Healthcare Industry Flashcards
Generally, companies in the healthcare industry make money through the following (3):
- Products
- Healthcare Services
- Health Insurance
The healthcare industry consists of different sub-industries such as (5)
- pharmaceuticals,
- biotechnology,
- equipment,
- facilities, and
- managed health care.
Five (5) mutually reinforcing categories of activities [core activities] that health systems can implement to enhance integration:
- assistance,
- adjustment,
- alignment,
- advocacy, and
- awareness.
are mainly concerned with improving the provision of individualized care to patients based on data regarding their social risks and conditions that may reduce or eliminate such.
Assistance and Adjustment
The roles that the healthcare industry play in influencing and funding social care resources at the community level are related to
Alignment and Advocacy
Includes companies that manufacture equipment and supplies, ranging from the basics such as crutches and bandages to advanced equipment like MRI machines.
Healthcare Equipment and Supplies
Includes companies that own and operate healthcare facilities– hospitals, rehabilitation centers, nursing homes, and animal shelters.
Healthcare Provider and Services
Includes companies that engage in research and development (R&D), as well as analyzing data to innovate current healthcare practices.
Healthcare Technology
Includes companies that perform research and development or manufacturing that are generally
derived from living organisms.
Biotechnology
Includes companies that develop and produce drugs and vaccines that are generally derived from a chemical basis.
Pharmaceuticals
Includes companies that study living things and provide analytical tools, clinical testing services, and general contract research services.
Life Sciences Tools and Services
are the individuals who receive the care or the goods and services offered in the healthcare industry.
Patients
They refer to healthcare professionals offering medical services
Healthcare providers
They conduct diagnosis and treatment of diseases, teaching, research, and training.
Hospitals and other medical centers
Offer short- and long-term care services. Short-term care may include rehabilitative care after surgery, illness, or injury, like
physical therapy, occupational therapy, or speech-language therapy. Long-term care, on
the other hand, is offered to the sick, elderly, and disabled.
Nursing homes and rehabilitative centers
Physicians and other health professionals who provide
outpatient medical services or non-hospital-based care.
Ambulatory service providers
refer to individuals, government agencies, and private companies
who pay for the goods and services offered in the healthcare industry.
Payers or health financiers
refers to payments from the government.
Public source
is where the government acts as both payer and provider. In this kind of system, the government itself funds and operates a national network of public hospitals that all citizens can access, mostly free of charge.
National health system
is where the government covers the bulk of healthcare spending through a public insurance program. Most providers are private as opposed to government-operated but receive payment for services through government insurance.
National health insurance
pay providers through claims against insurance policies, which can be employer-funded or purchased directly by individuals.
Private health insurers
refers to any costs not covered by the government or private insurance in which patients directly pay to providers.
Out-of-pocket spending
involve companies that provide medical supplies such as specialized equipment and pharmaceutical treatments by making drugs and other chemical products. It also includes biotechnology firms that conduct research and development, healthcare technology companies that engage in research and development (R&D), as well as analyzing data to innovate current healthcare practices
Suppliers and pharmaceuticals
set standards to regulate and
license health facilities and services such as hospitals, clinics, birthing facilities, laboratories, and other health establishments.
Health Facilities and Services Regulatory Bureau (HFSRB)
is responsible in the development of standards for radiation facilities and devices used in medicine, dentistry, veterinary medicine, industry, education, research, anti-crime, military, and consumer applications.
Bureau of Health Devices and Technology (BHDT)
is in charge of four major areas: (1) Center for Drug Regulation and Research, (2) Center for Food Regulation and Research, (3) Center for Cosmetics Regulation and Research and (4) Center for Device
Regulation,
Food and Drug Administration (FDA)
is mandated to develop policies, standards, and guidelines for the practice of various traditional medicine modalities and the manufacture, marketing, and quality control of traditional medicine products.
Philippine Institute of Traditional and Alternative Health Care (PITAHC)
are in charge with the provision of Mayors permit to operate and sanitation permit, and establishment of various health ordinances.
Local Government Units (LGUs)
administers, implements, and enforces standards for health personnel regulation. It also administers examinations to certify medical professionals and has the capacity to revoke license.
Philippine Regulation Commission (PRC)
is in charge with the licensing of
health human resource as a requirement in providing a license of health facilities.
Health Human Resource Development Bureau (HHRDB)
regulatory mandate is on accreditation of health facilities and professionals and protect the National Health Insurance
Program (NHIP).
Philippine Health Insurance Corporation (PhilHealth)
administers other certifications that ensures quality healthcare services like the Milk Code implementation, Mother-Baby Friendly initiative, TB DOTS, and Anti-smoking.
Department of Health (DOH)
monitors and ensures environmental compliance.
Department of Environment and Natural Resources (DENR)
Risks in the Healthcare Industry (4)
- Human Risk
- Process Risk
- Technology Risk
- Compliance Risk
a. Misdiagnosis and prescription errors
b. Inadequate follow-up or long-term management
c. Handoff miscommunication
Human Risk
a. Lack of clinical process guidelines
b. Lack of safeguarding policies
c. Inadequate patient safety protocols
Process Risk
a. Data privacy/security breaches
b. Inability to access electronic records
c. Data entry and barcoding errors
Technology Risk
a. Failure to meet regulatory quality standards
b. Non-compliance with waste legislation
c. Breaches of medication safety and regulatory controls
Compliance Risk
Accounting Standards distinct to the industry
- Revenue Recognition (IFRS 15)
- Leases (IFRS 16)
- Government Grants (IAS 20)
This sub-industry provides an efficient production and distribution of drug products that are safe, effective, and affordable which contributes to attaining the goal of the healthcare industry.
Pharmaceuticals
This sub-industry aims to develop, manufacture and market novel,
patented medicines.
Biotechnology
In this sub-industry, companies manufacture healthcare equipment and medical devices such as medical instruments, drug
delivery systems, cardiovascular & orthopedic devices and diagnostic equipment.
Equipment
This sub-industry comprises health care providers where medicines are
delivered to patients and professionals such as doctors practice medicine. Companies offer a variety of health care and social services through hospitals, doctors’ offices, nursing homes, and other facilities.
Facilities
This sub-industry is also known as the health insurance industry which
aims to reduce the cost of providing health benefits while improving the quality of the services. In the Philippines, there are health maintenance organizations (HMOs) that provide health insurance plans.
Managed Healthcare
Recent Developments (Sec A)
- Telemedicine and Virtual Healthcare Services
- Wearables and Remote Monitoring Devices
- Cybersecurity
- Big Data and Healthcare Analytics
- Immersive Technologies
Recent Developments (Sec B)
- Slowing down Alzheimer’s
- Gene therapy for muscular dystrophy
- mRNA vaccine to treat pancreatic cancer
- AI aids in detecting breast cancer
- Neuro Sensor Feedback for Controlling Artificial Limbs
- Virtual Reality in Surgery
This drug removes the amyloid plaques that build up in the brains of people with Alzheimer’s.
Lecanemab (Brand Name: Leqembi)
Due to a faulty gene, people with this muscle-wasting disease don’t make the protein dystrophin, which helps keep muscle cells intact. The therapy helps the body produce a version of the missing protein
Duchenne muscular dystrophy
a tool created by Kheiron Medical Technologies and Imperial College London, was able to identify 13% more cases of early breast cancer.
Mia
This can monitor a patient’s health, tracking metrics like heart rate, blood pressure, and physical activity. Along with remote monitoring tools, these devices prove valuable in dealing with chronic conditions by offering real-time data to healthcare providers.
Wearables