National Health Policy Problem and Solutions
National Health Policy Problem and Solutions
In this report, I take an interest in the National Health Policy problem. The National Health Problem ascribes challenges of unequal opportunities to health care services including limited access to health care, health care inflations, reduced physician autonomy and unavailability of a proper legal federal framework and initiative programs to handle National health issues. The scope of National health issues range from pediatric health care, maternity health, communicable diseases, reproductive and sexual health, gun violence, suicide, health equity, healthy housing, transportation accidents, urban health challenges such as access to water, proper drainage systems, public health accreditation and health concerns at community and national level such as illegal drug use, excessive drinking and smoking.
The summary of my recommended actions goes to the Legislative branch. The government needs to spearhead collaborations with all stakeholders and initiate community health programs to come up with a better health framework that will address the specific health issues such as chronic diseases and diabetes. Policies to discourage unhealthy eating habits should be put in place as well as educative programs to enlighten the youth on healthy living. The use of EHR should be highly promoted in hospitals through the awarding of additional health benefits packages and reimbursements.
*Introduction and Problem Definition*
National Health Policy is a critical issue of concern. Evidence-based surveys done by several research institutes and organizations have rated Health policy as a top priority. Pew Research Center, in its 2019 Report for how citizens in America viewed National issues ended up with a rating for health care concern at 69%. Other critical areas were Economy at 70%, Education at 68%, Terrorism at 67% and Social Security at 67% (Pew Research Center, 2019). Similar global reports indicate NHS spends a whooping 400 million Euros each year in the medication of older adults (Robinson, 2018). Although other policies also require urgent attention, I believe health concerns have to be prioritized more since it relates to fundamental human rights in the United States and globally, a fundamental right to life.
Medical expenses have skyrocketed due to the emergence of technology and the use of more superior systems to improve patient health care. These additional costs have pushed the hospital facilities to increase the medical expenses of patient treatment. Although there exist several health laws like HIPAA laws, Privacy laws, and Obamacare, there need to be more initiatives to educate the public majority on the need to live healthily and choose appropriately balanced diets. Also, laws are required to better subsidize the increased medical expenses for the citizens to afford better health care services. I believe that a healthy country is a wealthy country; a healthy nation will always be more productive than a sick one.
Additionally, the food Industry has radicalized to alternative methods of food production and preservation to boost profits. Use of GMOs in plants and animal breeding has escalated health risks so much more in this current millennium than in the past. These excessive uses of GMOs lead to health disorders, and the victims incur a lot of costs for medical treatments. All this would have been avoided if a proper framework was put in place.
Several lives have also been lost due to tragic road accidents. Most of these accidents would have been prevented if stricter rules and regulations regarding road safety and health standards were imposed. Traffic accidents due to carelessness on the part of the driver, driving under the influence of alcohol and non-compliance to traffic rules has led to deaths even to the innocent pedestrians (Santos, Rodrigues, Santos & Caminiti, 2016). Due to all these factors, the importance of establishing proper and better health standards is paramount.
The interpretation of the health laws, as well as the scope with which they can be implemented, is influenced to a great extent by the various stakeholders, major religious groups, private organizations, NGOs, the bureaucracy of processes, interest group and media influencers. The legislative and Executive only define the laws, but the implementation and frameworks that will add substance to these laws are determined by the civil servants who are at the grassroots. Several times, conflict of interest arises in the implementation of the rules, and therefore the mayors, council governments, and local officials need to engage the various stakeholders broadly before coming up with a comprehensive framework. Through engagements and community health strategies, appropriate structures can be obtained and passed along to the three main branches of government. The government elected officials must refrain from undermining the evidence-based solutions that civil servants propose. They should arrange for dialogues and meetings to see if the solutions are viable and after that, assimilate them into law (Christensen & Opstrup, 2017).
The religious institutions such as Evangelical Protestants and Catholic form a vital contributor to the health laws that are being established. The Evangelical Protestants form the largest religious group in the United States. After the enactment of the Affordable Care Act established in 2009, several controversial issues have been raised by the religious community. The ACA act has mandated that all American individuals enroll in an appropriate health insurance cover, those who do not do so are subject to annual fines when they fine the taxes. The ACA act has also mandated the provisions and use of contraceptives which have raised opposition from the religious community. Both of these reforms are viewed as infringement on the fundamental human rights of choice. Also, the use of contraceptives has raised a substantial religious conflict who see contraceptives as undermining the religious faith. Religious institutions have a strong belief against involvement in the secular world. This has led the religious groups to isolate themselves from participation in some government activities. Some religious groups have been vocal in criticizing the use of contraceptives and keeping politicians at bay. They coerce their followers also to follow suit and oppose vigorously such reforms, and this has made it very difficult to implement favorable health reforms properly.
The government must therefore use qualitative methods to study Evangelical Protestant and other religious beliefs and the nature of the surrounding community in relation to the specific social-economic factors that raise opposition and controversy — gaining a better understanding on how these social groups view the aspect of health and diseases will enable the formation of better organizational structures for health care. This will also provide a bigger picture that will allow the religious groups to buy in the idea of the associated health reforms as well as engage in better community-focused health care services.
The United Nations also acts as an essential external stakeholder and influencer on health issues. Its main view is the provision of equal opportunities, especially on reproductive health issues. Cultural based topics such as forced female genital mutilation that affects female reproductive health are viewed as a violation of reproductive rights. UNFPA spearheads giving women the right to decide on their sexual and reproductive health. This includes the freedom in determining the number of pregnancies and the spacing between the pregnancies, access to a full range of quality contraceptives and a broad range of family planning initiatives and advice. UNFPA has so far issued annual contraceptives to approximately 68 million couples in developing countries. It has a strategic goal to reduce the unmet needs for family planning to zero by the year 2030. UNFPA has estimated in their recent 2018 report that 12% of women globally have an unmet need for family planning. The unmet needs arise from the performance of unconsented procedures relating to a woman’s sexual and reproductive health such as forced virginity tests, forced abortions, and forced sterilizations. It also includes denial of access to sexual health service required by women and the provision of poor quality services. UNFPA might increase partnerships with government agencies, private organizations, and NGOs to speed up the process of reaching this milestone. Its report already shows that through partnered promotions for the use of contraceptives globally, 8.9 million unsafe abortions have been averted, 30 million unintended pregnancies avoided, and 6.3 million cases sexually transmitted infections prevented.
The World Health Organization has been at the forefront in vouching for collaborations and partnerships between nations. The cooperations are targeted at specific health issues and challenges to better manage global health problems, disease outbreaks like Ebola, natural disasters like earthquakes, airborne diseases and pandemics like HIV/AIDS, cholera, smallpox, influenza and bubonic plague. Pandemic outbreaks spread across international borders and can wipe out masses at once; smallpox has killed over 500 million people throughout history. Their view is that more collaboration builds more exceptional diplomatic relationships and reduces the chances of international wars which would lead to loss of innocent lives.
Sometimes, the World Health Organization receives some resistance from nations during the implementations of the collaborations as a result of conflicts of interest. The US government needs to set policies and framework to limit this resistance as the reports given by W.H.O are always broad and carry several surveys conducted annually. W.H.O is also at a conflict of interest as it is in the view that governments are not pushing so much initiatives and policies to discourage drug use such as excessive alcohol and use of tobacco. It is pushing an agenda to further increase taxes for such unhealthy products.
Some federal government officials, elites as well as preservatives may use the internet platforms to propagate fake and false information about a health concern which may result in fabricated public opinion of the health policy. Most of the online community contains a lot of companies that are more interested in making profits. Strategies such as digital marketing, SEO optimization, paid advertising all bombard the regular user more frequently than genuine health platforms. Besides, companies spend billions of dollars on promoting their unhealthy products and outweighing their counter advertising agencies like NGOs, private organizations, and public health promoters who spend millions of dollars. Additionally, healthcare professionals, scientists, researchers, and policymakers are not well trained in media strategies and risk communication. There is, therefore, a need for appropriate media training, more federal taxes on unhealthy products and a need to increase spending to promote better healthcare services (Lupton & Michael, 2017).
Centers for Disease Control and Prevention (CDC) has always been on the forefront of conducting medical research to come up with better solutions to handle health issues such as salmonella outbreaks, measles vaccinations (MMR) vaccine for individuals travelling abroad, chronic disease preventions, problems of morbidity and mortality such as seasonal influenza and Preexposure prophylaxis (PrEP) . After coming up with recommendations, they pass it along to the national government to assist in the widespread implementation. At times proper applications are so hindered due to bureaucracy of the federal government to set up the recommended vaccination policies. They also face the issue of a lack of sufficient funds to perform more medical research for better solutions.
*Proposed Solutions to a Better Health Policy*
*Use of technology to tackle population health challenges*
According to the CDC, extreme drug-related events account for medical costs of over 3 Billion U.S. dollars. Deaths of over 300,000 occur annually due to medical errors and CDC currently rates medical errors in the sixth position of leading causes of deaths worldwide. Medical errors come in various flavors; for example, the wrong diagnosis, multiple physicians unknowingly working on the same patient at different time intervals and false updates made to medical records. Use of Electronic Health records would cut down on these errors since machines are more efficient, can process data faster, and maintain the integrity of data (Wilkinson, Borycki & Kushniruk, 2019).
Some of the evidence-based approaches to minimize risks to patients and healthcare staff include TeamSTEPPS and HFMEA. TeamSTEPPS uses a system toolkit to improve communication, patient satisfaction, safety, and reduce clinical errors. It has user-friendly interfaces that include text, videos, and training curriculum for use by staff (Curtsinger, 2018). The Health Failure Modes and Effect Analysis (HFMEA) tool is used to assess risks. It is handy for a thorough analysis of all potential risks and promotes safety before catastrophic events occur. This analysis tool, however, is time-consuming. Several other technologies exist that can be incorporated with Electronic Medical records, this include sensors and handheld wearable devices, electronic microchips embedded in patients, automated medication with barcoding, long-range communication and real-time location systems, telemedicine, mHealth, remote monitoring tools, genome sequencing, self-service kiosks, pharmacy e-referral systems and portal technology.
*Stakeholders and their views on the policy of technology use in healthcare*
CDC, United Nations, WHO, and all other related private organizations who perform medical research are all proponents of extensive spread use of technology to facilitate better health care provision. CDC does a lot of medical research, and they require remote communication systems to collate data collected from various centers for faster analysis. The speed and accuracy with which technological systems can process data and do complex analysis have enabled them to come up with vaccines for measles and influenza among other treatments. United Nations has several times had to mitigate international disputes between nations through its peacekeeping soldiers. The soldiers make use of long-range communications systems and remote monitoring systems, including drones to precisely locate survivors and assist in their medical treatments. W.H.O has a strategy to promote global health through collaborating annual health events where top-level health professionals are invited to take part in the academic forums and give insights on various health issues. These stakeholders form a significant influence, and their support to improved technology use will yield better health care services to the patients.
The opponents of the use of technology are the religious groups as well as ethnic, cultural groups. The religious groups will oppose several controversial issues that they feel contradict their faith, such as genome sequencing. They would see this as interference to nature and a violation of their religious laws. Modification of a gene sequence is viewed as assuming God’s position, which would contradict their religious belief. Ethnic, cultural groups may see solutions that come out of sophisticated scientific experiments and research as not effective. Their traditional values may drive them to use natural herbs. This is because they view this alternative treatment as a more active approach with fewer side effects. Additionally, some ethnic groups, including subsets of religious groups, generally see technology as harmful and will not be willing to support such technological advancements.
*Evidence-based policies to Combat Obesity*
Obesity is a huge problem; currently, over 100 million people living in America are affected by obesity. Obesity leads to an increased risk of physical and mental diseases and early deaths. Some of the disorders include stroke, heart diseases, high blood pressure, type 2 diabetes, kidney disease, and arthritis. Obesity rates are the Highest in Black American and Latino communities majorly due to economic disparities. They live in neighborhoods that have limited options for healthy diets, coupled with the fact that they are middle to low-income earners who cannot afford everyday healthy foods. Possible prevention policies include limit racial and economic disparities by promoting evidence-based programs such as CDC’S SPAN and REACH Community health programs. Another approach is to increase the tax on sugary beverages; in 2017, Philadelphia increased beverage taxes by 1.5%, and the result was that retailers stocked less soda and more water bottles (Kane & Malik, 2019). Introduction of healthier WIC Food packages could also help. USDA report on children who enrolled for such programs between 2010 to 2016 showed a steady decline in obesity rates for children aged 2-4 years old (Sekhobo, 2017). Other options include strengthening essential nutrition support for low-income families through nutrition programs such as Supplement Nutrition Assistance Program (SNAP). Another approach is to open up channels and to expand capacity for CDC, other research centers, and health institutions to collaborate with other sectors such as housing, transportation, and planning. Physical activity Guidelines should be used in establishing better training exercises and training centers as well as physical education programs to the youth, school children and adults; lack of regular exercise is a risk factor that raises the chances of succumbing to diabetes.
*Stakeholders and their views on the policies to Combat Obesity*
CDC, United Nations, W.H.O will be the proponents. This is because of their integral role in looking for better solutions to major illness as well as promoting collaborations and partnerships to speed up the process of obtaining better health care. The three organizations usually release regular reports that rank major global health issues affecting the communities around. A recent survey reports from the National Health and Nutrition Examination between 2015- 2016 show that obesity rates have increased by 70% for adults and by 85% for children when compared to 1988-1999 reports. The three organizations also rate obesity as a current primary health concern, and they call for more radical approaches to reduce the considerable costs in medical treatments that are associated with obesity treatments. Some of the policy suggestions that I make, such as increased taxes for sugary beverages and promotion of exercise and nutrition programs, are supported by them. The three key stakeholders have made efforts too, like starting initiative programs to encourage healthy eating habits.
The proponents will most probably be the trade unions, including the institutions that look out for their employee rights and welfare. The controversy will be raised mainly on the issue of increased taxes for their beverage and sweet products. The decision-makers will have to use ethical principles to resolve this ethical dilemma. The beverage companies manufacture their products and comply with health standards; the decision-maker might have no moral justification of raising the taxes too high to the extent of driving them out of the market. This would otherwise be viewed as an infringement on their fundamental freedom to pursue life, liberty, and the pursuit of happiness. The decision-makers have to make a compromise for the greater good, but even still they would not be able to raise taxes beyond certain thresholds. The approach therefore used should be to discourage the sale to manageable levels to protect the health of the citizens. Besides, billions of dollars are spent on obesity treatments, so why not reduce the spread.
Another group of opponents would most probably be the religious conservatives as well as the ethnic, cultural-based communities. These groups are so selective on the initiatives and co-curricular out of school programs that they permit for their children. They may deny their kids from participating in such efforts and programs as they may feel their kids preserved values will get polluted by peer influence. Religious leaders may, in turn, discourage their congregation from participating in such support activities which may be detrimental to the progress that is desired.
*Racial Healing and Health Equity through Collaborations and Community Health*
Health Equity denotes attempts to avail equal health opportunities to all, including the disadvantaged groups so that disparities and inequalities may not arise. Many lives are lost in the U.S. due to limited access to health care services as well as the lack of funds to pay for medical expenses. Affordable Care Act has assisted in promoting forms of equity by coming in to subsidize for medical costs (Tebaldi, 2017). ACA also provides an opening for hospital institutions to participate in Community health programs frequently to better understand health issues affecting the community (Canady, 2016).
Community health initiatives can be used to address the underlying unfairness in the systems, environments, and policies that lead to poor health services. They include partnering with other institutions to create innovative youth and children educative programs, implementation of equity framework such as PHC model to address emerging urban health challenges and targeting specific health concerns at community level such as illegal drug use, excessive drinking and smoking (Tilahun, 2018).
*Stakeholders and their views on policies for Collaborations and Community Health*
The proponents for Community health programs will be research centers, CDC, NGOs, United Nations, and W.H.O. They believe that better ways to solving health issues are to target specific health concerns affecting the community and get involved with grassroots community stakeholders through community partnerships to come up with easy to adapt framework that ensures racial healing and promotion of health equity. They believe that through partnerships, they will be able to come up with evidence-based solutions that can be tailored to solve the exact health issues at the community levels. The federal government has also made some steps in promoting cross-sector collaboration through the enactment of the Affordable Care Act (ACA). The ACAs Community Health Needs Assessments program has led to better identification of issues and insurers, and health institutions are acknowledging the importance of screening patients and assigning them to community agencies to address their social and economic needs.
The opponents are the religious institutions as well as trade unions that represent employee’s welfare. Some of the outcomes of community health programs were to establish specific baselines that will enable health equity. ACA mandates that all Americans obtain health coverage or face fines when they file their annual returns. This has been viewed as a violation of the freedom of choice and oppositions have been raised as to whether this government intervention is warranted. Trade unions such as AFT, NNU, UAW, and SEIU are opposed to the idea that Medicare services for all is the only way to achieve health equity. To control the population and prevent deaths due to unsafe abortion the ACA act as well as UNFPA, are providing contraceptives and coordinating with community stakeholders to increase the access as well as provide educative programs on family health and planning. Religious communities such as Evangelical Protestants are against the use of contraceptives.
*Preventing Chronic Diseases and Reduction of long term Health Costs*
Millions of Americans suffer from diseases and ultimate death due to infections that could have been prevented if precaution was taken early enough. Chronic diseases account for 7 out of 10 deaths in America, and medical costs amounting to a staggering $1.3 trillion annually. About 20% of Americans are regular smokers and medical treatment costs due to tobacco-related illness amount to $97 Billion annually (Chew, 2019).
Stroke is rated as the second leading cause of death globally and the sixth contributor to disability. Approximately fifteen million individuals suffer from the first-time stroke annually, and a third of them, about 6.6 million die as a result; female deaths being at 3.5 million and male deaths at 3.1 million. Thirty-four million people were current smokers in the U.S in 2017. Approximately 140,000 individuals in the United States lose lives as a result of stroke and 795,000 in the United States have a stroke each year (CDC, 2017). Risk factors for stroke include smoking, high blood pressure, diabetes, and high cholesterol.
The federal government collects vast taxes and lawsuit fines from tobacco, but little of that is put into use to help smokers quit smoking. A proper prevention technique would be to increase the tax levied on smoking companies to discourage the sale. CDC currently proposes that 12% of the revenue collected from tobacco taxes be used to develop educative programs that are aimed at assisting individuals quit smoking.
Harnessing more funds and creating a pool of resources will enable better and faster diagnosis and treatment of chronic diseases such as cancer, heart diseases, diabetes, obesity, and stroke. Currently, the Prevention and Public Health Fund (PPHF) is the only dedicated health investment fund created by the federal government. PPHF has set aside over $14 Billion for the subsequent years that commenced from 2015 through to 2024 (Fraser, 2019). It also enabled the first-ever paid tobacco awareness program that ran nationally; Tips From Former Smokers (Tips). The campaign led to over 100,000 individuals quitting smoking immediately and resulted in 12% increased quit attempts for over 1.6 million people. Other solutions include promoting health programs that make healthy choices the easy choices. They involve providing safe places to exercise, access to cancer screenings, smoking quitlines, and vaccines.
*Stakeholders and their views on policies for chronic disease prevention*
The proponents of the strategies to prevent chronic diseases are the health research institutes, religious organizations, private health organizations, NGOs, W.H.O, United Nations, and CDC. Religious communities are at the forefront of discouraging unhealthy behavior such as smoking and even have guidance and counseling departments to assist drug addicts, smokers, and excessive alcohol consumers to quit drug abuse. W.H.O and CDC call for increased taxes on tobacco-related products. They also call for the creation of more awareness on healthy eating habits and running nationwide educative programs that let people know the harmful effects of tobacco smoking and why they should quit.
The opponents of the policies for the prevention of chronic diseases will be the trade unions associated with the tobacco companies and social media influence. Digital marketing strategies such as Paid Advertising and Television programs are used to promote tobacco products. The tobacco industry spent $8.24 Billion in 2015 on promotional ads, while the amount spent on marketing smokeless tobacco products was just 684 million dollars (truth initiative, 2017). During the same period, $7 Billion was spent on discounts to retailers and wholesalers, which represented over 84% of the tobacco marketing expenses. This demonstrates how far the opponents can go to make sure their product sells.
*Use of technology to tackle population health challenges*
The ability to access equitable health care services is affected by various factors such as geographical locations, economic factors, sex, age, ethnicity, and disability status. Technological advancements over the years have led to several transformations in the healthcare sector such as the use of EHRs, telemedicine, remote monitoring tools, wireless communication, wearable devices, portal technology, and mHealth.
I, therefore, believe that a better implementation of EHR and policies that encourage effective use of technology in health care services would solve several issues such as reducing the gap to access essential health services, better research and coordination of centers to come up with quick solutions to significant health diseases, fewer medical errors due to wrong medical documentation, better analysis of workflows to determine areas that are not well staffed and better reallocate resources to these areas, fewer hospital readmissions due to approaches such as home care and E-referrals also go a long way in assisting patients that are relocating to other cities by enabling them to enjoy required medications without necessarily being readmitted.
Based on the urgency of the matter, I feel that this is a more straightforward approach. Other approaches such as increased taxes, establishing more community health programs, significant reforms to ACA act to accommodate more communities, media influence, and national campaigns to discourage tobacco and excessive drinking would have temporary improvements. Based on research analyzed, the tobacco and alcohol companies are willing to spend billions to make sure their products are sold to the market in comparison to their counterparts who spend in millions to promote healthy living. Even an increase in taxes could not cross legal thresholds, and the government is not so proactive in using tobacco taxes to assist smokers in quitting. Establishing real health equity and ACA reforms are still facing bureaucracy and oppositions. Also developing a framework to enable health equity through collaborations with various other sectors such as transport, housing will again face bureaucracy of process and policy implementations which would extend the period required to reach such a milestone. Policies that promote the widespread use of technology to solve health issues are not expected to face several social, economic, or cultural considerations when compared to the other policies. Religious communities are expected to oppose few sections such as genome sequencing, and conservative ethnic communities will probably oppose E-referrals for pharmacy as they may prefer herbs and traditional medicine for their perceived medical effectiveness. Policies could include extra reimbursements for hospitals that use an effective EHR, more funding, and investments to monitor EHR effectiveness and regular meetings between stakeholders to suggest modifications based on live- use insights obtained. Several reports, however, show that EHR system adoption in hospitals is at 80%, at least in the most basic forms. But many hospitals are not leveraging this additional resource to realize the full potential. I would, therefore, suggest the below EHR implementations to be effected in about six months by engaging all stakeholders, health informaticists, private hospitals throughout the country.
The implementation of the EHR system will span over six months. Progress and modification will not end once the system goes live; continuous monitoring will go on for further years. On the onset, all stakeholders must be involved, including top board management and all representatives for each hospital. Communication is critical during the entire process, and the whole hospital staff must be informed prior in advance of the impending EHR system and when it’s expected to go live. I recommend the following proposal for the implementation after a thorough consultation with all the health practitioners and the board of management.
This forms the first stage of implementation. A feasibility study of the existing systems in the hospitals needs to be conducted. This is to determine the exact framework and come up with the best system possible that will meet the unique requirements of each hospital. An interdisciplinary team of 12 members that include all representatives from all departments will be meeting twice a week for the next three months and will give reports on the progress of the project. The six months will be broken down into chunks of weekly and monthly deliverables.
* Planning *
At this stage, a definite plan has to be jotted down. In doing this, the right project teams must be formed. It is important to encourage members to appreciate each other’s diversity, recognize their strengths and weaknesses to promote cohesion among team members. Members who are fast learners are supposed to support and guide other members to improve on speed and make sure the deadlines for the deliverables are met. The actual requirements of the EHR system, the associated costs, and analysis of return on investment must all be clearly understood. Proper documentation of the proposed workflows must also be done, and staff members should be encouraged to share ideas and be involved in decision making.
*Selecting the appropriate vendor for the EHR system*
This should be a detailed process and not just an aspect of looking at a few sales
demonstration and making a pick. This forms a very crucial stage as picking a vendor that does not correctly understand the requirements of the system needed will lead to the installation of poor designs that are not compatible. Reference checks for the vendors should be done, and the top management also involved as this may require an executive decision on costs and time taken to assimilate such a system entirely. The vendors will be allowed to show demonstrations of the proposed system, and a collective decision will be made for the best pick.
*Implementing the EHR system*
This involves the actual stage of converting all the physical health records and storing them as online records. To avoid the rise of ambiguous and duplicate records, bar codes must identify the correct type of patient form; link it to the specific patient and upload it to the EHR system. I would suggest that health records be adopted incrementally to ensure that all patient records are correctly transferred with none being left out. Critical areas should be handled first, such as ICU, trauma departments, and then progress to other areas such as inpatient and daycare surgery departments. To reduce work overload, outpatients that are discharged during the rolling out of this system should still be referred to their health care doctors who will use the physical health records available.
*Staff training and continuous monitoring of the EHR system *
Training sessions should be organized to educate the Health Information Management (HIM) staff and all health practitioners on the effective use of the new system to reduce on erroneous medical records being updated. A primary concern should be to avoid the death of patients due to wrong diagnoses and treatment as a result of these errors. A testing phase should be enacted where test data is used to monitor the progress and efficiency of the usage of the system. Even after the system goes live, the HIM project should continue and further suggestions on improvements to included, proposed, and implemented by the vendor. The following Grant chart can be used for each of the healthcare institutions.