Healthcare systems for a better social world | Karl Lauterbach | TEDxRWT...

This talk was given at a local TEDx event, produced independently of the TED Conferences. Lauterbach talks  about how social status and poverty can adversely affect the genetic setting of the youngest members of society, resulting in a life-long disadvantage and earlier death :)

Healthcare Systems : US Healthcare Delivery Systems

The video show healthcare delivery channels, operation unites and other system components. please let me know your feedback:)

What is behind healthcare system

Healthcare system in usual to get good grade of performance quality, would not be work without supportive background tools run at the same time of work. Whether those have appeared publicly or not, quality considerably important and own strong linkage toward processing of whole delivery channels.  Many medical institutes identified and defined quality problems since decades in the USA, IT related problems, humankind acclimatization and training sessions assessments etc.

Clinical Decision Support has advocated delivery accessory equipment providing original system with padding or informative cushion which do pavement to the road of daily work. CDS is medical informative tool provides clinicians, staffs, patients and other community individuals with knowledge and personal specific information.  No one can deny that misleading information capable of doing a lot of mess in workplace, fatally, if these data more close to human life. In order to understand the real significant of CDS; that explained in coming case study;

Andres is asthmatic patient used to do follow up specialist visit monthly, the existed information about case medication history, did  not record much about medicine interactions for instance with Asthmatic patient is Aspirin, but what is the risk going to occur when Andres take normal medications of Asthma with Aspirin? Aspirin simply will case sever asthmatic attack with much noticeable bronchial constriction threaten his life. Thus, found delivery information pop-up alert giving specialist green light for what is or is not suitable, possible and even prohibited during patient medication journey.

It is better to show clinicians full access to potential harms and possible complications rather than dealing with them subsequently. Within, they can get all information needed about medicine ingredients, composition, chemical structures, warming booklets, patient medication history and interactions guidelines. CDS idea driven originally from research data supply channel with access platform that might be useful for medical stakeholders and also offer the patients all information related to their illness. Table below explain some sorts of intervention care areas;

Target care area	Categorized
Preventive care	Immunization, screening, disease management guidelines for secondary prevention
Diagnosis	possible diagnoses that match a patient’s signs and symptoms
Planned or current treatment	Treatment guidelines for specific diagnoses, drug dosage recommendations, alerts for drug-drug interactions
Follow up disease management	Corollary orders, reminders for drug adverse event monitoring
Provider efficiency	Care plans to minimize length of stay, order sets
Cost reductions and improved patient convenience	Duplicate testing alerts, drug formula guidelines

Types of CDS are many and deemed branched somehow in order to cover wide range of customer and professional demands. For instance; in case of supplying clinicians with data about patients or/with data for pharmacies or/with diagnostic physicians and pharmacists differs from supplying patients themselves with awareness programs data or apps. Depending on sort of data shape and figure of network with access platform and if these platforms linked to electronic health records or not to strongly attain more privacy form toward medical data. Therefore; issue of EHR data privacy and form of informatic architecture deeply will discuss later in coming posts. 

Why is our healthcare system always in crisis? | Dr. Bill Ghali | TEDxCa...

Preventive care versus illness care

Healthcare marketplace and within contains supposed to do full of coverage to adult and children either.  Deal by which to achieve chosen market segment what represented always with patients. Segmentation is branched process facilitate the whole introduced services to certain society category to assure of efficiency and equality. Thus; socioeconomic status and health being determinants of each identify which medical services on basic level would be provided and distinguish tight indicator for resource mobilization and allocation. Preventive care is ongoing process horizontally through civil programs of human being encounter diseases preventive measures, chronicity management, and women children welfare determinants. Vertically, it been delivered by primary care provider and regular service work. Whatever standards of medical service you used to receive and how much beneficial you are, still preventive care one of the most effect way to minimize care complications and human mistakes remove.

For those who would like to get precise meaning of preventive care, Center of diseases control and prevention have declared that:

Preventive care includes health services like screenings, check-ups, and patient counselling that are used to prevent illnesses, disease, and other health problems, or to detect illness at an early stage when treatment is likely to work best. Getting recommended preventive services and making healthy lifestyle choices are key steps to good health and well-being.

Preventive care core meaning doesn’t close to exaggerate the community awareness toward certain illness or contagious antigen, actually that little from realistic meaning. Nevertheless, Community responsiveness and individual reactions in such illness and health retardation, set out overview, regarding community caution and awareness in form of defensive behaviours that protect soma against threatens and illness. In parallel meaning of core concept; the regulations had been taken from patient side build really barrier far from illness complications. Literature of patient is a key of improvement to build scientific supportive background going to be protective even in emergency situations.

In comparison versus illness care and disease management shows that processing of problematic pathway of illness, alternately; attains extreme exhaustion form for patient and the system itself. Moreover, end delivered value is full of complications and associated intervention needs for corrections trying to overcome illness late phase patterns.

Ultimately, the real impact of preventive care toward society members put a lot of resources and services in site with full maximum beneficiaries and less waste of time, money and effort. So, keeping the patient in preventive care, decrease predominantly aside services taken in case of progressive illness phase such as Laboratory measurements, radiographic films...etc, these must be done in case of diseased patient in advanced stage.

with minimizing the patient delivered values, that owns direct effect on the availability and accessibility rate of services and due to lack of daily work exhaustion, medical workers ready to provide our customer with high quality performance integrated with more equality standards and for sure achieve equity receiving satisfaction among society demographic sectors. 

Why Are American Health Care Costs So High?

Most of american citizens asking why we pay more for medical insurance and the state expenditures exceed more any global standards in comparison with other countries, what make state expenditures going up  more year after year due to the same medical budget and policy. if you have idea about how to minimize the healthcare system budget over there you welcome to post your comment.  

Mistakes of Health systems

It seems that there is not human work devoid errors and mistakes, including human or machine. Success of system depend more on designing, planning, implementation and correction with assessment. Nevertheless the process of continuous development sound appropriate pathway for health welfare. The core meaning of problem is not existence of error that may be affect indirectly sometimes with restricted drawbacks to the patients but lies more causes and future potential repeating.

Some society voices do not care much about study of possible happen mistakes but that undoubtedly give new contextual meaning to error and human factor associated. As a overview, reviewing the whole healthcare system mistakes in one package some sort of unfair behavior particularly if we explain that most of mistakes found as a result of misunderstand of the system nature and in other situations sudden changes from traditional atmosphere to digital one.

With new technologies many of benefits carried out, on numerous levels with variable grades either directly or afterward, with this truth we feel better with most of systems and technologies in healthcare but producing more complicated system models at the same time pushing into the surface new unexpected problems as well. We going to discuss some of them in coming paragraphs;

Neglecting to prepare 2^nd &3^rd rows of the leaders and experts due to:

1)      Lack of training, coaching skills necessary to help new generations.

2)      Information background support does not reach to level pushing others learn.

3)      Focusing only on basics without highlighting of system details involved.

4)      Absence of will for unknown reasons.

No prier planning for system changes; that simply can create heavy burden to the whole staffs and even professional workers who did not used to work deeply with modern IT systems, take more time to accommodate with, and as aside hint, almost all the human mistakes arrived from this reason.

Stop personal development and working to improve the staff skills in order to exaggerate their roles with integrated new system.

Failing to develop working strategy for the daily work therefore considerably accounted objects determination within could be much helper.

Less satisfaction for medical workers lives requirements and other staff  that leading to cold work responsiveness with more less of responsibility toward duties.

Modest budget for maintenance and fixation than optimum does not enable staffs of caring about system and rapid corrections.

The aforementioned tips briefly describe most of health systems setbacks and human mistakes. Moreover it could be more valuable if be avoided or mitigated from their impact on the working system to maximize the benefits gained in both avenues patient and medical staffJ

Healthcare System Overview

This video explains main role of Healthcare system and some of their components, please if you have any questions about the video and inside content let me know:)

Truth.....Healthcare is not a mystery

Years ago, the whole process of medical service offering and beyond related care was much difficult than nowadays for many reasons. Moreover in that time; the accessibility with unequal distributed administration platforms make the problem more complicated and service provision less effective among public. May be that because of poor developed infrastructure of system itself and/or from human side, inferior management models with lack of progressive working vision, played a main role in the retardation of service delivery process. Practically; we should not blame anyone about all previously carried out mistakes. Why?, because the process of healthcare development and management absolutely, could not be performed solitary.

That for sure, make the process of assessment for all previous working healthcare systems worldwide are not easy to perform from practical review. Thereof, there is good significant value would be taken in mind putting the base for coming system operating unites design. This value briefly described that the working medical system does not ever means that is the best or optimal level of the same system.

Mention of this point leading us to further explanation about currently medical networks distributed in many countries all over the world and Although there are modern working procedures with good results but still numerous mistakes and errors dominant the scene, and also the reality proves how far the gap between the purpose of systems and how closely the implementers want to produce system in certain look.

As a fact, healthcare system is not a mystery to be produced and provide public with professional and real values. Instead of caring only with how much this system must be modern and matching with global technology regardless other parameters for health determinants the community really needs. Thus, should be considered the main purpose of the system and if that achieve the society objects and reach public satisfaction and in what level also what possibilities in future could be followed to going forwardly toward more development with keeping the same purposes and achievable values.

Healthcare delivery system is a critical issue because somehow it touches the politics management and their policies and strategies of the whole state. Subsequently, implementation viewpoint in reality taking in account more the state policies than the community needs and the public purposes. So, many of examples prove that when the system purpose is not government but community oriented that draw clear beneficial purpose for implementation and the community coming first than anything else.

Nordic healthcare systems prove that, when they put the main community needed values first and then do appropriate design to innovate different ways of service delivery and all moving around the individuals with community benefits. That by role makes some sort of equilibrium between the state future plans with strategic vision of politicians and current demands of public with modified needs in future.

Last not least, one of the highly significant rule of healthcare system designing; as much the system close to the people needs and demands with more simplified steps to get what they looking for as you get balance between state medical policy and patient satisfaction with lowest level of errors and all within high quality contour. It is really important to me to know what in your mind about  healthcare domain? J

Healthcare provider gives service or product

Days ago, one of my friends went to polyclinic for checking up some blood analysis. We met after and perfectly he is now. We were discussing about the form of services have been got there on different work unites. Moreover; the clear modification process in modern healthcare system has been carried out to figure of services to got closely more to commercial products. For sure; on one feels glad to get unnecessary service or afford more cost devoid of need. Actually, if we going to analyze the service figures of current healthcare systems, we will find out that most of them keen somehow to reach financial resources directly from the patient pocket. Even with private insurance enterprises should be paid some little fees at the access point of the provider. 

On the other side; there are a lot of useful services implemented with most innovative ways in order to offering efficient, effective, more responsiveness values.  Although productize everything in HC cycle is not proper idea of work and improvement especially with medical domain but core strategy to get some additional resources for future tangible improvement of introduced service fit more to give low quality or inappropriate medical intervention. In this point would like to remember Batstone words about medical intervention:

The application of interventions which have been shown to be efficacious to appropriate patients in a timely fashion to improve patients' outcomes and value for the use of resources (Batstone, 1996).

Mean of word product carries some sort of financial benefits to the providers and will be optimum if that reflect on the patient welfare and quality of received values. Therefore, the cycle going in positive way and grow more and more in the patient side integrated deeply to create higher health status records in the society. 

If the additional services or additional fees were not using to develop the current system and avoid humankind mistakes and possible errors, that seriously put the whole medical process in the first of down chart pattern. To prove that, easily you should look at many of public funded systems; the volume of movable money is bigger than private ones and also the state announces always that 90% of the medical services are free of charge but what is the reality?

The reality says that all medical services have behind fees plus the private clinics business which compete the public state medical system by sending cases to the private hospitals and clinics what generate huge revenue to the medical workers. The behind fees go to the individual pockets to enable the patients getting more quality of certain service. So, that money is dead out from the state cycle and loss any opportunity for development.  

 

In the opposite; using little more fees with contract of insurance registered and announced to the state finance cycle undoubtedly; doing enhancement of quality level of service and labor skills as well. The matter of resources allocation still crucial burden for being optimum and reaching acceptable level of satisfaction with numerous grades, by which optimism of the system would be achieved with lowest errors.

Overview of healthcare system setbacks

Most of modern countries healthcare business model, they are looking for better meaningful achievements for health concepts in order to exaggerate the society health welfare. They always are looking for healthcare efficiency, equity, effectiveness & responsiveness of aimed care. We are going to discuss all of them later separately. Previously; we discussed design drawbacks and how it affects the working process and implementation of the whole system. Today highlighting on the other set of setbacks would be necessary in order to explaining all possible clear or hidden errors for any HC system as follow:

Ill developed implementation: designing is important but the process of implementation more than important while linkage of the numerous unites and operators together in one articulation still considered the main burden for many of implementers the project. For sure the process of implementation is the key for the successful healthcare one and as well as how much that execution complying to the theoretical project design already prepared. It is hard but not impossible even the most modern implemented systems suffered the same problem during time of making project going to be real. The process of articulation is a mutual working between designers and IT teams to get proper efficient implementation. Only by that way; we can get unexpected stunning results from the healthcare projects and giving highly valuable services to our people.

Ill developed management from labour force: post development stage is successively come to the HC success journey, and could not be neglected on the base of integration to the system. For instance, if we have got well designed and implemented system. But on the other way, still suffered from delaying intervention of operation errors and/ labour or equipment mistakes. You can imagine the picture of this system how going to be in future. You can imagine all be done well with poor errors management, undoubtedly that form additional obstacle in front of any working tasks preventing the system to fulfil the aimed results awaited by professionals and public. Running post implementation system is the crucial for any system, and if the IT team succeed to put redirection platform scheme properly would give all perfect results and lowest ever percent of operation mistakes.

Poor development process for future quality &auditing: this stage is continuously running with all working schedule, of course it is far from daily work but following the steps of regular auditing keep the system young and in highest level of efficiency. Auditing is normal organization work to get following the daily errors and assure soundness of the normal pathway of tasks results. On other direction, planning for development is going parallel to the process of auditing, how?!!!

In order to developing any working system, problems and drawbacks should be firstly identified, at the same thinking of finding different unique methods for solutions more useful and necessary. In context; that why monitoring, assessment, correction and intervention are more valuable in this stage. While absence of the future planning for development is considered big step in adverse road with unwanted results. J

Systemic approach of Healthcare operating unites

 As a truth; ideal healthcare system is not existed practically in real life. That means practically there are operation errors appeared on the surface from each system, labor force & unfit design of whole involved unites. It is seriously not hidden for everyone the setbacks of HC systems especially with those who used to travel a lot to see different medical services portfolios. But what is the optimistic here, with modern IT auditing and new technologies recent appeared that making the process of identification declared better. In order to understanding the efficiency degree of any HC system, the definition of system should be highlighted first; international council of systems engineering (INCOSE) declared sound definition of system.

‘’ A system is a construct or collection of different elements that together produce results not obtainable by the ele­ments alone. The elements, or parts, can include people, hardware, software, facilities, policies, and documents; that is, all things required to produce systems-level results. The results include system level qualities, properties, char­acteristics, functions, behaviour and performance. The value added by the system as a whole, beyond that con­tributed independently by the parts, is primarily created by the relationship among the parts; that is, how they are interconnected’’

Firstly; this definition gives a brief idea about what HC system should be. There are many working systems all over the world with numerous business models supposed to aim whole society categories whether privately or publicly funded but the level of harmony between each of them and other working component within the same system reflect the professionalism in the process of design. One other highly significant core would mention here, that professionalism of designing means not only theoretically but also never going far from the need of public health welfare demands. In other way, as much as the system more flexible with each community members, as much as this system going more to be succeed with society and state policy. But there are no other benefits with good designed working HC system. Actually there are huge especially with hierarchical management model and how much the process of management going to be much easier.

We are going to start our approach with system by:

Identify system goals, targets & objects.

Establishing the interdependencies implementation processes of the system

Clarification of the working system unites able to attain the objectives.

Identify work abilities and system soundness level.

Measure the level of performance expectation versus current system received values.

Auditing, analysis and regularly assessment of the system uncover setbacks fast and open the door for development.

Formerly; referring to systemic approach process with main depending on system objects which caring to reach optimism that from side. From other side; level of system accessibility and distribution access point forms additional value to the Health service cycle and also study working steps. Thereby; once you start to deal with HC system, clearly figured out how level of system quality is. We are asking HC professionals pay more effort to innovate high valuable services and benefits J