Health Care Delivery Issues

HealthCare Delivery Issues

Tableof Contents

  1. SUMMARY 3



3.1 Ethics in Healthcare and Incorporation of Information System 6

3.1.1 Information System 6

4. Ethics in the Healthcare Sector 6



References 15


Theresearch paper is going to discuss the current issues in thehealthcare sector that are affecting service delivery. In the paper,I sought to give two contracting issues, one that is derailingservice deliver and the other that is enhancing service delivery. Inthe paper, I will discuss the integration of information system inthe health care system, the need for its introduction and the gainthe sector has reaped from the same. Also, I will show how the costof service delivery has reduced drastically following theintroduction of information systems in the healthcare sector.Secondly, I will discuss the other issue of ethics. Most of theethics issues in healthcare are reported through medical researchpractitioners. Other relevant issue of ethics will be discussed. Thedisadvantages of not observing ethical practices and the costinvolved in cases of ethics will be discussed in the paper I amwriting. The paper will have an introduction which will introduce thetopics to be discussed. It will have a problem definition sectionwhere the issue will be detailed and then a brief discussion of theissues will follow. I will complete the paper with a conclusion.


Allsectors of the economy have been going through radical change inorder to increase and manage service delivery. The needs of thepublic have been escalating and governments are doing a lot in orderto ensure that the limited resources can help improve the currentsituations as they are. Costs of service delivery have also been onthe rise in delivery of service to the people. To reduce cost, allunnecessary expenditure need to be eliminated and new methods thatare cheaper to sustain service delivery be introduced in order toreach that goal. Investments in research and development have beencarried out in the country to facilitate the urge to achieve thisgoal. Healthcare, agriculture, energy and the service industries ingeneral are all placing huge amount of budgetary allocation to theresearch and development teams to enhance the effort of increasingservice delivery to the people and also to lower the cost of servicedelivery.

Thehealthcare sectors have been facing many different problems and theyhave made delivery of health service to be affected negatively.Access to health facilities and medical records of patients is one ofthe limiting factors that organizations are facing. Moreover, casesof hospitals facing court decisions requiring payment of fines forwrong handling of patients have been on the rise in the recent past.Research medical practitioners are also involved in unethicalpractices by using patients to carryout research without properconsent from the persons concerned. Lapse in keeping medical recordsand weakness in coordination programs among the medical practitionersis the other issue that is derailing the level of and quality ofservice delivery in the health sector. The paper will be discussingthe issues of ethics in the medical practice and the need forintroduction of information system in the health sector in order toenhance service delivery.

Servicedelivery and integration of services in the healthcare sector havebeen faced with different issues challenges in the recent past. Thisfactor have derailed and other enhanced service delivery. The needsto study this factor are to enhanced service delivery and facilitatethe integration of critical and core activities in the healthcaresector. The issues are the introduction of information system inservice delivery and the associated ethical issue that surround it.

Theintroduction of information system has enhanced sharing ofinformation between professional in the medical practitioners.Sharing of information keeps these professionals up-to-date with thelatest development in the disease and, hence, patients can be treatedin the best manner. Information systems also have enhanced andexpedited access to patient’s information and record by storingthem in electronic health records system. Central database in thehealthcare sector has also improved decision making in the healthcaresystem because the management can get real-time information on thelatest development. The internet enhanced sharing of informationthrough computers. Information systems have increased efficiency,reduced the cost of service delivery and also improved the quality ofthese services

Theethical issue has been reported in the healthcare system. Informationsystem security have had loophole and have encouraged disclosure ofpatient’s information to third parties contrary to the requirementsof the ethical standards. Research medical practitioners have alsobeen reported to use human patients as subjects of their studieswithout obtaining the requisite authorization. Some have also failedto provide full disclosure of the risk contrary to the requirementsof the medical ethical guidelines. However, the healthcare sector hasexperienced tremendous growth in the current generation. When thisissue is resolved, service delivery will be enhanced and greatlyfacilitated.

PROBLEMSDEFINITIONEthicsin Healthcare and Incorporation of Information SystemInformationSystem

Informationis system is a set of objects, people and technology arranged in sucha way as to enhance flow of information and communication in order toimprove the performance of an organization. The field of medicine andhealthcare in general is dynamic and new developments in terms ofknowledge emerge every day. As such, it is important that the medicalpractitioner be up to date with any development in the medicalsector. Sharing of information before the introduction of informationand communication technology took time before it was internationallycommunicated. As a result, some parts of the world were better offand service delivery was never rational. But come the informationage, sharing of information was expedited and medical practitionersfrom all over the world can now be informed or inform other of anydevelopment in the healthcare sector. Access to medical records was astrenuous activity since it had to be done manually. Patients had towait for days or even weeks before their records were found.Introduction of information system and computers eased that work andit is now possible to access a patient record by the click of abutton (Campinha-Bacote, 2002).

Ethicsin the Healthcare Sector

Ethicsrefers to the systematic recommendations that define a wrong and aright. In all professions, there are rules and regulation that governtheir practice. Healthcare and medical professionals also do havesome ethical standards that govern the way they have to carry ontheir practice. In the recent past, many cases have been reported ofmedical professionals, including nurses and doctor actingunprofessional and against the ethical code of standards that governthe way they practice. The public have lost credibility in some casesand service deliveries have been derailed tremendously. Nurses andclinical officers have been reported to be discriminating patientsand service deliver have been affected. Hospitals have been sued bypeople and hefty penalties paid to the patients due to negligence orother issue that tough on the issues of ethics. How has ethicscompromised service delivery in the healthcare system and what hasbeen done to enhanced observation of ethics by the medicalprofessionals? (Hollingsworth, 2008).


Dueto the new developments that are been confirmed day in day out, themedical and healthcare sector need to be informed about the sameevery day. This is to enable other professionals to be ready totackle the patients if they have similar symptom. Information systemshave enabled sharing f the information to be such an easy task.Doctor in United States can easily share anything of concern withtheir counterparts as far as Europe or even japan without the need tomove. Mobility has been increased by use of and integration ofinformation system in the health sector. Physical movement has beenlimited and it has been shifted to the digital platform. Informationcan flow from any part of the world in a matter of minutes thanks tothe invention and milestone of the information age. Databasemanagement systems are used to store data in a central locationhence, access to that same can be done by the members. Updated andauthenticated information about all relevant issues of healthcare isfed into the database and doctors or nurses and any other person whowork in the healthcare sector can have access to the data.

Theplatform also has provided healthcare professional with an avenue ofinteraction with their peers and that enhance research anddevelopment. Exchange of notes by doctors help them better understandthe diseases and so is the treatment of patients. For example, therecent cases of Ebola in west Africa brought doctors from all overthe world to work together in order to find a solution to the virusthat cause the disease. Sharing of the research finding by thedifferent research centers located in different locations in theworld would not have been a success were it not for the informationsystems. Information sharing helps in expediting he process ofresearch and also lowers the cost of carrying out researchaltogether. Doctors, nurses and other healthcare professional alsoget to learn the practice of their professionals in different part ofthe world and in the process it is likely to identify the bestpractice and emulate it. This is likely to improve the servicedelivery in the healthcare sector and integration of healthcareservices. Information system, therefore, has improved servicedelivery by providing a platform to benchmark the service beenoffered by various countries and regions and adopting he betterpractices. Surgeons from different part of the world can carry out anoperation via video conferencing and be of great help (2015).

Thehealthcare sectors have been facing many different problems and theyhave made delivery of health service to be affected negatively.Access to health facilities and medical records of patients is one ofthe limiting factors that organizations are facing. Moreover, casesof hospitals facing court decisions requiring payment of fines forwrong handling of patients have been on the rise in the recent past.Research medical practitioners are also involved in unethicalpractices by using patients to carryout research without properconsent from the persons concerned. Lapse in keeping medical recordsand weakness in coordination programs among the medical practitionersis the other issue that is derailing the level of and quality ofservice delivery in the health sector. The paper will be discussingthe issues of ethics in the medical practice and the need forintroduction of information system in the health sector in order toenhance service delivery.

Anelectronic health record system is another invention enabled by theintegration of information system in the healthcare system. Before apatient is treated, the doctor needs to have a look at their medicalrecords in order to prescribe the appropriate medication. In somecases, subsequent patient would require a different medication andthe same would not be provided in the case the doctor does not haveaccess to that information. Access to the patient file manually wasan uphill task, and as earlier along said, it could even take a weekfor large hospital and healthcare centers. The invention of computersand subsequent integration of information system in organization gavebirth to the electronic health records system. Patient’s recordsand information are stored in a database where doctor can have accessto. Emergencies are not a worry since the doctor can access the datain a matter of minutes. Electronic health records keep track of thepatient’s healthcare including the immunization program and therecords can help understand the current disease extensively. It isalso important because it saves on cost for physical data management(Lazakidou&amp Daskalaki, 2012).

Otherinnovations include computerized provider data entry. This is a toolthat was developed with an aim of facilitating workflow for theclinical medical work. The system was introduced in the 1990’s andhave undergone through various development and it is still beingdeveloped to eliminate its inconvenience in the workflow. The otherinnovation courtesy of information age is the decision and diagnosticsupport. This system facilitates system delivery in healthcare bydiagnosing the disease and carrying out research to identify anappropriate remedy. The system has a specific feature or a generaldiagnostic utilizes both the artificial intelligence andstatistical tool in analyzing diseases and finding the appropriateremedy. Continuous diagnostic of the disease helps track the progressof the disease causing microorganism and a recommendation of the bestcure proposed. The findings are reported and shred with the peers inorder to increase awareness and open room for improvement on thecurrent diagnostic. The other systems enabled to function by theinformation system include prescribing systems, mobile computing anddata exchange networks. All the above mentioned in one way orincrease awareness on healthcare matters and informs aboutavailability of healthcare services.

Whathas been the leading factor that has enabled the information systemto thrive in healthcare? First, the internet and concepts ofnetworking has been a leading contributor. If it were not for theinternet, the contribution of information system would have beenminimal as far as organizations are concerned. In the 1990’s, theuse of internet started to be commercialized. Many organizationsbecame aware of its importance and wanted to integrate it into theiroperations. The healthcare systems also were not left behind.Secondly, computer literacy and availability to computers has been onthe rise. Cost of buying computers has reduced drastically since themicrocomputers innovation. As a result, people and organizations haveaccess to these facilities and can share the information via thenetworks. The need for change is the other factor that led to theintroduction of information systems in the healthcare. Operationswere becoming redundant and there was need for paradigm shift in theway business was carried out. Information system was the betteroption of all the available avenues (Juraja,2010).

Informationsystems have been of significance to the healthcare service deliveryand integration of services since its inception. First, thehealthcare sector has experienced operational efficiency andeffectiveness. Flow of information is faster and medicalpractitioners are updated on how to handle patients. Cure of manydiseases have been discovered and patients can easily access medicalfacilities and get help. Information systems have also enhanced andimproved the quality of services delivered by the health facilities.Many a times, patient’s complaint of poor services due toinformation asymmetry on the part of the medical professional. Withthe introduction of information system, doctors and nurses canbenchmark from the best practices from around the globe and apply thesame to improve the healthcare delivery. For instance, the healthcaredelivery in Australia was ranked first in 2006, and the United Statesprofessional could learn something from the practice in Australia.Last but not least, reductions in cost have been experiencedfollowing the inception of information system in the healthcaresector. Some of the strategies that reduce on cost have beendiscussed above.

However,everything ha its faults and information system has faced quite anumber of challenges. The investment in healthcare information systemrequires heavy capital investment. Such investment can be effectivelyachieved through government intervention. The government has relaxedover the years but it is committed as at now. The healthcare sectoris also displaying a slow rate of adopting the information system andinformation technology in its operations. Management of healthcarefacilities, hospitals and research teams seem to be receptive to theidea of including information systems. Limited knowledge on the useand importance of information system is also a limiting factor.Interoperability of medical data hinders the application as is alsomisalignment of the incentives that could motivate use of informationsystem. Future challenges of information technology system are itseffective use in the field of medicine to supplement and complementservice delivery.

Ethicalissues are the other milestones that affect service delivery and theintegration of healthcare services. Issues of ethics are reported ona daily basis and many cases battles are already in court. Patientshave died on mysterious ways and their corpses have been used tocarry out research study without the consent of relatives or evenproper authorization. The code of ethical standard prohibits the useof people as a subject of study unless there is properly writtenauthorization from the persons concerned. In other cases, the personhave provided consent but they have been tricked to get into thedeal. It is expected that before the research on people, the fullextent of the expected loss be disclosed to the people in order forthem to make the decisions out of goodwill. Some of the historicalcases of ethical dilemma can be seen perhaps in the case of anAfrican-American lady who died of cervical cancer. Cells from herbody were successfully removed from her body before she died byscientist for medical research without proper authorization. Hercells were used for widespread research yet none of the familymembers was asking for the approval of the same.

Racismhas also been a subject used to propagate ethical issue. It is foundthat medical practitioners in the United States target theAfrican-American for their study. The monumental scam includes thecase of research of syphilis among the African-American men. Duringthe study, treatment for syphilis was withheld and living cancer cellwas introduced into their bodies. Ethical concerns were raised inthis case as it is a clear disregard to the life of people. Despitethe existence of a clearly defined code of ethical standards thatcontrol the practice of researchers in healthcare sector, still,there is widespread breach of the ethical standard. The practiceaffects healthcare service because the public lose confidence withthe healthcare practitioners and seek alternative healthcare which inmany cases inferior. The repercussion is poor healthcare quality andservice delivery in the healthcare system (Siddiqi, House &ampHolmes, 2006).

Clinicalnurses have been reported to exhibited characteristics of breach ofthe ethical standards. Clinical nurses are expected to treat patientin the most polite manner and provide the best care in the best oftheir ability. However, some nurses are said to be motivated to servethose who produce tips. Unfortunately, for those who are unable toprovide the tips, they are neglected and sometimes left unattended.In case they are attended to, the clinical nurses treat themcasually. Clinical nurses are also reported to discriminate nurses onthe basis of race, social welfare, age and also economic status.Those who are richer are given priority in service delivery and a lotof time is taken on with them. The don’t haves are given limitedtime to express their attentions to the doctors and the clinicalofficers by the nurses. It is against the ethical requirements of thenursing practice to discriminate any patient on whichever basis.Service delivery and integration of services is compromised in suchcases and the authorities have to implement policies that preventthis from recurring. Unethical nurses should be investigated and theappropriate measure taken to prevent these occurrences (Wennberg,2002).

Informationsystems also possess a platform where ethical standards have beenbreached. Patient information is supposed to be private andconfidential between the patient and the doctor. The same isadvocated by the patient-doctor confidentiality de-facto rule.However, with the introduction and adoption of information systems inthe healthcare system, Access to patient’s information by otherdoctors other than the one who is handling the patient is likely.Disclosure of a patient’s information can only be allowed if thepatient directly or impliedly gives consent. Nevertheless, manypatients’ records have been subjected to scrutiny to other peopleworking in the healthcare system. Security and confidentiality ofdata stored in the information system database is of greater concern.The system should assure patient that their medical records aresecure and can only be accessed by authorized persons only. It isagainst the ethical requirements of the medical practitioners todisclose a patient’s medical records unless the patient so allows.Individuals who disclose such information are acting unethical andguidelines on its application should be initiated to increaseconfidentiality. Service delivery is derailed since patients willfear to disclose the full extent of their problem for fear that thesame may be subjected to disclosure to third parties (Woolf, Grol,Hutchinson, Eccles, &amp Grimshaw, 2009).


Toimprove service delivery in the healthcare system, the management andauthorities have to fight the major issues and challenges.Integration of information system to the operations of healthfacilities is important in order to improve information flow andsharing. Moreover, information system provides a platform forpeer-to-peer consultation and enhances wide consultation on thedevelopment in the field of medicine and healthcare management.Research studies in medicine have also been made effective byinformation system through sharing of various resources around theglobe and pooling of leading minds across the globe. Ethical concernshave also been a major factor that has derailed service delivery andintegration of services in the healthcare system. Management ofhealthcare is going to work on these challenges in order to effectthe necessary changes and improve service delivery in the healthcaresector.


(2015)(1st ed.). Retrieved from,d.ZGU

Campinha-Bacote,J. (2002). The process of cultural competence in the delivery ofhealthcare services: A model of care. Journalof Transcultural Nursing,13(3),181-184.

Hollingsworth,B. (2008). The measurement of efficiency and productivity of healthcare delivery. Healtheconomics,17(10),1107-1128.

Juraja,M. (2010). Who is the failure: the patient or the healthcare system?.HealthcareInfection,15(2),57. doi:10.1071/hi10005

Lazakidou,A., &amp Daskalaki, A. (2012). Qualityassurance in healthcare service delivery, nursing, and personalizedmedicine.Hershey, PA: Medical Information Science Reference.

Siddiqi,N., House, A. O., &amp Holmes, J. D. (2006). Occurrence and outcomeof delirium in medical in-patients: a systematic literature review.Ageand ageing,35(4),350-364.

Wennberg,J. E. (2002). Unwarranted variations in healthcare delivery:implications for academic medical centres. BMJ:British Medical Journal,325(7370),961.

Woolf,S. H., Grol, R., Hutchinson, A., Eccles, M., &amp Grimshaw, J.(2009). Clinical guidelines: potential benefits, limitations, andharms of clinical guidelines. BMJ:British Medical Journal,318(7182),527.