Introduction
Increasing costs of health care services in the US require some measures to be undertaken in order to control these costs by lowering costs of prescription drugs, high premiums for health insurance policy and misuse of Medicaid /Medicare services. Federal government has taken initiatives to cut down its spending on public health care expenditures through programs such as health care reform bill which was enacted last (Flowers, 2010). Thus individuals and health care organizations, both governmental and non-governmental, have to work with constrained budget due to reduced funding by the federal government. This is not an easy task to them since they have to continue providing health care services as usual without compromising its quality. One way of doing this is to ensure that health care services are given to the deserving patients only and no abuse of prescription drugs, Medicare benefits and health insurance coverage. Thus, this paper gives a proposal of a system that can be developed to enable doctors and other health care service providers to know whether the persons who are seeking these services deserve them or they just want these services to satisfy their addiction. The system will also help health care providers to know where these persons have been treated there before and to what extent do they need to be treated.
Background information
In the past it has been difficult for hospitals, pharmaceuticals, Medicare and Medicaid and insurance companies to know the previous records of their clients who go to them to seek their services. For instance, many people have been given health benefits from Medicare not because they are needy or deserve them but on the basis that they are entitled to receive them. In addition, as a result increased out-of-pocket expenses and the general increase in the costs of the health care services, many people have gone for free or subsidized drugs which they do not necessarily need thus making other needy people especially the poor and the elderly not receive these drugs(Culliton, 2011). The law also allows people to purchase health insurance coverage from different insurance companies which also make it complex to manage insurance coverage data of such people. Thus, there is need to have a data base system for every individual in order to have a clear record of their health status.
Database system
Developing an intranet health care database system will help health care providers to identify the deserving patients through evaluation of their personal information. This system will contain all the health care information of every citizen and all the records about past treatment to enable doctors and other health care providers to know whether the person seeking their services deserves them or not. Every person who goes to seek health care services of any kind will be required to give all their personal health information which will be recorded in their own page on the health care database system. People may also be requested to send their personal health information either through an email or any other means to various health care providers in order to create their health data profile. After that all the other times an individual go to seek health care services, his or her treatment, prescription drugs given, medical tests undertaken and their results and any other health information like insurance records will be entered in their personal page in the intranet database system (Scheier, 2008).
This database system is provided electronically which means that it can be assessed every time by the doctors and other service providers wherever they are (Lightsey et al., 2010). All the hospitals can access the information of the patients who visit them such as when they were treated last, the medication they were given, the hospital they attended, treatment fee they were charged and other details concerning their health status(Briggs, 2003). This will help to ensure that they are effectively and safely treated since the doctor will just use their medical records and know how they need to be treated(PR Newswire, 2002). This will help to reduce the cost of treatment since no funds will go to the treatment of the wrong diseases. The hospitals will also know the right amount of fee to charge the patients using their personal information to gauge their category and financial capability. Government health organizations such as Medicare and Medicaid will also use this electronic database system to identify those people who deserve their benefits and those who do not deserve.
Previously, the services of these organizations have been abused as those people who do not really deserve their services go for them and as a result those who deserve them particularly the elderly and poor in the society miss their services. This has also led to increased government spending in health care expenditures since it has to give more funds through these organizations to cater for those people who miss health cares services and yet they deserved them. However, with implementation of this intranet data system, these organizations will be in a position to scrutinize health care profile of every person seeking for their benefits before providing them to the seeker. For instance, the intranet data system will show all the health care records of the person such as the last time he or she went for any services like prescription drugs, the amount paid if there was any, date for the next prescription among other personal details. If the person has already taken his or her drugs for a given period, it will be portrayed in the intranet data system thus denying him or her to be given drugs another time before other people who are not yet given receives. Financial status of the person will be assessed through this system to know whether the person deserve to be given subsidized health care services or not. This will eliminate all the cases of abuse of subsidized government health care services by ensuring only the right people are given these services. As result, government spending on health care expenditures will reduce and at the same time it will be possible for all people to access health care services they deserve since government will only assist those who deserve them (Sabugueiro, 1994).
An efficient database system for health care status of individuals will also be of great importance to the insurance companies that provide cover for medical services. First, it will be easier for the companies to classify different people in different coverage groups depending with their medication history. Those people who has no good medical history will be required to pay more for their coverage premium since they have high chances of becoming ill or even dying compared to others who have good medication history. Secondly, this information will also help the insurance companies to know the financial position of the person and therefore knowing the type of insurance policy he or she deserve. Finally, it will be easy for the insurance company to know whether the person is telling the truth about their medical history since their information is already provided in the database system.
Advantage of the system
Initially, patient health information was kept in the manual files in the clinic or hospital that one attends (Turner, 2002). These files could not be easily accessed since it could take a lot of time to look for one file from thousands of them. Again, manual files could not be assessed in different hospitals or other health care providers since they were only found in one place. However, adoption of electronic database system will make it easier to obtain patients health information within a short time and in all places through the internet. Secondly, the costs of health care services will reduce since the limited resources will only be distributed to the deserving population. With this intranet data system, it will be possible for the health care providers to identify the deserving people thus reducing cases of misusing health care resources which are already limited. According to Alshawi et al. (2003), a good data system may also help the organisation to meet their clients’ needs more effectively. Finally, the system will help to improve the efficiency of the health care providers as they assess the previous medication records of their patients. This will enable them to know the right medication to give to their patients.
Disadvantage of the system
Though the electronic system has numerous advantages, it is not problem-free system and has a number of weaknesses that may be used to criticize it. First, there is confidentiality risk where the information of the patients can be assessed without their knowledge (Laura, 2000). In order for all the health care providers to access the information of patients’ medical history, they need to be in a position to access this information anytime and anywhere which increase the risk of mishandling it. Wrong persons may also access personal information of the patients which will not be to the advantage of the patients. Secondly, the system is expected to experience technical problems just like other digital systems. Technical problems such as system failures, unknown problems among others are common in many digital systems. This is likely to affect the efficiency of the system when the patients visit health care providers and yet doctors cannot access their health information due to system failure. Finally, managing this information is also not easy since it require high technical skills among the staffs of health care providers. The Data system may contain health records of millions of people which may not be easy task to sufficiently handle and access those records whenever they are required.
Conclusion
In order to control the rising costs of health care services, it is necessary to come up with a system that will help doctors and other health care providers to identifying the deserving patients. Adoption of an intranet database system will help to track records of each and every patient thus ensuring that only the deserving patients are given the first priority. The system will also help to improve the efficiency of health care providers. Nevertheless, confidentiality risks and technical problems may be encountered in this system.
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