Health Care

Nepal has made important advancement in cut downing infant mortality in the last few decennaries. The infant mortality rate in Nepal has dropped from 113 per 1000 in 1987 to 48 per 1000 unrecorded births in 2006. However ; this diminution is non equal to run into the Millennium Development Goal ( MDG-4 ) .One of the grounds for this is, the hapless diminution in neonatal mortality rate ( NMR ) .The neonatal mortality accounts 69 per centum of IMR ( 33 in 48 ) .1 The MDG-4 can non be met unless we do more to cut down neonatal deceases, particularly in developing states in Africa and South Asia.2 Further betterment in infant endurance is critically linked to improved newborn endurance.

Each twelvemonth 4 million babes die in the four hebdomads of life – the neonatal period. That is more than 10000 deceases a twenty-four hours. Most of these deceases are live and remain unseeable to all. Virtually, 99 per centum of these deceases occur in developing countries.2

Government wellness services are non the chief contact points while they become sick. When unwellness occurs, a scope of local attention suppliers are available. Choices are made within a web of traditional and allopathic options that besides encompasses sensed costs, geographical and climatic restraints, and the clip of twenty-four hours, the type of unwellness, cultural and spiritual concerns and opportunity. Seeking of medical aid is done merely after supplier shopping. Family patterns and behaviour drama a cardinal function in the attention of newborn. Inappropriate eating and other patterns predispose neonates to hazard of complications and delayed acknowledgment of unwellness and delayed wellness seeking may take to a potentially preventable decease. Hence it is of huge value to understand community perceptual experiences about newborn wellness in order to invent behavioral alteration communicating schemes.

Newborn mortality remains a serious job in the underdeveloped universe. Every twelvemonth 30000 Nepali kids die before they are 28 yearss old.The state with a NMR 33 per 1000 unrecorded births has the 3rd highest neonatal mortality in the universe 1 The hazard of decease in the neonatal period in developing parts of the universe is more than six times the hazard in developed regions.3 To day of the month, Child endurance programmes in the development universe have tended to concentrate on Pneumonia, Diarrhoea, malaria and Vaccines preventable diseases, which chiefly causes deceases after the first month of life. In add-on Safe maternity programmes have focused chiefly on the female parent. Prevention of newborn deceases has been lost between kid endurance and safe maternity programmes.

Rationale for the survey

The pattern of appropriate wellness seeking has a great potency to cut down the happening of terrible and dangerous newborn unwellnesss. Information on the wellness seeking behavior helps the policy shapers set schemes to diminish the mortality due to Newborn unwellnesss. However, no such surveies have been reported from Nepal specially done Dalit community.

Newborns attention is one of the national precedence plans. Governments are get downing to include newborn ‘s demands in national wellness policies in conformity with the Convention on the rights of the kid and other international committednesss. A few states are developing specific policies for newborn wellness ; for illustration, Nepal, had developed National Neonatal Health Strategy ( 2004 ) , National Safe Motherhood and Newborn Health- Long Term Plan ( 2006-2017 ) and Community Based Newborn Care Package ( CBNCP ) 2008.

Improved family patterns and usage of services, frequently at the community degree, will increase newborn endurance. Behaviour, that is, attention for or usage of services by female parents and neonates, is cardinal. Therefore, this survey has been designed to measure the determiners of wellness seeking behavior for newborn unwellness in Dalit community, which will be a utile piece of information for policy shapers to put schemes to diminish newborn morbidity and mortality. Besides, it will be utile for the research worker to place the factors related to newborn unwellness and attention seeking behavior of Dalit community and hence develop farther research in this country. The intent of this survey is to measure wellness seeking behavior of the female parents during newborn unwellness and to observe the consequence of socio- demographic, socio-cultural, economic and disease-related variables, on female parent ‘s attention seeking behavior during newborn unwellness. The intent is to measure the grounds for preferred attention seeking behavior and female parents ‘ cognition about danger marks of Newborns.

Literature Review

Newborn Care

The female parent should take her newborn babe to the nearest wellness attention installation ( SHP ) if the babe has/is, hapless eating or suction, hapless call, refusal to feed, stiffness of the organic structure, xanthous stain of organic structure, fast external respiration, bluish babe ( bluish lips ) , discharge from the Umbilicus or eyes, hot or cold babe on touch, being born excessively early or excessively little at birth, grunting respiration, lassitude, diarrhea, etc.

About all believed in giving foremilks, although a few grandmas were against it, because they thought that it was old and stored milk, and therefore non good for the babe. Almost everyone believed in utilizing day-to-day addendums, H2O, or honey along with chest milk. Very few female parents expressed cognition about sole breastfeeding ; nevertheless, they were concerned that they may non be able to pattern due to the contrary sentiment of the grandmothers.

Causes of Neonatal Death

Estimates from 2000 of the distribution of direct causes of decease indicate that preterm birth ( 28 per centum ) , terrible infections ( 36 per centum ) , including sepsis/pneumonia ( 26 per centum ) , tetanus ( 7 per centum ) , and diarrhea ( 3 per centum ) , and complications of asphyxia ( 23 per centum ) history for most neonatal deceases. Of the staying 14 per centum, 7 per centum of deceases were related to inborn abnormalcies

Late neonatal deceases are chiefly due to infections. Case direction of neonatal infections is chiefly provided through child-health services, both in installations and through family-community attention. Remarkable advancement has been made in cut downing neonatal lockjaw, but riddance is an unfinished planetary committedness, originally scheduled for 1995, so broadened to maternal and neonatal lockjaw and postponed to 2005.12 Neonatal lockjaw is now responsible for a little proportion of planetary neonatal deceases ( 6 per centum ) and is about entirely a disease of the hapless. It is eminently preventable, but the universe looks set to lose the riddance mark for a 2nd clip, while turn overing out much more expensive intercessions, such as bar of mother-to-child transmittal of HIV/AIDS.

Problems in accessing wellness attention

On being asked about health-care seeking, most felt that it was appropriate to first seek home-based redresss and so seek medical attending. If medical attending was required, they preferred to take the kid foremost to the unqualified small town practicians and so to authorities infirmaries. Reasons for non taking a ill babe to the authorities infirmary included distant location, long waiting lines, and impolite and indurate behavior of the staff.

It is likely that Behavioural alteration intercessions and communications preparation of wellness services forces could potentially better opportunities for endurance if they result in neonates being seen quickly and serious unwellnesss being identified every bit early as possible.

Newborn – A National Priority

Government of Nepal developed a national newborn wellness scheme program to the twelvemonth 2017 through a advisory procedure, affecting representatives from diverse backgrounds e.g. , neonatology, safe maternity, and community mobilization. Although strong leaders are of import, the power of civil society, including the imperativeness, should non be ignored. Community authorization should be a basis of programme design.12 Involving and authorising communities-not simply aiming them-seems to amplify the consequence of intercessions 12 and increases answerability of clinical attention suppliers.

Dalit community – province of exclusion

Despite the best attempts of Plan Nepal to make them, many people within its programme countries have still non benefited. Those surveyed, peculiarly Terai Dalits rely about wholly on agribusiness. Unfair and exploitatory labor dealingss in the agribusiness sector contribute to the digesting want. More than 40 per centum of Madhesi Dalit families, in a province of practical bondage, depend on ; local money loaners, normally rich husbandmans, to survive.13 There are Madhesi Dalits 4.7 per centum of entire population Literacy rate of Dalit adult females was 11 per centum and life anticipation of Dalit adult females was 42.14 Dalits are most excluded, partially due to their deficiency of consciousness and partially to caste-based favoritism. Dalits have the highest per centum of unmet demand of contraceptive method about 35 per centum and 2nd last entree to Antenatal attention ( 58 per centum ) .14 These are the factors that Mothers and their neonates remains most vulnerable. Among Terai Dalits, although about all went to a wellness station, the pattern of health- seeking behavior is really really hapless. They go to wellness stations for immunisation but are loath to travel when they are sick.

Research Aims

General aim

1. To place factors impacting wellness seeking behavior for newborn unwellnesss in Dalit community of Sunsari territory

Specific aims

1. To place socio – demographic and socio – cultural factors act uponing the wellness seeking behavior for newborn unwellness.
2. To research cognition of female parents act uponing the wellness seeking behavior for newborn unwellness.
3. To happen out wellness seeking pattern for newborn unwellness.
4.  To measure the handiness and handiness of wellness services act uponing the wellness seeking behavior for newborn unwellness.

Operational Definitions

Health seeking behavior

Behavior of neonate ‘s female parent who consulted for aid and intervention of newborn unwellness from authorities wellness installations and private hospitals/clinics was known as Health seeking behaviour.

Dalit community

The socially excluded group of people given the name as Dalits such as Mushahar, Chamar, Paswan, Tatma, Khatway, Bantar, Dom, Chidimar, Dhobi, Halkhor are considered as Dalit community, as mentioned in ( Caste/Ethnic Groupings, Planning Commission )

Education of the female parent

It was defined as figure of schooling twelvemonth completed by the female parent. It included nonreader who can non read and compose and literate who can read and compose with formal schooling. Among literate, they were categorized as primary degree instruction ( formal schooling up to standard five ) , secondary degree instruction ( formal schooling up to standard 10 ) and above secondary.

Income position of the household

It was categorized on the footing of adequateness of the household ‘s income to feed their household. There were four class of income position such as:

1. Daily earning and day-to-day disbursal that has to gain day-to-day for day-to-day nutrient
2. Adequate for one-three months whose annual income was equal for one to three months to feed their household?
3. Adequate for four to six months, households that had income adequate for four to six months to feed their household.
4. Adequate for seven to twelve months, households that had income adequate for seven to twelve months to feed their household.

Knowledge of female parents sing symptoms of unwellness

Knowledge of the female parent was measured in footings of the figure of the right reply of marks and symptoms as reported by respondent and categorized it as hapless cognition, mean cognition and first-class cognition.

Mother

Mother holding kids less than 6 month of age of the Inaruwa Ilaka, Sunsari. However the inquiry was asked to the female parent about the first month of her baby.

Percept on behavior of wellness workers

The old experience of female parents with the behavior of the wellness worker.

Use of free services

It refers to the cognition about the handiness of free wellness services at Government wellness Institution, addition in the figure of visit by female parent of neonate from Dalit community after deduction of free services and the perceptual experience of service hr.

Percept on service Hour

Percept of wellness installation gap clip which is really frequently 10am to 2pm.

Appropriate attention

Care sought from qualified medical professionals in authorities wellness installations and private hospitals/clinics.

Inappropriate attention

Other type of attention such as buying medical specialties from pharmaceutics, place redresss, sing pharmaceuticss, temples and traditional therapists was defined as inappropriate attention.

Prompt attention

Any type of attention that was sought/given within 24 hours from the acknowledgment of the unwellness

Conceptual model

Religion

Education

• Age
• Occupation
• Economic Status

New Born Baby Care Practice

Knowledge of Mothers Regarding Symptoms of Illness

Socio Demographic and Socio Cultural

• No. of New Born Baby
• Aware of handiness of wellness service
• Health Seeking Behavior for Newborn Illness
• Transportation system
• Accessibility of Health Service

Household Decision Maker

Use of free service

Methodology

Study Design

A descriptive and cross-sectional survey design

Study Area

The survey will carry on in Inaruwa Ilaka of Sunsari District. The territory and Inaruwa Ilaka will be purposively selected for the survey. Sunsari territory is one of the eastern territories of Nepal consists of 15 Ilaka, 49 VDC and 3 Municipality.

III. Data aggregation technique

– Direct interview with female parents of babies.

IV. Data aggregation tools

– Pre tested structured and semi structured questionnaires will be used for direct interview

Sampling frame

Entire female parents holding kids less than 6 months of age of Inaruwa Illka from Dalits such as Mushahar, Chamar, Paswan, Tatma, Khatway, Bantar, Dom, Chidimar, Dhobi, Halkor are the sampling frame.

Sampling Design

Simple Random Sampling

Sample size

The entire no of Dalit female parents ( 150 ) holding kids less than 6 months of age from the choice countries are the sample size.

Ethical Considerations

Data will be collected merely after blessing from Research Committee, School of Public Health ( SRM University ) after taken permission from District Health Office, Inaruwa Municipality and Village Development Committee.

Consent of the caput of the household or Husband of the respondent and the consent of the respondent will be taken prior to roll up informations.

The information collect in the survey is merely usage for the survey purposes no individualized information will be exposed.

Restriction of the survey

Merely one Ilaka will be taken as the survey country and merely Dalit population are the survey population therefore the consequence may non be generalized to the big population. To obtain such information big graduated table survey is necessary.

Bias Reduction

Choice Bias Minimize

Randomization

Information Bias Minimize

Structural Inquirers

Confusing Variable Decrease

Mothers Having Baby less than 6 months of age

There has been increasing usage of Health Information Technology ( HIT ) into governmental and private wellness attention sector. The authorities has already spent plenty on federally regulated wellness industries for implementing HIT, and achieved favourable results. The private health care organisations like place health care, group place, grownup Foster attention, private patterns, and rehabilitation centres are the targeted centres for implementing HIT to better the quality of attention, lessening wellness costs and diminish medical mistakes. The execution of HIT has many possible positive effects, but it besides has few negative effects that have to be resolve in close hereafter. The demand of implementing HIT is increasing twenty-four hours by twenty-four hours because of deceitful activities may endanger state ‘s wellness. This research survey concludes that execution of HIT has possible to better state ‘s wellness attention services.

Section I: Definition OF THE PROBLEM

Background

The wellness attention system of United States began as a chiefly voluntary or generous system where patients paid small to no money for wellness attention services. Since its initial phases, this system has undergone some major alterations ( Thomas-Brogan, 2009 ) . Health attention has now evolved into a concern organic structure that requires considered planning, fiscal direction, equipped controls, and efficient fortes to keep its feasibleness in both governmental and private wellness sectors. Harmonizing to Thomas-Brogan ( 2009 ) , “ the wellness attention industry is one of the largest industries in United States, using over 13 million workers with the jutting addition of over 3 million new occupations by the twelvemonth 2014 ” . The mean life expectancy for U.S. citizen is 77.9 old ages of age, harmonizing to the National Center for Health Statistics. As the mean life anticipation bound additions, the aged citizens, which is the largest group of wellness attention consumers, will besides turn wellness attention industries ( Thomas-Brogan, 2009 ) . Due to current progresss in engineering and emerging jobs associated with efficiency and quality of wellness attention services, there are some chances to better quality life for underserved United States citizens through execution of information engineerings ( Moiduddin & A ; Moore, 2008 ) . The attending is being targeted towards the potency of Health Information Technology ( HIT ) in private health care industries to diminish wellness attention costs and to better quality, safety and efficiency of wellness attention services in United States of America ( kaiserEDU, 2008 ) .

Harmonizing to Miller ( 2005 ) , in 1999 the Institute of Medicine ( IOM ) surprised the American population with its estimation that between 40,000 to 90,000 lives were lost due to medical mistakes. While the IOM established a balanced facet of the root causes, many wellness attention organisations seized a solution to better quality attention of the patient: Computerized Supplier Order Entry ( CPOE ) . The effectual drivers of investing in HIT contain the promise of quality and efficiency additions.

Key privateness moralss for screening personal information have been in continuance for old ages and supply a charity for privateness Torahs, patterns, and policies ( Koontz & A ; Powner, 2007 ) . In 1996, the execution and ordinance of the Health Insurance Portability and Accountability Act ( HIPAA ) define the conditions under which an person ‘s privy wellness information may be used or disclosed. In April 2004, under the supervising of President Bush an executive order has been issued for the development and execution of interoperable HIT in both the populace and private sectors to better the effectivity of wellness attention services in United States, and developing the office of the National Coordinator for HIT ( ONC ) ( Koontz & A ; Powner, 2007 ) .

The barriers of execution of Information Technology ( IT ) include the beginning cost and complex construction of IT execution, which often requires important procedures and cultural alterations ( Medpac, 2004 ) . Certain features of wellness attention like payment policies and fragmented bringing system can besides present barrier for IT acceptance. Over cumbrous informations and deficiency of convenience of doctor besides considered as barriers for implementing IT system in wellness attention. Security and privateness issues for patient information besides can play function as barriers in wellness information engineering.

Statement of the job

There is grounds to propose that Health Information Technology has potential to better the quality of attention in state ‘s wellness attention services.

Purpose of the survey

The intent of this survey is to heighten readers ‘ consciousness about benefits available sing Health Information Technology in private wellness attention sector which could better state ‘s wellness and wealth.

Research Questions

The undermentioned research inquiries created the solid foundation for this research. The inquiry stated will assist to place how to utilize the information engineering in wellness attention system, what are the chief concentrated countries for the execution of HIT, and the negative and positive effects of HIT.

Does wellness information engineering have capableness to better the quality attention, cut down medical mistakes and wellness attention costs?

What are the positive and negative effects of implementing wellness information engineering in private wellness attention sector?

Definition of footings

Electronic Health Record ( EHR ) : “ The Electronic Health record ( EHR ) is a longitudinal electronic record of patient wellness information generated by one or more brushs in any attention bringing scene ” ( himms.org, 2010 ) . These electronic wellness records include patients ‘ demographics, advancement sheets, diagnosing and medicine lists, research lab consequences and radiology studies. These wellness records streamline the doctor ‘s work procedure.

Underserved U.S. citizens: Underserved U.S. citizens mean those citizens populating in U.S. still non having proper wellness attention services. The major features of this type of population are hapless ; uninsured ; have limited English linguistic communication proficiency ; lack acquaintance or complexness with wellness attention system ; and those who live in rural countries ( Koontz & A ; Powner, 2007 ) .

E-Prescription: E-Prescription is “ a prescriber ‘s ability to electronically direct an accurate, error-free and apprehensible prescription straight to a pharmaceutics from the point-of-care ” ( CMS, 2010 ) . In 2003, the constitution of electronic prescribing in the Medicare Modernization Act ( MMA ) was the first measure, and in July 2006 the Institute of Medicine developed the function of e-prescribing in diminishing medical mistakes, and helped to heighten the apprehension of e-prescribing in patient safety.

Computerized Physician Order Entry ( CPOE ) : CPOE is defined as a computing machine system that permits direct credence of medical orders by the professional who has licence and civil autonomies to make so. The benefit of direct come ining orders in COPE system is reduced mistakes by disregarding the uncertainness of hand-written medical orders ( CPOE, 2009 ) .

Clinical Decision Support ( CDS ) : Cadmium is a information system premeditated to better clinical determination doing sing patients ‘ diagnostic and curative advancement of attention ( Koontz & A ; Powner, 2007 ) .

Centers for Medicare & A ; Medicaid ( CMS ) : CMS is a federal bureau of U.S. Department of Health and Human Services, antecedently known as Health Care Financing Administration ( HCFA ) which governs Medicare Programs, Medicaid Programs, State Children ‘s Programs ( SCHIP ) , and other wellness portability plans. The Medicare and Medicaid were established through Social Security Act on July 30, 1965 by President Lyndon B. Johnson ( CMS, 2010 ) .

Restrictions

Due to the six hebdomads clip restraint, it would be deficient to carry on more primary and secondary research on current proviso of wellness information engineering in wellness attention installations. Therefore, the figure of research will be limited due to the short clip period.

Section II: Reappraisal OF LITERATURE

Introduction

Information Technology includes informations direction, networking, technology computing machine hardware, package design, database design and direction and disposal of systems. Information Technology uses electronic computing machine package which allows converting, hive awaying, protecting, processing, conveying and recovering the information in a unafraid manner. Information Technology allows sharing calculating power and split work load between different systems ( Hill, 2010 ) . Health Information Technology ( HIT ) is the wide model to depict the comprehensive direction of wellness information with the secure transmittal between wellness information consumer and wellness attention supplier. The wellness information engineering can be identified as the most promising tool to better the overall quality, safety every bit good as efficiency of the wellness bringing and receiving system ( NACCHO, 2010 ) .

The wellness attention system of United States of America consists of governmental wellness organisations and private wellness organisations. Implementation of Health Information Technology has been playing function since 1990s, but Congress could non accomplish success in implementing HIT in private sectors of wellness industries such as, place wellness attention, nursing places, grownup Foster attention, group places, place doctor services, pressing attention, rehabilitation plans, skilled nursing installations, etc. The wellness attention services in these countries count about 40 % of entire wellness attention outgo by wellness insurance companies. Even though available benefits by federal, many wellness organisations are non ready to utilize advanced wellness information engineering to better quality services.

The health care section of United States of America is puting over $ 1.7 trillion yearly in wellness attention services ; still the citizens are inundated with pathetic quality and inefficient services ( RAND Health, 2005 ) . The Institute of Medicine ( IOM ) , the National Committee on Vital and Health Statistics ( NCVHS ) , and other proficient panels have recognized information engineering as one of the most dominating cogwheels for cut downing medical mistakes, diminishing wellness attention costs, and educating the quality of wellness attention services. The end for these systems is to work impeccably as an component of a National Health Information Infrastructure ( NHII ) , which could ease wellness attention suppliers anyplace in the state to entree patient information at the point of attention ( Redhead, 2005 ) .

In early 1987, a particular study was published on infirmary information system at the Veterans Administration sing its efficiency. That early attempt was the gradual oncoming of wellness information sciences, but absence of advanced engineerings ceased down the early success. But strong attempts by the authoritiess and fiscal bond outs helped Health Information Technology to deep their roots into the land. The lone drawback of implementing wellness information engineering in little wellness industries and organisations is an expensive initial apparatus of engineering ( RAND Health, 2005 ) .

Most of the wellness attention suppliers need advanced information technological system to organize a patient ‘s attention with other wellness attention suppliers. This system transfers required wellness records, size up conformity with bar and disease direction rules, and buttocks and percolate up public presentations ( RAND Health, 2005 ) .

Each province in United States has its ain health care squad to implement Health Information Technology into their wellness attention system. Michigan is the great illustration which has good developed health care squad called the Michigan Health Information Network ( MiHIN ) ( MiHIN, 2010 ) . The MiHIN is initiated by State of Michigan to concentrate in betterment of quality wellness attention services, efficiency, and safety of the patients. The MiHIN is a joint venture by the Michigan Department of Community Health ( MDCH ) and the Michigan Department of Information Technology ( MDIT ) . The MiHIN is seting indispensable attempt in wellness attention suppliers to utilize electronic wellness records in a important manner that permits patient ‘s medical records to be available as it needed ( MiHIN, 2010 ) .

Why Healthcare System of United States Needs HIT

The wellness attention system of United States becomes more and more expensive, and the entire outgo by the wellness attention section is about $ 1.9 trillion or $ 6,500 per capita each twelvemonth. The relationship between the growing of wellness attention disbursement and current economic system is per se compound and multidimensional. The addition in wellness attention outgo can be considered as a weight on immense economic growing and as a driving force of local prosperity. At a local degree, the growing in wellness attention disbursement is viewed as good portion, because its creates more occupations in wellness attention sector, increases wage criterions, expands local grosss, and increases usage of wellness related goods and services ( U.S. Department of Health & A ; Human Services, 2004 ) . The tabular array 1 shows passing on wellness attention services in comparing with other disbursals such as energy, labour, pension, judicial proceeding and adoption in twelvemonth 2004.

Table 1. Greatest Cost Pressure on U.S. Businesss

Beginning: The U.S. Department of Health & A ; Human Services ( 2004 ) . The effects of Healthcare

disbursement on U.S. economic system. Retrieved March 17, 2010, from

hypertext transfer protocol: //aspe.hhs.gov/health/costgrowth/

The tabular array 1 sum-ups entire per centum cost of wellness attention services by authorities in comparing with other disbursals. In the twelvemonth 2004, the entire wellness attention outgo counted for 43 % from the whole governmental outgo. The sky-rocketing cost of wellness attention services and increased fraudulent activities by wellness attention suppliers played a large function in weaving off authorities histories.

The chief ground in holding HIT effectual into the health care system is to diminish the fraud activities and therefore lessenings healthcare disbursals. In the current health care market many wellness attention frauds were caught by FBI and Centers for Medicare and Medicaid. The biggest medical fraud was settled in June, 2003 paying $ 1.7 billion by HCA Inc – the health care company in amendss originating false claims to Medicare and other wellness insurance plans by federal. The proprietor of the company Bill Frist was involved in civil liability for fraud claims due to assortment of illegal activities, fraud charge and payment to doctors by hard currency kickbacks ( Bozita, 2009 ) .

Tools of HIT in Private Health Care Sector

There are different types of tools for implementing HIT into the wellness attention system for private patterns, such as Electronic Health Records, E-prescription, Computerized Decision Support ( CDS ) , and the Computerized Physician Order Entry ( CPOE ) . The usage of these HIT tools varies by their maps, and besides depends on the medical installation utilizing them consequently. The usage and benefits of these tools concrete in improved quality attention, diminish medical mistakes, and cut down wellness attention costs. And the description of part replies absolutely to oppugn one of the research. The description of the widely recognized tools is following:

Electronic Health Records

The Electronic Health Record ( EHR ) can be defined as the electronically available wellness records of a patient, created for speedy and easy entree for both, physicians and patient, at any clip with unafraid cyberspace sites, and created by one or more than one wellness attention suppliers. This record covers the patient history, get downing from present reference, immunization/vaccination, any wellness conditions, any medicines or prescription, advancement notes, medical trials conducted and its consequences ( HIMSS, 2010 ) . An first-class illustration for implementing EHR into the system is Palo Alto Medical Foundation ( PAMF ) which has all its patients ‘ information electronically saved into their database. The handiness of electronic wellness record at unafraid internet site of PAMF by their patients let them to see of import constituents of their medical records, reexamine the medical trial consequences and discourse it with doctors, petition electronic prescription and renew or do assignments ( PAMF, 2010 ) .

EHR besides allows doctor and office member of private patterns to remain off from documents and at finger tip they can hold the patient history in forepart of them as needed. Health attention suppliers are besides able to reexamine patient ‘s insurance information along with the charge information. Physicians are now able to mention the patient to specialist or surgeon if they want to supply expertness intervention. Before ordering any drugs, they can reexamine the patient history or information if any drug interactions are at that place ( PAMF, 2010 ) . The study conducted in November 2007 shows 63 % of 2153 U.S. grownups had agreed that the sharing of the electronic wellness record allow patients to have better wellness attention as a ground of now physicians and research workers are available to portion the information and same clip are able to extinguish the medical mistakes ( Bright, 2007 ) .

E-Prescription

E-prescription has been explained as the key to better patient safety and to cut down expensive medicine costs. E-prescription is an electronic way to compose prescription by come ining informations through e-prescription package and reassign informations to take parting pharmaceuticss. It is estimated that due to medical prescription mistakes around 7000 deceases occur every twelvemonth in United States of America. These mistakes are fundamentally due to hand-writing illegibility, false dose information, and missed medicine-medicine or medicine-allergy reactions. Around 3 billion paper based prescription written yearly, which counts the biggest paper-based concerns in United States of America ( Pennell, 2009 ) .

The construction and map of the e-prescription package are setup with full of benefits and extraordinary characteristics. The warning and watchful system of the package provide guidelines on holding the incorrect information on the prescribed drugs. The package is equipped with medicine direction procedure with the aid of Drug Utilization Review ( DUR ) plans. The DUR plans check patient ‘s current medicine program for drug-drug interactions, drug-allergy interactions, multiple diagnosings, right dose of prescribed drugs, inauspicious effects, etc. Many of the new soft-wares can besides entree patients ‘ program of wellness with the diagnosings and intervention at a clip of ordering drugs as an qui vive if there is any drug wrongness ( Pennell, 2009 ) .

The private patterns and place wellness bureaus receive 1000000s of phone calls from pharmaceuticss sing the prescribed medical specialties, doses, and refill petitions. An E-prescription helps to cut down the phone calls and call-backs for pharmaceuticss and physician ‘s offices. The study conducted in 2003 by Medco Health Solutions has ruled out that doctors and the staff of doctors ‘ offices in Boston spend one tierce of their office clip in replying pharmaceutics phone calls, facsimiling prescriptions, draw out charts, replenishing charts, call-backs which reduces office work flow and productiveness ( Pennell, 2009 ) .

Harmonizing to Pennell ( 2009 ) , it is estimated that 20 % of the hand-written prescription orders go lost and ne’er filled by the patient at pharmaceuticss. But the e-prescription systems increase patient conformity by progressing the filling of prescription and provides drug literature printed to the patient. It besides helps patients to better formulary attachment by look intoing generic substances at point of attention. It increases patient convenience by cut downing their visits to pharmaceuticss and diminishing their waiting periods ( Pennell, 2009 ) .

Recent study by Pamela Dolan ( 2010 ) describes a important rise in the figure of wellness attention suppliers who prescribe medicine electronically. In private wellness attention sector, there is merely one doctor out of four seeking to utilize e-prescription. The Surecripts, state ‘s largest e-prescribing web, released advancement study which shows important advancement in utilizing e-prescription. Table 2 shows the drastic rush of Numberss of wellness attention suppliers utilizing engineering from 2007 to 2009.

Professionals of Implementing HIT in Private Healthcare Sector

The usage of computing machines and electronic devices enables doctors and other wellness attention suppliers to administer and entree medical records ( Bihari, 2010 ) . Health Information Technology helps to acquire the higher quality attention and is readily accessible by physicians at any location. As all the information is electronically available, physicians can rapidly entree to patient history any clip. This electronic information eliminate paperwork and the same clip cut down the storage infinite and cut down staff clip to keep medical records. As a consequence it helps wellness attention concerns to cut down costs and clip ( Wangia, 2009 ) .

An electronic wellness record provides information about any immunization/vaccination that has been taken in past and any medical trials that have been conducted in past with its trial consequences. Therefore, it is easy for physicians to happen whether the immunization/vaccination or medical trial was already done or non and money salvaging for the patients, as they do n’t necessitate to reiterate the immunization/vaccination or medical trial ( Bihari, 2010 ) .

The Health Information Technology provides evidence-based reviews to the doctor about any type of radiological trial order to patients, and happening out whether the patient had that earlier or non with its consequences ( CBO, 2008 ) . This finally helps to command the costs. The electronic wellness records of infirmaries, which include the Clinical Decision System ( CDS ) every bit good as the Computerized Physician Order Entry ( CPOE ) to cut down the cost of prescription drugs. The electronic wellness records allow doctors to look into the list of medicines patient return, list of possible drug allergic reactions ( if any ) and any drug interactions or reaction of medicine. Therefore, physician before ordering any drug or medical specialty can travel through the electronic wellness record of patient to avoid or to minimise the hazard of any drug interactions or reactions ( CBO, 2008 ) .

Besides these, the Health Information Technology ( HIT ) with the electronic wellness records allows patients to hold active entree of wellness attention records of medical history and intervention. This besides allows to see the refill a prescription and to reexamine any conducted medical trial consequences. Thus an electronic wellness record allows patients to discourse wellness job with the physician on phone without seeing really ( Bihari, 2010 ) .

Harmonizing to 2005 drumhead study of infirmaries, because of wellness information engineering, the nurses have less paperwork and they use the saved clip productiveness work such as assisting patient to acquire appropriate preventative attention, supplying better instruction about their heath, etc ( CBO, 2008 ) . However the electronic wellness records of Health Information Technology are available on a really unafraid web that means it has strong privateness available. This allows a patient to inquire concerns to the physician by electronic mails without any vacillation. The electronic mails are merely accessible by physicians, which reduces the transmittal mistake of accurate information electronically every bit good as cut downing the opportunities of error that may happen while one misread physician ‘s script. The electronic wellness records of Health Information Technology cut down the duplicate hazard of any wellness attention supplier ‘s diagnostic process ( Wangia, 2009 ) .

Improvements in Governmental HIT Sector

The President Clinton and President Bush had besides applied compulsory usage of HIT in 1999, 2003, 2008 and now President Obama made it confirmed that by 2012 each and every medical installation must utilize wellness information engineering into their system. The Congress had declared bundles many times to deep the root of HIT into the system to do it truly effectual in bettering quality attention throughout the state, but merely the half success is achieved.

An electronic wellness record is a systematic record of electronic wellness information of a patient and allows an person to hold large scope of informations in comprehensive or drumhead signifier such as medical history, medical conditions, allergic reactions or reactions of any medical specialties, immunization/vaccination taken, medical trial consequences every bit good as charge information. Therefore, late the quality of wellness record in the Veterans Hospital has improved a batch. Millions of pending or inactive documents are now active and are resolved. These were possible merely because of the electronic wellness record of wellness information engineering ( Goldstein, 2009 ) .

An employee of Cedars-Sinai Medical Center in Los Angeles, was working in the charge section and was involved in the offense of stealing of patients ‘ record and earned tonss of money by victimizing the insurance companies or by bear downing patients for the intervention that they ne’er received it. But due to the handiness of electronics records both by patient and the physicians, this type of offense or fraud are now evitable easy and rapidly ( Goldstein, 2009 ) .

Cons of Implementing HIT in Private Healthcare Sector

Even though the wellness information engineering have rationalized the concern procedure, it has besides decreases occupation, downsizing every bit good as outsourcing of employees, these all leads to unemployment overall. For illustration, due to the wellness information engineering, there is less paper work for office employees which means with lesser figure of people the same sum of work can be done. And people start losing their occupations as there is no excessively much paper work to make.

Besides the quicker, easy and convenient communicating by the wellness information engineering, there are opportunities of interceptions to e-mail hacking. And besides people do non desire that their personal information is going public accessible. For illustration, to salvage their ain clip people send an electronic mail to their physician about their concern inquiry for their wellness and the electronic mail hacker can read their personal information in electronic mail and do it available for general populace. Therefore, sometimes people get more disquieted with electronically available information.

However, as per the research survey conducted by Richard Hillestad and associate members at RAND, the Las Vegas Sun reports the execution of an Electronic Health Record ( EHR ) system would take about 15 old ages countrywide and initial puting cost of an Electronic Health Record ( EHR ) system in hospital apparatus is about $ 98 billion and in doctors is about $ 17 billion. This means that the mean annual cost in hospital apparatus is $ 6.5 billion whereas the mean annual cost in doctors ‘ apparatus is $ 1.1 billion ( MediLexicon, 2005 ) .

It is in general being said by the industry experts that today ‘s biggest issue of occupation security is due to the cyberspace engineering. In the universe of invariably altering engineering, people have to do their egos cognizant and update about it, otherwise it would be hard to work for them and finally they lose their occupations. For illustration, the aged staff members at physicians ‘ office have to larn this electronic heath record maintaining system or they might lose their occupations because of non able to execute accurately. This besides relates to elder patients, who do non hold any thought about the computing machine systems and can non entree their personal information at a peculiar clip.

As technological progresss take topographic point twenty-four hours by twenty-four hours, there is besides a menace of cyberspace viruses any minute on computing machine systems. Peoples learnt a lesson in earlier yearss, when Y2K virus infested many computing machine systems, and wipe out all informations from difficult thrust. If this could go on to damage patients ‘ informations in infirmaries, so there is no usage to hold wellness information engineering to continue medical records updated ( Koffey, 1999 ) .

Some advocates sustain that put ining Health Information Technology ( HIT ) system in doctor ‘s office or private infirmary apparatus is harder and complex than put ining merely a Health Information Technology ( HIT ) system or package in a computing machine and connecting to the Internet Explorer ( NCPA, 2010 ) .

The Health Information Technology ( HIT ) is fundamentally manus held device, intending the electronic wellness record is maintained and updated by worlds into the computing machine. Therefore, there might be possible opportunities of holding an mistake during the information direction. There might be possibility of an mistake during come ining the study or consequence of any medical trial consequence, which at later may do bigger or unsafe jobs. For illustration the medical trial consequence of X individual says the blood sugar degree is 120 and by misidentify the individual who come ining the information in the system typed 210, which means individual X is diagnosed with higher sugar degree and considered as diabetic patient.

President Obama ‘s HIT Contribution in Healthcare Reform Plan of 2010

The current economical drawback and increased fraud, maltreatment and waste in wellness attention disables consumers from acquiring economical medical benefits and leads to worsen in quality of wellness attention ( Hasan, 2010 ) . One of the biggest challenges for United States of America is to finalise scheme and thoughts which help consumers holding medical benefits with quality and economical coverage in private wellness attention sector. The recent scheme of President Obama is to welcome and appreciate any thought which can diminish the wellness attention outgo, bring quality attention, cut down fraud and maltreatment, and gives consumer pick of health care.

The Major Constraints

The major restraints in President Obama ‘s Health Care Reform Plan are ( Hasan, 2010 ) :

Low-cost, Portable, and Quality Health Coverage for All

Standardizing and Overhauling the U.S. Health Care System to Lower Costs & A ; Improve Quality

Promoting Prevention and Strengthening Public wellness

Description & A ; Coverage

The President Obama ‘s vision to the health care system is so concrete that non even a individual U.S. citizen suffers from unequal health care. President Obama ‘s estimated cost for health care reform program is about $ 50 to $ 65 billion. The existent measure provides $ 5 million to Centers for Medicare & A ; Medicaid ( CMS ) in 2010 and $ 10 million every twelvemonth from 2011 to 2019 ( Brewin, 2010 ) . The health care reform program caters investing in HIT aimed at dropping extreme disbursals that occur from decreased medical mistakes and weave off uneffective paper-based charge system. The health care program ‘s chief docket is to give cosmopolitan wellness insurance which will decrease unsalaried health care services ( Hasan, 2010 ) .

Benefits to HIT of Private Healthcare Sector

The wellness reform measure calls to innovative centre construct up for inveterate sick patients. With the aid of wellness Information Technology, patients ‘ coordination of attention would be managed by a web of suppliers connected to a chronic disease register and tele-home wellness services. For an illustration, about 20 million U.S. citizens suffer from Diabetes, and for them tele-home wellness engineering provides patients to relay blood sugar degrees to their primary attention suppliers through remote glucose metres. The statute law provides $ 5 million every twelvemonth from 2011 to 2015 to develop the autonomy at Home Medical Practice Demonstration Program, which could incorporate homecare visits by doctors, distant patient monitoring and nomadic diagnostic machines. One of the centre parts of the program is that each household will salvage around $ 2,500 every twelvemonth ( Brewin, 2010 ) .

Critics

The chief critic is sing to make another plan for the citizens under age of 65 or merely like Medicare is itself an expensive thought, which would do cost switching instead than cost decrease. President Obama besides wants to give more power to governmental plans like Medicaid and State Children ‘s Health Insurance Program ( SCHIP ) . Another point of treatment is about doing an investing in HIT and sing HIT is an of import component of cost control scheme of the program. Obama finds the lone manner to decide these issues is important usage of wellness information engineering ( Hasan, 2010 ) .

Drumhead

The private wellness attention sector of United States of America is at hazard due to increasing demand, intensifying costs, inconsistent wellness attention services, and inactive coordinated wellness attention systems. The groundss show that wellness information engineering can better the efficiency, cost effectivity, quality, and safety of wellness attention release by doing proper rules available to doctors throughout the wellness attention web. The wellness information engineering consists of different types of tools such as Electronic Health Records ( HER ) or Electronic Medical Records ( EMR ) , E-prescription, Computerized Physician Order Entry ( CPOE ) , Clinical Decision Support ( CDS ) which have their ain functions to play consequently to better the wellness attention system in general. Though there are more positive effects of implementing HIT in private wellness attention sector, but some negative effects are besides present to blockade the complete success.

Section III: Methodology

Data Collection Method

This research will use primary research methods to back up secondary research database with the aid of on-line databases. The secondary research methods include scholarly diaries, magazines, articles, intelligence paper, and texts will be used to back up the results of primary research database. The major portion of this research will be drawn from appropriate old surveies and well-performed researches that evaluated several facets of implementing wellness information engineering in governmental health care sector and private health care sector. The information aggregation method will be performed to find the possible success of implementing wellness information engineering in private health care sector.

The on-line resources and studies conducted by different writers will be considered to measure the usage of wellness information engineering into their system. The demand of technological progresss into the wellness attention system of private patterns will be gathered on a proper manner to happen out the hereafter obstructions. Besides the informations aggregation method will assist to happen the grounds for hold in implementing HIT into their system.

This research will besides assist to happen the ways to set e-prescription system effectual to work in private wellness attention sector to diminish hand-written prescription mistakes. The usage of electronic medical records besides can be evaluated easy in private wellness attention sector though research work.

Section IV: Analysis OF DATA

Evidence suggests the chances for implementing HIT is bit by bit lifting in United States health care system from governmental health care sector to private health care sector. The little private patterns and place health care bureaus have besides started seting more attempt in utilizing HIT tools to better the quality attention countrywide. The research inquiries have given solid foundation to this research undertaking and happening the nutshell was the nucleus intent of this research undertaking. These research inquiries were analyzed below:

Section V: SUMMARY, CONCLUSION, AND RECOMMENDATIONS

Drumhead

The wellness attention system of United States of America is confronting economic drawback in present clip, and truly needs reform in wellness attention engineering to better quality of attention and decreases cost and medical mistakes. The President Obama ‘s wellness reform measure boosted up the execution of wellness information engineering in both governmental and private wellness attention sector. The current governmental scheme seting more attempt in usage of advanced engineering into health care system to accomplish success by cut downing sky-rocketing wellness attention expenditures. The old bailout bundle counts around $ 19 billion helped a batch in implementing wellness information engineering in governmental entities.

The different signifiers of HIT are Electronic Medical Records ( EMR ) , E-prescription, Computerized Physician Order Entry ( CPOE ) , Clinical Decision Support ( CDS ) , etc. are really utile tools and are really easy available to put up into the system these yearss. The initial set up is small expensive, but President Obama ‘s bundle offers fiscal aid for utilizing wellness information sciences. For an illustration, if any private physicians ‘ office wants to utilize EMR or E-prescription package, the package company will be paying to the company excess money at certain continuance on annual footing.

Despite of first-class benefits such as capablenesss to cut down medical mistakes, utmost cost benefits, reduces paper-based system and thinks environmentally green, better quality of wellness attention services ; though execution of HIT has some negative effects and more researches are traveling on to diminish the cost for initial set up and do safer transit of computerized medical informations. With the aid of telephonic interviews and secondary resources, the research can do solid decision on possible benefits of implementing HIT in private wellness attention sector.

Decision

In decision, the execution of wellness information engineering has been turning from governmental wellness attention sector to private wellness attention sector. The potency of HIT has been achieved by implementing it into the wellness attention system with proper planning and proper vision. In governmental wellness attention sector, execution of HIT has reached to the success by diminishing medical mistakes, cut downing costs, and bettering quality of attention. The execution of HIT in private wellness attention sector besides has the same capablenesss to accomplish the success in affair of quality services and diminishing medical frauds. However, there is no cogent evidence that all private patterns and place attention bureaus can take active portion in implementing wellness information engineering.

Recommendations

Based on the findings of this research survey, there are some recommendations which should be implemented in private wellness attention sector for better result. In information analysis, most private patterns and place wellness attention bureaus agreed to utilize HIT tools to diminish the medical mistakes and better quality intervention. The President Obama ‘s program besides has possible to set adequate attempt, but there is no surety in following regulations and ordinances by private wellness organisations.

The major recommendation is to set compulsory statute law for implementing wellness information engineering into their system to acquire choice consequences. There must be formation of a jurisprudence or the authorities has to go through a sentence for conformity to utilize HIT tools, and breaching of an Act cause important mulct or penalty. This will take definite consequences in bettering quality of attention by utilizing wellness engineering in proper manner.

Other recommendations include mandatory application of wellness information engineering package for e-prescription. At least an applicable tool for e-prescription saves possible hand-written prescription mistakes and deceases occurred from these types of mistakes can be lower down finally. The same manner, EMR besides can be implemented for safety transportation and to keep the confidentiality of patients ‘ medical records.

The authorities will besides do a database which can salvage all medical records of the patients countrywide. So, that manner if something happen to any private wellness organisation so at least authorities has entree to all informations and safety sedimentation of medical records can be achieved easy.

The authorities besides has to do a HIT tool for electronic charge for private patterns, so they can diminish paper-based procedures and think green environmentally. This will besides take to diminish deceitful activities by the wellness attention suppliers at private patterns and place wellness bureaus.

“Every information exchange is a communication act, whether it is the exchange that occurs between two people or two machines. Communication can be studied at the level of the interaction between individual agents, or as a set of processes that coordinate different health services” (Elsevier Ireland, 2005, para. 1). These concepts of communication are applicable in every unit of the society, particularly to organizations. The health care systems and organizations are among those where communication plays a very vital and critical role.

“Communication systems are a crucial component of the information infrastructure of any health care organization, not just as pipes through which information flows, but as the systems where humans share, discuss and eventually decide upon clinical actions. Communication research in health care thus deserves a seat at the high table of health informatics, not just because we want to improve communication, but because by understanding communication, we better understand the role of the information systems we are so keen on building” ((Elsevier Ireland, 2005, 3).

The health care organizations however, have evolved in as much as the changes in the societies. As the societies have gradually become multicultural and multi-ethnic, so have the health care organizations. These changes have emerged due to the global migrations between nations. “The health professional/client relationship is changing. The once passive receiver of care is transforming into an active and informed participant in health care. This client wants to be informed about and involved in the medical decision-making process.

Consequently interactions with consumers are no longer limited to the face-to-face consultation, but now use every communication medium possible, and increasingly use e-mail” (Elsevier Ireland, 2005, 1). On top of these migratory and multicultural evolutions is the fact that a healthcare organization is composed of various players or actors. Hence, communication occurs among different characters which may be coming from different cultures, and probably with different languages.

In a typical healthcare organization, we have doctors, patients, managers, supervisors, nurses, attendants, surgeons, pharmacists, clerks and many others. For every patient or medical case, every one of these positions communicates and transacts with the patient and/or his escort in the hospital. The more players and roles, the more complex the communication process becomes. The more diverse the cultures and languages, the more difficult the communication process would be.

“Underlying this effort is the belief that understanding and being understood is a critical component in ensuring equal access to, and quality of, health care for all patients. Developing effective communication between physician and patient who speak different languages and who come from different cultural backgrounds is, therefore, an integral part of the effort to reduce or eliminate health disparities” (National Center for Health Statistics, Healthy People 2000, 2010 cited in Lee, S. 2003, 4).

Gender and Cultural Barriers in Communication in a Health Care Organization The two vital factors which can affect the effectiveness a communication process in a healthcare organization are cultural barriers and gender differences. “The effects of cultural differences on health care use are similar to those of language: cultural differences often translate into cultural barriers that lower access to health care. However, the research on cultural barriers on access or use of health care is not as extensive as research on language barriers.

The role of culture is mostly explored in terms of quality of care” (Lee, S. 2003, 7). “The growth of the culturally and linguistically diverse population has led to many efforts to encourage or ensure that health care systems respond to the distinct needs of culturally and linguistically different patients by becoming “culturally competent” (Fortier et al. 1998; U. S. Department of Health and Human Services, Office for Civil Rights 2001; U. S. Department of Health and Human Services, Office of Minority Health, Closing the Gap 2001 cited in Lee, S. 2003, 4).

“Overcoming the language barrier is a major step in effective communication with her Vietnamese-speaking patients, but cultural differences can still affect the patient-doctor relationship” (Lee, S. 2003, 7). “If there is cultural discordance between doctor and patient, effectiveness of communication is expected to be lower. Communication is additionally influenced by how familiar each is with the other’s cultural background. The higher the degree of cultural knowledge and familiarity each has of the other’s culture, the more effective the communication.

If there is language discordance, then effectiveness of communication is reduced, and is further influenced by how proficient each is in the language of the other. The more proficient each is in the other’s language, the more effective the communication. ” (Lee, S. , 2003, 16). As observed in many healthcare organizations, there seems to be insignificant difference in the effectiveness of communication in relation to gender. This is in contrast to the “” communication theory.

Moreover, Lee says, “There is little evidence on the effects of gender concordance on communication and health care, although the research is thin on this issue” (Lee 2003, 15). What Can Be Done to Improve the Situation? The effectiveness and accuracy of communication systems in health care organization is illustrated by Coiera in the following excerpt, “The sheer scale and complexity of these interactions within the healthcare system puts a heavy burden on the process of communication, and miscommunication can have terrible consequences.

Not only is the communication space huge in terms of the total information transactions and clinician time, it is also a source of significant morbidity and mortality. Communication failures are a large contributor to adverse clinical events and outcomes. In a retrospective review of 14,000 in-hospital deaths, communication errors were found to be the lead cause, twice as frequent as errors due to inadequate clinical skill. Further, about 50% of all adverse events detected in a study of primary care physicians were associated with communication difficulties” (Coiera, 2006, p.

90) Hence, we need to adopt effective strategies to overcome cultural, language and slight gender barriers and issues. ” Effective communication between patients and physicians who are culturally and linguistically different implies the employment of strategies to provide culturally competent health care, such as those described by Brach and Fraser, 2000 as cited in Lee, S. 2003, 4. “At the administrative level, the poor communication of information can have substantial economic consequences.

It is now clear, for example, that the healthcare system suffers enormous inefficiencies because of the poor quality of communication systems that are often in place” (Coiera, 2006, p. 91). The Communication Accommodation Theory can be applied in the communication systems in a healthcare organization. “This theoretical perspective examines the underlying motivations and consequences of what happens when two speakers shift their communication styles. Communication Accommodation theorists argue that during communication, people will try to accommodate or adjust their style of speaking to others.

This is done in two ways: divergence and convergence. Groups with strong ethnic or racial pride often use divergence to highlight group identity. Convergence occurs when there is a strong need for social approval, frequently from powerless individuals” (McGraw Hill Companies, Defining Communication Theories). Some basic strategies that can be applied include the conduct of multicultural orientations on language, gender, traditions and beliefs. These orientations can help the hospital staff in dealing with issues on these areas.

Another strategy would be to hire personnel and health care workers coming from various cultures and who can understand and speak other languages. References Toussaint, P. J. and Coiera, E. (Eds. ). Supporting communication in health care. International Journal of Medical Informatics. (10 Jan 2005). Elsevier Ireland Ltd. Retrieved from http://www. intl. elsevierhealth. com/journals/ijmi. The McGraw-Hill Companies. Defining communication theories. 2001 Lee, S. M. , Ph. D. June 2003 (Rev.

) A review of language and other communication barriers in health care. Assessing the impact of physician-patient communication barriers on health care costs and quality. Office of Minority Health (OMH), Office of Public Health and Science OPHS, US Department of Health and Human Services. Department of Sociology, Portland State University. Coiera, Enrico. (May 2006). Communication systems in health care. Clin Biochem. (27:89-98). Centre for Health Informatics, University of New South Wales.

All major business organizations dealing with economic conditions of uncertainty, opportunity costs, and scarce or depreciating resources have to develop capital budgets. The three major steps to developing a capital budget are: conducting a decision analysis to establish a base for knowledge building, establishing option pricing to secure an accurately assessed market position, and creating discounted cash flow (DCF) for making appropriate investment decisions for the organization.

No organization can manage capital projects by simply looking at the numbers of discounted cash flows. A financial analyst for any organization must look at the entire decision and assess all relevant variables and outcomes within an analytical hierarchy. Decision-making regarding capital budgeting is increasingly complex today because of uncertainty, particularly in the health care environment where safety assessments of pharmaceuticals, health care insurance allotments, and other factors may affect the future of the organization. All capital projects will involve numerous variables and possible outcomes-but health care perhaps more than most. (Evans, pp.1-2)

In the second phase of capital budgeting, financial management, or consideration of options within capital budgeting is called contingent claims analysis or option pricing. Timing (when to enter certain ventures), abandonment (what past ventures to discontinue) and growth (what ventures to expand upon) are all critical-one must ask such questions as, what aspects of health care in the organization are revenue-producing and/or necessary to the community, what areas are more necessary at certain times of year, and what can be discontinued? (Evans, p.3)

Discounting refers to taking a future amount and finding its value today. Future values differ from present values because of the time value of money. Financial management recognizes the time value of money because of inflation, uncertainty, and opportunity for investment. Thus, the more uncertain the economic environment or industry, the more necessary such revenue analysis becomes-and hence, once again, the necessity of such capital analysis for health care.

Health Care Communication Methods 1 Health Care Communication Methods Edilia Ramos HCS/320 August 27, 2012 Kim Foster Health Care Communication Methods 2

A communications coordinator is known as a marketing professional that coordinates organizations both internally and externally. This type of occupation is a key role in an organizations reputation with the employees and within the general public. Communications coordinator may work directly for an organization or for an agency that may specialize in public relations or marketing. Health Care Communication Methods 3

There are advantages and disadvantages of using traditional, electronic, and social media for health care communication. Social media these days can raise awareness, and increase knowledge of an issue. Traditional communication and social media may not be able to meet all of the communication goals that are being addressed, or be able to target all of the audience’s needs that are being requested. Due to the recent outbreak of negative side effects that have been reported to the national drug manufacturer there are several ways that I will reach out to the media in reference to the situation at hand.

There are traditional, electronic, and social media forms of communication all at each will be provided the proper information as to what has been done to correct the problem that has been brought forward. The modern mass of communication would include the newspaper, radio, television, and telephones which would be the first to be told of the situation and what is going to be done to fix the reports of the negative side effects that have been reported.

Traditional communication has come a long way from story-telling, myths, and carvings on monuments to the middle ages in which came the radio, and then onto the internet. Due to the severity of this situation and the importance that needs to be sent out in a timely manner, I am first going to call the television reporting stations within the local areas first seeing that everyone watches their tv’s and that would be the fastest way to get this information out to the public next to the newspaper company, and radio stations that would follow.

Health Care Communication Methods 4 The information that was provided to the national drug manufacturer and the effects that have been brought forward are very important to us and the reputation of the company along with the health of the many American’s that take this product. The advantages of traditional, electronic, and social media have enabled us in so many new methods of communicating all in one in which technology has integrated mobile phones with internet, television, email, and text messaging all in one.

These are some of the advantages that have derived from the advanced technology in communication, and are of the easiest forms of communication that is able to be seen and viewed by many people all over the world. Electronic communication is also one of the easiest ways to communicate because it lets you combine numerous media text, graphics, sound, and video all into one message. With the internet you are given the ability to transmit and receive large messages of information to and from individuals along with workgroups quickly and in a timely manner.

Social media has become world- wide within today’s society and is the most commonly used websites that people are using frequently today and they include twitter, google, myspace, and the infamous facebook that is being used by people of all ages. This new era brings pros and opportunities seeing that in the past you had numbers of or contacts of how people generally got ahold of you, and today with the large part of social media here are many different levels of communication each with a specific purpose. Only you are able to limit the people that know and have your information Health Care Communication Methods 5 and can see what you post on any profile. Therefore social media has made it easy for the national drug manufacturer to be able to become a social media website and post and information that is needed and wanted by its viewers.

In this case this type of communication has many pros in the way it can send out information to people all over, targets a wide audience, effective recruitment tool, facilitates open communication, and you are able to deliver communication to the specific person it is intended for. The disadvantages of electronic, and social media is that it increases the risk online scams that seem real, possibility of hackers committing fraud , and negative comments that can be seen about the company in which they may not be true.

It has become more popular to receive a telephone call, or a text message verifying an appointment or a prescription pickup and if a person has changed their telephone number or even their email address someone else is going to receive that information that belongs to another person and that could contain some personal information in which the HIPAA regulation comes into effect.

HIPAA also known as the health insurance portability and accountability act went into effect April of 2003 in which the purpose is to protect the patient’s privacy pertaining to their individual health information. HIPAA gives the patient the right to obtain copies of their medical records so that they are able to go over the information on it and correct any errors that they may find. “All healthcare providers are required to comply with the HIPAA privacy rule. The basic requirement of this rule is that a covered entity may only

Health Care Communication Methods 6 use or disclose an individual’s protected health information for treatment, payment, or health care operations or other noted exception’s as permitted or required by the rule. ”(www. courseslearningsomething. com/script2) “HIPAA imposes the following limits on the situations in which employer group health plans may have preexisting condition exclusions and the length of time that such exclusions apply”(HIPAA and other laws, chapter 10, pg. 2) A list of pros and cons have been listed and described in the areas of communication related to traditional, electronic, and social media. In any event the privacy of the patient or individuals that may be involved will be kept according to the HIPAA law that prevents such information being given out. Health Care Communication Methods 7 REFERENCES HIPAA and other laws, chapter 10, pg. 12 www. courseslearningsomething. com/script2

lI believe that technology is both good and bad in the healthcare field. With technology constantly changing, there is no end to what we can do. Technology allows us to use computers or computerized systems to collect, process, and store pertinent data. It also allows up to progress to the future with the machines we use in the healthcare field. Some of the upsides are better record keeping, data analysis, and convenient documentation which can provide more prompt medical billing. Patient security and safety is a concern with all advances in technology.

After all, without the patients, what business would the healthcare field have? Technology via machines that are used are constantly progressing. These can be very good in the development of better machines to help to aide patients in better treatment and less lengthy hospital stays. There are downsides to technology in healthcare though. Let’s think for a minute. What causes errors in healthcare technology? Human error. This can be via inadequately trained, inexperienced, tired, or even cases where people don’t admit they made a mistake.

How about faulty equipment or programming? If a machine or program is not running properly then it isn’t going to give the right results. One thing for sure is that there has to be constant monitoring and troubleshooting to maintain a safe environment for both the patient, the hospital or facility, and also for the companies who make the products we use in the technological aspect of healthcare. With technology being a definite for the future, I think it’s just a wait and see thing as to whether it ends up being better or worse.

Electronic Data Interchangehas helped evolve the healthcare market for claims management and supply chain management to depend from paper based to electronic based mode of transactions. The benefits associated with the use of EDI such as cost reductions and reduced time of transactions has helped improve the acceptance of this technology in the healthcare market. In this report the global healthcare EDI market is broadly segmented by components, type of transactions, end-users, and mode of delivery.

The market based on components are further divided into EDI software and EDI services, whereas, the type of transactions are vided into claims status, eligibility verification, payment remittance, referral certification authorization, enrolment/disembowelment transactions, and premium payments. On the basis of end-users the market is sub-segmented into healthcare payers, healthcare providers, and medical equipment/accessories suppliers. Based on mode of deliveries, the market is divided into web-based DE’, point-to-point DE’, mobile DE’, EDI VAN, and EDI via ASS.

Inquire before Buying @ http:// www. lifescienceindustryresearch. Com/inquire-before-buying? Rename=11357 . Over the past few years, the healthcare EDI market has shown a substantial growth. The arrest is expected to grow at a CARR of 13. 7% from 2013 to 2018 to reach $1 ,681. 1 million by 2018. EDI has been increasingly embraced by the healthcare industry, and is experiencing a growth due to various advantages associated with its use like reduction of the administration costs, reduced errors and time for transfer of claims, and initiatives by various governments.

The passing of the Beamer Act in 2010, in the United States has mandated the use of enrolment/disembowelment transactions between the payers and providers in the U. S. , with the North American market contributing the maximum share of the global healthcare EDI market. The European market also occupies a significant share of the global healthcare EDI market, with the Asian regions showing the maximum growth due to various factors like large population, growing burden of diseases, and government initiatives for the support of healthcare IT in these regions.