 2009. Introduction. Internet Reference: Anonymous. 20th May, 2010. One in four employers expect health reform’s 2011 requirements to add 3% or more to next years cost. Mercer. 24th June, 2010. http://www.mercer.com/summary.htm?idContent=1380755 Internet Bibliography: Anonymous. 2010. 10 Minutes on Health Reform. Pricewaterhousecoopers. 24th June, 2010. http://www.pwc.com/en_US/us/10minutes/assets/10Minutes-Health-Reform.pdf Kruger & Mike. 29th Oct. 2009. Affordable Health Care for America Act. Edlabor Journal. 24th June, 2010. http://edlabor.house.gov/blog/2009/10/affordable-health-care.shtml Kruger &Mike. 22nd June. 2010. Recently in Health Care. Edlabor Journal. 24th June, 2010. http://edlabor.house.gov/blog/labor/health-care/ Read More