Reply to the following two classmates’ posts (See attachment). In your reply posts, incorporate challenges you would anticipate for the proposals, as well as arguments to overcome those challenges. 

– Each reply should be 200 to 400 words.

– TURNITIN ASSIGNMENT (FREE OF PLAGIARISM)

Health policy replies

Reply to the following two classmates’ posts. In your reply posts, incorporate challenges you would anticipate for the proposals, as well as arguments to overcome those challenges. Each reply should be 200 to 400 words.

TURNITIN ASSIGNMENT (FREE OF PLAGIARISM)

POST # 1: Emily

Coordination of patient care plays an important role in positive health outcomes; however, it is becoming more of a challenge as the United States’ population is aging, diseases and treatments are becoming more complex and technological costs are rising (Seyedamini, et al., 2019, p. 6). This coordination of care is known as clinical integration, which can be defined as “the coordination of patient care across providers, settings and and time to achieve safe, effective, efficient and patient-focused care” (Regis College, n.d). Clinical integration has the potential to lower health care costs, improve efficiency and quality of care (Seyedamini, et al., 2019, p. 7).
          However, in order to facilitate efficient clinical integration, providers need proper financing, cultural adaptation and supportive resources (Seyedamini, et al., 2019, p. 7). Challenges that providers and patients face with clinical integration include continuously updating of medical techniques, equipment and computer-based information systems, increased complexity of care making communication between providers more difficult, as well as increased insurance coverage under the Affordable Care Act causing a higher demand for providers (Shi & Singh, 2019, p. 138). According to Haughom (2017), our modern health care system requires “comprehensive care management systems” (para. 8). He states in addition to electronic medical records, providers need a system that contains the five core competencies of care management including, 1) data integration, 2) patient stratification and intake, 3) care coordination, 4) patient engagement, and 5) performance measurement. 

          Currently, there is a comprehensive smartphone system being developed that has yet to be fully launched known as FHIR (Fast Healthcare Interoperability Resources). This system would allow providers, researchers and patients to store and share medical information all in one place (Rae-Dupree, 2019, para. 3). This system would support clinical integration and simplify the current complex process of sharing data between providers and patients, which in turn could result in greater efficiency in healthcare delivery (Regis College, n.d). However, this system is still working on gaining support from providers and institutions. They are also facing challenges with how to properly protect patient information in the cyber world (Rae-Dupree, 2019, para. 24). 
           With newly developing technologies to improve clinical integration, such as FHIR, health care professionals must be properly trained and adhere to new systems to achieve the intended outcomes of improved quality of care and reduced costs. New delivery models being used to replace periodic office visits to improve continuity and lower costs are virtual video consultations, which are estimated to double in 2020 (Shi & Singh, 2019, p. 578). However, providers must practice this model in order to reach its potential effectiveness. 
           There are many benefits to clinical integration, and we must continue to address and improve upon the challenges that providers and patients face with achieving it. With the increasing complexity of care, we must find a way to simplify delivery of services to ensure quality care and cost effectiveness.
References
Haughom, J. (2017). The modern care management team: Tools and strategies evolve, but the outcomes improvement goal remains. Health Catalyst. Retrieved from

https://www.healthcatalyst.com/the-modern-care-management-team-what-does-it-look-like

Rae-Dupree, J. (2020). How fast can A new internet standard for sharing patient data catch fire? Kaiser Health News. Retrieved from 

https://khn.org/news/how-fast-can-a-new-internet-standard-for-sharing-patient-data-catch-fire/

Regis College (n.d.). Improving patient care through clinical integration. Retrieved from: 

https://online.regiscollege.edu/blog/improving-patient-care-clinical-integration/

Seyedamini, B., Riahi, L., Farahani, M.M., Tabibi, S.J., & Asl, I.M. (2019). The effect of clinical factor on the health system integration. International Archives of Health Sciences, 1, 6. 

https://doi.org/10.4103/iahs.iahs_18_18

Shi, L., & Singh, D. A. (2019). Delivering health care in America: A systems approach (7th ed.). Burlington, MA: Jones & Barlett Learning

POST # 2: Carla

One of the biggest issues that healthcare is facing is the cost. For many people, the cost is a huge deterrent for getting care when they need it, and even quality care when they do go see a healthcare professional. While being able to afford health insurance is a major part of this issue, it is not the only factor involved. Many people who have chronic illnesses get bogged down by repeated costs—from the treatments they need, but also from repeat inpatient care. For these types of patients, getting the correct care when possibly seeing multiple different physicians can also cause problems. Team-based care and care coordination can help with these issues, not just for patients with chronic illnesses, but probably more so with them. 
While coordinated care may seem like an easy thing to accomplish—just make sure all doctors and healthcare professionals are all in the same loop and getting updated on each other’s care—there are a lot of issues that can hinder this coordination. Many patients may see different doctors for different issues, see specialists that are possibly not involved with their normal doctor, etc. These gaps in care can cause issues, possibly incorrect care, or repeated care that is unnecessary and costly. 
Nurse and doctor hierarchy has also been an issue. Nurses have a special view on the patient and what they need, how treatments and such affect the patient. This is because they work closely with patients, while doctors often just see files and step in when needed nurses and doctors just hold different roles in healthcare, but that does not mean one is less important than the other. With nurses working more closely with the patient and seeing them more often, they can have an insider view on issues that a doctor may not be aware of. This affects the patient if they get outpatient care by a nurse, too, as that could be the main person the patient interacts with at all. 
On the topic of out and inpatient care, inpatient care is not as favorable for team-based, coordinated care, leaves open for less quality in care, and possibly more cost. “The traditional hospital-centric care model…delivers care that is typical more fragmented, driven by the individual practitioner” while shifting to “outpatient settings require a high degree of alignment across the continuum” (Jacquin, 2014, p. 5). While shifting to this type of care may not be the easiest, as there needs to be a census between healthcare professionals to reach out to each other. 
There are some healthcare professionals in pediatric care that are solving this issue with care coordinators or care navigators (Huth & Kuo, 2019, p. 1). These are people that look into not only the patient’s medical problems but also “social, developmental, behavioral, educational and financial needs of patients and [their] families” (Huth & Kuo, 2019, p. 2). This type of person helping coordinate all of these lines of needs for a patient would be very helpful in any type of healthcare environment, not just pediatrics. 
There are even now outside communication companies that are trying to help fill the need for coordination in the medical sphere. Caregility is a company that wants to provide “secure, reliable two-way audio and video communications for any device and clinical workflow, in both inpatient and outpatient settings” (“Caregility,” 2020, p. 1). The use of technology can make team-based care and coordination amazingly easier, but it does bring in new ways of leaking people’s personal information. Every new way to share information between healthcare professionals needs to have the correct security with it.
While team-based care and coordination may be the way of the future for healthcare, there must be a major shift in the way people go to the doctor. Specific coordinators and technology can help, but the main need is for healthcare professionals to all work together in meaningful ways. The main goal for healthcare professionals is giving their patients the best quality of care for their buck, and so would hopefully take on the responsibility of helping collaborate.
                                                                            References
Caregility’s UHE Video Enablement Platform Expands Telehealth Integrations with Epic’s App Orchard. (2020, January 29). Retrieved from 

https://www.prnewswire.com/news-releases/caregilitys-uhe-video-enablement-platform-expands-telehealth-integrations-with-epics-app-orchard-300995003.html

Huth, K. B., & Kuo, D. Z. (2019). Using a team-based approach to improve care coordination. American Academy of Pediatrics. Retrieved from 

https://www.aappublications.org/news/2019/10/10/focus101019

Jacquin, L. (2014). A strategic approach to healthcare transformation: transforming the care delivery model across the continuum is a prerequisite to success under value-based payment systems. Healthcare Financial Management, 68(4). Retrieved from 

https://go.gale.com/ps/anonymous?id=GALE

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