HCS/531 Health Care Delivery in America

Jennifer Culotta RN, PhD

March 4, 2013

Learning Team BAlison Cayson

Debbie Fernando

Elizabeth McCarthy

Gina Kelly-Vasquez

Heidi Fawcett

United States health care system always evolving

Many factors influence system and force change.

The recession spurs reemergence of urgent care centers.

MedExpress: A case study.

Prior to 1800

•Insufficient knowledge, qualifications, and skills

•Foundation was the Greek principle of the “four humors”

Late Colonial Period ; early 20th century

•Introduced medical degrees and scientific training

•Physicians began charging for services

•National and private health insurance

Post World War II

•Technology advancement

•Introduction of institutions and programs

•Fee-for-service replaced by managed care

•Readily available health information

•Developing consumers’ role

MedExpress Urgent Care Center

Demographics (Two Centers)•Located in the Suburbs of Nashville, TN

•Southeast

•Northwest

Services

Physician on site

Analysis of RelationshipsStakeholders

HealthCare Professionals

Professional Organizations

Patient Protection and Affordable Care Act (PPACA)

•Physician Shortages

•Aging population growing

•Higher Pharmaceutical costs

•Decreased Medicare Reimbursements

“Accountable Care Organizations”

•Transparency in Efficiency

•Stricter Rules

•Established clinics revamp practices

•New clinic open targeting a niche

Real Impact • Immediate Care

• Licensed Professionals

Perceived ImpactThink facility can replace PCP• Long Waiting times• Low Quality Care

Positive ImpactQuick serviceHigh Quality Care

Negative Impact• Some may feel rushed• May rely on urgent care centers –should establish PCP

Health Information Technology & Terms: -Computerized Provider Order Entry (CPOE) -Clinical Decision Support System (CDSS) -Electronic Materials Management (EMM) -Automated Dispensing Machines (ADMs) -Radio Frequency Identification (RFID) -Bar Coding -Picture Archiving & Communications System (PACS) -Electronic Health Records (EHRs)

Interoperability

Integrated Electronic Health

Records (EHR)s

Secure, and Privacy Safeguards

Between Systems

Quality Indicators for Easy Access•Walk in Service•Extended Hours•Affordable•Family Physicians

Levels of Service•Doctors Office

•Retail Mini Clinics

•Emergency Rooms

Responding to a changing health care system

Urgent care is becoming more of a demand in the United States

• 3-4% growth rate from 2008

• Speed and convenience

Diverse consumer group

Costs

Access

Involvement of insurance companies

Relationship with primary care

Health care changes continue

•Technology

•Increase aging population

Entire system must adjust

The goal

•High-quality

•Effective care

•Long-term care

•Maintain HIPPA

CDC, (2006). National Hospital Ambulatory Medical Care Survey’s, Emergency Department summary. Retrieved from, http://www.cdc.gov/nchs/data/nhsr/nhsr007.pdf

Fillmore, R. (2001). The Evolution of the U.S. Healthcare System. In N. Schlager & J. Lauer (Eds.), Science and Its Times (Vol. 7, pp. 336-338). Detroit: Gale. Retrieved from http://go.galegroup.com.ezproxy.apollolibrary.com/ps/i.do?id=GALE%7CCX3408504403&v=2.1&u=uphoenix&it=r&p=GVRL&sw=w.

Jones, S.B. (2012, Feb 26). An urgent need. Roanoke Times & World News. Retrieved from http://search.proquest.com/docview/923599081?accountid=35812.

Leibenluft, R (2011). ACOs and the enforcement of fraud, abuse, and antitrust laws. New England Journal Of Medicine, 364(2), 99-101. doi: 10.1056/NEJMp1011464.

Medpac.gov (2004). Information technology in healthcare. Retrieved from http://www.medpac.gov/publications%5Ccongressional_reports%5CJune04_ch7.pdf.

Medexpress, (2013). Why medexpressWhat is urgent care?. Retrieved from, http://www.medexpress.com/why-medexpress/what-is-urgent-care.aspx .

Merritt Hawkins, (2009). Merritt survey study. Retrieved from,http://www.merritthawkins.com/pdf/mha2009waittimesurvey.pdf.

Simmons, R. (2013, Feb 19). MedExpress staff ready for patients. McClatchy - Tribune Business News. Retrieved from http://search.proquest.com/docview/1288879285?accountid=35812.

Urgent care association of America. (2012). Retrieved from http://www.ucaoa.org/index.php.