The changing complexity of the health care industry, which began with the development of the prospective payment system in 1983, continues today with the passage of the Patient Protection Affordable Care Act in March of 2010 as one of the most significant changes since the passage of Medicare and Medicaid in the 1960s. Changes come from myriad sources: legislative and policy initiatives, technological advances, and fundamental changes in the delivery of healthcare.
Figure 1 President Barack Obama Signing the Patient Protection and Affordable Care Act, March 23, 2010
As the industry transitions to integrate the mandates of the Affordable Care Act, long range planning is needed. New policy delivery models, reimbursement processes, health policy issues, research studies and data are necessary for evidence-based decision makers. Alternative reimbursement methods are being suggested as a means of controlling costs. Organizations must continue to monitor the quality of services, control costs, and improve access to services or lose certification to treat patient groups. Strategic to the healthcare industry is unique study, necessitating unbiased and independent research impacting the cost, quality and access to healthcare.
An individual entering this field, changing careers or seeking to advance, requires flexibility, teamwork, communication, and a thorough understanding of the industry from a variety of aspects. Understanding the U.S. healthcare system requires a comprehensive understanding of the entire system from conception to palliative care through the last days of life. A continuum of care starts with prenatal care to ensure the mother receives care for the delivery of a healthy infant, while maintaining the health of the mother.
Promotion of good health habits will help to prevent disease and maintain wellbeing, thus enhancing the health of the individual as part of the continuum of care. Statistics and clinical research indicate that a healthy lifestyle affects the mortality and morbidity of the individual. Health promotion entails encouraging regular physical activity and fitness, education on remaining tobacco-free and minimizing the use of alcohol and drugs, supporting mental health and diagnosing mental disorders, and addressing abusive and violent behaviours, through supportive community and educational programs.
While the passage of the PPACA was intended to provide health care for the entire nation, it has not proven to be the answer to the national healthcare coverage issue as compared to other countries. There have been some good outcomes; for example, implementation of the electronic health care record (EHR) systems mandate, online claim processing, e-prescribing systems, tele-radiology - all of which have been somewhat successful. These have added significant value to the existing healthcare system, but the full potential has yet to be realized. There are also opportunities to reduce errors and improve patient safety. This will facilitate the streamlining of current routine health information management processes, which have become increasingly complex due to multiple providers across departments whose EHR systems must be compatible in all areas of medicine and nursing.
As this era of healthcare reform continues to evolve, healthcare policy makers, administrators and managers will continue to be confronted with decisions related to the handling of information, allocation of funds, and the formation of strategies to pursue the success of not only the organization, but the industry. Questions will continue to be asked of providers, nurses, health professionals, and business associates who work collaboratively to anticipate and fulfill the needs and gaps, and proactively plan and leverage the skills, knowledge, and abilities of the entire workforce.
No healthcare system has gone through such a significant structural change as the U.S. healthcare system has in the past thirty years. The healthcare system is comprised of a variety of arrangements from joint ventures, network systems and consortiums. These various mechanisms have been created from a number of economic and environmental factors, having formed the delivery of healthcare services driving the development of the hospital system. Among these factors has been the transition from providing care in a hospital setting to a shift in ambulatory care. Mix this with an aging population, staffing shortages, increase in chronic care, introduction of new technologies, and alternative delivery of care and it is clear that there is increased attention to a greater spectrum of healthcare services.
Students making the decision to join the healthcare industry can benefit from selecting a mentor or tutor to assist them in their journey into the healthcare industry. Healthcare is a complex, challenging area which may at times require the assistance of a tutor to offer help performing qualitative or quantitative analysis. Strategic planning, budgetary analysis, and health policy are separate areas unique from other industries requiring assistance from individuals experienced in the healthcare industry.
To foster the necessary skills in this ever-changing workplace, partnerships are formed between a hospital and a university to train individuals in the policies, protocols and procedures of the specific hospital system. When an individual is hired by the hospital at which an internship, fellowship or residency is performed, the experience can be invaluable. Acquiring expertise in the diagnosis and medical and surgical management of all types of patients is an arduous journey. Working long hours, taking classes, and having to complete homework can be overwhelming.
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