Monthly Archives: May 2017

Acute Healthcare

Communication plays a crucial role in healthcare. Timely dissemination and sharing of information is critical for acute healthcare providers. Similarly, primary healthcare can be easily administered by using practical and handy communication channels. However, there are several factors that need to be taken into account before deciding upon an effective mode of communication in both primary and acute healthcare institutions. Reliability, coverage and confidentiality of transmitted information along with the institution’s capacity in handling the equipment, play an important role. Healthcare institutions can largely benefit from a mobile clinical staff and two way radios can provide prolific results if used effectively for sharing information.

Functionality and Build of Two Way Radios

Two way radios allow only one function at a time – either receiving or sending the signal. This helps the users efficiently communicate without interrupting the interlocutor. These devices are helpful in exchange of crisp information, rather than constant communication. Two way radios are also known as transceivers or walkie talkies.

Two way radios are simple devices made of primarily six components: power source, receiver, transmitter, microphone, speaker and the crystal. This implies that running and maintenance costs for these devices are not too high. Two or more communicating devices operate on the same radio frequency and a push-to-talk button switches the device between receiving and transmitting modes.

Primary Healthcare and its Challenges

There is a growing emphasis to offer primary healthcare to one and all. This requires creating an environment where equal emphasis is laid on healthcare for all individuals. However, shortage of trained medical practitioners poses a serious threat to achieving this objective. Medical planners have to focus on the use of technology to make the maximum use of the available resources.

Isolation of patients is a big problem that surfaces in primary healthcare. Patients who need medical attention are usually dispersed, especially in rural areas and may not have access to medical facilities. The supply of drugs and medical tests are difficult to conduct and this defeats the very objective of primary healthcare. Lack of communication is another major problem in administering primary healthcare.

A quick exchange of information offers a suitable solution to meet all these challenges. Two way radios enable exchanging of crucial medical information and gradation of current medical practices. The absence of advanced technologies in many locations also increases the importance of two way radio communication devices.

Using Two Way Radios in Primary Healthcare Settings

The most important use of two way radio in delivering primary healthcare is in connecting local medical practitioners with hospitals in cities and more advanced areas. This is critical to diagnosing a patient as well as for prescriptive purposes. A timely decision whether the patient must be referred to a hospital with advanced facilities can be crucial in saving lives. The hospital can also monitor the condition of a patient at another location through two way radios.

How well two way radio technology is implemented for primary healthcare will be dependent on medical and health protocols. Doctors in some countries contact health aides and monitor the situation of the patient by use of two way radios. The medical structure of a community and the country determines how effectively the two way radio can be used for primary healthcare.

Emergency situations can also be addressed by using two way radio. Lack of good transportation and communication facilities can jeopardize a community in case of a medical emergency. Two way radios can be used to send news of such medical exigencies to hospitals or district headquarters and help save many lives.

In some countries, two way radios are used to connect fieldworkers with doctors who are constantly on the move. Use of airplanes helps attend to critical patients in a very short time as soon as the news is delivered by way of two way radios.

Two way radios can also help in training field workers who play an important role in primary healthcare. It depends on the level of existing competence of the medical workers and the desired levels of training. Moreover, field workers can listen in to the conversation of co-workers with physicians and learn by observing the standard medical practices adopted in different cases.

Using Two Way Radios in Acute Healthcare Settings

Clinical information in a hospital can be shared with the help of two way radios. A mobile unit of clinical staff will be more efficient in dealing with day-to-day problems faced by patients and in specific cases where a patient requires immediate attention. A patient who undergoes a complicated heart surgery may require constant monitoring for a few hours after the operation. However, it may not be possible for the doctor who operated on the patient to stay by his side all the time. Two way radios can prove to be a handy solution for helping healthcare institutions, solve such critical operational issues. A nurse attending on the operated patient can inform the doctor about the patient’s progress or whether the patient needs immediate attention, using two way radios. This will not just update the doctor on the patient’s condition but also help him take immediate decisions based on the available inputs. The healthcare industry has successfully tested and used two way radios for acute healthcare. Hospitals make wide use of two way radios for exchange of information among healthcare workers.

Two Way Radios: Advantages

Two way radios provide for a cost effective medium of instant communication. Healthcare industry requires rapid and extensive sharing of information in the most cost effective and efficient manner. A large healthcare institution can be brought under the ambit of wireless radio communication without running up high costs. Moreover, radio signals are quite reliable as compared to mobile networks, where one must depend on the network strength and connectivity. Also, issues of interference do not surface often. Maintenance costs for these devices are also considerably low.

Two Way Radios: Standard Practices for Operation

Some of the standard practices followed for using two way radios in healthcare institutions are:

  • The devices are used in “receive only” mode in patient areas.
  • Medical staff is advised to leave the patient area if the device has to be used for outgoing communication.
  • Two way radios must be kept at a distance from highly energized medical devices.
  • Lowest possible setting must be used to avoid any interference if the device so permits.
  • In case of malfunctioning of any medical equipment, the use of radio devices must be stopped immediately.
  • Unnecessary use of two way radios may distract a medical practitioner during surgery. Therefore, such devices must be used only when required to avoid any delay in patient care.
  • Using Two Way Radio Systems: Interference and Other Issues

Two way radios do not generally interfere with other medical equipment. Research studies have proved that hospitals can safely use two way radios for communication purposes. These devices can be safely used at a distance of 0.5 meters from most medical equipment. The reason is that these devices operate at high frequencies and do not cause any interference. However, the use of two way radios is discouraged in highly sensitive medical environments like the ICU.

Some of the other issues with two way radio systems include problems, like poor maintenance, lack of power, non-availability of spare parts and poor training of the medical staff regarding the usage of these devices. Any compromise with the quality of the device can prove disastrous and defeat the entire purpose of setting up two way communication radios.

Towards A Successful Society

The success of any society is ultimately determined by how well its population lives and dies. Within this paradigm of “successful population” are two fundamental elements – individual and collective wellness. A successful society therefore embodies the notion that both individuals and the overall population are well, and these two measures are reasonable assessments of the wellness, and hence the success of any given society.

In other words, the success of a society can be assessed, characterized, and understood through these two main measures. To break it down, individual wellness consists of answering the question: does the society reasonably allow and encourage individuals to be well? Secondly, does the society allow and encourage wellness for the entire population from birth to death? To the latter question, the most important component of population wellness and hence, societal success, is the degree to which the sum of individual wellness creates collective wellness. The single-most important component of population wellness is a high level of population health, measured by the numbers of individuals who are well or have reasonable access to being well.

The four scenarios below represent a summary snapshot of healthcare systems currently in existence in the Western Hemisphere. The scenarios are predicated on the reality that the cost of healthcare is (next to purchasing a home) the most expensive cost one will experience during his or her lifetime and that these costs are expected to continue to escalate over time as new technology, treatments, and pharmaceuticals continue to drive costs. These four main approaches to healthcare are:

  1. No healthcare programs (other than free market)
  2. Universally funded programs
  3. Insurance company funded programs
  4. Combinations of the above

These four healthcare approaches are summarized below with respect to how well they represent the ability to create a successful society. Remember, a successful society is one that encourages, promotes, and allows for both individual and collective wellness, as measured by population health.

  1. No Healthcare Programs: Countries which have no healthcare programs generally have lower than average population health. While some members of the population in these societies (namely the very rich) who are able to afford healthcare may be healthy indeed, the overall population health is often quite low. It is important to note that socioeconomic status is generally a good predictor of population health. In countries where no healthcare programs exist, and the reason for these lack of programs is lack of finances, then population health is usually comparatively low. Using our definitions of societal success, the success of these societies would be low, or unsuccessful.
  2. Government Sponsored Programs: Countries with government sponsored and funded universal healthcare programs generally have a collectively higher level of healthcare than other countries. Again, if the one applies the definition of success of the entire population as the sum total of the wellness of all individuals within that system, then countries which offer healthcare programs that collectively confer benefits on the highest number of individuals are, by definition, successful. Since one cannot be more than well, there is no incentive for individuals to access more services than are required in order to be well. Leaving aside preventative programs and social marketing costs as key aspects of overall population health, health and wellness can be accessed within government sponsored programs up to a certain level depending on the aggregate overall need of the population. Therefore, by definition, and in spite of incentives and disincentives within the system, the societies that employ these systems are successful.
  3. Insurance Company: Healthcare programs sponsored by insurance corporations can work well, provided that the insurance coverage provides all members of society with at least basic coverage and coverage through catastrophic illness. Nobody plans on getting leukemia, or ALS, or meningitis, or lupus, for instance. If you are well-educated and have a position with health benefits with a corporation or you have been successful in your career or business, then it is likely you will be able to afford the costs of healthcare. However, since healthcare and profit-motive are mixed within the same crucible, there is a strong incentive to cheat or to create environments where profit supersedes care if the two vie for supremacy – much as suggested in Michael Moore’s movie, Sicko. The active removal or denial of healthcare is a logical and inevitable outcome of a for-profit, insurance corporation controlled system of care delivery – particularly where the population is aging. Also, there is no compelling motive for insurance corporations to cover individuals susceptible to high healthcare costs (i.e., those with catastrophic physical illness; mental illness; the frail elderly; new mothers and infants), period. The outcome of such a system would be to spiral into category 1 – No healthcare programs – (mediated by a very few insurance companies) wherein the richest segments of society would be able to access services. The irony is, the richest citizenry often require much less healthcare than others. The upshot is this: there is an increasing disparity in the number of people who are able to access healthcare in the face of age and cost escalations. One needs to question the current and future success of these social systems.
  4. Combinations of Above: Combinations of the above become extremely complex and difficult to assess. There are certainly advantages and disadvantages, as well as incentives and disincentives for a hybrid of the above systems. Each of these advantages and incentives (or lack of) are inextricably connected to the socioeconomic class you and your family belong to or are transitioning into as well as a host of external and internal factors. A government funded universal system provides healthcare to everyone, including those who are disadvantaged and could not possibly access care without subsidization. It also provides care to those who are charged by some who would abuse care (though unclear who this group might be as people do not consume unlimited healthcare once they are well). Alternatively, the system dominated by large insurance companies provides very high quality, responsive care to individuals who can pay or who are insured by corporations who in turn can pay. This system works well where individuals insured are reasonably healthy and young. A problem occurs when the population of employees becomes older and insurance premiums are either hiked to cover extraordinarily high costs (insurers will only cover healthcare costs where the profits of covering healthcare costs actuarially calculated costs) or removed entirely. Countries in which no healthcare programs exist (presuming healthcare is available) results in costly but accessible services for the very few. There is no need to get into the obvious personal suffering and strife in this latter healthcare system.

To summarize the four systems discussed:

  1. The richest members of society will continue to receive care regardless of the system in place.
  2. The poor will suffer the most in instances where there is either no system in place or where insurance corporations are the primary arbiters of healthcare delivery.
  3. The government funded universal system provides care to the greatest number of individuals in society, despite any shortcomings.
  4. Profit motive and linkages to incentive to constrain services and limit accessibility becomes increasingly prevalent as the workforce ages (and healthcare benefits supplied by employers become accessed more frequently).
  5. Societal Success = providing the opportunity for wellness for the greatest number of people that make up the society.

In conclusion, the success of a society is correlated with the individual and collective wellness of that society. Wellness of the society is inextricably linked to the overall health of the population within that society.

Societies that provide healthcare to the highest number of individuals to an established floor (as opposed to ceiling) level of care (inclusive of the most downtrodden and indigent) are successful. A ceiling level of care is redundant when referring to healthcare, since, with the exception of only an extremely rare and unusual incidence, people only access healthcare up to the amount which will result in wellness. For instance, unlike other goods or services (e.g., Ferraris, Rolex watches, massages, Gucci handbags), obtaining healthcare in excess amounts is both redundant and ridiculous and counterintuitive to human nature.

It is therefore reasonable to suggest that a system of care which provides for the greatest number in society (e.g., everyone), the most vulnerable in society; as well as those at the highest rungs of the socioeconomic ladder and everyone in between could reasonably be argued as the most effective. To those who would charge or decry a system that would benefit everyone as inefficient or unaccountable and therefore untenable, it is important to ask where they, themselves, fit into the healthcare-socioeconomic landscape. Secondly, are they interested in the societal success, will their approach move the society toward success, or are their own parochial interests – however they are justified – masquerading as societal success. You be the judge.

In essence, evangelizing capitalism to the exclusion or minimization of societal success as measured by population health is tantamount to “cutting off your nose to spite your face”.

Funding Your Own Healthcare

Introduction

More folks including both individual adults and families are on their own to provide funding for healthcare. There is a growing trend of being your own freelance business owner, being a contract employee or being employed by a business that does not offer a health insurance benefit. Many people make the mistake of buying price instead of value in a healthcare funding plan. This article provides an overview of options for funding healthcare with both advantages and disadvantages of each strategy.

How Much does Healthcare Cost?

Understanding what healthcare costs is important to deciding the best strategy for funding your own healthcare needs. Buying based only on price and not value (price vs. benefits) is a common and very grave mistake. Some examples of what healthcare can cost will help illuminate the importance of value and risk transfer (insurance) in funding your own healthcare.

Routine Care: Having an ongoing relationship with a medical doctor is important value and can help you avoid much more costly illness and improve your overall health outcome. I am an example of the benefits of routine medical care with the goals of avoiding cardiovascular disease, diabetes and managing my sinus allergies. My recent doctor visit including blood test = $248 Well Baby Check (price from local pediatrician) = $160 Annual Physical = $500? Cost depends on how elaborate a physical you get.

Rx Drug: Prescription drugs are approximately 10% of total healthcare spending [1]. Prescription drugs can be a large component of treating a major or chronic illness. These are drugs that I take with the list prices from my local drug store. OTC Claratin (equivalent house brand) = $10 / month Crestor = $137.99 / month Astelin = $115.99 / month An example of a more expensive medicine that my wife takes regularly for her chronic migraines: Topamax (generic equivalent) = $566.99 / month

Diagnostic Tests: Diagnostic tests are an important part of most disease identification, management and treatment and are a large component of healthcare costs. My recent blood test (three panels) = $152 X-Rays = $100+ Mammogram = $150+ MRI = $1000+; a complex MRI can cost several thousand dollars

Emergency Care: ER Visit = $1000+; this is based on my experience – I have never had an ER visit that was less than a $1000 in billed costs

Hospital Admission About 30% of healthcare costs are for in-patient hospitalization. The average length of a hospital stay is five days [2] with costs highly dependent on treatment. Heart Arrhythmia (irregular heartbeat) – Example from one of my clients = $45,000 including an ER admission and then three days in the hospital

Major Illness: Cancer (Lymphoma) – My brother over two years of treatment = $500,000+; It is hard to tell the actual total but when I called to see if my brother was close to exceeding his $1 million lifetime limit the expectation was at least $500,000 in paid benefits to complete his cancer treatment.

Chronic Illness: A chronic illness is defined by a medical condition lasting a year or more that requires ongoing treatment. Examples are Diabetes, Asthma, hypertension and Depression. Approximately half of all Americans have some kind of chronic aliment [2]. Type 2 Diabetes – Average Annual Cost = $5949 [3] Asthma – Average Annual Cost = $3192 [4]

Put all of this in a gigantic pile and the average cost of healthcare in Texas according to the Texas Department of Insurance in 2006 was $7110 per person. That is $593 per month per person. Admittedly that includes a lot of unhealthy and high healthcare uses but it provides some perspective on what healthcare costs. If you have not had a close relative, family or friend with a serious illness or injury, it is hard to imagine the high cost of healthcare. Value in funding healthcare is more than helping with the cost of routine care. Value to me means grappling with the risk of a major illness or injury.

Choices for Funding Healthcare

Cash – Just buy it when you need it and pay what it costs out-of-pocket. The big disadvantage of the “Cash” or what I call the “If we are Lucky Plan…” is that you have no protection of the risk for a major illness or injury. We have over 24% of Texans uninsured for healthcare with a fourth of the uninsured on the “Cash” plan by choice — about 6% of the entire population.

Advantages:

  1. No Monthly Premium / Fees
  2. Ask for Cash discount from healthcare providers
  3. Available to all

Disadvantages:

  1. No financial protection from the risk of a major illness or injury
  2. Difficulty in accessing cares without insurance; some healthcare providers may require advance payment
  3. You pay the whole bill for medical treatment

Discount Health Card – Buy it when you need it and pay less with an “Affordable Healthcare” discount card. Essentially, you access contracted network rates without a Health Insurance policy for an annual or monthly fee. I look at this plan as a variation of the “Cash” plan since you have no protection of the risk for a major illness or injury. “The FTC and many states have found that although some medical discount plans provide legitimate discounts that benefit their members, many take consumers’ money and offer very little in return.” – Federal Trade Commission

Advantages:

  1. Low Monthly Fee
  2. Discounted care from some healthcare providers
  3. Normally available to all applicants

Disadvantages:

  1. No financial protection from the risk of a major illness or injury
  2. Difficulty in accessing care without insurance; Some healthcare providers may require advance payment
  3. After any offered discount, you still pay the whole bill for medical treatment

Limited Benefit Plan – Pay a monthly premium for a defined-benefit insurance policy. Also often marketed as “Affordable Healthcare,” these mini-med health insurance plans typically offer a set payment amount for a specific healthcare treatment and a maximum benefit limit under $100,000. These plans don’t meet the “my brother test” – would this type of plan coped with the healthcare costs of my brother’s lymphoma? – No, so I won’t sell them. The healthcare discount cards and limited benefit plans are aggressively marketed on the internet. Just Google “affordable healthcare” or “low-cost health insurance” and you will see bunches. There just is no free lunch in health insurance. If the plan is cheap, then the benefits are limited.

Advantages:

  1. Less expensive monthly premium
  2. Discounted care from some healthcare providers
  3. Limited insured benefit payments for medical procedures
  4. Improves access to care
  5. Few enrollment restrictions

Disadvantages:

  1. Incomplete financial protection from the risk of a major illness or injury
  2. Due to benefit limitations, some healthcare providers may require advance payment
  3. After any offered discount and benefit payment, you pay the remaining balance of the bill for medical treatment

Major Medical Policy – This is your “Traditional Medical Insurance” policy for individuals and families. You pay a monthly premium for an insurance policy covering a wide range of healthcare risks with a substantial benefit limit, often $1 million or more. Most Major Medical Insurance policies now sold use a network concept called a “PPO” or Preferred Provider Option. Most plans feature co-pays for doctor visits and prescription drug purchases which reduce the out-of-pocket cost of these routine healthcare expenses.

Advantages:

  1. Protection from the financial risks of a major illness or injury
  2. Provider discounts if “in network”
  3. Improves access to healthcare providers and treatments
  4. Encourages preventive health treatments
  5. Reduced out-of-pocket costs for routine healthcare

Disadvantages:

  1. High monthly premium costs
  2. Applicants must qualify based on health screenings
  3. Generally, no maternity coverage
  4. Must use “in network” providers for lowest out-of-pocket costs

High Deductible Health Plan (with optional Health Savings Account) – This is a “Major Medical Policy” to grapple with a major illness but only after an annual deductible is exceeded. An optional tax-advantage savings account (H.S.A., “Health Saving Account”) is available to set money aside for healthcare costs prior to reaching the deductible. A family insurance plan that qualifies as a prerequisite for a Health Savings Account in 2009 can have a deductible of no less than $2400 and no more than $11,900.

Advantages:

  1. Protection from the financial risks of a major illness or injury
  2. Provider discounts if “in network”
  3. Improves access to healthcare providers and treatments
  4. Access to optional Health Savings Account to save toward future medical bills with a tax advantage

Disadvantages:

  1. Monthly premium costs (lower than Major Medical Plans but still substantial)
  2. Applicants must qualify based on health screenings
  3. Generally, no maternity coverage
  4. Requires making more choices on healthcare
  5. Larger deductible and no expensive reducing co-pays

Additional Advantage of Optional Health Savings Account:

  1. Reduced taxable income by amount saved in H.S.A. account
  2. Use it or keep it — any funds not used are retained for future medical expenses
  3. Funds saved are available for broad range of healthcare expenses while retaining the tax advantage