Respond to the following questions concerning the identified disparities to health within the Health
Respond to the following questions concerning the identified disparities to health within the Healthy People 2020:
Are there tools to help identify these gaps in care?
If you could develop a screening tool to address a barrier to healthcare, what would it look like?
Who would administer this and what resources would you need to coordinate with to solve this problem?
Is this feasible for a clinic setting? Why or why not?
ANSWER
Disparities to Health
Are there tools to help identify these gaps in care?
Currently, the U.S. healthcare system is poorly designed, as evidenced by the widening gap in the delivery of care. A person’s ability to access quality care services is influenced by sex, race, age, sexual orientation, geographical location, gender, and social-economic status. Based on a report provided by the Institute of Medicine (IOM), disparities in healthcare are linked to broader contexts of inequality (American Medical Association, 2021). A lack of trust has been identified as one of the barriers to accessing care. In the United States, several tools have been established to measure inequalities at a community level. For instance, The Health-Related Social Needs (HRSN) screening tool was established by the Centers for Medicaid Services (CMS) to assess the effectiveness of their support in promoting better health outcomes.
The HRSN screening tool primarily targets to provide evidence for disparities experienced at a community level. As such, the tool collects data concerning exposure to violence, homelessness, and hunger. Healthcare administrators can utilize the HRSN tool to create patient-centered treatment plans and refer them to community services. As highlighted by Healthy People 2020, family situations such as financial burdens can limit an individual’s ability to access quality healthcare services. In this sense, evaluating the family situation can help in identifying a person’s barriers to care services.
If you could develop a screening tool to address a barrier to healthcare, what would it look like?
The barriers to healthcare as identified in Healthy People 2020 range from lack of culturally-competent services, lack of insurance cover, high healthcare costs, and lack of care services. The screening tool would seek to address social determinants of health in a community. Today, structural and political aspects govern people’s lives. As such, the screening tool would focus on addressing the major forces influencing access to care services within a society. Most importantly, frontline workers in healthcare settings would catalyze the change process towards equal access to healthcare. The healthcare settings would therefore serve as the grassroots to promote change at the broader national level.
The screening tool would include an assessment of the patient’s assets, risks, and personal experiences. To understand the patient’s characteristics, providers would collect information concerning their race and ethnicity. Information concerning a person’s race helps in understanding the needs of a specific population. With this knowledge, providers can easily offer patient-centered care and improve the delivery of services for the target group. In addition, the tool would consider the patient’s ability to communicate in the English language. According to Showstack et al., (2019), care providers’ language proficiency determines a patient’s outcomes. Most notably, patients tend to trust medical practitioners based on their ability to communicate using their language. In this sense, the program would include recording a patient’s language preference.
Further, medical practitioners would be required to collect data about a patient’s current stress level. Patients would be expected to rate their stress levels based on a five-point rating scale. Studies on race-related stressors revealed a connection between racial discrimination and stress levels (Williams, 2018). As a result, racial discrimination within the care system can induce stress, eventually leading to substance abuse. Besides discrimination, violence within the residence can cause trauma on a patient. On some occasions, patients may feel reluctant to seek treatment or attend assessment sessions due to substance abuse.
Drug abuse can redirect an individual’s attention and act as a distraction, thus diminishing their interest to attend treatment sessions or therapy. Given these connections, the screening tool will inquire about a person’s past experiences of substance use. The patients will be questioned about their current levels of financial resources. Providers will therefore assess a patient’s education level and current occupation. People with college degrees are more likely to have a well-paying occupation, thus generating enough income to cater for their healthcare treatment. On the other hand, providers will understand the patient’s financial situation by collecting information about insurance.
Essentially, health insurance helps in covering treatment costs when an individual experiences an unexpected illness or condition. However, it is difficult for patients without health insurance to seek treatment due to the high costs of healthcare. The other issue would be access to convenient transportation for patients seeking healthcare services. In this case, patients would disclose information concerning the availability of transport means in their geographical region.
Who would administer this and what resources would you need to coordinate with to solve this problem?
The Screening program will be administered by physicians across healthcare settings. However, data collection will be conducted by other parties within the care settings including care coordinators, patient navigators, and community health workers. The team will be responsible for overseeing the screening processes to collect relevant information from visitors seeking care services. Accordingly, different care settings will decide on the teams that will coordinate data collection depending on the available number of staff. An important aspect, in this case, will be the care setting’s ability to store information and communicate the results to relevant parties. For instance, some healthcare settings may appoint the medical assistant to conduct an annual screening for a patient and record the results using an Electronic Health Record (EHR).
Given the complex nature of patients’ information, care settings will require financial resources to implement the EHR technology. To avoid overwhelming the frontline workers, the care setting will employ additional staff to assist with the data collection from patients. To successfully adopt an EHR system, care settings will need to cater for various expenses including hardware and software costs (Shah et al., 2014). Besides purchasing the components, a team of trained staff will be required to collect, analyze, and monitor client information.
Today, most care settings experience difficulties when communicating with patients from different ethnic groups. The hired staff is therefore supposed to have competence in handling multicultural communities. Patients’ quality of care will be influenced by the efficiency of the hospital in addressing racial, cultural, and ethnic differences. The process of collecting data will involve interactions between the hired staff and the patients. Thus, it is imperative for hospitals and healthcare institutions to address language barriers that may inhibit the program’s success. As a result, translation software will be required to ensure a clear flow of information between patients and providers. In addition, the care setting will be expected to recruit staff members from various ethnic groups. This approach will make it simpler for data collectors to communicate with patients while establishing a sense of trust.
The ability to collect and store patient information will simplify the duties of physicians, creating more time to attend to the patients. Consequently, EHR eliminates confusion among medical practitioners during a treatment session. Often, Practitioners may recommend the wrong treatment method due to the inaccuracy of client’ information. However, electronic storage enables practitioners to easily locate patients’ history concerning their treatment method and underlying conditions.
Is this feasible for a clinic setting? Why or why not?
Implementing the screening tool would require care settings to allocate a certain amount of financial resources to the program. Today, most healthcare institutions lack enough funds to finance new projects outside the normal practices. As the screening tool would involve hiring new staff members, it would be difficult for healthcare institutions to cover the expenses. The costs involved in the implementation range from software, hardware, training, hiring, and maintenance. While some hospitals can afford to finance the project, many small establishments may find it challenging to acquire the necessary resources for the process. The need for accurate information would also compel such institutions to implement EHR systems. As such, the staff would require additional training in order to handle the new tasks. An important aspect, in this case, is that existing employees may resist the transformation, limiting the management’s ability to implement the program.
Another aspect in the implementation of the EHR systems is the process of providing training to new staff. As Shah et al., (2014) suggest, before deploying the data collection team, the setting needs to ensure that members are well-trained in collecting and handling EHR systems. In this case, the process will consume a lot of time, diminishing the setting’s ability to perform other operations. Many healthcare settings may feel discouraged by the potential impacts of the program on business activities, as some of the staff will dedicate their services to the project.
A major constrain to implementing the screening tool for disparities is the challenge of data privacy. The electronic storage of patient information creates vulnerabilities to cyber-attacks. Statistically, the United States recorded approximately 1001 cases of data breaches, exposing the personal details of close to 155.8 million people (Statista, 2021). EHR systems contain patients’ personal information including name, financial information, social security number, names of next of kin as well as current address. Given the value of these data, the screening tool program would attract a wide range of cyber attackers, making healthcare setting a target of data breaches.
While other data breaches such as credit card theft may be detected, stolen patient information can remain undetected for several months, creating an opportunity for intruders to perform malicious acts. As such, healthcare settings may find it unreasonable to implement the screening tool due to the underlying risks. Cyber attacks on a care institution not only cause financial losses, but they also ruin the setting’s reputation. Initially, clients trust the care system with their information by disclosing personal details to improve the quality of healthcare. However, a data breach can violate this trust and affect the relationship between patients and the healthcare system.
While implementing the screening tool may be difficult, hospitals can address the highlighted challenges by setting up a strategic plan. An important point to consider is that the team members should be informed and trained in advance, prior to the implementation of the tool. To limit the number of resources spend on the project, management teams can rearrange work schedules, to avoid overwhelming workers with new duties. For instance, healthcare settings can schedule data collection periods for a particular patient. As such, a patient would provide details in case of any changes concerning the recorded data. On the other hand, resistance from employees can be mitigated by following a gradual implementation process. During this period, the management team can prepare workers by highlighting potential benefits from the program. Employees should also be compensated for additional duties introduced by the program. Overall, the benefits of the screening tool for disparities in healthcare outweigh the underlying challenges.
References
American Medical Association, (2021). Reducing disparities in health care. https://www.ama-assn.org/delivering-care/patient-support-advocacy/reducing-disparities-health-care
CMS, (2020). Health-Related Social Needs Screening Tool. https://innovation.cms.gov/files/worksheets/ahcm-screeningtool.pdf
HealthyPeople, (2020). Disparities. https://www.healthypeople.gov/2020/about/foundation-health-measures/Disparities
Shah, J. R., Murtaza, M. B., & Opara, E. (2014). Electronic health records: challenges and opportunities. Journal of International Technology and Information Management, 23(3), 10.
Showstack, R., Santos, M., Feuerherm, E., Jacobson, H., & Martínez, G. (2019). Language as a social determinant of health: An applied linguistics perspective on health equity. AAALetter (AAAL’s newsletter).
Statistica, (2021). An annual number of data breaches and exposed records in the United States from 2005 to 2020. https://www.statista.com/statistics/273550/data-breaches-recorded-in-the-united-states-by-number-of-breaches-and-records-exposed/
Williams, D. R. (2018). Stress and the mental health of populations of color: Advancing our understanding of race-related stressors. Journal of health and social behavior, 59(4), 466-485.
