The text book for this course:
Case study
Chapter 3:
Historical Overview of U.S. Health Care Delivery
The history of health care delivery began in earnest after the Flexner Report was published in 1910. The Flexner Report established the supremacy of science and medical education as the foundation of the U.S. health care system. Following the Flexner Report, medical schools began to implement strict eligibility requirements for prospective students and rigorous scientific standards for medical school graduates ((University of Rochester Medical Center, 2014). As a result, licensed medical providers and health care professionals began practicing medicine in rudimentary hospitals and traveling on house call circuits. Over time, these care delivery models would later give way to the modern medical office-based visits, urgent care centers, outpatient surgical centers, and various classifications of hospitals (Lathrop & Hodnicki, 2044).
Introduction
The health care landscape is still evolving because of government efforts toward health care reform and the emergence of innovative integrated care delivery models, such as accountable care organization and patient-centered medical homes. Over the past decade, health care reform has ushered in the rapid advancement of state-of-the-art clinical information systems to modernize health care delivery. The future landscape of health care is a partnership between patients and providers, facilitated through federal health policy and health information technology.
Case Report
The University of Rochester Medical Center (URMC) is one of the nations leading academic, health research, teaching, and patient care medical centers (University of Rochester Medical Center, 2014). The medical center was co-founded in 1921 by Abraham Flexner to fulfill his vision for scientific medical education and a health care delivery system and university hospital (University of Rochester Medical Center, 2014). URMCs health care delivery has expanded beyond traditional office-based visits toward a coordinated care model that integrates mobile health technology as a vital component of disease prevention and management (University of Rochester Medical Center, 2014). For example, the use of mobile personal health records can enable patients to obtain a clinical summary from a recent visit and review physician orders. Mobile health services and applications are an ideal self-management tool for patients with chronic diseases (Odier, 2016). The innovative coordinated care model is built upon the historical foundations of the house call, office visits, and hospital stays by broadening care delivery through mobile health, personal health records, and telemedicine.
In 2013 URMC launched a pilot telemedicine program called Tele-I-Care. The goal was to increase the number of eye examinations for as many as 3,000 patients in underserved areas of the community (University of Rochester Medical Center, 2014). URMIC also provides telemedicine services for pediatric, diabetic, and neurology patients. Its telemedicine program for Parkinsons patients, for example, removes a geographical barrier to access to health services (University of Rochester Medical Center, 2014). Diagnosis of Parkinsons disease is expected to double by 2030, and it is estimated that more than 40% of patients do not seek treatment with a neurologist (University of Rochester Medical Center, 2014).
Conclusion
Technological advances in telemedicine are just the beginning of exciting changes in health care such as an increase in collaboration between health systems or the consumer demand for access to personal health information through smartphone and wearable technology (Kuramoto, 2014). For example, URMSs extensive telemedicine service line delivers health care to patients with various chronic conditions and has received high patient satisfaction ratings (University of Rochester Medical Center, 2014). URMCs coordinated care delivery, chronic disease prevention, and treatment core objectives are born from Flexners scientific approach to health care delivery.
Questions
1. How can telemedicine programs such as URMCs reduce health disparities and inequalities for patients in underserved areas of the community or of lower economic status?
2. Despite the technological advances in health care (i.e., mobile health, wearables, and telemedicine), what barriers still exist for patients to access them to improve their quality of life?
References
Kuramoto, R. K. (2014). Specialties: Missing in our health care reform strategies? Journal of Health Care Management, 59(2), 8994.
Lathrop, B., & Hodnicki, D. R. (2014). The Affordable Care Act: Primary care and the doctor of nursing practice nurse. Online Journal of Issues in Nursing, 19(2). doi:10.3912/OJIN.Vol198No02PPT02
Odier, N. (2010). The US health-care system: A proposal for reform. Journal of Medical Marketing, 10(4), 279304. doi:10.1057/jmm.2010.17
Staff. (2014, March 24). University of Rochester Medical Center100 great hospitals in America. Beckers Hospital Review. Retrieved from https://www.beckershospitalreview.com/100-great-hospitals-2014/university-of-rochester-medical-center-gh-14.html
Rubric
CASE STUDIES
Each case studiy includes a description of the assignment and a grading rubric. Assignments are submitted in Blackboard under Submissons.
Instructions for Developiing Case Study Analysis
Purpose of a case study is to build upon your foundational knowledge gained from the assigned readings and create an analysis of an assigned topic using critical thinking skills.
Read each case and the questions carefully. Most errors occur when students do not answer the actual question. I read many interesting papers about the assigned topic that do not answer questions, and unfortunately do not receive a passing grade, regardless of how well written.
Work is evaluated for a logical approach as well as accurate content. Use Case Study Resources to learn how to approach assignment in terms of critical thinking.
Write a critical analysis of selected theme using evidence based literature and not based on your own opinions, values or beliefs. This is not an assignment to write summaries of other persons’ work; this is a course where you must demonstrate the ability to think critically and to apply models and theories to real world situations.
You must know how to conduct research to obtain journal publications — ((evidence-based (EB) literature))– and how to use the library databases for obtaining information. You can request assistance from the library staff, if needed. [ jwesterd@odu.edu]. The ODU Information Literacy Tutorials provide you this instruction.
References should be less than 7 years old and a minium of 5 peer-reviewed journal articles. Any reputable websites (such as government websites, like the CDC, CMS, etc.) count above the 5 minimum EB sources. Sources like newspapers, blogs, and Wikipedia are unacceptable for use as a reference. Use your textbook for;your own foundational knowledge but do not quote..
Include an introductory and closing paragraph. Use subheadings to delineate the case questions. Headings should match the question content. I should not have to guess the topic.
Instructions for Formating Case Study Paper
All typed work should be double-spaced, use Arial or Times New Roman, font size 12.
Basic knowledge of writing is required, such as how to construct a paragraph, an introduction and closing. This is a technical report written in 3rd person and without contractions (cann’t, don’t, doesn’t, wont’t, etc.).
Must use APA Style format for entire work: cover page, page numbering, subheadings, citations, and references.
Cover page must include number and title of case, your name, course number and name (CHP 390 U.S. Healthcare Delivery System), instructor’s name (Dr. Shuman), date of submission, word count, and ODU Honor Pledge. Headers are not needed so please do not use.
Paper should be 800-1,000 words. Any less indicates insufficient content and is an automatic failure. Assignments 5% in excess of the word count (50 words) will be penalized. Cover page and references are excluded from the word count.
Do not use direct quotes, but rather paraphrase original work and include citation and corresponding reference. See APA Style.
Similarity Index for this assignment is at 20%. Any paper with a similarity index greater than 20% will be penalized with automatic failure. I only count highlights within the body of the paper. Sentences typically get highlighted that are too similiar to original work or have improper citations. You have multiple opportunities for submission so that you can check your work, edit and resubmit.
Please submit the assignments in the designated Drop Box in BLACKBOARD. NO other submission method is acceptable. Never email papers to instructor.
All assignments are evaluated using the grading rubric. All grades on BLACKBOARD are final.
Papers less than minimum word count (800 words), with no in-text citations or with highlighting by SafeAssign in the body of the paper receive an automatic failing grade. See Syllabus, “Automatic Failing Grades on Assignments.” No exceptions and no resuMbmissions.
