Discussion 1

As I mentioned in my introduction, I manage two OBGYN practices at the University of Kentucky. One of those practices is located in Rowan County, in a small town called Morehead, KY. In the community, our clinic is one of only two OBGYN practices. In addition, many of the surrounding rural counties are without OBGYN physicians. Therefore, many of our patients make a lengthy commute to see one of our providers.

Fortunately, Morehead does have a hospital that is equipped with labor and deliver services. The next closest hospital or OBGYN high risk specialist is over an hour's drive away on the main UK campus in Lexington, KY. Recognizing the lack of services, and the difficulty of travel for our patients, we started offering telehealth in 2013 to expand access of care and improve the quality of care for our high risk OB patients with the Blue Angels program.

All patients who are considered as having a high risk pregnancy are offered a telehealth consult with a high risk OBGYN specialist from Lexington via telehealth with the Blue Angels program. This consultation occurs during the patient's routine ultrasound. The exam room is equipped with a large 55 inch monitor that allows the physician to see both the patient and the ultrasound that is being performed by the sonographer, in real time.

This allows the provider and the patient to communicate as if they were face to face in an office visit. From 2015-2016, 1,863 patients participated in the Blue Angels program - a 62% growth in patient volume from the previous year. Deliveries and NICU referrals from the area to Lexington grew almost 40% from 2013-2016.

The set up cost for telehealth was minimal in comparison to the progress and benefits being made in our high risk patients. According to the document "The Role of Telehealth in an Evolving Health Care Environment", telehealth allows rural areas to increase quality of care and patient volumes, reduce emergency department visits and hospital readmissions, and offer specialty care at a lower cost, not to mention saving the patients time, money, and traveling to Lexington.

Other methods of web-based communication tools have also proven to help manage complex health care needs by providing virtual access to multiple specialty providers.

In a pilot study, researchers developed the "Loop", a secure online communication tool that allowed patients to communicate with multiple members of a health care team. The study proved the "Loop" to be successful in providing effective medical team collaboration with patients.

Similar in design and access, patient portals allow for patients to get medical information, appointments, and prescriptions all in the click of a computer. In the article "Patient Web Portals, Disease Management, and Primary Prevention", the authors state that web portals have been shown to increase patient adherence to medical regimens, and have improved the overall efficiency and quality of health care.

Patient-centered care was our approach in the planning, delivery and implementation of the Blue Angels Program. Poor access to medical specialty care in rural Kentucky is a key factor resulting in high infant mortality rates. It is critical to diagnose high risk mothers early in their pregnancies, and avail them to appropriate care. Since 2013, eleven additional sites have been established. Our goal is to eventually break the barriers created by geographic circumstance, workforce shortages, and even socioeconomic factors for women in all rural areas of Kentucky.

Discussion 2

The health industry is a very dynamic environment. Healthcare organizations are faced with many challenges. The leadership in an organization coupled with teamwork will make all the difference in meeting those challenges. A constant evaluation process is needed to identify all factors affecting the working success of an organization. Various influences may affect the success of an organization. These generally fall within one of two categories. The first being internal and the second being external (Ginter, P. M et.al 2013).

Within health care organizations of all sizes-from large academic medical centers to independent solo practices-many people are experiencing distress. Some of this is appropriately attributed to such external factors as payment reductions, regulation, and the business practices of insurers.

Less well recognized is the contribution of factors internal to the organizations: styles of leadership and management, administrative policies and procedures, and organizational culture. As compared with external factors, these internal characteristics have more direct, immediate, and powerful effects and are far more amenable to change at a local level. Quality in healthcare is a production of cooperation between the patient and the healthcare provider in a supportive environment.

Personal factors of the provider and the patient, and factors pertaining to the healthcare organization, healthcare system, and the broader environment affect healthcare service quality. Healthcare quality can be improved by supportive visionary leadership, proper planning, education and training, availability of resources, effective management of resources, employees and processes, and collaboration and cooperation among providers (Kotler, P., Shalowitz, J., & Stevens, R. J. 2008).

The health organization I know is known as Green view hospital. It provides health care services to all people and it's known for high quality delivery. The main way the hospital market its services is by providing high quality services and products to its customers. Also, Green view hospital has been able to create a conducive environment for their patients thus making them feel at home even when they are in pain.

Finally, the hospital has a well-established nurse/doctor- patients' relationship thus making it easier for the patient to express their needs to the nurses and doctors. The major changes that I have noticed in Green View hospital is that it has helped improve the quality of Healthcare services as the providers can take care of customers as well as their employees since the Medicare is classified as per the group it cares for.

Respond to at least two posts from two different classmates. Each response to your peers must be at least 100 words with a minimum of one (1) reference is required per peer reply.