Essay Example on ICU vs eICU An electronic intensive care Unit

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ICU vs eICU An electronic intensive care unit eICU utilizes modern technology to monitor and communicate with patients staff and families to deliver better health outcomes over a traditional intensive care unit ICU According to Cheryl Hiddleson monitoring within an eICU is accomplished via video voice bedside sensors monitors microphones and speakers Braunstein 2017a The data generated by these sensors is monitored remotely by both humans and algorithms and the local providers can be alerted to respond to the data Braunstein 2017a Leong Sirio and Rotondi have shown that eICUs are capable of delivering better care as measured through lower mortality rates as well as lowering hospital stay durations from an average of 4 35 days to 3 63 days 2005 Historical Relationship between HL7 and FHIR 200 Health Level Seven International HL7 developed the Fast Healthcare Interoperability Resources FHIR as a next generation standards framework that combines the best features of HL7 s v2 HL7 v3 and CDA product lines while leveraging the latest web standards and applying a tight focus on implementability Health Level Seven International 2017 The broad goal for the development of these standards is to enable electronic healthcare data exchange Health Level Seven International n d FHIR is considered an evolution over HL7 v3 and the two can coexist alongside one another Health Level Seven International 2017 As Buchman mentions in the interview the HL7 v3 standard is cumbersome and may require 60 pages of data to report a single lab value Braunstein 2017a FHIR addresses this challenge in a few ways utilizing concise specifications being built on web standards and human readability alongside a formal mapping 



The use of web standards within FHIR will ease interoperability across platforms tools and departments within healthcare facilities Health Level Seven International 2017 As the FHIR is still published under Trial Use the full benefits of implementation are likely yet to be seen Impact of Uninsured on Healthcare Costs Uninsured individuals increase healthcare costs for others in several ways A government report from 2003 estimated that cost shifting from uninsured patients to insured patients accounted for 1 6 of national spending on physician and clinical services after accounting for government subsidies and charity Institute of Medicine US Committee on the Consequences of Uninsurance 2003 However the authors found that the impacts of cost shifting from uninsured tend to primarily affect the local communities in which the cost shifting takes place Institute of Medicine US Committee on the Consequences of Uninsurance 2003 Given the nature of insurance increased participation of healthy individuals will better spread risk around to minimize negative effects of the uninsured on local communities while reducing the average cost for each participant Fortunately the Affordable Care Act ACA requires risk pooling and included an individual mandate to encourage healthy individuals to participate and reduce risk of adverse selection American Academy of Actuaries n d Costs are partially driven by chronic diseases Anderson and Horvath identify that 78 of each dollar spent in healthcare is spent on those with chronic diseases and they further observe that the most common chronic diseases in working adults are hypertension high blood pressure respiratory diseases or mental conditions p 264 265 Since these chronic conditions often coexist within patients many patients seek out healthcare from multiple specialists further contributing to increased healthcare costs There's an opportunity here to increase access to preventive care mental health care and proactive campaigns to reduce behavior such as poor diet nicotine use and excess alcohol consumption that contribute to the development of these chronic conditions Role of Health Informatics 



To reduce costs when patients visit multiple providers for their multiple chronic conditions newer standards of data exposure such as FHIR combined with newer information systems may enable faster and simpler interoperability between physicians in different fields and increase access to knowledge and information This change could be as simple as providing transparency to tests others have completed but it could be more in depth as sensors become more prevalent Given that tests can be costly reducing redundancies in testing could lower costs As technology advances opportunities for identifying and addressing risk factors for individuals increases While measuring data has become easier for many in the general population consumption of that data into a meaningful format for healthcare providers remains an area of opportunity Future EHR interoperability with data from phones wearables and other devices will provide a more complete picture to providers In the past this may have required specialized technology to be present with a patient at all times say for monitoring the patient's heart function The Apple Heart Study demonstrates the potential of wearables users can enable additional tracking on their Apple Watch to obtain advance notice of atrial fibrillation and seek care earlier Apple 2017 Without this technology the monitoring would require specialized equipment and many patients may not be aware of their condition until treatment is more urgent and costly Health informatics still has a critical role here to ensure this data is available to the individual and their providers The broader adoption of FHIR has the potential to transform healthcare delivery and outcomes even further As Braunstein discusses FHIR will enable a level of data interoperability that supports aggregation and a more responsive learning healthcare system Braunstein 2017b A learning healthcare system might be able to identify risks in individuals even sooner and offer solutions that don t require intervention by a specialist or inpatient care One potential challenge for the US healthcare system will be how insurance companies utilize this additional information if at all to discriminate in pricing of healthcare options


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