The CDC describes an epidemic as the increase in the number of cases of a disease surpassing what would typically be expected for the population of that area. This increase is often sudden. Healthcare settings, critical components of the healthcare system, play vital roles in the prevention of epidemics, including the preparation for and management of these situations. Healthcare settings are places where healthcare occurs, it goes beyond hospitals and doctors’ offices, it includes urgent care centers, rehab facilities, nursing homes and long-term care facilities, as well as outpatient care facilities and others. Such places are expected to have a plan in place to respond to the outbreak of an epidemic.

Healthcare workers need to be trained and fully aware of their roles for preparing and responding to epidemics, and these healthcare settings need to have the appropriate resources necessary for treatment and quarantine events. Conversely, healthcare settings can actually amplify the spread of epidemics due to inadequate measures being taken to control the disease or simply due to the rapid evolution of these complex situations.

For these reasons, some healthcare settings across the country are turning to tele-medicine to assist in safely screening and treating patients who may have contracted the disease in question. The goal here being to provide remote services to help contain the spread of these illnesses. During epidemics tele-medicine companies see an increase in the number of calls from people seeking information and those worried about their symptoms. This type of medicine is not new, and many health insurances offer this option in addition to seeing a nurse or doctor in the traditional setting.

Unfortunately, many people do not go this route when looking for medical care and that can make controlling the spread more problematic because even asymptomatic individuals can pass along certain diseases. But even having people treat themselves at home does not stop the overwhelming demand for health care. During epidemics there is demand for hospital space and medications as well as trained health care professionals and these high-level demands can last weeks or even months.

Consequently, disease epidemics tend to lead to burnout epidemics that can affect both the providers and the patients because despite the preparation and management for these situations, epidemics are always overwhelming to the healthcare system. This burnout is caused by increased responsibility and the ever-changing care-delivery methods. Burnout is characterized by emotional exhaustion and depersonalization and can affect the quality of care and even outcomes of patients. All things considered, in the same way that health care settings prepare for epidemics, they also need to prepare for burnout epidemics when the health care system becomes overwhelmed by actively identifying the affected professionals and implementing solutions. 

A new inpatient medical facility will offer comprehensive inpatient and outpatient services for residents in the many communities we serve. The building is designed to move the patient through the journey to wellness. It uses “best practices” to enhance patient care. Of course, this doesn’t account for the cost and components of actually running the hospital after it’s built, but the following highlights provide context for all that goes into constructing a medical center:

Main Entrance and Lobby

Single entrance to simplify way-finding

Comprehensive medical library and resource center that is open to the public

Education center with meeting spaces for up to 300 people

Spiritual center with space for meditation and prayer

Front of House/Back of House Design

Separate corridors for the public and for patient transport

Streamlined Emergency Department (ED)

Comprehensive diagnostic services next to the ED

Helipad near the ED to ease emergency transit

Operating/Procedure Rooms

Three oversized operating rooms

One Cardiac Cath Lab

Seven specialty-sized or general operating rooms

Six procedure rooms for endoscopy and cystoscopy

Private patient rooms for pre-operative preparation and post-operative recovery so families can stay with patients

Inpatient Wings

Located away from the main entrance to reduce noise and disruption

Separate wings devoted to specific types of inpatient care

192 private patient rooms which:

Enhance patient safety and healing by reducing infection risk

Allow confidential communications with doctors and nurses

Feature family visiting/sleeping capacity

Have large windows to maximize light and views of nature

Outpatient Facilities

Extensive diagnostic facilities and doctor’s offices

One of the big ways in which the traditional hospital and healthcare system fails is when it disempowers individuals to understand the cost of their healthcare services. Health provider networks frequently claim to offer greater overall efficiency, but it’s hard to know and hard to measure when costs and services so frequently seem made up on the fly. Perhaps, just as bad, it creates an environment in which patients are unable to clearly understand the cost of their healthcare and, thus, are less empowered to plan for their future health needs.

 

Even Dental Coverage is Anything but Transparent

I’ve recently had a couple different circumstances to experience these frustrations, if not outright failings. I had a crown put in last November and December. During the initial visit, I sat down with the dentist’s billing coordinator to go over how much it would cost. I was told one price, split over two different bills that I paid during the initial visit as well as the follow-up visit. Putting in the crown was a two-step process.

In between the two visits, our health insurance was cancelled by my wife’s employer. So, then, in January, I got a bill for $133 itemized over some two dozen different largely indecipherable service descriptions. Now, this wasn’t my first rodeo when it comes to billing codes, service authorization, coverage policies, and the murky ways in which health insurance doesn’t works. But this bill seemed entirely unintelligible. I ended up calling the dentist and, after telling my whole story to a new billing coordinator and the regional manager, they decided to simply write the bill off. I still don’t know how much what service cost. I mean, it’s one thing to not consider costs for emergency health services, but the dentist office? Can’t I at least take a proactive approach to my dental care and service costs?

 

Trying to Get a Quote at the Dermatologist Office

Right around the same time, my wife went to the dermatologist and was deciding whether to get ultimately harmless but not very pleasant-looking age spots removed from her face. How much was the necessary liquid nitrogen treatment going to cost? The dermatologist’s office wasn’t sure. The Internet said the treatment might cost anywhere from $150 to $1,600. We eventually had to contact the health insurer with the correct billing codes from the dermatologist office to know what the bill was going to be.

 

Partisan Conflict Increases Dysfunction in the Health Care System

The health care system suffers from the haphazard way that competing philosophies have been implemented. It’s like we keep telling people and families to take greater personal responsibility for their health care and health outcomes, while simultaneously subjecting them to an over-managed and largely opaque health care system that tells them to shut up, wait to see what the bill will be, and then pay it—or don’t.

It starts with our state and national politics and then slowly, perpetually infects local health providers and individual health consumers. It degrades the trust that patients have in any number of hospital and healthcare settings. And it creates invisible inefficiencies that make it difficult for even health care industry experts to understand how to improve the system itself.