The United States of America stands at a watershed moment. In the early weeks of the year 2014, as the changes that accompany the Affordable Care and Patient Protection Act begin to take effect, this much-discussed topic has been cause for everything from jubilation to despair. However, for those who take scholarly investigation into a topic seriously, the reactions in the media and in public discussion need not be the only points of reference; rather, an evidence-based approach opens up a whole world of scholarly articles which may provide additional insight as to how to implement a complex and shifting healthcare system so that patients, who are ultimately the ones who matter most even when one treats healthcare as a business, can have the best possible outcomes. In particular, two articles will be examined for their input into the areas of routine care and patients’ psychosocial wellbeing, and from this discussion, key factors and critical factors will arise that suggest areas requiring attention in the future.
The two key factors that can be gleaned from the two articles are the ways in which preventive care improves both patient outcomes and long-term healthcare costs and the ways in which patients’ psychosocial wellbeing is as important as their physical wellbeing. For example, Eccles, Grimshaw, Walker, Johnston, and Pitts (2005) took a detailed look at the theoretical systems in use for routine patient care and found such systems wanting. Without a good framework for such an important area, it is obvious that the implementation of the changing healthcare coverage in the United States of America will fail in this regard. Routine care is too important to leave to chance, but if the evidence from the literature is vague as to how helpful it is and which actions, specifically, are helpful, this ultimately leads nowhere. In addition, Hack et al. (2011) put attention on the areas of psychosocial health and supportive care. While their specific focus is on the area of oncology, their findings can be extrapolated to care for chronically ill patients in general. Having identified the two key factors, it will be interesting to compare them.
The most critical factor is unquestionably the issue concerning routine care. Whereas psychosocial health and supportive care are certainly important issues, these concerns apply only to patients requiring long-term care. Mental health in general is still a rather separate system from the medical world except for those patients, and though this compartmentalization may be less than ideal, it is the system with which one must work now. Routine care, however, is indispensable and also makes good business sense, and implementing healthcare change must revolve first and foremost around getting patients the routine care they need and helping them to overcome the inertia that may discourage them from getting such care. However, there are still potential issues with the research that must be addressed.
Fortunately, neither paper provided seems to suffer greatly from omissions. The worst that can be said is that Hack et al. (2011) might have chosen a wider population to investigate, but as they imply toward the end of the paper when discussing potential future studies, their omissions simply leave room for future researchers to carry on the work. The other paper, from Eccles et al. (2005), struggled with a lack of theoretical frameworks to analyze, but that is a flaw in the data rather than in the paper itself. Overall, these are two solid, sound sources that can safely be used to identify critical factors in implementing healthcare change, as discussed elsewhere. Now that routine care has been noted as the number one issue to remain focused upon in the coming months of healthcare change implementation for related businesses in the United States of America, a clear starting point has been laid out. Where the future takes the country and its healthcare system from here remains to be seen.
Eccles, M., Grimshaw, J., Walker, A., Johnston, M., & Pitts, N. (2005). Changing the behavior of healthcare professionals: The use of theory in promoting the uptake of research findings. Journal of Clinical Epidemiology, 58(2), 107-112.
Hack, T. F., Carlson, L., Butler, L., Degner, L. F., Jakulj, F., Pickles, T., . . . & Weir, L. (2011). Facilitating the implementation of empirically valid interventions in psychosocial oncology and supportive care. Supportive Care in Cancer, 19(8), 1097-1105.