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Index - Major Sections
Site Map
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IntroductionAt InHCc, we are consultants to the largest service business on the globe -- healthcare. While each nation and organization considers itself special, organizations can no longer be directed by their past but rather by a common vision of the future. We at InHCc endeavor to look into the future and create those tools and processes that will make a successful system. Health Care is one of the largest industry in the world and continues to grow. In the U.S. expenditures are over $1 trillion annually, or almost 16% percent of the U.S. economy. In the EU, Japan, and Australia it represents just under 10% of GNP. The "ageing population," the demand for more health care services from the population as they become better educated, and the rising costs of medical technology will continue to be the impetus for increased Health Care expenditures. The consumer now has an insatiable appetite for healthcare services and information. The more they receive, the more they demand. Generally, the wealthier a national or individual is, the more they spend on healthcare. An important issue for developing countries will be "how much is enough." It must be remembered that the more that a country spends on health and education, the less it has to spend on other items. [Cuba is a very real example of this dilemma] As was stated in the Introduction...there is no limit to the expectation of individuals for healthcare...Healthcare is a product with unlimited demand... Healthcare: The easiest Service to Market and the hardest to Manage Data is usually designed for only one thing (operation, or research)…it must be designed to do both Effective Decisions are choices that move an organization closer to an agreed-on set of goals in a timely manner A Successful Organization is knowing what is available and knowing how to use it. In order for Management to make Effective Decisions, they require:
The first, largest, and ultimately fatal problem for many organizations is they do not use External and Internal data (“they do not know what is out there”) to define exactly what success looks like. A manager that is isolated has no means to “Set a Goal.” Goals must be set against the comparison of one process or event with another. If an individual has never seen a proven management technique, it is a little hard for him to be able to set it as his goal. The second fatal problem is that many organizations have very good Information Systems but the “Decision Maker” does know how to use that information. Healthcare Intelligence is not simply rows and rows of numbers on a report. Viewing data in whatever form is not Intelligence until the decision-maker knows how to use that data. It is using the data to create meaning actions that is Intelligence An organization may have great sounding mission statements, such as “superior customer satisfaction”, “better meeting our community needs”, or “greater profits” but these statements DO NOT make for milestones for measuring business performance nor can they be used for the evaluation of results. “Better meeting our community needs” is a noble goal, but what are those needs and how can we tell when they are met? Instead, we need to select a specific community need such as “better health care.” We then need to define what is meant by better health care. Examples may be (1) increase the proportion of the “poor” population who uses our services (2) number of individuals that attended our health education classes, or (3) the number of individuals who say they can “afford” our services… (4) and any of a number of variables on a Client exit interview. Healthcare Intelligence (Data Analysis, Data Mining, Decision Support is such a large suject in this web site that it is covered in its own sections) Models of Health CareTwo major conceptual models of healthcare have been proposed. The Medical model views illness as an event directly caused by disease, trauma or other health condition (including psychological), which requires medical care provided in the form of individual treatment by medical professionals. This model of illness calls for medical or other treatment or intervention to "correct" the problem with the individual. The Social model illness sees illness as a socially-create problem and not at all an attribute of an individual. On the social model, illness demands a political response (probably why politicians prefer the medical model!) since the problem is create by an unaccommodating physical environment brought about by attitudes and other features of the social environment. (adapted from Towards a common Language for Functioning, Disability and Health ICF, World Health Organization, Geneva, 2002) Here at InHCc, we believe that neither model is adequate, although both are partially valid. The Declaration of Alma-Ata definition of health: A state of complete physical, mental and social well-being and not merely the absence of disease or infirmity Health is a complex phenomenon that is both a physical problem and a social problem; it is always an interaction between the person, and the environment in which he or she lives. It is a "Biopsycholsocial relationship". InHCc believes that in many poorer locations in the world, that as much as 80% of the illnesses are caused by the Biopsycholsocial interaction....not the physical model that is being practiced in the wealthier countries....and for which the current Healthcare Information Systems are being developed...These systems will NOT work in the developing countries! Now, that said, InHCc also believes that healthcare is so very complex that no one person, healthcare professional, or healthcare organization can do the work along. It does, indeed, require specialists and a "division of labor"...but at the same time, it does require an "integration" of the information. The InHCc system is based on the Biopsycholsocial model. The key to integrate the medical with the social. We attempt to develop a system that requires the medical professional to ask "why." InHCc has been accused of "gathering too much information," "taking too much time to collect data", "collecting data that does not pertains to the "medical problem." We are sorry that these people feel this way, but we do believe, that in the long run, using the Biopsycholsocial model will provide better healthcare and at a lower cost to society. The Politicians have it all wrong...healthcare really does matter.
Purpose of the InHCc Web Site
This Web Site deals with issues relevant to Health Care Management and mainly emphasizes how to use Information to Manage. We will endeavor to be more practical then theoretical by offering examples and case studies in lieu of long tomes. A real practical information system is presented at InHCc Healthcare Management Information System (InHCc HMIS) You cannot manage it if you can measure it. Don't measure it if you cannot use it to manage it. You cannot manage it if you do not repeatedly measure it. This site presents many examples of how information can be used to provide good quality care to the client, manage the health care organization, collect information for research, and implement National Health Reform Policies. It must be emphasized at this point that, although this site emphasizes Information Systems, Information systems are only TOOLS for Management. In every case where information is collected, examples will be given on how to use this information
Just as the carpenter must know how to use the hammer to build a house, and the surgeon must know how to use the scalpel, the authors of this site, believe that health care managers must know how to use their tools, information systems, in order to evaluate and monitor their own organizations. Contrary to the belief that information must be "fed back" to staff, it is InHCc's experience that
Without knowledge of costs and revenues, managers cannot budget and control costs; without day-to-day data, managers cannot monitor their progress over time; without cross comparisons between other projects, they have no way of evaluating how well they themselves are doing. We believe that if managers are trained to manage properly, then they will demand and use the information system.
The moral of this tale is that it's not the tools and materials that a man uses which create disasters, it's his naiveté' and lack of skill. A badly managed program is a badly managed program, not an indictment of the tools used to managed the program in the first place or the design of the project. [adapted from Peter Wright's Beginning Visual Basic 6, Wrox Press, 1998] Health Care Structure
Must fuss is being made over "how to structure the health care organization" but very little is being done on training managers to manage these organizations. No organization structure will succeed if the managers are not trained...if managers are trained then they will create the right structure for their own local environment! This Web Site is dedicated to those involved in the most difficult of endeavors-- and the most rewarding-- Public Health.
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Two
project managers, each with the same set of resources are given identical plans
to build a new world. The first manager [sic] builds himself a great job but
little else. The project soon tumbles down. For generations to come, project
developers refuse to use the
tools outlined by the developers in this project. The second manager however
builds a fine world out of his resources and everyone lives happily ever
after.