Universal health care is a hot topic for discussion these days, with people arguing for and against it. While proponents of the system argue that it is the right of every human being, opponents argue that it may not be economically feasible, and may harm a lot more people than it will help. The issue is much more complicated by the fact that there is no one system in the world that is adopted by all the countries that currently has universal healthcare, and therefore it becomes difficult to gauge its success across the world. Let us try to break this complex issue to gain a better understanding of the system, and form informed opinions.

Universal health care is a system that ensures all the people in a region or a country gets healthcare without affecting their financial status.  According to WHO Universal health coverage (UHC) means that all people and communities can use the promotive, preventive, curative, rehabilitative and palliative health services they need, of sufficient quality to be effective, while also ensuring that the use of these services does not expose the user to financial hardship. In practice, this does not mean that everyone has insurance coverage or that all medical issues are covered by the insurance, it just means that everyone has access to healthcare.

Universal healthcare first started in Germany in 1883 with the sickness insurance law, which mandated industrial employers to provide insurance for their workers using funds made from deductions in employee wages and from employer contributions. By 1930s, almost all of western and central Europe had similar systems in place. Currently, of the 33 developed countries, all of them except the USA has universal healthcare.

Implementation strategies

Even though the definition of universal healthcare is uniform throughout the world, the implementation strategies used in different countries are very diverse and difficult to classify. Each of these systems are linked with the governing systems and the laws and regulations of that country, and therefore may even differ in different parts of a single country, as in the different provinces of Canada, where each province has reasons to determine what is considered essential, and where, how and who should provide the services.

In some cases, the government pays for healthcare from a single fund. In some countries like Canada, this would mean that the government pays private organizations which in turn provide healthcare to its public, while in countries like the United Kingdom, the government maintains a healthcare system, owning healthcare resources and employing healthcare professionals. Such systems are referred to as single-payer systems, which means that the fund for the system is managed directly by the government or a government regulated agency. In such a system, the entire population is brought together under a single health risk pool, and one set of standards for services offered, and the cost for these services. Generally, the idea is that the high healthcare costs that arise from the sicker section of the population are balanced by the low healthcare costs for the healthy section of the population.

In a multi-payer system, the medical costs are paid for by multiple entities, which may include the person or their family, their employer, and the government. Countries like Germany follow a multi-payer system, with a statutory health insurance, and private health insurance. Compared to single-payer systems, multi-payer systems provide more options to the patients, and are generally difficult for the governments to exploit, but falls below in terms of healthcare equity, risk pooling, and negotiations. Multi-payer systems are also associated with higher administrative costs.

In some countries like Switzerland and Germany, universal healthcare is enforced by legislation. In Switzerland, there are no free state-provided health services, but private health insurance is compulsory for all persons residing in Switzerland (within three months of taking up residence or being born in the country). Swiss are required to purchase basic health insurance, which covers a range of treatments detailed in the Swiss Federal Law on Health Insurance. It is therefore the same throughout the country and avoids double standards in healthcare. Insurers are required to offer this basic insurance to everyone, regardless of age or medical condition.

The advantage of universal healthcare is that everyone gets medical coverage, no matter how poor they are, and everyone gets the same standard of care. Various studies have shown that universal healthcare has lead to healthier populations, with lower infant mortality rates and improved life expectancy. Universal healthcare is also associated with improved economic well being of the population. In Thailand within ten years of the implementation of Universal Health Scheme, the catastrophic healthcare expenditure in the poorest households fell from 6.8% to 2.8%. In Mexico, impoverishment from health expenditure fell from 3.3% in 2001 to 0.8% in 2010, with the implementation of a national protection programme called Seguro Popular, funded by general taxation and modest contributions from richer households.

Implementation of universal healthcare is complicated with a lot of difficult choices. The healthy section of the population ends up paying for the sicker section of the society, the money which may well be spent on economically better ventures, which will improve the quality of life for everyone. Universal healthcare may end up crippling the economy and may even lead to poor quality of healthcare, as doctors have more incentive for treating more patients, but less for treating fewer patients with more care. People may also be less careful of their health and can lead to less healthy choices if they don’t have the incentive to stay healthy.

So the debate on whether universal healthcare is good or bad, essentially is a debate on how to achieve universal healthcare - should it be done by implementing laws and regulations specifically for universal healthcare, or should we do it improve the overall standard of living that access to healthcare is not a problem for anyone.  

The success of a universal healthcare system will depend on how it is implemented, and choices have to be made based on the size of the population, the economic well-being of the population, the available funding and the fine balance between the choice similar to as mentioned above.

The healthcare sector is facing pressure to move to digital systems, both from regulatory authorities and from the general public. The government is pushing for digital systems so as to make the functioning of hospitals and other healthcare systems more transparent. The public is becoming more aware of their healthcare requirements and options and is demanding more efficient and accessible healthcare systems, and the healthcare providers are becoming more aware of this need. Many healthcare IT firms are trying to fulfill this need, and are providing a variety of software services. Let’s try to understand the different types of healthcare software used by various healthcare providers.

EHR

Electronic health records or EHRs are used for storing patient information in a digital manner. It is used by hospitals and clinics to store the complete medical history of a patient. Government health regulators in many countries are moving forward with plans to make electronic health records mandatory.

These records provide a secure and easily accessible way of storing medical records compared to paper-based records. Electronic records do not have the risk of loss of medical history or being illegible or destroyed over a long period of time. It also prevents duplication of medical records, since there is only one file that is modified over time.

Electronic health record software is used in both clinics and hospitals and usually comes integrated with hospital management software and practice management software.

Practice management software ( PMS)

Practice management software or clinic management software is used for managing clinics. Depending on the requirement of the clinic, software with various combinations of features is available. Generally, they contain appointment management, billing, and electronic health records. Software with integrated lab and pharmacy management features is also available if there are labs or pharmacies associated with the clinic. Practice management software helps to streamline the workflow of a clinic, gets error-free documentation, manages appointments and billing, and makes the system more efficient.

Specialized systems are available for dental care, ophthalmology, and other specialty clinics, with customized prescription management and health records.

Queues in the clinic can also be managed by the system, either on the basis of tokens or on the basis of appointments

Hospital Management System ( HMS )

Hospital management system has almost all the features described above, and more. They are a fully integrated system capable of managing the entire hospital. They are capable of managing appointments and electronic health records for both inpatient and outpatient departments. They are used for managing doctors’ schedules, surgeries, other procedures, and all the aspects related to them. They are also capable of handling the labs and pharmacies attached to the hospitals. The HMS systems can also manage the rooms, marking rooms as occupied, unoccupied, undergoing maintenance, etc, making it easy to allocate rooms and beds for patients.  

Hospital management systems are often linked to the websites of the hospitals and patients can use them to book their appointments, get access to their health records and treatment plans, and manage their prescriptions. These days they also come with apps for patients that aid the patients in these same tasks much more easily through their smartphones. Alerts are provided through SMS services for follow-up procedures, vaccinations, etc in some hospital management systems.

Due to the integrated nature of the HMS, all the procedures done in various departments of the hospitals, all the tests done, medicines administered, and prescribed are tracked, thus allowing easy comprehensive billing.

Laboratory information management systems ( LIMS )

Lab information management systems, as the name implies, are used to manage the functions of a lab. It will have provisions for sample collection, inventory management, accounting functions, and provisions for machine interfacing with the lab equipment.

A good lab information system will provide full automation and ensure error-free results, with alerts for abnormal results. With machine interfacing, data from the instruments in the lab are directly read by the software, and accurate records are made against the sample data. In the case of LIMS systems integrated with the hospital management system, provisions may be there to add the test results to the patient records. Stand-alone systems are also available for use by independent laboratories.

The Laboratory information management system helps lab technicians to achieve a smooth workflow and better quality control. From the point at which the sample is collected, till the results are delivered, samples are tracked using the software, which means that any technician in the lab can find out what to do with a sample at every step of the way, thus avoiding issues with sample management. The system also prevents errors, thus improving the credibility of the lab.

Billing software

Billing software has been used as part of hospitals and clinics ever since accounting went digital. Even before EHRs came, accounting software was being used in many hospitals.

Billing software helps to manage insurance claims and provides a smooth accounting of medical bills. The entire medical costs of all the patients can be easily accessed and organized in an efficient manner using billing software. Though they come along with hospital and practice management systems these days, they are still available as stand-alone systems. 

What is Cloud Computing?

Cloud computing is a pool of configurable computer system resources and higher-level services that can be provided quickly, often over the Internet, with minimal management effort. Cloud computing relies on resources for consistency and economies of scale, similar to a public utility.

Clouds from third parties allow organizations to concentrate on their core businesses instead of spending resources on computer infrastructure and maintenance. Advocates point out that cloud computing enables companies to avoid or reduce the cost of IT infrastructure upfront.

Proponents also argue that cloud computing enables companies to get their applications up and running faster, with improved management and less maintenance, and that it enables IT, teams, to adjust resources more quickly to meet fluctuating and unpredictable demand.

The healthcare industry has started to see considerable changes in the past few years. From cancer and chronic diseases to risk assessment and radiology, there are multiple opportunities to influence technology. It is used to implement more effective, impactful, and precise interferences at the right moment in taking care of the patients.

Artificial Intelligence acts as the central aspect, which drives enhancement across patient care. AI provides many advantages over other clinical decision-making techniques and traditional analytics. Getting to know algorithms can become more accurate and precise. It is because they allow humans to gain insights into diagnostics, and interact with training data, treatment variability, care processes, and patient outcomes.

8 Ways AI Impacts Healthcare:

Proceed below to find out some practical ways in which AI changes the healthcare industry.

1. Integrating Machine and Mind using Brain-Computer medium:

Utilizing systems to collaborate is not a unique idea. However making direct communication between humans and technology without any requirements for monitors, mice, and keyboards is considered to be an essential area of research with a significant application for several patients.

Trauma and Neurological diseases to the nervous system may take away the abilities of patients like moving, interacting, and speaking meaningfully with the surroundings of people. BCIs (Brain-Computer mediums backed by AI can restore the primary experiences.

It's easy to decode the activities of the neural system affiliated with the purposive moment of one by utilizing AI and BCI. We can enable the person to collaborate the same way as different people work four to five times across the morning course. The communications are processed with the phone, computer, tablet, or using other universal communication technology. The medium of Brain-Computer helps to increase the quality of patient life with locked-in syndrome, strokes, ALS, spinal cord injuries, and more.

2. Producing the next generation of tools in Radiology:

The images of Radiology acquired by X-rays, CT scanners, and MRI machines provide non-intrusive reflectivity into the human body's inner workings. But many processes in diagnosing depend on the biopsies' physical tissue samples, which carry a risk that includes the infection potential.

According to experts, AI helps the next generation of tools in Radiology that are detailed and accurate to rebuild the requirements for tissue samples. Providers also can target the treatments and define the cancer aggressiveness appropriately. AI helps to make use of virtual biopsies and progress the intuitive field of radiomics that deal with utilizing image-based algorithms to represent the tumors' genetic properties and phenotypes.

3. Extending access to care in developing or underserved regions:

The lack of professional healthcare providers like radiologists and ultrasound technicians can constrain access to critical care in developing nations across the globe. AI enables mitigating the cause of a severe deficit of professional clinical staff by handling different duties that are provided to humans.

4. Decreasing the problems of using Electronic Health Records:

Electronic Health Record has a significant role in the industry of healthcare journey into digital recording. However, the switch comes with numerous issues affiliated with user burnout, endless documentation, and cognitive overload. The developers of Electronic Medical Records are now making use of Artificial Intelligence to develop more new interfaces. It also automates several processes in a routine which consumes the user's time.

All users spend their time on three crucial processes, namely sorting through the right thing, order entry, and clinical documentation. Dictation and voice recognition help to enhance the process of clinical documents, but NLP (Natural Language Processing) tools are not suitable for it. AI also helps to take care of routine requests like result notifications, and medication refills from the inbox. It also enables to make use of the tasks that severely need the attention of the client.

5. Comprising the Antibiotic Resistance risks:

Antibiotic Resistance is a threat that grows huge across the globe due to the overuse of drugs. Multi-drug resistance organisms can make a massive change in the hospital setting and also claim various numbers of lives every year.

Electronic Health Record information can help in highlighting the patient's problems and identifying the patterns in infection before they develop to show symptoms. Influencing AI and machine learning tools to drive all these analytics can create more accurate, faster alerts, and also improve their accuracy for healthcare providers.

6. Make accurate analytics for Pathology images:

According to Jeffrey Golden, Professor of Pathology at HMS and MD, Chair of the Pathology Department at BWH and Pathologist acts as the crucial diagnostic data source for providers across the care delivery spectrum.

70% of all healthcare decisions depend on the pathology results. AI also enhances productivity by finding out the features of interest in slides. AI is capable of screening through the slides and then directed to the right path to look, so it's easy to assess what is significant. It helps to enhance the effectiveness of the pathologist's use and improve the time value they spend on every case.

7. Admitting Intelligence to Machines and Medical Devices:

Smart devices provide everything from the refrigerator to real-time video to cars, which can detect when the driver gets distracted. Smart devices are essential for taking care of the patients in the ICU.

Artificial Intelligence helps to improve the ability to suggest Sepsis, identify degradation, and sense the complication development. The reason is that it can enhance the outcome significantly. It also decreases the cost related to penalties in clinic-obtained conditions. Making use of intelligent algorithms in smart devices can reduce problems for physicians and doctors while making sure that patients receive care at the right time possible.

8. Progress Immunotherapy usage for the treatment of cancer:

Immunotherapy is considered to be the critical avenue for cancer treatment. The therapy makes use of the immune system in the body to attack malice. In this case, patients can beat difficult tumors. The fact is that fewer patients get the advantage of immunotherapy. Oncologists do not have a reliable and precise method for recognizing which patient can gain with this immunotherapy. The algorithms of Machine learning and their ability to utilize different datasets illuminate unique options for exploiting therapies for a single genetic makeup.

Bottom Line:

Apart from the above impacts, there are several factors like

· Utilizing EHR as a precision risk predictor,

· Taking care of the patient's health through personal devices and wearable,

· Turning smartphone selfies into a robust and useful diagnostic tool,

· Making clinical decisions using AI is one of them that can change the healthcare industry.