Changes that Reform the US Healthcare Delivery System Sample

Changes that Reform the US Healthcare Delivery System Sample

Privacy Laws in Electronic Health Records and Internet of Everything

The U.S. healthcare system is increasingly relying on the internet to provide personalized preventive medical care to patients. Nonetheless, the success or failure of such systems depend on their ability to maintain patient privacy. A system based on decentralized ontology may effectively cater for an organization’s privacy needs, besides the associated security concerns that define the Internet of Things (IoT) trends and Electronic Health Records (EHR) (Kanaan, et al., 2017).

New laws and policies concerning privacy and confidentiality of patient data have emerged consistent with growth of both IoT and HER. In essence, an effective HealthCare Security and Privacy (HCSP) ontology in combination with three-agent filters: the Policy Mapping Agent (PMA), Privacy Assurance Filter  (PAF) and Exception Creation Agent (ECA); identifies infringement on privacy and violation of organizations’ policies.

The implications of the EHR and IoT privacy and confidentiality of patients’ data regarding nurses is a topical issue. First, the nurse’s obligation is to ensure that patient information remains inaccessible to unauthorized personnel (Kanaan et al., 2017). Nurses are required to maintain this high level of confidentiality by having unique passwords to login into the EHR database. In addition, the nurses must be proficient in basic computer literacy skills such as data entry and querying.

Skills in querying a database are necessary when the nurse needs to look up for particular details about a patient. Proficiency in EHR handling may necessitate inclusion of EHR skills within the nursing curriculum at diploma, undergraduate and postgraduate levels.

Effects of Pay-for-Performance

The effects of pay-for-performance on patient outcome has largely been insignificant. Initially, pay-for-performance aimed at providing better quality healthcare to patients, as evidenced by the presence of financial rewards or penalties to individual healthcare providers, groups of providers and institutions, based on their scores on measures of quality.

At inception, the key goals of pay-for-performance programs entailed, among others, minimizing on the unnecessary utilization of costly health care and improving the patient health outcomes (Mendelson et al., 2017). Especially in the United States, the long-standing fee-for-service system was responsible for health disparities as most healthcare organizations focused on service volume instead of quality.

Despite the well-focused aims of pay-for-performance programs, its impact on patient outcomes has been negligible. In fact, Mendelson et al. (2017) contends that the programs managed to deliver limited improvement in the outcomes of process-of-care.  Performance-for-pay programs may motivate the nurse to respond more rigorously to delivering better quality patient care in order to score highly.

High scores would translate to incentives such as increased pay for the nursing personnel. Thus, increased motivation to deliver on the assigned duties and responsibilities is likely to correlate with enhanced service provision to patients and increased patient satisfaction (Lee, 2020). When combined, these two factors can result in improved patient outcomes. However, studies involving performance-for-pay programs and patient outcomes suggest that the former does not lead to any significant improvement in the latter.

Nursing Leadership and Management Roles

Emerging trends in nursing leadership and management roles consist of transformational leadership. Key components of transformational leadership include the ability to stimulate, inspire and motivate followers (Giddens, 2018). Stimulating, inspiring and motivating other individuals would be impossible without the inclusion of teachable competencies, such as translation of evidence into practice.

In fact, Fischer (2016) observes an association between transformational leadership in nursing with high performing teams, which in turn results in improved patient care. Often, this emanates from the fact that transformational leaders seek to model ethical behaviors within the organization by embodying honesty and integrity, and tends to emphasize personal and professional development among all team members.

Transformational leadership enables the nurse to establish an appropriate rapport with the patient, an invaluable tool that enables the nurse to compile a comprehensive patient data. Majority of persons tend to share personal information to nursing officers who have established a rapport with them (Giddens, 2018).

The information shared usually proves to be key to the patients’ management and treatment process. Moreover, transformational leadership skills enable the nurse to educate the patient on important details about the disease process. The leadership and management skills are vital when the nurse conveys knowledge about the pathophysiological aspects, clinical manifestations, management, and preventive measures against various illnesses.

Transformational leadership also plays an important role in medication safety education. Essentially, Vaismoradi et al. (2016) that transformational leadership helps deliver idealized influence, inspirational motivation for medication adherence, intellectual stimulation among students to value change and enhances student’s individualized consideration towards the attainment of goals, practice development and improved patient outcome. Accordingly, these skills are important in reducing medical errors among student nurses, enhances student collaboration with educators and ensures learners are conversant with nursing policy-making process.

Emerging Health Care Trends

Recent trends in healthcare include the use of blockchain technology to manage health data. Blockchain technology is projected improve key components of the U.S healthcare system such as efficiency, health system quality, access to care, healthy lifestyles and equity (Connor-Green, 2016). In addition, blockchain technology will enhance communication between healthcare providers, reduce the costs and time spent in administering insurance and cut-down costs arising from duplicative medical testing. Improvements in the concerned sectors is projected to improve the global ranking of the US health system.

Moreover, blockchain technology will provide a learning health system, giving patients the central power in their own healthcare and allowing health providers access to patient information from several servers. This scenario will mitigate the limitations of individual health information to electronic health records (Esposito, 2018).

Furthermore, with additional sources of health information, an individual will have comprehensive record of his/her longitudinal health history, as opposed to the current periodic histories as recorded by solitary sources. Diagnostic tests will be repeated only when extremely necessary, cutting down on costs for the patient. Also, the resulting improved access to information will enable researchers and health agencies to learn and develop rapidly, thereby providing up to date effective measures.


As discussed in this paper, new trends in nursing practice are likely to have extensive impacts on the country’s healthcare system. New laws relating to patient wellbeing and healthcare settings equally affects nursing practice at the nurse level. Also, new technology in health care directly affects nurses since they handle instruments used in patient healthcare directly.

For instance, while the integration of EHR has made patient data collection and management easier, it has presented new challenges on patient data security that nurses must carefully navigate. For effective nursing leadership and management, it has emerged that transformational leadership strategies plays a crucial role in enhancing knowledge on medication management, inspires nurse-patient rapport and results in high-performance teams that in turns delivers improved care.


  • Esposito, C., De Santis, A., Tortora, G., Chang, H., & Choo, K. R. (2018). Blockchain: A Panacea for Healthcare Cloud-Based Data Security and Privacy?,” in IEEE Cloud Computing, 5(1), 31-37. doi: 10.1109/MCC.2018.011791712.
  • Fischer, S. A. (2016). Transformational leadership in nursing: a concept analysis. Journal of Advanced Nursing, 72(11), 2644–2653. doi:10.1111/jan.13049
  • Giddens, J. (2018). Transformational leadership: What every nursing dean should know. Journal of Professional Nursing34(2), 117-121.
  • Kanaan, H., Mahmood, K., & Sathyan, V. (2017). An ontological model for privacy in emerging decentralized healthcare systems. In 2017 IEEE 13th International Symposium on Autonomous Decentralized System (ISADS) (pp. 107-113). IEEE. doi: 10.1109/ISADS.2017.37.
  • Mendelson, A., Kondo, K., Damberg, C., Low, A., Motúapuaka, M., Freeman, M., … & Kansagara, D. (2017). The effects of pay-for-performance programs on health, health care use, and processes of care: a systematic review. Annals of Internal Medicine166(5), 341-353.
  • Vaismoradi, M., Griffiths, P., Turunen, H. & Jordan, S. (2016). Transformational leadership in nursing and medication safety education: A discussion paper. Journal of Nursing Management, 24(7), 970-980.