Medical Law and Ethics

After taking this course, reading Chapter 13, and also considering your experiences in health care, what do you consider the most important trends in U.S. health care moving forward? Please discuss at least two major trends that you can anticipate.

SEE ATTACHED STUDY GUIDE FOR CHAPTER 13 BELOW⬇️

REPLY TO OTHER STUDENTS COMMENT. SEE ATTACHMENT BELOW TO REPLY⬇️

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Course Learning Outcomes for Unit VIII

Upon completion of this unit, students should be able to:

1. Describe the legal and ethical aspects of healthcare information.
1.1 Describe the major stakeholders in the U.S. healthcare system.
1.2 Explain the key areas of concern for major stakeholders in the U.S. healthcare system.
1.3 Discuss key trends for the future of U.S. health care.

7. Differentiate the roles of various providers throughout the continuum of health care.

7.1 Explain key trends in the medical technology field.
7.2 Describe key trends in health information technology field.
7.3 Discuss key trends in personalization and patient participation in health care.

Reading Assignment

Chapter 13:
Health Care Trends and Forecasts

Unit Lesson

Major Trends for the Future of U.S. Health Care

Throughout this course, key legal and ethical aspects of U.S. health care have been shared. Hopefully, you
have found it interesting and relevant to your career interests and pursuits. The topics presented in this
course are certainly essential understanding for current or aspiring healthcare leaders.

In this final lesson for the course, you will take a look at the future of U.S. medicine and try to make some
realistic predictions about where the industry is headed. There is no perfect crystal ball, of course, but smart
healthcare managers can at least anticipate some of the major directions that health care is taking and
prepare accordingly. It has been said that useful and effective predictions may be wrong in many ways, but
they must be directionally right. They must tell you the general direction in which an industry is heading so
that one can prepare. That will be the focus for this lesson.

Interoperability of Health Information Systems

Some of the best medical computer systems in the world exist in the United States. Arguably, the best
technology and the best thinkers about health information systems are right here; however, the United States
has trailed the world in one very important aspect. The problem in the United States is that our information
systems have not communicated with each other. Two leading health information system vendor companies
are good examples. If your hospital uses Cerner for electronic medical records, then you will not be able to
communicate electronically with another hospital that uses the EPIC electronic medical record system. It is as
if Cerner speaks only French, and EPIC speaks only German.

Things have evolved that way for a very good reason. In the United States, we are driven primarily by the
profit motive, and the Cerner company wants you to buy only Cerner hardware and software. They are happy
to let you communicate with other Cerner customers, but it stops there. They have had no interest in giving
you the capability to work with a competing vendor. That would not make business sense. The ability of
different hospitals to share information about a patient, however, does make excellent clinical sense. In fact,
this is essential for quality medical care. Nations around the world have now implemented systems that talk to
each other, and this ability is already demonstrating the benefit for patients.

UNIT VIII STUDY GUIDE

Health Care Trends for the Future

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Things are really changing, however, in terms of this interoperability of medical computer systems.
Interoperability is just a fancy way to say that systems are talking to each other. The federal Health
Information Technology for Economic Health (HITECH) Act is driving the change. The HITECH Act, passed
by Congress, provides funding for hospitals, clinics, and even doctor’s offices to implement electronic health
records, but it also attaches strings to that funding. If you want the money, you must cooperate in sharing
medical information with other providers, and you must purchase and operate only systems that have that
capability. The mutual language that is being used to make this reality is called Health Level Seven
International (HL7). Computer vendors who refuse to use the HL7 language are essentially out of business
because no hospital or clinic can buy their products.

Imagine this scenario. You are a patient who lives in Columbus, Ohio. All of your routine health care is
provided in Columbus, and your records are there. While traveling on vacation or business in Los Angeles,
you become ill and wind up in the emergency room (ER) at 2 a.m. As things have worked historically in the
United States, there would be no way for the ER doctor in Los Angeles to gain access to your medical
records. That would be very helpful in taking care of you in the ER, but it will not happen at 2 a.m.

Beginning in 2017, however, the computer system in Los Angeles and the one in Columbus will speak the
same language, and the ER doctor will be able, with your permission, to access your records from Columbus
at any hour, any day, and within minutes. That will allow better patient care, reduce delays in care, and also
help to avoid unnecessary, duplicate testing.

Additionally, the ability to efficiently integrate medical data into a single national repository will allow medical
researchers to do data mining. That means that they will be able to identify community health needs, improve
population health management, and determine the causes of diseases and effectiveness of treatment. It is
very likely that once true interoperability exists in the United States, cures will be found for some diseases that
were once considered incurable.

Interoperability Around the World

Will interoperability actually work? Well, the answer is definitely yes because nations around the world are
already doing it, some for as long as eight to nine years.

Estonia: The tiny nation of Estonia was the first country in the world to implement a nationwide electronic
health record (EHR) system. They passed a law requiring registering of all residents’ medical history from
birth to death. Their system was launched on December 17, 2008. All hospitals and clinics in Estonia
communicate in the same language, and care has improved as a result. Granted, things are much simpler in
Estonia where there are only 1.3 million residents. Interoperability works, and this was first proven in a very
small but progressive nation.

United Arab Emirates (UAE): The UAE is far ahead of the United States in terms of true national EHRs. It
started there as a live longitudinal study for assessing the risk of cardiovascular disease. Medical
professionals there soon realized the huge value of interoperability, not just for cardiovascular disease but for
all diseases. True interoperability was launched in 2009 in the UAE.

Saudi Arabia: In 2010, national health affairs interoperability came to exist among all Saudi healthcare
providers. They are truly interoperable. The tremendous wealth of Saudi Arabia made this an easy task to
accomplish. The government simply purchased the same EHR technology for all hospitals, clinics, and
doctors and mandated the use of that technology on January 1, 2010.

Switzerland: In 2007, the Swiss Federal Government approved a national strategy for adoption of “e-health”
as they call it. Full implementation of interoperable EHR was completed in 2012. The stable political
environment and longstanding tradition of “nation above self” in Switzerland made it relatively easy to
accomplish this goal.

Australia: Australia focused on development of a lifetime EHR for all citizens. The personally controlled
electronic health record (PCEHR) deployed in July 2012, and it is now fully operational. Australia also beat
the United States by about five years.

Some other nations, however, which you might have expected to have interoperability by now, are not really
there. Germany, Canada, and England are examples. All of these countries are still trying to achieve the goal.

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In general, nations with a difficult political environment have found the implementation to be slow. So much
money is involved, and politics come into play fiercely. That certainly explains our situation in the United
States where politics have slowed this process down many times, but it was finally achieved due to the
federal HITECH law.

Disease Management

Disease management and preventive medicine initiatives are two other major trends for U.S. health care. This
refers to assigning a health coach or disease manager to each patient. The coach or manager works directly
with the patient to make sure that the patient understands the disease, attends all appointments, completes
all diagnostic testing, obtains and takes prescribed medications, and participates in physical or respiratory
therapy as ordered in addition to other duties.

The trend for disease management is being driven for two major reasons:

 there is a tremendous strain on state healthcare budgets, particularly as they absorb the cost of the
newly eligible Medicaid patients in their state; and

 states need to align with federal programs that are driving providers toward accountable care in the
form of Accountable Care Organizations (ACOs).

Telemedicine

Another important trend in U.S. health care moving forward is telemedicine. One example is the INTEGRIS
TeleStroke Network in Oklahoma.

This program connects hospitals all around the state, providing the fastest possible response to stroke or
possible stoke patients who present to the ER (INTEGRIS, n.d.). This program uses two-way interactive
videoconferencing technology to assist rural Oklahoma hospitals when a patient presents with symptoms that
could be the result of stroke. The program gives rural hospitals instant access to neurologists at INTEGRIS
Baptist Medical Center, which is a major teaching hospital with board-certified stroke specialists on duty all
day and year round (INTEGRIS, n.d.). Because of this immediate access, clot-busting drugs like Activase (a
tissue plasminogen activator or tPA), which is proven to save lives and reduce disability in stroke patients,
can be administered more quickly.

Well-Informed Patients

The future also will see more well-informed patients than ever before, and patients are bringing their demands
to the clinic and hospital. Here are just a few examples of the ways in which patients are getting medical
information today:

 Internet sites like Mayo Clinic and WebMD,

 direct to patient pharmaceutical advertising on TV and in magazines,

 widespread social media sharing on innovations in medicine, and

 medical professionals themselves posting information on social media.

Conclusion

The future of health care in the United States is bright, and there has never been a better time to become part
of it. Hopefully, this lesson has provided some insight into the directions you are likely to take as you move
forward in your career.

Reference

INTEGRIS. (n.d.). TeleStroke. Retrieved from http://integrisok.com/telestroke

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