Long Term Care Administration Palliative Care Services

Case Study: U. S. Health Care Delivery The coordination of care through integrated delivery systems is at the foundation of health care delivery in the United States. Often a primary goal of government officials, public health professionals, and health care administrators, measuring care coordination is a key performance indicator that directly correlates with the overall success of the health system (Johnson & Stokopf, 2010). Northwestern Hospital first opened its doors back 1882 in Minneapolis, Minnesota. Early hospitals were small, often with fewer than 50 beds, unsanitary, and nonscientific compared to their modern counterparts (Allina Health). Moreover, they mainly served the poorest members of the community or patients who were mentally ill or facing life-threating illnesses. Northwestern Hospital was an early pioneer in the establishment of what would eventually become an evidence-based medicine (EBM) practice and featured one of the first schools of nursing in the United States (Allina Health). Introduction For over a century Northwestern Hospital’s use of EBM has enabled clinicians and practitioners to incorporate best treatment practices at the point of patient care in both their hospital and ambulatory organizations. For example, Northwestern’s goal to enhance quality delivery and overall patient care hastened the formation of a new entity, Minneapolis Medical Center Incorporated (MMCI). In 1966, Northwestern Hospital, along with other health care facilities in the Minneapolis area, formed the nucleus of an organization that would significantly master care coordination and delivery in the ensuing decades. Ultimately, an EBM environment created a standard of patient care that enabled MMCI to advance care delivery and medical education and lay the foundations of a modern health care delivery system. Case Study: U. S. Health Care Delivery Case Report MMCI established a culture of continuous quality improvement (CQI). Wenke, Jongwha, LaClair, and Paz (2013) have linked CQI to better clinical quality and improved patient satisfaction. The best practice in EBM methodology is to ensure that patient care is coordinated and of high quality through the use of objective clinical data from credible sources and references. Long Term Care Administration Palliative Care Services

By the 1980s, a desire to add resources and support services for the coordinated care of patients such as physical rehabilitation helped lead an evolution from Northwestern Hospital to MMCI and then formation of Abbott Northwestern Hospital. Since that time, the hospital’s health services offerings have grown into a primary health system, supporting cardiovascular care, medical education, and health plans. Conclusion MMCI recently went through a merger and is now part of a larger health system called Allina Health that serves patients in locations across the Midwest. It has significantly expanded its portfolio of EBM to include mental health services, neuroscience, orthopedic care, and cancer treatment. Additionally, decision makers throughout this newly formed health system must understand and master each care component to maximize system efficiency and effectiveness. For example, the diagnosis of a medical condition is a fundamental activity that clinical professionals perform during a physical examination. It is crucial in modern health systems that clinicians execute due diligence by ordering the necessary laboratory tests, medical procedures, and diagnostic imaging. Patients who seek treatment from multiple health care organizations ought to raise a red flag to clinicians to prudently exhaust all evidence-based options to resolve symptoms through medical treatment. 2 Case Study: U. S. Health Care Delivery Questions 1. In your own words, what is EBM? Is it a worthy goal for U.S. health care delivery? Why or why not? 2. How has MMCI/Allina Health mirrored how U.S. health care delivery has evolved into a modern EBM institution? References Allina Health. (n.d.). https://www.allinahealth.org Johnson, J., & Stoskopf, C. (2010). Comparative health systems. Global perspectives. Boston, MA: Jones & Bartlett Publishers. Wenke, H., Jongwha, C., LaClair, M., & Paz, H. (2013). Effects of integrated delivery system on cost and quality. American Journal of Managed Care, 19(5), e175–e184. http://dx/doi/org/10.2471/BLT.13.126698 Case Study Shi, L. and Singh, D. A. (2019) Essentials of the U.S. health care system, 5th Edition. Sudbury, MA: Jones and Bartlett. 3 Case Study: Long-Term Care Services Long-term care planning is a critical component and building block for the delivery of health services. Measuring the cost-benefits of health information systems and technology and their effects on outcomes of long-term care is essential to the viability and sustainability of the health system. The components of long-term care planning include skilled nursing facilities, home health care, and mental health centers (American Recovery and Reinvestment Act, 2009). The use of advanced computer information systems (CIS) to support long-term care planning requires a redesigning of care delivery systems and the integration of technology into the way clinicians practice medicine. Introduction Physicians and nurses influence patient behavior that can potentially result in improved health outcomes. Introducing patient-centered health records (PHRs) to patients continues in this same tradition by providing self-management tools. Furthermore, PHRs also lead to improved communication with care team members and elucidate a higher level of patient interaction (Weitzman, 2012). For example, PHRs are beneficial for patients with chronic illnesses by enabling both the patient and physician to monitor a disease or to prompt earlier intervention (Wager, 2013). Case Report Apple recently entered the PHR market by configuring its popular Health app to allow individuals to access their electronic health records, potentially revolutionizing how consumers manage personal health information from multiple healthcare providers. With their health records at their fingertips, patients with this app become active participants in their long-term Case Study: Long-Term Care Services care planning and delivery (Krist et al., 2014). Both patients and providers can use PHR data for analyzing, monitoring, and planning health interventions and initiatives (Weitzman, Kelemen, Kad, & Mandl, 2012). Long Term Care Administration Palliative Care Services

Medical care team members can utilize current and accurate patientmaintained health data that are reliable and valid for chronic disease management. By integrating PHRs into long-term care planning, patients are actively engaged to significantly participate in prevention or intervention to improve health outcomes. For example, Jones, Shipman, Plaut, and Selden (2010) emphasized that widespread robust PHR usage will result in higher patient engagement and improve the quality and delivery of health services. But improving health outcomes are just the beginning of why patients ought to record and update their personal health information in an electronic format. For example, Apple’s PHR pilot involved working directly with various health systems across the United States and ensuring that national standards for interoperability in data sharing with major EHR systems was achieved (Spitzer, 2018). Discussion The health information for patients with chronic conditions often has gaps; medical records often are siloed and difficult to access, leaving room for a lack of continuity in the health information for a given patient (Pai, Lau, Barnett, & Jones, 2013). PHRs allow patients to be the mediators of their own health information. Patient populations with multiple chronic conditions that require ongoing planning and monitoring are ideal participants to use PHR for long-term care planning (Krist et al., 2014; Pai et al., 2013). Encouraging patients to both manage and maintain the PHR ensures that reliable health data are available for long-term care planning. Introducing patients to PHRs early in the planning process can help them self-manage and follow through on the long-term care plan. However, there are challenges with the use of PHRs. For example, 50.6% of participants in a recent survey failed to adopt PHRs because they were 2 Case Study: Long-Term Care Services unfamiliar with the technology; older patients with more chronic conditions who may need the app the most are also typically the least literate in mobile technologies (Donohue-Koeniger et al., 2014). Additionally, hospitals and health systems will likely be slow to adopt use of the apps, so using them in a meaningful way is years down the line. Questions 1. In your own words, create a definition for long-term care planning. 2. How does your definition incorporate technology into the planning process? 3. In your opinion, how can the quality of health outcomes be improved under your definition? 4. In what other ways can consumer-driven technology, such as the iPhone app, be integrated to support a healthy lifestyle or manage health conditions? Be sure to include an example from the textbook and three peer-reviewed references to support your analysis. References American Recovery and Reinvestment Act. (2009). P.L. 111-5, as signed by President Barack Obama on February 17, 2009. Donohue-Koeniger, R., Kumar Agarwal, N., Hawkins, J. W., & Stowell, S. (2014). Role of nurse practitioners in encouraging use of personal health records. Nurse Practitioner, 39(7), 1–8. Jones, D. A., Shipman, J. P., Plaut, D. A., & Selden, C. R. (2010). Characteristics of personal health records: Findings of the Medical Library Association/National Library of Medicine Joint Electronic Personal Health Record Task Force. Journal of the Medical Library Association, 98(3), 243–249. 3 Case Study: Long-Term Care Services Krist, A. H., Woolf, S. H., Bello, G. A., Sabo, R. T., Longo, D. R., Kashiri, P., . . . Cohn, J. (2014). Engaging primary care patients to use a patient-centered personal health record. Annals of Family Medicine, 12(5), 418–426. Pai, H. H., Lau, F. F., Barnett, J. J., & Jones, S. S. (2013). Meeting the health information needs of prostate cancer patients using personal health records. Current Oncology, 20(6), e561– e569. http://dx.doi.org/doi:10.3747/co.20.1584 Spitzer, J. (2018, March 29). Apple’s health records beta feature now available at 39 health systems. Becker’s Health IT & CIO Report. Retrieved from www.beckershospitalreview.com/healthcare-information-technology/apple-s-health-recordsbeta-feature-now-available-at-39-health-systems.html Wager, K. A., Lee, F. W., & Glaser, J. P. (2013). Health care information systems: A practical approach for health care management. (3rd ed.). San Francisco, CA: Jossey-Bass. Weitzman, E., Kelemen, S., Kad, L., & Mandl, K. (2012). Willingness to share personal health record data for care improvement and public health: a survey of experienced personal health record users. (2012). BMC Medical Informatics & Decision Making, 12(1), 39–48. Case Study Shi, L. and Singh, D. A. (2019) Essentials of the U.S. health care system, 5th Edition. Sudbury, MA: Jones and Bartlett. 4 …Long Term Care Administration Palliative Care Services