Health care is changing profoundly and permanently
Health care is changing profoundly and permanently
When we are a very sick, we are very vulnerable all kinds of interpreted transgressions of decent interaction in health care. An angry word, an unpleasant face, and even doing nothing may decode as unfriendly behavior. As handshake has said to develop as a form of conduct to show that we do not have a weapon hide in your hand, as a similar way the rights of patients have evolved to warrant a respectful demeanor on behalf of caregivers in different facilities in health care. But even caregivers behave correctly, it is a typical scene to witness not-functioning IT-solutions in every health care facility. The general outcry in health care is to demand only more resources already deficiently designed and processed health care. Health care is changing permanently in the age of digitalization and artificial intelligence.
In 1991 in her book “The limits of medical paternalism” a practical philosophist Heta Häyry condensed solidly about the lengthy discussion of inequality between a patient and a doctor. Paternalism means to restrict freedom and responsibilities of patients. She stated that the patients should have more freedom and rights instead of the old tradition of “the doctor knows the best”, aka medical paternalism. Earlier it was the long education of medicine and inaccessibility to the medical books prevailed the knowledge gap between patients and doctors. The only option was the doctor knew better than the patient. The advent of Internet was a significant fact that changed the situation. It was no longer necessary to wait your turn to borrow expensively medical books from distant medical libraries to your library; it became possible to have same e-book sources as the physicians have. The patients and the doctors had almost equal access to the newest findings of the medical knowledge. Also, the discontentment for the medical service has cumulated over the passing decades, and turbulences of the societies have obliged the transition from an old patient to a new consumer perspective (Wolfe 528). Samuel Wolfe cited Dr. Warbasse that “ … health care is a right, not a privilege… a service, not a business” (528). The patient should have a right to a health care service. The rights of patients, ensured with the laws of the patient rights, dictated the circumstances where the service of health care for the patients should deliver. Patients have a growing role in health care, they are not just a passive object of care, but an active consumer of health care. The more proactive role of health care consumer has advocated as a promoter of health care change (Newman and Vidler 193-196). The role of a physician is changing from an expert of the ivory tower of the hospital to a consulting health care provider to the vicinity of a local shopping center.
The growing demands of access, quality, and treatment options in health care and simultaneous frequent financial crises created almost a mission impossible. The increasing needs of health care must balance with the financial resources available. The costs of health care (for example, new very expensive medicines and sophisticated devices) escalated faster than the economic growth which made impossible to allocate more and more resources to health care and the rights of patients to health care. Michael Porter and Elisabeth Olmsted Teisberg (1-2) posited: “The combination of high costs, unsatisfactory quality, and limited access to health care has created anxiety and frustration for all participants. No one is happy with the current system – not patients…not employers…not physicians and other providers…not health plans…not suppliers of drugs and medical devices…not governments.” The disagreements of the unsatisfactory situation have led different shareholders to various activities. Patients to ask their rights by lawsuits with lawyers, and accordingly, physicians to make much unnecessary and time and resources consuming examinations in the name of defensive medicine, and political parties to endlessly decades to dispute about the possible solution for the chiasm. The governments of Finland, one after another, have tried - in vain - to solve that mission impossible now about thirty years. Desired or not, health care is and must also be a sustainable business.
Health care has not traditionally defined as a business. It has portrayed as a last resort of a free artistic craftsmanship. The physicians have led hospitals without a proper management education based only on seniority. Senior doctors have asked what resources they want to execute a high quality of care and the administrators have allocated them required new resources. Frequent financial crises have obliged to have a certain ceiling sum of money in the yearly budget for those never-ending wishes of new expensive medicines and devices. In addition, the efficacy of health care has questioned. In a decade, the costs of health care for employers has increased 146 % (about 10 500 dollars per employee per year in 2012), at the same period the cost share of workers has rocketed 222 %, and the average salaries have risen 36 % (Provancal 24). Tina Provancal label the mentioned discrepancies as an “affordability gap” which is still widening. The efficacy of health care has not recuperated 100 – 200 %. It is a financial impossibility to allocate more money to an inefficient health care.
The efficiency promises of industry have encouraged to apply the successful methods of manufacturing to health care. The famous book of Modig and Åhlström “This is Lean –Resolving the efficiency paradox” in 2016 described how to apply the Lean principles of Toyota automobile industry to get health care processes efficient. Already implemented lean solutions of health care surmount quickly older ways to organize health care. Traditionally health care is arranged by functionality principles which have meant more and more specialization. The functionality of health care system must replace by lean processes in which the resource efficiency has substituted by the flow efficiency. Correctly applied to health care the Lean ideology will change the whole hospital concept of health care. The old and high buildings of hospitals are transforming similar memorial monuments as smokestack industry earlier. It is impossible to practice a lean health care industry in those ancient and unpractical buildings. Also, it will not profit the make up those buildings by small changes in architecture. The big masses of obsolete buildings are waiting for new enterprises.
Finally, the age of digitalization and artificial intelligence transform the whole experience of sickness and health care. A long waiting list for an ivory-tower expert of health care is changing to own home-based mobile health information sending devices in your clothes. The small elegant parts in your wrist watch are sending all necessary and even unnecessary health care information for yourself selected health care provider at the same time when you are having your breakfast or watching your favorite television program. The transformation of the passive object of health care is changing upside down when we are ending to discuss “customer experience management, CEM” (Homburg C et al 377). The quality of care is no longer the only feature which weighs in customer experience of health care.
Thus, health care is changing rapidly, profoundly, and permanently. The experienced senior doctors in prestigious university hospitals will be replaced by a home version of IBM-Watson and a Google artificial intelligence doctor in your wrist watch and accompanying data analysis software for your various mobile devices. The autonomy and ownership of own health care information increase to a possibility to sell own health care data to private insurance companies. The old people continue to tell the days when you were to wait weeks and even months for a visit to an arrogant, distant, and dreadful physician. At grandmother´s home, a four-year-old grandchild does not understand what grandmother is telling about when she is complaining about the aches all around the body when he is checking from her iPad all the dashboard interpreted health care results of grandmother. He knows that the grandmother is doing well.
"Häyry Heta". The Limits of Medical Paternalism. London: Routledge, 1991. Print. Social Ethics and Policy
"Newman, Janet, and Elizabeth" Vidler. "Discriminating Customers, Responsible Patients, Empowered Users:Consumerism and the Modernisation of Health Care." Journal of Social Policy.Apr (2006): 193--209. Print.
"Wolfe, Samuel". "Consumerism and Health Care." Public Administration Review.September/ October (1971): 528--536. Print.
´Modig, Niclas, and Pär´ Åhlström. This is Lean –Resolving the Efficiency Paradox. Halmstad: Rheologica Publishing, 2016. Print.
´Porter, Michael E., and Elizabeth´ Olmsted Teisberg. Redefiening Health Care- Creating Value-Based Competition on Results. Boston: Harvard Business Review Press, 2006. Print.
´Provancal, Tina´. "Can Private Health Care Exchanges Improve the U.S. Health Care System?" Benefits Quarterly Fourth Quarter.4 (2013;): 24--29. Print.
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