An Introduction to the U.S. Healthcare Industry, Information Technology, and In formatics
Healthcare is probably one of the most complex business models in American industry given the uniqueness of the marketplace in which it operates. It is perhaps the only industry where the consumer does not necessarily pay for the service he or she receives, but rather third parties (in this case, insurance companies) negotiate arrangements with service providers to determine payment rates and types of service that are to be paid on the consumer's behalf.
Data provide the building blocks to information, a vital resource to administrators, practitioners, and decision makers in healthcare organizations. The process of transforming data into information is a daunting task, and given the complexities described above, the task is particularly challenging in this unique industry. This challenge must be managed, as healthcare is one segment of American industry where incorrect decisions or errors can cost lives or put innocent people in significant danger. The need to understand what patterns of treatment for a variety of different conditions will produce the best outcomes is profound. Adding to the challenge are the financial burdens healthcare providers are experiencing, as reimbursements are being cut and more and more conditions are being mandated in order to pay for services rendered. Healthcare organizations invariably lose money on certain classes of patients, and it is critical to understand where those areas are and how to address them.
One industry, however, lagged behind the strong pulse in leveraging information technology, and this involved healthcare organizations. The fragmented nature of the industry is often cited as a reason for the lag in technological implementations along with the adherence to traditional paper-based procedural modes of operations.
Some critics of applying management and business concepts in the healthcare sector argue that treating patients should not be considered a business. They argue that these initiatives could adversely affect patient treatment and care as the quest for achieving enhanced operational performance may dictate procedures. The answer to this critique lies in monitoring the overall activities of health providers , and this process includes enhancing the patient experience. The bottom line to all these capabilities is helping allocate the correct resources to the demand for those resources.
Source: www.ittoday.info
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