course material

1. HLT308 PU Healthcare Issues Questions
DQ1 Adrienne Brock 1 posts Re: Topic 2 DQ 1 Many things in the world are becoming
computerized instead of controlled by a person. I think this is sad because it is taking jobs
away from people. There are pros and cons to these self-help machines. Some pros are there
is more patient privacy, decreased data errors at check in, and decreased wait time at check
in. Some cons found that the kiosk was not equipped with foreign language, not good for the
visually impaired, and wheelchair patients had a hard time reaching it. The biggest issue
with these kiosks is the cyber threat (Shuman, 2014). No matter how good the hospitals
cyber security is cyber thieves are out there trying to steal information. The hospitals found
that they still had to have staff available to assist patients that needed help with the kiosk.
Employees I am sure are scared for their jobs but hopefully this will just take some of the
pressure off their workload. I am not sure this will really reduce staffing because patients
will still need help with it but maybe in the future it will reduce the number of staff needed.
Shuman, E. (2014, June 04). Medical kiosks raise security flags.
https://www.healthcareitnews.com/news/medical-kiosks-raise-security-flags DQ2 Grace
Philips 1 posts Re: Topic 2 DQ 1 Technology has had a huge impact on recent changes in the
last decade of healthcare. We rely on technology for many things such as charting, retrieving
vitals, and easy communication between staff memebers. Self help kiosks and new apps are
being developed to create a quick and easy way for the general public to get medical
consultation without the worry of a bill for visit by their primary care physician. Although
for small things such as sore throat and chornic nausea, this may be beneficial. Physicians
are quickly able to assess their patients and determine the acuity of their illness. There are
many benefits to having technology such as time saving measures, easier communcation
and so on. There are also red flags that develop. Not only does technology completely
erradicate human interaction, and that feel of comfort and safety, there are things that
human beings can do that robots just aren’t capable of. On top of that, human to human
interaction decreases mistakes, as sometimes robot technology may have a hard time
determining information being given. This can potentially delay care and cause greater risks
for the patient if it is an urgent matter. As written in an article recently about healthcare and
the advantage and disadvantage of technology, machines are still far from replacing many
kinds of tasks that people are good at or tasks that require creativity, innovation, or
empathy (Hyacinth, 2018). A threat to employment also is hieghtened because the
production of more innovative technology will eventually lead to decreased need for people,
and eventual job loss. References Hyacinth, B. (2018). Will Robots Take Your Job In

2. Healthcare? Retrieved from:
https://healthmanagement.org/c/healthmanagement/issuearticle/will-robots-take-your-
job-in-healthcare DQ3 Kecia Edwards 2 posts Re: Topic 2 DQ 1 – Interesting Perspective
Hello Class, As I read this question I thought about a conversation I had with a colleague
who informed me that United Healthcare is sending a great deal of jobs overseas. Please
share your thoughts on this blog. Worries grow as healthcare firms send jobs overseas
Some healthcare companies are starting to shift clinical services and decision-making on
medical care overseas, primarily to India and the Philippines. By Don Lee for the Los
Angeles Times – WASHINGTON — After years of shipping data-processing, accounting and
other back-office work abroad, some healthcare companies are starting to shift clinical
services and decision-making on medical care overseas, primarily to India and the
Philippines. Some of the jobs being sent abroad include so-called pre-service nursing, where
nurses at insurance firms, for example, help assess patient needs and determine treatment
methods. Outsourcing such tasks goes beyond earlier steps by healthcare firms to farm out
reading of X-rays and other diagnostic tests to health professionals overseas. Those
previous efforts were often done out of necessity, to meet overnight demands, for instance.
But the latest outsourcing, which have contributed to the loss of hundreds of domestic
health jobs, is done for financial reasons. And the outsourcing of nursing functions, in
particular, may be the most novel — and possibly the most risky — of the jobs being shifted.
At the forefront of the trend is WellPoint Inc., one of the nation’s largest health insurers and
owner of Anthem Blue Cross, California’s biggest for-profit medical insurer. In 2010,
WellPoint formed a separate business unit, Radiant Services, aimed at advancing
outsourcing and other cost-saving strategies. WellPoint has eliminated hundreds of jobs in
the U.S. over the last 18 months as it has moved jobs overseas, a company spokeswoman
acknowledged. The spokeswoman, Kristin Binns, said WellPoint’s shifting of clinical jobs
overseas was a small part of the outsourcing and being done through Radiant because it has
the technical expertise and can ensure compliance with laws. Nursing organizations,
however, were cautious. “It’s obviously a very disturbing trend,” said Chuck Idelson, a
spokesman for the California Nurses Assn. “There are serious questions if you’re talking
about utilization reviews … and making recommendations on procedures.” Nursing experts
said there also may be licensing issues as states generally require certification for those
practicing and dispensing health information. Current and former Radiant executives
declined to comment or weren’t available. It’s not clear how many other U.S. healthcare
firms have contracted with Radiant or other outsourcing specialists, but industry experts
said companies were increasingly looking at more healthcare tasks that could be
outsourced globally as they face greater cost pressures and sweeping changes in how they
do business. Aetna Inc.has an arrangement with EXL Service, a U.S.-based company with
operations in Manila, to provide “targeted care-management support,” spokeswoman
Cynthia Michener said. Health Net Inc., which is laying off dozens of information technology
and accounting workers whose jobs are being sent to India, said its outsourcing has
generally been confined to administrative and IT functions. UnitedHealth Group, the
nation’s largest health insurer, didn’t respond to inquiries. Outsourcing jobs out of the
country has become a hot issue in the presidential campaign: President Obama is pounding

3. Republican challenger Mitt Romney for his private equity firm’s involvement with
companies that sent jobs abroad. Although such outsourcing has been going on for years,
American manufacturers in recent years have brought some jobs back to the U.S. as labor
costs have risen in China and elsewhere. Some experts argued that sending jobs abroad
could help U.S. companies by enabling them to tap global talent and efficiencies, making
them more profitable. When U.S. companies are stronger, the thinking goes, it creates more
opportunities for American workers. Also, shifting operations to lower-wage countries can
help consumers by holding down prices. Outsourcing jobs to places such as the Philippines
can save U.S. healthcare firms 30% in labor costs, according to experts. But the practice
remains controversial, especially with the U.S. unemployment rate hovering above 8%.
Patient advocates worry about crucial decisions involving a patient’s care being in the
hands of foreign insurance adjusters. Analysts said there was another concern as well:
patient privacy. Even something as straightforward as medical transcription can raise
questions, said Uwe Reinhardt, a healthcare economist at Princeton University. Over the last
year, Iowa Health System and hospitals in Utah and Washington state have joined other
medical centers that have outsourced the transcribing of doctors’ notes and other records.
“Suppose I’m an AIDS patient,” Reinhardt said. “That person in India would know — and
[the information] could be valuable to someone…. For the U.S., there’s nothing more
personal than healthcare.” Dr. Kaveh Safavi, head of the North American health practice for
Accenture, a major consulting and outsourcing firm that has partnered with WellPoint’s
Radiant, said nearly all countries have laws for protecting patient privacy. And to safeguard
patients’ records, he said, healthcare companies store and maintain their records locally. As
for outsourcing services that are more clinical in nature, he said, “People are looking at all
the tasks that can safely and responsibly be moved. It’s still an emerging market. We’re still
trying to understand the market’s tolerance for it.” In general, hospitals are moving more
slowly than health insurers to send jobs overseas. But with financial pressures intensifying
and the uptake of electronic record-keeping accelerating, analysts and industry people see
more consolidation and outsourcing ahead. “When you have people’s medical, billing and
other records kept electronically, then it opens it up to establishing a call center virtually
anywhere,” said Steve Trossman, a Los Angeles spokesman for the Service Employees
International Union, which represents hospital workers. “There is no longer a reason for it
to be physically in the same place as the paper records.” Moreover, the healthcare reform
law could prod insurers to move more jobs to cheaper-wage countries. The new law
requires companies to spend 80% to 85% of premiums on medical care, limiting the
amount available for administrative expenses. Few have been as aggressive as WellPoint,
which made a profit of $2.65 billion last year on revenue of $60.7 billion. WellPoint’s total
employment at the end of last year was 37,700, down from 40,500 two years earlier. In one
of its recent efforts, WellPoint laid off pre-service nurses in Colorado and Nevada so the
work could be done in Manila, according to a Labor Department filing by a WellPoint human
resource manager in Denver. WellPoint spokeswoman Binns said none of the decisions that
involve denial of procedures or treatment for patients are made overseas. Overall, Binns
said, fewer than 2.5% of the 37,000 employees, or at most 925 workers, had lost jobs in the
last 18 months as a result of work sent overseas. Only about 50 of those positions involved

4. clinical management of care, she said. WellPoint’s “sourcing strategies have enabled us to
make our services more effective, accessible and affordable to our customers, while
allowing us to expand our programs and maintain our service levels,” she said. WellPoint’s
offshoring covers a wide range of departments and tasks involving claims, enrollment,
billing, postservice clinical claims review, utilization management and pre-service nursing,
according to filings made by company managers and state government officials. Both were
helping secure federal trade-assistance benefits for WellPoint workers who have lost jobs
because of outsourcing or import competition. Shannon Cunningham of Columbus, Ohio,
who processed medical claims for WellPoint, was laid off last month after a colleague went
to the Philippines to train people to do her job. Cunningham, 43, said she received eight
weeks of severance pay. She and others working in medical claims earned $30,000 to
$40,000 a year with health benefits, she said. “I know other countries need work,” said
Cunningham, a company employee for three years. But “I just felt like it wasn’t fair. We’re
having a rough time too.” Reference Retrieved from https://www.healthcare-
now.org/blog/worries-grow-as-healthcare-firms-send-jobs-overseas/ DQ4 Jenna Raila 1
posts Re: Topic 2 DQ 1 Technology plays a huge role in health care and is constantly
improving and changing our practice. We use technology for charting, surgeries, lab work
and more. Recently there has been a rise in the use of technology for the purpose of
telemedicine. Telemedicine allows patients to see and speak with providers through video
chat on a phone, computer or tablet. There are both advantages and disadvantages to
telemedicine. Some advantages include improved access to information; provision of care
not previously deliverable; improved access to services and increasing care delivery; and
reduced health-care costs. (Hjelm, 2005). Additionally, with COVID-19 this provides patient
with a safe way to receive care without possibly exposing themselves to the disease. Some
disadvantages include a breakdown in the relationship between health professional and
patient; issues concerning the quality of health information; and organizational and
bureaucratic difficulties. (Hjelm, 2005). The introduction of telemedicine allows for less
staff required for facilities which poses a benefit to them but can be seen negatively from a
patient perspective as they do not receive one on one, in person care, creating a more
distant and distrusting relationship between providers and patients. Telemedicine cannot
be a full replacement for traditional medicine, as we sometimes need to see the patient, in
person, in order to give them the best quality care however, telemedicine is a great resource
and option for many situations. Reference: Hjelm, NM. (2005). Benefits and drawbacks of
telemedicine. Retrieved from https://pubmed.ncbi.nlm.nih.gov/15829049/ DQ5 Grace
Philips 1 posts Re: Topic 2 DQ 2 Health care administrators than run an HR department face
many challenges when dealing with a large group of people in a healthcare setting. One of
those issues is compensation for employees and determining fair wages. One challenge HR
departments face is staying in communcation with the employee whena in incident arises.
There are multiple departments and people that have to go through an employees pay
history and compensation paperwork for issues. Mistakes can be made with too many
people in the line of communcation. Administrators also need to communicate in a way that
employees are able to understand, as they often don’t deal with the grammatics on a
financial level. As far as someone who is nonmanagement, I think there is greater risk of

5. being able to reach certain departments and take care of the problem quickly and
effectively. Administrators have a line of command and are able to report the issue, whereas
a nonmanagement staff member may face more challenges in connecting with the right
person. By creating an incentive system, or something that would benefit the staff of a
heatlhcare organization could potentially help to earn additional compensation for
physicians, staff, and the hospital, and also can create cost effective care that improves
patient outcomes (Hanchack, 1996). References Hanchak, N. (1996). US Healthcare Quality
Based Compensation Model. Retreived from:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4193601/ DQ6 Read Chapters 21-23 in
Legal and Ethical Essentials of Health Care Administration. URL:
https://www.gcumedia.com/digital-resources/jones-and-bartlett/2013/legal-and-ethical-
essentials-of-healthcare-administration_2e.php Read “Considering Potential Benefits and
Consequences of Hospital Report Cards: What Are the Next Steps?” by Schold and Nicholas,
from Health Services Research (2015). URL:
https://lopes.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?direct=true
&db=ccm&AN=10376910 6&site=ehost-live&scope=site Read “Taking the Pulse of Health
Care Risks,” by Mahoney and Harrison, from Business Insurance (2015). URL:
https://lopes.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?direct=true
&db=bth&AN=11090456 0&site=ehost-live&scope=site Read “Cultural Events Provided by
Employer and Occupational Wellbeing of Employees: A Cross-Sectional Study Among
Hospital Nurses,” by Tuisku, Pulkki-Raback, and Virtanen, from Work (2016). URL:
https://lopes.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?direct=true
&db=bth&AN=11842021 9&site=ehost-live&scope=site Read “Good Background Screening
Crucial to Avoiding Liability,” from Healthcare Risk Management (2017). URL:
https://lopes.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?direct=true
&db=ccm&AN=12654091 4&site=ehost-live&scope=site Read “Four Main Components for
Effective Outlines,” located on the Purdue Online Writing Lab (OWL) website. URL:
https://owl.purdue.edu/owl/general_writing/the_writing_process/developing_an_outline/i
ndex.html