Healthcare Changes to Healthcare Practice and Delivery:

Healthcare Changes

Changes to Healthcare Practice and Delivery: A Study of Two Detroit, MI Healthcare Facilities Separated by Twenty Years

Changes to technology and to the political and regulatory landscape have led to many changes in the ways that businesses in all manner of industries operate. Increased communications capabilities, the shrinking size and cost for advanced technologies, and a variety of other changes have provided many businesses with an opportunity to operate more efficiently, and in so doing have also made many industries and markets more competitive. An examination of some typical businesses operating in these industries today as compared to their counterparts that were in operation twenty years ago provides ample evidence of the changes that have occurred and the ways in which businesses have adapted.

The healthcare industry has by no means been immune from these changes, but in fact has changed more than many other industries due to both technological and legislative developments. Through change sin information system, data storage and communication, and a variety of other technological enhancements and innovations, the level and cost of care as well as the manner in which care is provided in many cases has undergone some significant changes, largely to the benefit of physicians and patients together. This paper will examine operations in a standard mid-sized private practice medical office in Detroit, Michigan, comparing a modern organization to a similarly sized and located location from the early 1990s. This will show many similarities, but will also highlight the key differences in these business operations.

Information Systems

One of the major changes that has taken place in the medical industry since the 1990s has been the rapid growth of communications capabilities and data storage abilities, with an enormous effect on how the administrative and even the medical aspects of the business operation work (Amoni 2000; Wager et al. 2009). Information systems that are currently in place in medical facilities allow for much faster retrieval of records by administrative and medical personnel; communication between medical offices, billing offices, insurance departments, etc.; and even faster and more efficient communications between medical professionals and their patients (Wager et al. 2009). Computerized and Internet-accessible information systems have truly revolutionized much of the goings-on at a typical medical office.

At a standard contemporary medical office in Detroit, a single information system is in place that allows for the updating and accessing of patient records by physicians, notification of labs and pharmacies of needed procedures/prescriptions through Internet-based electronic messaging, the coding off procedures for billing and insurance purposes, and several other administrative functions. The usefulness of this system is further facilitated by terminals in every examination room, allowing for immediate access and updating and limiting the risk of mistakes due to information transfer, time lapses, etc. For patients that have themselves updated to twenty-first century methods of communication (many haven't), this system also provides patients a means of contacting or receiving information from their physician.

Many of the basic technologies that support this integrated and streamlined yet highly comprehensive information system already existed in the 1990s, of course (Amoni 2000). The cost and complexity of such a system, however, would have made it impractical, and thus these systems were not a standard part of medical business operations two decades ago. Most offices still kept primarily paper records, possibly with digital backups but certainly not with the degree of storage, cross-referencing, and communicability that exists today. Many offices also would not have had an Internet connection, and the infrastructure did not exist for communications between offices at sufficient enough speeds to make such communications of billing and insurance information practical. Information systems consisted of paper records and many different phone and fax numbers, all likely collated by a computer at some level but not coordinated at all to today's level.

Other Health Care Information System Advances

The major differences in the information systems that existed in healthcare offices two decades ago and those that exist today are the result of many smaller specific innovations in many different areas (Wager et al. 2009). Software development that has specifically targeted medical businesses has led to major changes in the way healthcare organizations store and process information, making systems far more accessible to users and requiring less intensive specialized training then in previous decades (Anderson & Aydin 2005). Without the specialized software created for this purpose, the Denver office could not operate in as integrated a fashion.