Introduction
Provision of proper healthcare is an important initiative that all countries should undertake. Medical care plays an essential role in the overall success of a country. A healthy population is regarded as being more productive that an unhealthy one. However, provision of proper healthcare services requires outstanding and comprehensive health care policies. Creation of an effective healthcare policy however requires consideration of various factors such as level of education, social status and age amongst others. Age is indeed an imperative factor since the type of healthcare services vary depending on age (Althaus, Bridgman & Davis, 2017). For instance, children suffer from health problems that are completely different from those affecting the elderly. Creation of healthcare policies therefore require strict adherence to age requirement with regards to healthcare. An effective healthcare policy has five basic elements that makes it essential to citizens. The elements include; sustainability and equity of the policy, collaboration between different sectors, co-benefit, engagement of all stakeholders, and creation of both structural and procedural change (Leask, Helms, Chow, Robbins & McIntyre, 2010). These factors play an imperative role in ensuring that a policy offers the best services to the intended persons. Countries should therefore ensure that health policies belonging to all ages must possess the above elements. Care should however be taken to ensure technocrats and other vital stakeholders within the healthcare sector are fully involved in the creation of such policies.
Health policy is an essential aspect in many countries. After savings and pensions studies have shown that most citizens believe that there should be a favorable health policy that favors them. Several health insurance companies offer services to the citizens of both the United States of America and the European Union. The health policies however come with both advantages and disadvantages. However, the benefits surpass the disadvantages in most healthcare policies. In the United States for instance, there are different health policy that varies with the cost. It is nevertheless, advisable that when an individual is looking for a medical plan, then they should consider the value of each program (Black, Bateson & Harvey, 2013). Premium policy: this is the amount of money that you pay to the insurance company to purchase the program. This money is usually spent on a monthly period or a specific day of a year or week. For those who are employed, it is the responsibility of the employer to pay the premiums by deducting a certain amount of from your salary and remitting it to the insurance companies. The health insurance policy is similar to car insurance as many insurance companies will require its clients to pay a certain amount from their pockets before their coverage’s starts (Black, Bateson & Harvey, 2013). An example being if one’s deductible amount is $200 then he/she has to pay the first $200 of the medical cost before the insurance starts to pay. For some plans, the deductible only applies when one gets services that the insurance company does not provide.
Most people say that the official European Union health policy has paradoxically been built, this is because most leaders over some time wanted the European Union to be seen as working while in most cases it was not (Collins & Lapsley, 2008). Health policy is always high on the political agendas that most governments do not want the government to interfere with it. The European Union came up with a solution of having a mandate to encourage unity and cooperation among the member states and to lend support in the public health. The European Union was given money to lend it to the member states but was later forbidden to pass laws that could harmonize the public health measures. Just like the United States health policy, the policy does not favor the citizens, but it protects them. The insurance policy has its advantages as it provides coverage for the patients (Althaus, Bridgman & Davis, 2017). This will help the patients as they won’t need to look for money to settle their hospital bills. The insurance policy is also advantageous for the doctors as they get to be paid in time by the insurance covers (Groundwater-Smith, Le Cornu & Ewing, 2011). Although there are advantages, there are also disadvantages to the insurance policy. The insurance policy is always expensive, and some citizens cannot afford it. There is also a disadvantage as the insurance covers does not cover certain medical conditions.
The elderly people are of great value to the society. Despite being at their advanced age, this group of people play a vital role hence should be taken care of. Healthcare policies should therefore be implemented to ensure proper medical services is given to them. The senior citizens suffer from various health issues a factor that makes it important to establish a comprehensive health policy for them. Improving the healthcare of this population is essential in increasing their life span (Althaus, Bridgman & Davis, 2017). Advocates and policy experts should however be fully involved in the creation health policies for the aged. Inclusion of policy experts will ensure that all policy considerations are included hence making the policy effective. This study therefore aims discussing health polies with the aged population as the target group. While there exist different age groups in society, the senior citizens were chosen due to their imperative role and advance age in society. Many countries often forged to offer proper healthcare services for the aged hence their choice. It will further discuss the importance of such policies in the outcome of healthcare services. Lastly, the study will explain why elaborate and comprehensive policies are needed for the senior members of society.
Telemonitoring Policy in Heart Failure Patients
Senior citizens often suffer from heart failure. Due to their advanced age, proper care should be provided to them hence the importance of telemonitoring. The telemonitoring interventions have been implemented in numerous healthcare setups, and they have shown improvement among the patients due to timely interventions. Telemonitoring involves structured telephone support, standard devices used at home in measuring blood pressure, weight, heart rate as well as and oxygen saturation. It further monitors cardiac implantable electronic devices hence providing useful physiologic data that aids in Heart Failure Management. The following is an outline for this Policy in cardiac facilities.
Policy Outline
Introduction
- Purpose of the paper
- Outline of the paper
- Overview of the Policy, which entails the description of telemonitoring.
- Functions of Telemonitoring (Slade, Johnston, Teesson, Whiteford, Burgess, Pirkis & Saw, 2007).
- The purpose of the Policy
Defining the Problem
i. What is the problem with heart failure patients?
ii. What causes readmissions?
iii. How many patients are readmitted over a specific period?
iv. What are the impacts of readmission to the healthcare providers, the patients, and their families as well as the entire healthcare system?
- What interventions have been implemented in the past to avoid readmission of patients
- Why would Telemonitoring work?
Source of Information/ Evidence
i. Description of the types of facilities with telemonitoring
ii. Discuss the use of telemonitoring
iii. Review literature on the outcomes of the use of telemonitoring in cardiac facilities
iv. Discussion on how the telemonitoring will aid patients in the current healthcare facility
Develop Alternative Solutions
- Discuss alternative solutions such as available frequent check-up visits for the cardiac patient
- Discuss and weigh the available solutions: frequent follow-up checks and establishing healthcare facilities near all cardiac patients (Hoy, 2016).
- The discussion involves the benefits of the various methods and disadvantages, as well as the costs implied.
Decision making Criteria
i. All the seven steps of decision making are outlined (Hector, Hyde, Worgan & Macoun, 2008).
ii. Identify the decision
iii. The decision to be made involves the solution to readmission of heart failure patients
iv. Gather relevant information
a. The relevant information is the proposed Policy which is telemonitoring
v. Identify the alternatives
a. Alternatives include frequent follow-up visits and the setting of new health care facilities in remote areas.
vi. Weigh the evidence
a. Refer to organizations which have used the methods and the outcomes
vii. Choose among alternatives
a. The best interventions form the Policy
viii. Take Action
ix. Review the decision
The decision is reviewed by citing the expected advantages and policies.
Implementation of strategy
- Key stakeholders which include healthcare administrators, healthcare policymakers, healthcare workforce, and cardiac patients
- The required resources for implementation
- The time frame and activities required during the implementation process
The expected challenges and solution to the challenges
The political implication of the health policy
Telemonitoring is a broad activity that involves various departments, including political activities and interventions. For instance, telemonitoring activities should comply with policies from various authorities such as federal governments that must be adhered to in the Policy. The policies include tax remissions, healthcare regulations, and rules. Therefore, these rules and regulations will shape operations in the telemonitoring facility (Schon, 1984). The telemonitoring facility will operate within the set standards and laws. The involved healthcare practitioners will also adhere to the laws and regulations which will affect their operations. The Federal grant realizes the funds according to the relevant to the act, which allows funding (AIoHa, 2016). Therefore, the federal grants will determine the size of the facility and the financial budget. The planning and implementation of policies are directly affected by politics. For instance, telemonitoring health is affected by insurance policy, research partners, and policymakers.
As much as the health authorities decide, the insurance companies must be involved in the process. Politics directly affect health policies through the political determinants of health, including political processes such as elections, law-making, and political structures. The other determinants include political outputs such as taxes, social security benefits, and public service. A favourable political environment is composed of favourable taxes and laws which support healthcare policies (Wilson, et al, 2018). Therefore, the political environment which will prevail at the time of implementation of the telemonitoring policies will determine how the Policy will thrive. The Policy may also have effects on the political environment. It may spark reactions from the political structures that might support or fail to support it. However, if the Policy is likely to benefit the citizens, it may receive massive support from political structures that would help in the implementation process. Therefore, the attitude which the Policy evokes from the political structures will determine its implementation and funding process. Healthcare policies that support current health agendas and objectives have received applause from political structures. This Policy should be explained to the political structures to avoid negative attitudes and discouragement from the political class.
The ethical and legal dilemmas and constraints involved in formulating and enacting the health policy
Health policies are indeed imperative in improving the quality of healthcare services especially to the senior citizens. Development and implementation of health policies however involves a number of ethical legal dilemmas that should addressed effectively. The dilemmas present a confusing situation that renders both patients and policy implements into an awkward situation with limited options. The most outstanding ethical dilemmas that need to be addressed when developing or implementing health policies especially to aged include; patient confidentiality, informed consent, patient relationships, physician assisted suicide issues and negligence and malpractice (Pinnock, et al., 2013). Effective considerations should therefore be made on the above ethical dilemmas. Formulation of the telemonitoring policy was indeed faced by a number of challenges. The policy formulator must ensure that information about the patients’ health condition is kept confidential as far as possible. This is important in ensuring that the senior citizens be benefiting from the policy do not suffer from any stigma. Violation of the confidentiality of patients amounts to both legal and ethical offences. It is therefore imperative for individuals involved to take care of data pertaining the patients’ health history.
Patients’ relationships is another vital ethical dilemma that faced the formulation of telemonitoring policy for the aged. In the health arena, nurses and other healthcare practitioners are prohibited from getting into or interfering with personal relationships of the patient (Oudshoorn, 2009). The policy is therefore formulated in a manner that highly respect all personal relationships of patients. Moreover, the policy ensures that all healthcare providers involved in the monitoring do not interfere with the personal relationships. Additionally, patents’ consent must be acquired before administration of the policy on patients. Care must therefore be taken by the formulators to ensure the elderly accept the policy and its implementation. The policy further offers the patients a freedom to seek for information about the policy before they subscribe to it. Patients who are too old to communicate effectively have the freedom to be represented by the relations especially those tasked with the responsibility of taking care of them. Malpractice and negligence have been on the rise in recent years.
Many patients have lost their lives at the hands of healthcare providers especially due to carelessness and illegal healthcare activities (Chaudhry, Barton, Mattera, Spertus & Krumholz, 2007).This ethical dilemma proved difficult during the implementation of the policy. However, the policy experts offered effective insights on how to avert the challenge hence giving solutions. Proper attention and strict monitoring is done to ensure such cases are reduced. The last ethical issue that affected the formulation of the policy was cases and issues of suicides aided by physicians. Available data indicate that cases of patients committed suicides especially those assisted by doctors and other medical practitioners have been on the rise in recent decades. To solve this dilemma, the policy offered a procedure through which such issues are reported before actualized.
A part ethical dilemmas, formulation of the policy consequently suffered from legal dilemmas. The main legal dilemmas experienced include; professional boundaries, data privacy, and access to care (Akalu, Rossos & Chan, 2006). During the formation of the policy, it was required that healthcare positioners involved maintain their professional boundary. Respect to the vulnerability of patients is one of the critical areas that required maintenance of professional boundary. Patients are often vulnerable and are ready to offer almost anything to acquire health services. However, healthcare practitioners are required by law to always adhere to the rubrics and dictates of the professional requirements hence maintaining professional boundary. Activities such as inappropriate involvement with patients are thus outlawed (Baimyrzaeva, 2013). Protection of patients’ data is another vital legal issue that affected formulation of the policy. All nurses and other medical practitioners involved in the process are required to take the precautionary measures to offer proper protection to patients’ data. The policy therefore offered an elaborate mechanism of protecting data. Data privacy is thus an outstanding legal issue that requires proper attention from the policy formulators (Chaudhry, et al., 2007). Despite the challenges faced in ensuring data privacy, required steps were taken to guarantee data privacy and protection.
Benefits of Health Policy to the aged
Various changes occur in the world especially with inclusion of technology into the healthcare industry. There are changes that do great harm and changes that do great good. A new change is arising that can dramatically change the health condition of the aged. The telemonitoring policy is therefore one of the best policies in the history of healthcare. The most outstanding benefits of the policy is improving quality of healthcare services to the aged while making it both accessible and affordable to people (Bobrow & Dryzek, 1987). The policy provides access to health monitoring to all senior citizens with insurance covers as well as those without. This step in essential in ensuring every citizen including the poor have access to quality healthcare services especially the aged. Inclusion of insurance covers to all uninsured, the Aged are able to get quality medical care through the program. The program had led to an increased used of the medical extenders, such nursing specialists as well as the telemedicine courses.
To reinforce the accessibility of primary health care services, the policy offers new enticements through the law to increase the number of principal care nurses, doctors, nurses as well as physician supporters. The incentives include subsidy for scholarships and loan payments for primary medical care personnel working in underserved regions. Offering support to primary care providers in underserved areas is imperative in supporting the quality of healthcare services and well as their availability in such areas. Medics and nurses getting payments through state loan payment programs intended at increasing the obtainability of medical services in health specialized shortage areas do not pay taxes on those payments (Menzel, 1987). It has massively encouraged medical practitioners to be more productive in their various areas of specialization thus improving the quality of healthcare services.
Conclusion
In a nutshell, it is right to infer that healthcare plays a vital role in the overall success and development in a country. However, establishing a comprehensive and strong healthcare system requires a strategic plan that develops plans and measures that support provision of quality healthcare. The health history is full of healthcare programs and policies introduced by different leaders in different countries. The telemonitoring policy is highly ranked ahead of other policies. It is celebrated as one of the best healthcare schemes to be introduced and consequently implemented in the history of aged. The program has greatly reduced the cost of healthcare services while improving its availability through provision of healthcare insurance covers. Besides, improving the quality of medical services, the program has supported people within different age groups such as the seniors and children. To the seniors who were retired before their retirement age, the programs has established a mechanism through which the life savings of such people can be secured.
However, despite the several benefits of the policy, many critics have highlighted instances in which the limitations of the program are visible. One of the most factors affecting in formulation and implementation are ethical and legal dilemmas. The government is forced to increase its level of taxation to support the program. Individuals with alternative medical covers have also been disadvantaged by being forced to take a new health cover. With regards to the implementation, the policy has faced a number of challenges ranging from political interference to confusion from misinformation given to people by the elite members of society thereby causing confusion. A lot of myths and misconceptions have been developed around the program thus causing misunderstandings. It is however imperative for stakeholders and policy experts to conduct a review on the policy to ensure it fulfils its initial aims.
References
AIoHa, W. (2016). Australian burden of disease study: impact and causes of illness and death in aboriginal and Torres Strait islander people 2011. AIHW: Canberra.
Akalu, R., Rossos, P. G., & Chan, C. T. (2006). The role of law and policy in tele-monitoring. Journal of telemedicine and telecare, 12(7), 325-327.
Althaus, C., Bridgman, P., & Davis, G. (2017). The Australian Policy Handbook: A practical guide to the policy making process. Allen & Unwin.
Baimyrzaeva, M. (2013). Policy analysis as a Profession in Government: Who does what and how? University of Central Asia, Institute of Public Policy and Administration, Occasional Paper, (2).
Black, K. I., Bateson, D., & Harvey, C. (2013). Australian women need increased access to long-acting reversible contraception. Med J Aust, 199(5), 317-318.
Bobrow, D. B., & Dryzek, J. S. (1987). Policy analysis by design. University of Pittsburgh Pre.
Chaudhry, S. I., Barton, B., Mattera, J., Spertus, J., & Krumholz, H. M. (2007). Randomized trial of telemonitoring to improve heart failure outcomes (Tele-HF): study design. Journal of cardiac failure, 13(9), 709-714.
Chaudhry, S. I., Phillips, C. O., Stewart, S. S., Riegel, B., Mattera, J. A., Jerant, A. F., & Krumholz, H. M. (2007). Telemonitoring for patients with chronic heart failure: a systematic review. Journal of cardiac failure, 13(1), 56-62.
Collins, D., & Lapsley, H. M. (2008). The costs of tobacco, alcohol and illicit drug abuse to Australian society in 2004/05 (p. 143). Canberra: Department of Health and Ageing.
Groundwater-Smith, S., Le Cornu, R. J., & Ewing, R. A. (2011). Teaching: Challenges and dilemmas. South Melbourne: Cengage Learning.
Hector, D. J., Hyde, A. N., Worgan, R. E., & Macoun, E. L. (2008). Research evidence can successfully inform policy and practice: insights from the development of the NSW Health Breastfeeding Policy. New South Wales public health bulletin, 19(8), 138-142.
Hoy, W. E. (2016). Australian burden of disease study: impact and causes of illness and death in Australia 2011.
Leask, J., Helms, C. M., Chow, M. Y., Robbins, S. C. C., & McIntyre, P. B. (2010). Making influenza vaccination mandatory for health care workers: the views of NSW Health administrators and clinical leaders. New South Wales public health bulletin, 21(10), 243-247.
Menzel, D. C. (1987). An interorganizational approach to policy implementation. Public Administration Quarterly, 3-16.
Oudshoorn, N. (2009). Physical and digital proximity: emerging ways of health care in face‐to‐face and telemonitoring of heart‐failure patients. Sociology of Health & Illness, 31(3), 390-405.
Pinnock, H., Hanley, J., McCloughan, L., Todd, A., Krishan, A., Lewis, S. … & Pagliari, C. (2013). Effectiveness of telemonitoring integrated into existing clinical services on hospital admission for exacerbation of chronic obstructive pulmonary disease: researcher blind, multicentre, randomised controlled trial. Bmj, 347, f6070.
Schon, D. A. (1984). The reflective practitioner: How professionals think in action (Vol. 5126). Basic books.
Slade, T., Johnston, A., Teesson, M., Whiteford, H., Burgess, P., Pirkis, J., & Saw, S. (2007). The mental health of Australians 2. Report on the, 20(07).
Wilson, S., Davies, R., Stone, T., Hammerton, J., Ware, P., Mawson, S., … & Mountain, G. (2018). Developing a telemonitoring system for stroke rehabilitation. In Contemporary Ergonomics 2007 (pp. 505-510). Taylor & Francis.
