COMMUNITY'S DEMANDS

Your Community's Demands

Your Community's Demands

Community's access to health care technology

In the US and many other countries, members of the healthcare sector are looking to technology for insights to address the public policy, clinical and management challenges of healthcare. For policy makers, technology provides a new way to understand public healthcare policy as being coherent across populations while, at the same time and paradoxically, 'inconsistent' in application because it allows for variation in response to local needs. This creates tensions for public healthcare policy makers which have often seen coherence and consistency as synonymous just as equity and equality have often been taken to mean the same. In practice, the National Health Service (in the UK) has used design principles inspired by technology in their redesign of the delivery of healthcare; while the Institute of Medicine (in the USA) has drawn upon technology and complexity science to understand and address quality shortcomings in healthcare delivery.

The clinical applications of technology and complexity science range from relationship-centered care to using fractal geometry for diagnosis and treatment of cardiac conditions. In practice, most of the clinical applications are still in their infancy but show great promise for diagnosis and treatment of a wide range of diseases, especially chronic diseases. In terms of health care management and leadership of health care organizations, technology has been transformative in many health care organizations through understanding distributed network models of control and authority. In practice, jobs been redesigned, care delivery modes been altered and patient safety initiatives have applied technology-inspired principles to address issues such as hospital acquired infections.

Public policy for health includes articulating objectives for the government, choosing priority areas, selecting policy instruments (e.g. legislation, budgets, contracts, etc.) as well as content, and implementing. Technology has something to contribute to the selection of policy instruments as well as policy design and implementation. Healthcare policy deals both with the front-line delivery of healthcare to individual patients and with public health activities which are population based such as pandemic preparedness or reduction in rates of obesity or substance abuse. In both arenas, technology has started to play a role.

The Institute of Medicine (IOM) in the USA issues an annual report on the state of healthcare in America. In 2001, the report focused primarily on front-line service delivery issues. It described quality problems not merely as a gap but a 'chasm'an an enormous difference between what delivered and what should be delivered based on resources employed and expectations of the public (IOM, 2001). The IOM described the US healthcare system as a complex adaptive system.

One of the challenges of public policy for health is the concept of planning in light of uncertainty, emergence and surprise. Many traditional planning approaches in policy across the globe focus on developing single-point forecasts or extrapolations of current trends into the future based on probability distributions (Lempert et al., 2002). Public health, which focuses on communities rather than healthcare delivery to individuals, often seen in a negative light within healthcare systems as distracting attention away ...