Overview
Reply to La'shyia, Wendy, Rachel, and Christian. Replies must be 100 words or more. Assignment can be done on Word. I need 4 different replies for each discussion. ( reply to the discussion itself)
HCAD500 Health and Healthcare Systems
LA’SHYIA:
Hello class,
For this week’s discussion, I have selected question three to answer.
The difference between acute and chronic diseases is important to understanding its impact on use, costs and access to health, especially in different age groups. Acute diseases are infections that last a short time period but usually lead to immediate action of medical care. The reason why is because of the spike in health when symptoms arise. For example, a person who suffers from the flu (influenza virus) or pneumonia may require hospitalization, emergency care and subsequent rehabilitation depending on their age. Both are infections that can be resolved in a short time period but depends on age and access to healthcare. On the other hand, chronic diseases such as diabetes or hypertension are characterized by long -term management strategies and recurring health visits. This requires continuous resources which can possibly lead to an expensive health costs over time. Approximately 80% of older adults have at least one chronic condition, and 68% have two or more (Centers for Disease Control and Prevention, 2022).
As stated above, age groups play a major key role in this dynamic. Younger populations may face acute conditions more often due to various reasons such as their current living environment, genetics, being around other individuals the same age, etc. This can lead to explosions of health use that can force emergency services. Meanwhile, the elderly generally manage various chronic conditions which require them to conduct chronic care management. The demand for specialized care impacts their access to health services. The growing prevalence of chronic conditions between aging populations connects with increased health costs, as the management of these conditions requires multiple approaches. A study found that individuals with multiple chronic conditions incur healthcare costs disproportionately higher than those with acute diseases alone (Bodenheimer & Berry-Millet, 2009).
Socioeconomic factors create roadblocks to access when analyzing demographic data across different age groups. For example, younger individuals may have difficulties with access to health due to the lack of consistent health coverage. The elderly faces issues such transportation or mobility, getting to and from their healthcare appointments. Addressing the characteristics of acute and chronic diseases is essential for ensuring equitable health access between all age groups. Acute and chronic diseases significantly affects individuals and health systems.
-La’Shyia
Centers for Disease Control and Prevention. (2022). Chronic Diseases in America. Retrieved from CDC (https://www.cdc.gov/chronicdisease/resources/infographic/chronic-diseases.htm).
Bodenheimer, T., & Berry-Millet, R. (2009). Care Management of Patients with Chronic Illness. Health Affairs, 28(1), 75-85.
WENDY :
While standards of medical education is a widely accepted principle today, it was not a formalized concept in United States history until 20th century (Bórquez, 2023). According to Johnson & Green (2010) as healthcare advanced, the American Medical Associations identified significant deficiencies in medical education. This prompted the AMA to collaborate with the Carnegie Foundation to recruit Abraham Flexner to review medical education practices within the United States. As a healthcare administration graduate student, the Flexner report changed how medical education was taught but we must understand its limitations based on the historical and social context of 1910.
Abraham Flexner
Duffy (2010) reiterates that Abraham Flexner was not a physician, he was a prominent educator who authored a critique of higher education’s ineffective teaching methods advocating for educational reform. The AMA also acknowledged medical education required reform to keep pace with rapid scientific progress. Driven by this common vision, Flexner undertook the task of evaluating 155 medical schools across United States and Canada.
The Flexner Report
Medical education in the United States and Canada bulletin Number Four (the flexner report),(n.d.) reported the Flexner Report was published in 1910, the 345-page page document provided an evaluation of medical schools across 40 states in the United States (148 medical schools) and Canada (7 medical schools). Flexner divided information by state, city, then by the medical school. The medical school data encompassed admission requirements, student and faculty information, resources for building facilities, laboratories, and clinical facilities. Finally, Flexner would also include some additional information that was more specific to that location that may be impacting on medical education within that state.
Results
The data within the report was comprehensive for the time in 1910 as it related to medical education. Johnson & Green (2010) note Flexner advocated for improvements across medical education, including standardized prerequisites in basic science courses, emphasized scientific methodology and clinical experience through hospital rotations, and enhanced state regulation of physician licensure. While intended to improve medical education standard, Flexner’s recommendations resulted in the closure of many medical schools that disproportionally limited opportunities for Black students and women in healthcare.
Healthcare and medical education continue to remain a vital concern in the 21stcentury. The medical education system would improve throughout the 20th century due to the Flexner Report. However, healthcare and education systems have evolved since 1910, and a comprehensive reassessment may be required to reevaluate current priorities to ensure relevance and effectiveness of medical education.
References
Bórquez R. L. (2023). The WFME Basic Medical Education Standards on the Horizon 2030. Medical science educator, 33(Suppl 1), 15–18. https://doi.org/10.1007/s40670-023-01947-0
Duffy T. P. (2011). The Flexner Report--100 years later. The Yale journal of biology and medicine, 84(3), 269–276. https://pmc.ncbi.nlm.nih.gov/articles/PMC3178858/
Johnson, C., & Green, B. (2010). 100 years after the flexner report: reflections on its influence on chiropractic education. The Journal of chiropractic education, 24(2), 145–152. https://doi.org/10.7899/1042-5055-24.2.145
Medical education in the United States and Canada bulletin Number Four (the flexner report). Carnegie Foundation | eLibrary | Medical Education in the United States and Canada Bulletin Number Four (The Flexner Report). (n.d.). http://archive.carnegiefoundation.org/publications/medical-education-united-states-and-canada-bulletin-number-four-flexner-report.html
HCAD - Health Care Business
RACHEL:
Of course there is waste in governmental spending, right? Currently the Army is going through the Army Transformational Initiative (ATI) to reduce wasteful spending. We have been going through every contract in our organization, and the excessiveness of spending is just crazy. In the memo titled Army Transformation and Acquisition Reform, Secretary of Defense stated to reform contracting processes to improve efficiencies in the Army as well as utilize performance-based contracting, which we have never done before to my knowledge. If anyone here has heard of QTC, which stands for Quality, Timeliness, and Customer Service, is the contract that the Reserve Component is currently under for health readiness exams or Periodic Health Assessments. This contractor under the Reserve Health Readiness Program has struggled since taking over the military medical exams. The Army Reserve has been at 68% medically ready for a while now and just slowly ticking up. The lack of providers in network has been the biggest hurdle and they lost most during COVID when they were awarded the contract. This contract is huge and costs the Defense Health Agency millions. QTC is an example of a non-efficient contract, in my opinion.
Other changes in the quest to reduce waste is to reduce the number of commands along with unnecessary and outdated technologies. In his letter to the force, Secretary of the Army Mr. Driscoll states to “eliminate waste and obsolete programs”. I fully support this initiative, especially after I saw that DTMS is on the list (worst program in the military), but honestly, they are moving at the speed of light and there are programs on the cutting block that we cannot duplicate in the allotted time. I worry that Soldiers records or the Line of Duty process will be negatively affected. It is an interesting time to be in the Army. Are any of you seeing these things in your organizations? Do you think these are in line with The Toyota System?
Driscoll. D. (2025). Letter to the force: Army Transformation Initiative. https://www.army.mil/article/285100/letter_to_the_...
Hegseth, P. (2025). Army transformation and acquisition reform. https://media.defense.gov/2025/May/01/2003702281/-1/-1/1/ARMY-TRANSFORMATION-AND-ACQUISITION-REFORM.PDF
CHRISTIAN :
In my experience working within a healthcare setting, I encountered waste in the form of time and motion when it came to patient intake and charting. Nurses and medical assistants would often spend significant amounts of time walking back and forth between exam rooms, supply closets, and the nurses’ station to gather equipment, update charts, and communicate with providers. This constant movement not only slowed down the pace of care but also increased patient wait times, which caused frustration for both patients and staff. The process was detrimental because it led to inefficiency, unnecessary delays in patient care, and contributed to staff burnout due to the repetitive and avoidable workload. Unfortunately, the issue was not directly addressed at the time, but it could have been mitigated through process improvement strategies aligned with the Toyota System. For example, reorganizing supply storage so that commonly used items were readily available in each exam room would have reduced motion waste. Implementing electronic medical records accessible in every room could have minimized wasted time walking to central stations to input information. Additionally, creating streamlined communication protocols between staff could have reduced the back-and-forth exchanges that slowed down workflow. By applying lean principles, the clinic could have significantly improved efficiency, staff satisfaction, and the overall patient experience.
-Chris
References:
Kenney, C. (2010). Transforming health care: Virginia Mason Medical Center’s pursuit of the perfect patient experience. CRC Press.
Toussaint, J. S., & Berry, L. L. (2013). The promise of lean in health care. Mayo Clinic Proceedings, 88(1), 74–82. https://doi.org/10.1016/j.mayocp.2012.07.025
Womack, J. P., & Jones, D. T. (2003). Lean thinking: Banish waste and create wealth in your corporation(Rev. ed.). Free Press.