Fragmentation is one of the major issues that have crippled the healthcare system in the United States. Health care is a critical area in the lives of Americans. Thus, decisions relating to health care cannot be left to one person. Individual decisions may lack a whole perspective and may result to wrong decisions that may result to loss of life. Fragmentation is very high and tackling it may prove to be difficult. Most professionals in healthcare may suggest the complete removal of defragmentation as the very best solution to the problem. However, such a move may affect some of the desirable characteristics of fragmentation. The subsequent pages provide a discussion of the desirable factors of fragmentation as well as the undesirable ones. Undesirable factors may outweigh the desirable factors but an argument is given as to why the solution needs to be more of slowing fragmentation rather than stopping it.
Desirable and undesirable aspects of this fragmentation
Desirable of this fragmentation
Fragmentation in healthcare relates to a situation of having multiple decision makers. Therefore, such a situation can have several advantages or desirable characteristics as well as undesirable characteristics. One aspect of fragmentation that is desirable in healthcare is the issue of division of labor and specialization. Medicine is very broad and requires different areas of specialization such as radiology, pediatrics, and oncology. Such health conditions like cancer can only be effectively treated if handled in a fragmented manner, as a physician can be able to focus on particular health condition. Furthermore, fragmentation in the different areas of specialties allows further research to be conducted concerning the different health conditions affecting individuals.
According to Evans (2013), the American Nurses Credentialing Center (ANCC) an ancillary of the American Nurses Association (ANA), focuses on issues of innovation, research and promotion of growth and quality in its services. This is a good example of how fragmentation helps to improve the healthcare sector by making it more efficient.
Furthermore, fragmentation in health care provides an opportunity, which can be exploited in addressing some of the current problems facing healthcare. Fragmentation leads to the creation of vacancies in the different specialties. Additionally, fragmentation provides a platform for alternative care providers to offer treatment solutions to patients that have been dissatisfied with the traditional method of treatment. Normally, the traditional standard of care is facing shortages in doctors and nurses. As such, the human aspect in medical care is reducing, and patients are viewed more as revenue rather than patients (Stange, 2009).
Undesirable aspects of fragmentation
An undesirable aspect of fragmentation of the healthcare professions is that patients may be forced to visit a number of different physicians or specialists without finding a solution to their problem. The issue here is that when a patient visits each specialist, the specialist focuses his or her attention on the organ of his or her specialty. Such a perception is common in physicians, as they view that they have accomplished their contract with the patient when they focus on the body organ (Stange, 2009). As such, even if the organ itself is okay, the physician locating a problem that is not there for purposes convincing the patient that the problems lie in the organ in question. The constant movement and shifting of physicians may be too overwhelming for the patient or family and in the process may fail to receive adequate treatment on time.
With fragmentation, the increase in different specialties may result in certain healthcare professions being threatened by others. Consequently, such a situation may escalate to the development of unhealthy competition, which may compromise patient care. Furthermore, the lack of cooperation between the different professions may result to reducing sharing of critical patient information, which may be significant in helping the patient.
When it comes to issues of decision making regarding patient care, fragmentation can be detrimental to the health of an individual. For instance, fragmented decision making on delicate issues of management care such as peripheral vascular catheter (PVC) may result to patient safety being compromised through infections (Castro-Sanchez, Charani, Drumright, Sevdalis, Shah and Holmes 2014). Fragmentation also increases inequality in the healthcare sector (Stange, 2009). Access to health services is costly. However, doctors are more focused on individual who can pay their billable hours rather concerning their efforts on benefiting the patients.
Despite the fact that fragmentation may increase efficiency and effectiveness due to specialization and division of labor, it will at the same time cause inefficiency and ineffectiveness. According to Stange (2009), most of the services offered by the different professions are branded in such a way as to attract customers. The goal here is to make profits and not deliver results based on healthcare. Additionally, much focus on the healthcare system has been in the individual professions. There is no aspect of the healthcare industry as a whole. As such, there is a lack of a coordinated research approach in healthcare.
Should actions be taken to slow or stop this trend? If so, what should be done and how can it be achieved?
Necessary action need to be taken to slow this trend rather than completely stop it. Complete removal of the fragmentation may affect the different areas of specialties, and this may limit further advance in technology and research in healthcare. Slowing it down may be the best approach as fragmentation has generated many problems for the healthcare system. According to Stange (2009), implementing such an approach requires first a clear understating of the problem of fragmentation. Healthcare should be viewed as different parts that working together to contribute to the whole health care situation. It should involve a collaboration of the different aspects of the different professions in health care.
Elhauge (2010) indicates that healthcare organizations need to be more coordinated and integrated to such an extent that patients are able to access cheaper and well-coordinated care. Consequently, such a move will help reduce the burden managing care of the patient as the healthcare organizations are better equipped to handle it. Additionally, no additional payments need to be charged for the coordination of the patients’ medical history between different professions. Physicians need to take responsibility for fulfilling all their duties focusing on the good health of the patient as their main goal.
It is important to have continuance defragmentation checks in the healthcare system. Different governing professional bodies in healthcare need to align their strategic goals with the health of the patient being the main concern. Furthermore, healthcare providers need to view fragmentation as an avenue of addressing certain obstacles in healthcare. Thus, they may be required to find a point where fragmentation is applied to certain limits only. To achieve this healthcare professional need to work together no matter their specialty
Castro-Sánchez, E., Charani, E., Drumright, L. N., Sevdalis, N., Shah, N., & Holmes, A. H. (2014). Fragmentation of Care Threatens Patient Safety in Peripheral Vascular Catheter Management in Acute Care– A Qualitative Study. Plos ONE, 9(1), 1-6
Elhauge, E. (2010). The fragmentation of U.S. health care: Causes and solutions. New York: Oxford University Press.
Evans, M. L. (2013). Report of the American Nurses Credentialing Center (ANCC) to the 2013 ANA Membership Assembly. Retrieved from the Nursing World Web site: http://nursingworld.org/ancc/
Stange, K. C. (2009). The Problem of Fragmentation and the Need for Integrative Solutions. Annals Of Family Medicine, 7(2), 100-103.