Blog

THE SEEN AND THE UNSEEN INDIA

Author: Angel Joy

THE OUTSOURCING HEALTH CARE ITS BENEFITS, IMPORTANCE, AND CIRCUMSTANCES

CONTENTS

1. OUTSOURCING THE HEALTH CARE IN INDIA AND FUTURE TRENDS.
2. BENEFITS
3. PROBLEMS AND SOLUTIONS OF OUTSOURCING OF STAFFING PROCESS FOR LONG TERM
4. REVENUE RECYCLE MANAGEMENT ( RCM)
5. PATIENT DEMOGRAPHIC ENTRY PROCESS
6. MEDICATION CHART REVIEW, CLINICAL REVIEW FROM PHARMACISTS
7. CONCLUSION
8. MESSAGE

ABSTRACT

This article emphasises on the impacts that outsourcing have on companies, healthcare sector, and industries. Its not a short-term theme it must be sustainable. As a viewer, my ideas are illustrated in the given article.

INTRODUCTION

Long by there was a carpenter who was very good at his work but he didn’t know how to get the wood because he had no means to cut the tree. So what did he do he approached a guy who had an axe and asked him to cut a tree and he will make a handle for it . that’s all the outsourcing begin.

Outsourcing has taken up huge impact in all industries, though health care is lying behind and has recently taken up the strength other industries have been having it for a longer period. This is not a new concept.

Let me begin with definition of outsourcing

 Continuous procurement of services from a third party making use of highly integrated process, organization models and information.

Dave Griffith’s quote goes like this “The strategic use of outside resources to perform activities traditionally handled by internal staff and resources. ”

Outsourcing involves the transfer of the responsibility for carrying out an activity to an external service provider.

Healthcare is one of the biggest industries in the world and until very recently, it lagged behind most others in its adoption of outsourcing.

Why should we think about outsourcing?

* Reduce costs

* Enhance service quality

* Access intellectual capital

* Drive transformational change

* Manage business environment

According to studies in 2007 it is estimated that the sampled hospitals chose to outsource services in order to decrease cost 78% also it increase the quality of services rendered increase flexibility and share risks Upton 36%  .

Aim premix Wipro chairman said that:” The important thing about outsourcing or global sourcing is that it becomes Powerful tool to leverage talent, improve productivity and reduce work cycles.

Outsourcing is exploding in healthcare _ will the trend LAST??

Several hospitals and health system have begun to outsource more as finances becomes tight to tight due to consolidation the outsourcing trend may soon reverse.

This is a report in 2013 but in 2021 one report came as that is insights on the hospital outsourcing global market to 2027 will reach put $ 579 .58 billion .

What is driving it?

* Increasing cost liabilities on hospitals

* Focus on value-based health care

* Consistent rise in chronic diseases due to Lifestyle changes

* Rise in hospital admissions

* Regulatory changes

Some points to Keep in mind while outsourcing;

1. HR must play in lead role while deciding
2. Clear goals to be finalized.
3. Careful vendor selection.
4. Relationship management.
5. Properly structured subcontract and vendor agreements.

We can proudly say that health care is the core of our existence of what we do not only from the perspective of the well-being and the overall human beings life care but also the policy makers all around the world are realizing the healthcare sector is very important aspect of existence.

Unfortunately, that last two years we saw that COVID India and made us realise the healthcare sector is in a dear need for a huge investment that it requires attention and also prioritization from policymakers but beyond that it did to highlight there was a need to bring all stakeholders together bringing a cohesive efforts of strengthening the healthcare is more robust.

Think about how we are going to finance the future health of even vulnerable communities is it able to manage the requirement of funding that we require building infrastructure.

With collaboration and thinking about new innovative models and leveraging the large capital that exists across the value chain, sector, and stakeholders many more to drive health care sector for sustainable healthy India.

Outsourcing is certainly appropriate in situations where a hospital can’t feasibly carry out a task in house as in the case for smaller hospitals the decision to outsource in general must not taken lightly as data suggests that outsourcing clinically relevant services can harm the patients and fail to deliver any cost savings to hospitals in our paper used we used several examples and data to demonstrate the risks of outsourcing.

5 COMMON PROBLEMS AND SOLUTIONS IN HEALTHCARE/ MEDICAL STAFFING.

1. Finding an ideal candidate

Most of the medical entrepreneurs face difficulty in finding the right fit as per the requirements whether it’s a nurse or doctor getting a profile that matches 100% of the job description is a tough task solution .you can consider the candidate’s possessing a skill set of 70 to 80 % of the job description another thing to be considered is the gap that is required to train the candidate in his weak spots.

2. Longer hiring time

This is mainly due to the unavailability of candidates for the interview or because the multi-round interviewing process solutions after picking out the resume can conduct a telephonic interview to screen the candidate and make a second list .

3. Budget concerns

Most often the manager or CEOs a lot of meager salary budget for a vacant position but want the best skills solutions in case you find an exact candidate.

4. Find a stable candidate

A candidate’s job changing frequency is essential when it comes to finding their stability a frequent job changer to be a code red. Meanwhile if the profile is good consider him for interview and ask the reason behind their frequent job changing.

5. Culture mismatch

You may encounter a candidate whose profile has the appropriate qualities you were looking for but he may leave you with doubts regarding his adoption of your company’s culture here you can emphasize about the health center operations.

REVENUE RECYCLE MANAGEMENT (RCM)

First and foremost that is appointment scheduling it means that if a patient want to go to hospital they should be pre registered, it’s nothing but just like text messages, emails…

Secondly eligibility checks and benefits verification it involves a team which ensures the patient is with insurance (active nature).

Encounter its nothing but the patient is scheduled with doctor (treatment plans and workups.)

Medical coding

Just a voice converted in the data transcripts.  No more medical role for medical transcriptase.

Demo/charge entry

Works on demographics of patients.  Just paste the demographic details and have claimed form with all details.

Claims submission All the patient details with respective ICDs. This will not directly reach the insurance.  This will first reach for clearing house rejections .If passes the claims it reaches insurance adjudication its nothing but its insurance processing.

IF CLAIM GETS PAID

Gone to payment posting and then to credit balance (to check overplayed or lower played).

Finally patient collections here the patient collects the details payment status from physician or if not he or she to be taken from the pocket. 80 % is success and 20 % depends on the relationship between policy and provider.

MEDICATION CHART REVIEW AND CLINICAL REVIEWS FROM A PHARMACIST

Proudly pharmacists are the most trusted healthcare professionals; we are experts in medicines and their safe and effective use. This is particularly important as medicines are the most common intervention in healthcare. As a health care professional, the role of pharmacist in ensuring sustainable health care to all is endless.

The pharmacist’s role as a healthcare provider will continue to expand. Pharmacists not only fill prescriptions but also educate consumer about the healthy lifestyle choices, recommend over-the-counter treatments, perform medication monitoring and refer consumers to physicians as necessary.

To be sustainable, it is necessary that medication therapy management (MTC) to be clubbed effectively with contemporary pharmacist-provided services, including patient counseling, disease management and pharmaceutical care. Pharmacists can actively participate in disease prevention as they are the health care professionals in constant touch with public, they can well convince people about vaccination to prevent disease, importance of taking booster doses, need for calcium supplements and iron in children and pregnant women.

First to mention in this regard is the lack of medication adherence due to lack of proper patient education. Patients starting new medications need to be warned about their side effects so that these predictable and usually manageable issues are not a barrier to compliance. In case of drugs, such as antibiotics, it may be left unfinished if the patient is feeling better. Here, the patients need to be counseled to finish their regimens to completely cure themselves and to prevent bacterial resistance. This is beneficial not only to the patient’s medication therapy outcome but also to the question of sustainability. A pharmacist right it is the fundamental responsibility of a pharmacist to ensure Appropriateness of medication order.

What should be a medication order? One pharmacy should have the proper and all the essential knowledge about the order.  It serves as a starting point for other clinical pharmacy. It is very much essential for a pharmacist organizing information according to the medical problems helps to break down a complex situation in to individual parts.

So the medication charting involves process such as a medical chart audit organizing of the chart chronographically and checking and gives the summary of the chart.

CONCLUSION

Look towards the new trends behind the outsourcing of healthcare which helps all the communities in nook and corner of the globe. We are going through a challenges phase which we will have to change the exponential development in healthcare towards sustainable outsourcing healthcare. We are working for the nation its culture towards the theme local Samantha suction bavandhu !