Integrated Health Delivery System Nursing Essay

Integrated Health Delivery System Nursing Essay

Healthcare services have seen several changes throughout the years to respond to changing demands of the population. The present key drivers and issues that stakeholders (patients, healthcare providers, vendors and government) in the healthcare sector face are ageing population, increased burden of chronic conditions, rising public demand/expectation for quality healthcare, fragmented and uncoordinated healthcare services and rapid advances in information technology.

At present, information technology is considered a “strategic necessity” by world class organizations instead of just a supporting tool. To obtain a competitive advantage in an environment with intense competition, it is vital for organisations to use more sophisticated information technology tools to address the challenges of building and deploying system in the short term and the identification, research and design of future system.

Information technology (IT) is rapidly becoming integrated with healthcare to improve processes and communications, support decision making, reduce inaccuracies, and improve patient safety. The advancement of medical science through the years has made possible the use of more expensive equipment and the latest technology. This will allow healthcare providers and patients to gain access to health information easily and thus has the potential to improve the quality, safety, and efficiency of health care. As the healthcare industry is information intensive and knowledge intensive, there is also a need to publish health care information and knowledge.

Healthcare systems vary from country to country but they all have a common aim that is to meet the healthcare needs of target populations. In this report, I will be focusing on healthcare IT in Singapore context.

Healthcare System in Singapore

Singapore has a dual health care system where individuals can choose between public and private providers. The government through Ministry of Health (MOH) manages the public healthcare system. MOH plays a major role in formulating national health policies, coordinating the improvement and planning of the public and private healthcare sectors and regulating health standards. MOH’s mission is to promote good health and reduce illness, to ensure Singaporeans have access to good and affordable healthcare and to pursue medical excellence (Ministry of Health, 2007). MOH’s vision is to develop the world’s most cost-effective healthcare system to keep Singaporeans good health.

Delivery Structure
Healthcare services in Singapore are provided by different types of providers from primary care to tertiary care and to step-down care.

Primary Care
Primary care includes primary medical treatment, preventive healthcare and health education (Info-communications Development Authority of Singapore, 2009). In Singapore, primary health care is provided through outpatient polyclinics and private medical practitioner’s clinics. 80% of the services are provided by private practitioners while the remaining 20% by government polyclinics.

Conveniently located in town centres all over the island, polyclinics are one stop health centres which offered services such as outpatient medical care, maternal and child care health.

Secondary and Tertiary Care
For the secondary and tertiary care, 80% of the hospital care being provided by the public sector and the remaining 20% by the private sector.

This public sector is organised into two vertically integrated delivery networks, National Healthcare Group (NHG) and Singapore Health Services (SingHealth) – that operate as not-for-profit private companies. Having these two groups enable more integrated and better quality healthcare services through greater cooperation and collaboration among public sector health care providers. Each cluster consists of both general hospitals that provide multi-disciplinary healthcare services and specialised hospitals in various disciplines e.g. obstetrics and gynaecology and ophthalmology.

The private sector provides similar specialist disciplines and comparable facilities to the public clusters. The two main providers are Raffles Medical Group and Parkway Group Healthcare (Info-communications Development Authority of Singapore, 2009).

Step-Down Care
Voluntary welfare organisations (VWOs) provide most of the step-down care services. They run nursing homes, inpatient hospices, community hospitals and chronic sick hospitals. Four of the public acute hospitals also provide geriatric units (Info-communications Development Authority of Singapore, 2009).

Public Healthcare Delivery Structure
One of the objectives of forming the two clusters is to facilitate integration of healthcare services at the various levels. The clusters have begun introducing measures to integrate primary healthcare at the polyclinics and secondary care at the hospitals.

A Vision for 21st Century Healthcare

Intelligent Nation 2015 (iN2015) is a 10-year masterplan to help Singapore realise the potential of infocomm. The vision of iN2015 is “An Intelligent Nation, a Global City, powered by Infocomm”. The goal for the Healthcare and Biomedical Sciences sectors is “To accelerate sectoral transformation through an infocomm-enabled personalised healthcare delivery system to achieve high quality clinical care, service excellence, cost-effectiveness and strong clinical research”. (IDA, 2006) Refer to Figure 1 in Appendix to see how it will look like. Key drivers of change in Singapore’s healthcare sector were identified and a number of likely shifts and changes to the system were predicted (IDA, 2006).

Key Drivers

Shifts/Changes

Ageing population of chronic conditions

Focus on prevention, health promotion and wellness care

Rising public expectations of healthcare services

Integrated and patient-centred system of delivery

Fragmented and relatively uncoordinated healthcare services

Consistent widespread application of evidence-based medicine

Very rapid advances in infocomm, medical science and technologies and biomedical research

Greater role of members of the public in managing their own health

Greater facilitation of data flows between healthcare sector and biomedical sciences

Strategies and Programmes
(IDA, 2006)

The targeted outcome is a well-integrated quality healthcare, cost effective healthcare services and greater ability of public to manage their health. To bring about successful business change using IT, healthcare providers should ensure that IT works in performance with meaningful changes in organisational functions and processes (Rothenberg, 1995).

How IT can be used?

In the healthcare industry, one suite solution is not common because certain user departments will need to have more in-depth functionalities than others. A more common approach in the industry is best of breed where it attempts to give full equal weight in terms of functionalities and features to individual user departments. Some considerations for best of breed approach are:

It deals with more than one vendor

A need to connect or interface the different applications to provide a fully integrated solution

Future upgrades issues.

Therefore, there is a need to strike a balance between having too many application platforms and departmental requirements or functionalities (Online Consultant Software).

IT Infrastructure for the Healthcare Industry
Functional interoperability is needed in order for computers to be able to share clinical data with one another. Computers must have functions to b……………………………..