BUSI 505HLTH 501 Liberty University Health Discussion Board Posting assign.pdf

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BUSI 505

Aricka Fayton

Governance, Compliance, and Health Policy

CO LL AP S E

Health literacy is a very broad term and consists of multiple meanings. One meaning of health literacy is

the motivation and ability to access, understand, and use information in ways which promote and maintain

good health” (Benyon, 2014). Health literacy helps to determine an individual’s health outcomes based on

their health literacy level. Health literacy affects a variety of issues including doctor and patient relationship,

adherence to medications, implementation of the management plan, and self-management of chronic illness,

hospital admissions, emergency department attendances, health inequalities, and lifestyle behaviors (Benyon,

2014, p. 438). Health literacy is critical as it helps individuals understand the process of things from

insurance paperwork in health care to preventative care and disease management.

A person’s medical record is not kept in one location and may sometimes get lost or mixed around. A

solution to this is for a patient to have a Personal Health Record (PHR). A PHR is an electronic, lifelong

resource of health information needed by individuals to make health decisions (Noblin, Wan, & Fottler, 2012).

A PHR aids in eliminating this problem but also improves the patient and doctor communication and allows

the patient to have more involvement in their overall health care as a whole. An example of PHR in my area is

called EPIC MyChart, which is used at all Sentara facilities and hospitals within the Hampton Roads and

Northern North Carolina areas. This PHR provides secure messages between patients and providers,

ePrescriptions for refills and creating appointments online.

According to Ajzen and Fishbein, a patient’s attitude about their ability to find, use, and evaluate e-

health meant that the more favorable the reaction, the more willing the patient would be to adopt and use the

PHR (Noblin, Wan, & Fottler, 2012). They also mention that subjective norms play a role in how a patient will

adopt the PHR. Subjective norms mean that the more others of influence feel that something is important, the

more likely the individual will change their behavior.

There were two different hypotheses were addressed regarding Personal Health Record (PHR). The

first hypothesis states that patients who are younger, educated, and of affluent backgrounds are more willing

to adopt the PHR, as opposed to individuals who are older, less educated, and lower income individuals. The

second hypothesis states that patients with high levels of e-health literacy are more likely to adopt the PHR as

opposed to those with lower levels. The results of the previously mentioned two hypotheses indicated that

the first hypothesis was not supported and the second hypothesis was supported based on the responses of

eHealth Literacy Scale (eHEALS).

In the study regarding health literacy and PHR, 562 patients were sampled over the course of six

weeks. The patient’s adoption of PHR as well as their health literacy was evaluated. Results showed that 74%

of the participants would adopt the PHR, of that percentage, patients 41-55 years old were among the most

common age group. Over half the patients sampled had a high school education or less and a little less than

two-thirds of the patients were of low socioeconomic (> $20,000 a year) background. The results of the

eHEALS (8 questions that assess the patient's level of using technology for e-health) showed that 65% of the

patients who wanted to adopt a PHR as well as 38% of patients who didn’t want to take a PHR all had high

perceived health literacy levels. 35% of patients who didn’t want to take a PHR had a low perceived health

literacy level.

In conclusion, PHR’s are useful as it is a customizable, personalized record of anything that pertains to

an individual’s healthcare” (Kupchunas, 2007). The adoption of a PHR will help patients not only have access

to their health records but also allow them to make better-informed decisions about their health care.

1 Corinthians 6:19-20

19 Do you not know that your bodies are temples of the Holy Spirit, who is in you, whom you have received

from God? You are not your own; 20 you were bought at a price. Therefore honor God with your bodies.

References:

Benyon, K. (2014). Health literacy. InnovAiT: Education and inspiration for general practice

Nelson, R., & Staggers, N. (2018). Health Informatics: an interprofessional approach. St. Louis, Missouri:

Elsevier.

Noblin, Alice M, Wan, T. T. H., & Fottler, M. (2012). The impact of health literacy on a patient's decision to

adopt a personal health record. Perspectives in Health Information Management

Kupchunas, W. R. (2007). Personal health record: New opportunity for patient education. Orthopaedic

Nursing

BUSI 505

Please respond to these Posting in APA Format 450 word count for the Discussion board Posting.

Roxanne Bryan

Governance, Compliance and Health Policy-Roxanne Bryan

CO LL AP S E

Health Literacy and a Patient's Decision to Adopt a Personal Health Record (PHR)

This article addresses the impact of health literacy on a patient's decision to adopt a

personal health record. According to the article, Health literacy is a concept that describes a

patient's ability to understand materials provided by physicians or other providers and factors

such as education level, income, and age can influence health literacy. (Noblin et al., p.1). The

ability to read and understand health information has been characterized over the past 20-30

users as health literacy and the term focuses on whether an individual can not only read but also

understand the health information being provided to them. (Raynor, D. K. p.1). In order to

receive financial subsidies under Medicare and Medicaid, physicians must adopt electronic

health records (EHRs) and so, and an increasing amount of physicians have opted to provide

personal health records (PHR), an electronic lifelong resource of health information needed to

make health decisions, to their patients. (Noblin et al., p.1). PHR improves the communication

between physicians and patient because it allows a provider to be able to send secure messages to

the patients, provide online appointment scheduling and let the patient know of prescription

refills. (Nelson & Staggers, 2014, p. 250). There are certainly benefits to providing PHR to

patients. One advantage that the patient will likely become more engaged in the healthcare

process which will have the added benefit of making the patient eager to understand the

information being provided. (Noblin et al., p.1). This will lead to satisfaction of care since the

patent’s involvement in the process, will lead to successful self-management. (Noblin et al., p.1).

Low health literacy can lead to longer and more frequent hospitalization, higher usage of

emergency rooms, and inability to manage chronic diseases such as asthma and diabetes. (Noblin

et al., p.2). Indicators of low health literacy are having less than high school education, speaking

English as a second language and being of advanced age having declined in mental capacity,

visual acuity, and auditory acuity. (Noblin et al., p.2). eHealth Literacy Scale (eHEALS) was

developed in 2006 and was used to determine how patients feel about their ability to find and use

health-related information on the internet. (Noblin et al., p.2). Clinical decision making and

health promotion were guided by eHEALS because it examined health literacy deals with

obtaining, processing and understanding health information, as well as e-health literacy which

dealt with the patient’s ability to find and use electronic health information. (Noblin et al., p. 2).

According to Ajzen and Fishbein, an individual will either react negatively or positively

and they will also respond to social pressures based on certain behavior. (Noblin et al., p. 2). This

is known as the theory of reasoned action. Attitude is considered to be one of the predictors of a

person’s behavioral intention and as it related to health literacy, the study wanted to determine a

patient’s attitude about his or her ability to locate, evaluate and use e-health information. (Noblin

et al., p. 2). A patient’s attitude which is their confidence in finding and using health information,

directly correlates with their likelihood of adopting PHR. (Noblin et al., p. 2). The study had two

hypotheses: Hypothesis one was that younger patients are more educated and have higher

income and are therefore more willing to adopt the PHR that those who are older, less educated

and with lower income. The second Hypothesis stated that patients who had high levels of e-

health literacy were more willing to adopt the PHR than those with low levels of e-health

literacy. (Noblin et al., p. 2). As it relates to hypothesis 1, the results of the study showed that 74

percent of the participants indicated that they would adopt PHR, the range 41-55 years was 29

percent, and the most common age range and 77 percent of those patients were willing to adopt

PHR. (Noblin et al., p. 3). Another finding was that the majority of the patients had a high school

education or less and 71 percent of those individuals were willing to adopt PHR. In addition, 59

percent of the patients were in the lowest income category, only making $20,000 annually.

(Noblin et al., p. 3). As it related to hypothesis 2, a comparison of responses on all questions and

PHR adoption were significantly at the <.01 level and the patient who intended to adopt a PHR

and agree with the eHEALS statement represented 65 percent and indicated high health literacy.

(Noblin et al., p. 13). Therefore hypothesis 1 was not supported by this study but hypothesis 2

was supported because patients who have a high level of e-health literacy are more willing to

adopt the PHR than those with low levels of e-health literacy. (Noblin et al., p. 13).

This study provided much insight and helped to dismiss and speculation, because many

may have assumed that most individuals with a high level of education or income would be more

apt to adopt PHR than the individuals who are older, less educated and with a lower income.

This study has dismissed that assumption. A person who only completed high school is certainly

appreciative of the use of technology in healthcare. Technological advances in medicine and

healthcare are accepted by the majority, and educational standing and affluence have nothing to

do with the need to and willingness to accept PHR. PHR improves the communication between

physicians and patient because it allows a provider to be able to send secure messages to the

patients, provide online appointments information and fill prescriptions. (Nelson & Staggers,

2014, p. 250). It is certainly no surprise that everyone or most patients embrace the use of

technology in this way. We all have one thing in common, we will all need medical treatment or

we will all need to get a routine examination at one point in our lives. Certainly, the scripture

reminds us that if anyone among us is sick, we should call the elders of the church to pray over

them and anoint them with oil in the name of the Lord. (James 5:14-15). Unfortunately, though,

some of us may not get the immediate healing and will need to go to the doctor to receive the

necessary treatment. Since most of us will need to seek treatment at some point in our lives, it

only makes sense that educational background has no impact on the willingness to adopt PHR.

Works Cited

Nelson, R., and Staggers, N. (2018). Health Informatics: An Interprofessional Approach. St.

Louis, MO. Elsevier Mosby.

Noblin, Alice M, Ph.D., R.H.I.A., C.C.S., Wan, T. T. H., PhD., & Fottler, M., Ph.D. (2012). The

Impact of Health Literacy on a

Patient's Decision to Adopt a Personal Health Record. Perspectives in Health

Information Management, 1-13.

Retrieved from http://ezproxy.liberty.edu/login?url=https://search-proquest

com.ezproxy.liberty.edu/docview/1124431243?

accountid=12085

Raynor, D. K. T. (2012). Health literacy. BMJ: British Medical Journal (Online), 344

doi:http://dx.doi.org.ezproxy.liberty.edu/10.1136/bmj.e2188

BUSI 511

Please respond to these Posting in APA Format 450 word count for the Discussion board Posting.

Lynn King

Health Care Providers and Professionals

*Note Reference can not be over 10 years old

CO LL AP S E

Shi and Singh (2017) explained the different types of health professionals and the difference between the diverse

groups of physician disciplines. There are physicians that are generalist and others that are specialist, most Doctors

of Osteopathic medicine (DOs) are generalist and most MDs are specialists (p.85). “In the United States, physicians

trained in family medicine/general practice, general internal medicine, and general pediatrics are considered primary

care physicians or generalist (Rich et al., 1994). Physicians in non-primary care specialties dealing with particular

diseases or organ systems are referred to a specialists” (Shi & Singh, 2017, p. 85).

Shi and Singh (2017) provided a list of the common specialties and the six major functional groups of these

specialties. The 4th group is surgeries of all types (p. 85). Surgery has many subspecialties consisting of physician

specialists or surgeons within those subspecialties. For example, cardiothoracic surgery (cardiac surgeon, thoracic

surgeon, vascular surgeon); general surgery (Colo-rectal surgeon, robotic specialist, breast specialist, thyroid

specialist); Gynecology (GYN) surgery (GYN surgeon; GYN-Oncology surgeon); orthopedic surgery (Orthopedic

trauma surgeon, hand specialist, orthopedic spine specialist). The physicians that work in surgery depend on an

entire team, consisting of physician specialist such as anesthesiologist. The 5th group of the six major functional

groups of specialties according to Shi and Sing (2017) is hospital-based radiology, anesthesiology, and pathology (p.

85). It is interesting that anesthesiology is grouped with hospital-based radiology and pathology rather than surgery

of all types.

Physicians also depend on surgical physician assistants (PAs) to assist with various procedures under their

supervision. “The American Academy of Physician Assistants (AAPA, 1986, p.3) defines PAs as “part of the

healthcare team..[who] work in a dependent relationship with a supervising physician to provide comprehensive

care” (Shi & Singh, 2017, p. 97). Although PAs are licensed, they do not have a medical degree and their training is

not as rigorous or extensive as the training for a physician. Physician “specialists musk seek certification in an area

of medical specialization, which commonly requires additional years of advanced residency training followed by

several years of practice in specialty. A specialty board is the final step for becoming a board-certified specialist”

(Shi & Singh, 2017, p. 85).

Nurses have varying levels of educational preparation and require a license to work as a Registered Nurse

(RN). They must graduate from an institution with an approved nursing program and successfully complete a

national exam to meet the licensing requirements (Shi & Singh, 2017, 95). Nurses can also work as scrub nurses in

the operating room, working along-side the surgeon during surgery, passing instruments and performing other

duties. Nurses that have additional education and clinical expertise beyond what is required of an RN are called

Advanced Practice Nurses (APN) of which a nurse practitioner is one area of specialization (Shi & Singh, 2017, p.

96). According to Mathias (2014) “The number of nurse practitioners is expected to double by 2025, and the need

for surgical first assistants is growing as residents work hours are reduced and surgeon assistants are eliminated to

cut costs. This situation offers a great opportunity for advanced practice perioperative nurses. A double certification

of nurse practitioner (NP-C) and RN first assistant (CRNFA) allows nurses to fill 3 roles: preparing patients for

surgery, assisting at surgery, and following patients postoperatively. Hospitals and surgical practices are beginning

to realize the value of these qualifications. To give NPs the necessary experience to assist at surgery, Schatz says, a

perioperative NP specialty akin to the family practice and acute care NPs is needed that includes an OR didactic and

clinical piece” (retrieved from http://web.b.ebscohost.com/ehost/detail/detail?vid=10&sid=580e0fbb-f24d-

422a-a335-

60a0fd6be165@sessionmgr101&bdata=JnNpdGU9ZWhvc3QtbGl2ZQ==#AN=103953663&db=rzh)

“The operating room nurse is an integral part of the surgical team as well. According to Sharma et al. (2018), “The

operating room (OR) constitutes a complex setting where surgical, anesthesia, and nursing staff must collaborate to

ensure a safe and successful patient outcome, often in a time-constrained and high-stress environment. These

challenges are complicated by varying levels of personnel experience, case needs, and preoperative preparation, all

of which can disrupt case flow, impair communication, and generate inefficiency. Hence, success in the OR

mandates an effective and reproducible team-work oriented strategy” (p. 225).

“You shall give to him freely, and your heart shall not be grudging when you give to him, because for this

the LORD your God will bless you in all your work and in all that you undertake” (Deuteronomy 15:10). Physicians

and nurses work in very stressful environments. It’s important to remember to have faith and trust god, and know

that He “will bless you in all your work and all that you undertake” (Deuteronomy 15:10).

References

Mathias, J. (2014 June). Surgeon-nurse duo delivers excellent, efficient patient care. OR Manager,

30(6). Retrieved from: http://web.b.ebscohost.com/ehost/detail/detail?vid=10&sid=580e0fbb-f24d-422a-

a335-60a0fd6be165@sessionmgr101&bdata=JnNpdGU9ZWhvc3QtbGl2ZQ==#AN=103953663&db=rzh

Sharma, K., Morgan, A. L., Stroud, J., & Mackinnon, S. E. (2018 August). The Whiteboard

Technique. Personalized Communication to Improve Operating Teamwork. Annals of Surgery, 268(2):225-

Shi, L. & Singh, D.A. (2017). Essentials of the U.S. Health Care System (4th ed.). Burlington, MA: Jones &

Bartlett, LLC.

The Holy Bible, English Standard Version. ESV (2016). Crossway Bibles

BUSI 511

Please respond to these Posting in APA Format 450 word count for the Discussion board Posting.

Justin Waldron

Discussion Board Module 3 - Justin Waldron

*Note Reference can not be over 10 years old

CO LL AP S E

Bringing healing to the hurting should be the mindset that each healthcare professional should daily

reflect upon and ask themselves, am I showing and reflecting Christ in how I walk and talk? In Matthew 4:23,

we learn that " 23 Jesus went throughout Galilee, teaching in their synagogues, proclaiming the good news of

the kingdom, and healing every disease and sickness among the people" (NIV). Jesus was healing, but also

teaching and bringing the good news. Is this what we do as healthcare professionals?

In being currently employed at a College of Osteopathic Medicine, I am daily asked the question "What is

the difference between an MD (Medical Doctor) and a DO (Osteopathic Doctor"? According

to Shi and Singh (2017) "DOs stress preventive medicine such as diet and the environment, while MDs are

trained in allopathicmedicine, which views medical treatment as an active intervention to produce a

counteracting reaction in an attempt to neutralize the effects of disease" (Shi and Singh, 2017). In order to

become a medical doctor, you used to be able to "match" or be accepted into a residency program with

only MD's in one pot and DO's in another per say. Now all are in one pot, which makes specializing very

tough. Shi and Singh (2017) say that "most DOs are generalists and most MDs are specialists" (Shi and Singh,

2017), this holds according to the data and information of 2017, but the osteopathic field is becoming more

competitive in each field, residency, specialty and is becoming more accepted even at "MD only residencies".

This topic could be discussed alone, but in this discussion i want to tie in the similarities and differences of

the medical doctor, not specifying allopathic or osteopathic, but as a whole in comparison to a physician

assistant or P.A.

First, we need to discuss what is the definition of a PA? In their January 2014 article on PA's in primary

care, BMC health services research defines a PA as "health professional, with a PA qualification, who

undertake physical examinations, investigations, diagnosis and treatment within their scope of practice as

agreed with their supervising doctor, who also have prescribing rights" (Halter, et al.; 2014). Now the

question arises, is a PA a doctor, does a PA have the same authority. In another January 2014 article in BMC

health services, it has become "effective" to have a PA "take the place" of an MD for the mere fact that

according to the article it is " indicated that they (physician assistant's) provide care that is comparable to

that of MDs, with high levels of patient satisfaction" (Timmermans, Vught, Wensing, Laurant, 2014). Is it a

replace method for a MD, no, but in the a 2016 study by Gershengorn, Xu, Chan, Armony, and Gong on the

impact of adding a PA to the team, if a PA can efficiently and effectively prove worthy, a "PA annual salary is

$90,000-$110,000 versus $275,000-$300,000 for an medical doctor" (Gershengorn, Xu, Chan, Armony, and

Gong, 2016).

A medical doctor will begin training and complete two years of course work in a residential class setting.

After this coursework is complete, they must successfully pass their "boards" or the COMLEX or USMLE exam.

After that, they will complete clinical rotations for another two years at a site provided by

their respective school. While in these rotations they will begin to take more "board" exams of Level One and

Level two PE and CE. Upon completion of the two year rotation period, completion of each exam, and

completion of a final assessment by their respective school, they are graduates of medical school. This does

not mean that everything is over and they are ready for work, this just means that "school" is over for them

and they can begin to "job search" to put it lightly and "match" into a residency whether it be family medicine,

general surgery, internal medicine, or neurology. The residency programs are different in how long they

occur due to the amount of knowledge you must learn, but after successfully completing a residency, you can

call yourself a true doctor! So, added all up 4 years of undergraduate work, possibly 2 more years of masters

work, 4 years of medical school, and 2-7 years of residency, you could be looking at 10-17 years of

school after high school to become a doctor. According to Timmermans, Vught, Wensing, Laurant (2014),

"PAs follow a 30 month training program at a Master’s degree level and conduct low to moderately complex

medical tasks within a certain specialty, both in primary and secondary care. Most PAs practice in the hospital

setting" (Timmermans, Vught, Wensing, Laurant, 2014).

Gershengorn, H. B., Xu, Y., Chan, C. W., Armony, M., & Gong, M. N. (2016). The Impact of Adding a Physician

Assistant to a Critical Care Outreach Team. PLoS ONE, 11(12), e0167959. Retrieved

from http://link.galegroup.com/apps/doc/A473671658/AONE?u=vic_liberty&sid=AONE&xid=24c00c41

Hooker, R. S., & Everett, C. M. (2012). The contributions of physician assistants in primary care

systems. Health & Social Care in the Community, 20(1), 20-31. doi:10.1111/j.1365-

2524.2011.01021.x, https://bmchealthservres.biomedcentral.com/articles/10.1186/1472-6963-13-223

Shi, L., & Singh, D. A. (2017). Essentials of the U.S. health care system — with access(4th ed.). Burlington,

MA: Jones & Bartlett Learning.

Timmermans, M. J. C., Vught, A. J. v., Wensing, M., & Laurant, M. G. H. (2014). The effectiveness of substitution

of hospital ward care from medical doctors to physician assistants: A study protocol. BMC Health Services

Research, 14(1), 43-43. doi:10.1186/1472-6963-14-

43, https://bmchealthservres.biomedcentral.com/articles/10.1186/1472-6963-14-43

HLTH 501

Alicia Amon

Discussion Board 2

Please respond to these Posting in APA Format 450 word count for the Discussion board Posting.

*Note Reference can not be over 10 years old

CO LL AP S E

When conducting an experiment, it is important to carefully consider the design of the study so that the

results obtained are as conclusive and informative as possible. In general, randomized study designs are

considered the gold standard when conducting experimental research in the medical field. Randomized

controlled trials are studies in which participants are randomly assigned to either a control group or a group

that is to receive an experimental treatment or medication. Similarly, in the crossover trial, participants are

also randomly assigned to a group to receive an experimental treatment or a control. Randomly assigning

participants to groups helps to minimize bias and control the effects of confounding throughout the study

process and with the final results (Sullivan, 2018). The major difference between randomized controlled

trials (RCT) and crossover trials is that in a crossover trial, participants will eventually receive both of the

treatment options (experimental and control). With both of these study designs, it is imperative that

participants follow the regulations and comply with necessary follow-up so that accurate data can be

collected for the duration of the trial.

Between the two aforementioned study designs, the crossover trial has the greater likelihood of encountering

ethical concerns. Depending on which treatment a participant in a crossover trial gets assigned to first, that

person could have to take the control treatment first, resulting in a delay in when they are to receive the

experimental treatment. While this may not be of great concern since there would be no evidence that the

experimental treatment would benefit them, what if a participant is randomly selected to receive the

experimental treatment in period 1 of the study? If that participant begins to experience improvement in

their condition while using the experimental treatment, it could be considered unethical to have them stop

that treatment and move into the washout period, especially if stopping it could result in the progression of

an illness or return of symptoms. This kind of ethical dilemma is not as readily evident in RCT. In a RCT, either

the participant gets the experimental treatment or they get the control (assuming they are only two

treatment groups). The control could be whatever the standard treatment for a disease or illness and,

especially if the study is blinded or double -blinded, there would be no way to tell which treatment the

participant is receiving.

In conducting studies and research having to deal with disease and illness, it is important to think about what

is written in Galatians 6:9. "So don't get tired of doing what is good. Don't get discouraged and give up, for we

will reap a harvest of blessing at the appropriate time". The desire to obtain good research results should

never overshadow the need to ensure that we are doing what is right and in the best interest of those who

may be participating in our research. As a Christian, maintaining my ethical values, even through my work, is

essential to my overall success.

References

Sullivan, L. M. (2018) Essentials of Biostatistics in Public Health. Burlington, MA: Jones & Bartlett Learning.

HLTH 501

Annie Bennah

Forum 2

Please respond to these Posting in APA Format 450 word count for the Discussion board Posting.

*Note Reference can not be over 10 years old

CO LL AP S E

A case-control study is frequently used in epidemiologic research when the interest is in whether

an association exists between a particular risk or exposure and outcome (Sullivan, 2018). Case-

control studies are useful when the outcome being studied is rare (Essebag, Genest, Suissa &

Pilote, 2013; Sullivan, 2018). Participants in a case-control study are selected based on their

outcome status (Sullivan, 2018). A set number of cases/persons that have the outcome of interest

are selected, controls similar to the cases but without the outcome of interest are also selected for

the study (Sullivan, 2018). Risk factor and exposure are assessed, and a hypothesis is formed

(Sullivan, 2018). Finally, the study is evaluated by comparing the cases to the controls and

drawing inferences about the relationship between exposure or risk factor status and disease

(Sullivan, 2018). A major challenge with a case-control study is selecting a representative

sample of controls, misclassification bias and selection bias (Essebag, Genest, Suissa & Pilote,

2013).

A crossover trail is a type of clinical trial where participants are assigned to two or more

treatment groups (Deng, Hanna, Bril, Dalakas, Donofrio, van Doorn et al., 2012; Sullivan, 2018).

Each participant in a crossover trial receives all the treatments. The two most popular ways to

conduct a crossover trial is through random or fixed assignment. In a fixed assignment, everyone

in the trail is assigned to the same treatment sequence (Sullivan, 2018). In a random assignment,

the groups do not all follow the same treatment sequence. A crossover trial allows participants to

be their own control and receive all the treatments being offered in the trial (Sullivan, 2018).

However, like other clinical trials ethical dilemmas exists. An ethical dilemma commonly

associated with all clinical trials such as crossover trials is the safety of the treatments involved

(Sullivan, 2018).

The cross-sectional survey is a study that is conducted at a single point in time (Sullivan, 2018).

Cross-sectional surveys are helpful when focus is on the prevalence of a disease. It is not a

randomized study, participants have been identified at a certain point in time and information is

gathered at that time (Sullivan, 2018). Cross-sectional surveys are large, easy to conduct and are

usually ethical (Sullivan, 2018).

Proverbs 10:9 “People with integrity walk safely, but those who follow crooked paths will slip

and fall.”

Deng, C., Hanna, K., Bril, V., Dalakas, M. C., Donofrio, P., van Doorn, P.,A., . . . J. (2012).

Challenges of clinical trial design when there is lack of clinical equipoise: Use of a

response-conditional crossover design. Journal of Neurology, 259(2), 348-52.

doi:http://dx.doi.org.ezproxy.liberty.edu/10.1007/s00415-011-6200-0

Essebag, V., Genest, J., Suissa, S., & Pilote, L. (2003). The nested case-control study in

cardiology. The American Heart Journal, 146(4), 581-90.

doi:http://dx.doi.org.ezproxy.liberty.edu/10.1016/S0002-8703(03)00512-X

Sullivan, M. L. (2018). Essentials of biostatistics in public health (3rd ed.). Burlington, MA:

Jones and Bartlett Learning

HLTH 501 Discussion Board 2 Rubric

Criteria

Levels of Achievement

Content 80%

Advanced

Proficient

Developing

Not present

20 points*

Advanced comparison of two or

three research designs that might

be used to research life

threatening diseases/disorders.

15 to 19 points*

Thorough comparison of two

research designs that might be used

to research life threatening

diseases/disorders.

1 to 14 points*

A partial comparison of two research

designs that might be used to

research life threatening

diseases/disorders.

0 points

The student did not submit an

initial post.

Structure 20%

Advanced

Proficient

Developing

Not present

5 points*

More than two replies to other

students that move forward

4 points*

Two replies to other students that

move forward

1 to 3 points*

One reply post replies to other

students or two posts that are not

substantive

0 points

No replies to other students

*Please see the Levels of Achievement Points spreadsheet for standardized point values based off your school/department’s grading scale.

BUSI 511

Discussion Board Rubric

(50 Points)

Content 70%

Advanced

Proficient

Developing

Not Present

Thread

Content

Points: 18 to 20

All key components of the

Discussion Board Forum

prompt are answered in the

thread.

Major points are supported by

all of the following:

 Reading & Study

materials;

 Pertinent, conceptual, or

personal examples;

 Thoughtful analysis

(considering assumptions,

analyzing implications, and

comparing/contrasting

concepts); and

 Two peer-reviewed source

citations in current APA

format, the text and the

integration of 1 biblical

principle.

Points: 17

Some key components of the

Discussion Board Forum

prompt are answered in the

thread.

Major points are supported by

some of the following):

 Reading & Study

materials;

 Pertinent, conceptual, or

personal examples;

 Thoughtful analysis

(considering assumptions,

analyzing implications,

and comparing/contrasting

concepts); and

 Two peer-reviewed

source citations in

current APA format, the

text and the integration of

1 biblical principle.

Points: 1 to 16

Minimal key components of the

Discussion Board Forum

prompt are answered in the

thread.

Major points are supported by

none of the following:

 Reading & Study materials;

 Pertinent, conceptual, or

personal examples;

 Thoughtful analysis

(considering assumptions,

analyzing implications, and

comparing/contrasting

concepts); and

 Two peer-reviewed source

citations in current APA

format, the text and the

integration of 1 biblical

principle.

Points: 0

Not Present

Replies

Content

Points: 14 to15

Contribution made to

discussion with each reply

expounding on the thread.

Major points are supported by

all of the following:

 Reading & Study

materials;

 Pertinent, conceptual, or

personal examples;

Points: 13

Marginal contribution made

to discussion with each reply

slightly expounding on the

thread.

Major points are supported by

some of the following):

 Reading & Study

materials;

Points: 1 to12

Minimal contribution made to

discussion with each reply

slightly expounding on the

thread.

Major points are supported by

none of the following:

 Reading & Study materials;

 Pertinent, conceptual, or

personal examples;

Points: 0

Not Present

 Thoughtful analysis

(considering assumptions,

analyzing implications, and

comparing/contrasting

concepts); and

 Two peer-reviewed source

citations in current APA

format, the text and the

integration of 1 biblical

principle.

 Pertinent, conceptual, or

personal examples;

 Thoughtful analysis

(considering assumptions,

analyzing implications,

and comparing/contrasting

concepts); and

 Two peer-reviewed source

citations in current APA

format, the text and the

integration of 1 biblical

principle.

 Thoughtful analysis

(considering assumptions,

analyzing implications, and

comparing/contrasting

concepts); and

 Two peer-reviewed source

citations in current APA

format, the text and the

integration of 1 biblical

principle.

Structure

30%

Advanced

Proficient

Developing

Not Present

Thread:

Grammar and

Spelling, APA

formatting

Points: 2

Proper spelling, grammar, and

APA format are used.

Points: 1.5

Marginal spelling, grammar,

and APA format are used (1-3

errors are present).

Points: 1

Minimal spelling, grammar, and

APA format are used (4-5 errors

are present).

Points: 0

Not Present

Thread:

Word Count

Points: 5

Required word count (at least

600 words) is met.

Points: 4

Required word count (at least

600 words) is not marginally

met (300–599 words).

Points: 1 to 3

Required word count (at least

600 words) is not met (299

words or less).

Points: 0

Not Present

Replies:

Grammar and

Spelling, APA

formatting

Points: 3

Proper spelling, grammar, and

APA format are used.

Points: 2

Marginal spelling, grammar,

and APA format are used (1-3

errors are present).

Points: 1

Minimal spelling, grammar, and

APA format are used (4-5 errors

are present).

Points: 0

Not Present

Replies:

Word Count

Points: 5

Both replies are present and

contain a sufficient word count

(minimum 450 words each).

Points: 4

Replies submitted, but 1 reply

submitted with insufficient

word count and/or only 1

reply has been submitted.

Points: 1 to 3

Both replies submitted with

insufficient word counts and/or

only 1 reply has been

submitted.

Points: 0

Not Present

HLTH 501

DISCUSSION BOARD INSTRUCTIONS

Participation in the Discussion Board forums is critical for maximizing your learning experiences

in this course. You are required to be part of an online community who interact through

discussion to enhance and support the professional development of the group. Part of the

assessment criteria for the course includes assessing the quality and quantity of your

participation in the discussion.

Some characteristics we consider to be part of excellent discussion contributions are outlined

below. Your facilitator will consider these characteristics when assessing the quality and level of

your participation.

 Integrate Biblical Worldview into topic – May include scripture reference or testimony

pertaining to topic. Avoid anecdotal references to experiences of friends and/or

acquaintances.

 You should submit your initial post(s) early in the session and your subsequent responses

to the posts of other learners at timely intervals within the duration of the session. Keep

in mind that the goal is to have a dynamic discussion that lasts throughout the entire

session.

 Your posts and responses should be thorough and thoughtful. Just posting an "I agree" or

"Good ideas" will not be considered adequate. Support your statements with examples,

experiences, or references. You are, however, encouraged to be brief. Keep each post

and response to one or two short paragraphs. Be mindful that your fellow learners will be

reading and responding to you, too.

 Make certain to address the discussion prompt(s). This does not mean you should not

extend the topic, but do not stray from the topic.

 Discussions occur when there is dialogue. Therefore, build upon the posts and responses

of other learners to create discussion threads. Make sure you revisit the Discussion

Board forum and respond, if necessary, to what other learners have posted to your initial

responses.

 When relevant, add to the discussion by including prior knowledge, work experiences,

references, websites, resources, etc. Make sure to give credit where appropriate.

 Your contributions to the Discussion Board posts and responses should be complete and

free of grammatical or structural errors.

 Your initial posts are required to be a minimum of 300 words and are due by 11:59 p.m.

(ET) on Thursday of the assigned module/week.

 Response posts are required to be a minimum of 200 words and are due by 11:59 p.m.

(ET) on Sunday of the assigned module/week.

BUSI 505

Case Study_Discussion Board Rubric

(60 Points)

Content 70%

Advanced

Proficient

Developing

Not Present

Thread

Content

Points: 27 – 25

All key components of the

Discussion Board Forum

prompt are answered in the

thread.

Major points are supported by

all of the following:

 Reading & Study

materials;

 Pertinent, conceptual, or

personal examples;

 Thoughtful analysis

(considering assumptions,

analyzing implications, and

comparing/contrasting

concepts); and

 Two peer-reviewed source

citations in current APA

format, the text and the

integration of 1 biblical

principle.

Points: 24 – 23

Some key components of the

Discussion Board Forum

prompt are answered in the

thread.

Major points are supported by

some of the following):

 Reading & Study

materials;

 Pertinent, conceptual, or

personal examples;

 Thoughtful analysis

(considering assumptions,

analyzing implications,

and comparing/contrasting

concepts); and

 Two peer-reviewed

source citations in

current APA format, the

text and the integration of

1 biblical principle.

Points: 22 – 1

Minimal key components of the

Discussion Board Forum

prompt are answered in the

thread.

Major points are supported by

none of the following:

 Reading & Study materials;

 Pertinent, conceptual, or

personal examples;

 Thoughtful analysis

(considering assumptions,

analyzing implications, and

comparing/contrasting

concepts); and

 Two peer-reviewed source

citations in current APA

format, the text and the

integration of 1 biblical

principle.

Points: 0

Not Present

Replies

Content

Points: 15 – 14

Contribution made to

discussion with each reply

expounding on the thread.

Major points are supported by

all of the following:

 Reading & Study

materials;

 Pertinent, conceptual, or

personal examples;

Points: 13

Marginal contribution made

to discussion with each reply

slightly expounding on the

thread.

Major points are supported by

some of the following):

 Reading & Study

materials;

Points: 12 – 1

Minimal contribution made to

discussion with each reply

slightly expounding on the

thread.

Major points are supported by

none of the following:

 Reading & Study materials;

 Pertinent, conceptual, or

personal examples;

Points: 0

Not Present

 Thoughtful analysis

(considering assumptions,

analyzing implications, and

comparing/contrasting

concepts); and

 Two peer-reviewed source

citations in current APA

format, the text and the

integration of 1 biblical

principle.

 Pertinent, conceptual, or

personal examples;

 Thoughtful analysis

(considering assumptions,

analyzing implications,

and comparing/contrasting

concepts); and

 Two peer-reviewed source

citations in current APA

format, the text and the

integration of 1 biblical

principle.

 Thoughtful analysis

(considering assumptions,

analyzing implications, and

comparing/contrasting

concepts); and

 Two peer-reviewed source

citations in current APA

format, the text and the

integration of 1 biblical

principle.

Structure

30%

Advanced

Proficient

Developing

Not Present

Thread:

Grammar and

Spelling, APA

formatting

Points: 3

Proper spelling, grammar, and

APA format are used.

Points: 2

Marginal spelling, grammar,

and APA format are used (1-3

errors are present).

Points: 1

Minimal spelling, grammar, and

APA format are used (4-5 errors

are present).

Points: 0

Not Present

Thread:

Word Count

Points: 5

Required word count (at least

600 words) is met.

Points: 4

Required word count (at least

600 words) is not marginally

met (300–599 words).

Points: 3-1

Required word count (at least

600 words) is not met (299

words or less).

Points: 0

Not Present

Replies:

Grammar and

Spelling, APA

formatting

Points: 5

Proper spelling, grammar, and

APA format are used.

Points: 4

Marginal spelling, grammar,

and APA format are used (1-3

errors are present).

Points: 3-1

Minimal spelling, grammar, and

APA format are used (4-5 errors

are present).

Points: 0

Not Present

Replies:

Word Count

Points: 5

Both replies are present and

contain a sufficient word count

(minimum 450 words each).

Points: 4

Replies submitted, but 1 reply

submitted with insufficient

word count and/or only 1

reply has been submitted.

Points: 3-1

Both replies submitted with

insufficient word counts and/or

only 1 reply has been

submitted.

Points: 0

Not Present

BUSI 511

Discussion Board Rubric

(50 Points)

Content 70%

Advanced

Proficient

Developing

Not Present

Thread

Content

Points: 18 to 20

All key components of the

Discussion Board Forum

prompt are answered in the

thread.

Major points are supported by

all of the following:

 Reading & Study

materials;

 Pertinent, conceptual, or

personal examples;

 Thoughtful analysis

(considering assumptions,

analyzing implications, and

comparing/contrasting

concepts); and

 Two peer-reviewed source

citations in current APA

format, the text and the

integration of 1 biblical

principle.

Points: 17

Some key components of the

Discussion Board Forum

prompt are answered in the

thread.

Major points are supported by

some of the following):

 Reading & Study

materials;

 Pertinent, conceptual, or

personal examples;

 Thoughtful analysis

(considering assumptions,

analyzing implications,

and comparing/contrasting

concepts); and

 Two peer-reviewed

source citations in

current APA format, the

text and the integration of

1 biblical principle.

Points: 1 to 16

Minimal key components of the

Discussion Board Forum

prompt are answered in the

thread.

Major points are supported by

none of the following:

 Reading & Study materials;

 Pertinent, conceptual, or

personal examples;

 Thoughtful analysis

(considering assumptions,

analyzing implications, and

comparing/contrasting

concepts); and

 Two peer-reviewed source

citations in current APA

format, the text and the

integration of 1 biblical

principle.

Points: 0

Not Present

Replies

Content

Points: 14 to15

Contribution made to

discussion with each reply

expounding on the thread.

Major points are supported by

all of the following:

 Reading & Study

materials;

 Pertinent, conceptual, or

personal examples;

Points: 13

Marginal contribution made

to discussion with each reply

slightly expounding on the

thread.

Major points are supported by

some of the following):

 Reading & Study

materials;

Points: 1 to12

Minimal contribution made to

discussion with each reply

slightly expounding on the

thread.

Major points are supported by

none of the following:

 Reading & Study materials;

 Pertinent, conceptual, or

personal examples;

Points: 0

Not Present

 Thoughtful analysis

(considering assumptions,

analyzing implications, and

comparing/contrasting

concepts); and

 Two peer-reviewed source

citations in current APA

format, the text and the

integration of 1 biblical

principle.

 Pertinent, conceptual, or

personal examples;

 Thoughtful analysis

(considering assumptions,

analyzing implications,

and comparing/contrasting

concepts); and

 Two peer-reviewed source

citations in current APA

format, the text and the

integration of 1 biblical

principle.

 Thoughtful analysis

(considering assumptions,

analyzing implications, and

comparing/contrasting

concepts); and

 Two peer-reviewed source

citations in current APA

format, the text and the

integration of 1 biblical

principle.

Structure

30%

Advanced

Proficient

Developing

Not Present

Thread:

Grammar and

Spelling, APA

formatting

Points: 2

Proper spelling, grammar, and

APA format are used.

Points: 1.5

Marginal spelling, grammar,

and APA format are used (1-3

errors are present).

Points: 1

Minimal spelling, grammar, and

APA format are used (4-5 errors

are present).

Points: 0

Not Present

Thread:

Word Count

Points: 5

Required word count (at least

600 words) is met.

Points: 4

Required word count (at least

600 words) is not marginally

met (300–599 words).

Points: 1 to 3

Required word count (at least

600 words) is not met (299

words or less).

Points: 0

Not Present

Replies:

Grammar and

Spelling, APA

formatting

Points: 3

Proper spelling, grammar, and

APA format are used.

Points: 2

Marginal spelling, grammar,

and APA format are used (1-3

errors are present).

Points: 1

Minimal spelling, grammar, and

APA format are used (4-5 errors

are present).

Points: 0

Not Present

Replies:

Word Count

Points: 5

Both replies are present and

contain a sufficient word count

(minimum 450 words each).

Points: 4

Replies submitted, but 1 reply

submitted with insufficient

word count and/or only 1

reply has been submitted.

Points: 1 to 3

Both replies submitted with

insufficient word counts and/or

only 1 reply has been

submitted.

Points: 0

Not Present

HLTH 501 Discussion Board 2 Rubric

Criteria

Levels of Achievement

Content 80%

Advanced

Proficient

Developing

Not present

20 points*

Advanced comparison of two or

three research designs that might

be used to research life

threatening diseases/disorders.

15 to 19 points*

Thorough comparison of two

research designs that might be used

to research life threatening

diseases/disorders.

1 to 14 points*

A partial comparison of two research

designs that might be used to

research life threatening

diseases/disorders.

0 points

The student did not submit an

initial post.

Structure 20%

Advanced

Proficient

Developing

Not present

5 points*

More than two replies to other

students that move forward

4 points*

Two replies to other students that

move forward

1 to 3 points*

One reply post replies to other

students or two posts that are not

substantive

0 points

No replies to other students

*Please see the Levels of Achievement Points spreadsheet for standardized point values based off your school/department’s grading scale.

Running head: HEALTHCARE TECHNOLOGY AND FINANCE

Healthcare Technology and Finance

Name:

Institution:

Course Code:

HEALTHCARE TECHNOLOGY AND FINANCE 2

The Challenges Posed By the Growing Use of Technology in the US

Although technology in itself is a very useful and a vital growing tool in

healthcare, the effective use of the same in the health environment is still marred by numerous

challenges. One of these challenges is the growing cost of installations and maintenance of

healthcare IT systems ("3 Challenges of Technology Implementation in Healthcare | USC

EMHA Online", 2019). The US government spent between 17% to a fifth of its entire budget on

healthcare in the last ten years. In 2018 alone, the actual amount spent on healthcare was $1.1

trillion. The ever-growing cost of healthcare stems from the ever-growing cost of incorporating

IT in healthcare. Around 5-10% of the entire healthcare, budget goes towards IT systems. The

increasing cost of integrating IT systems is the decreasing learning curve posed by rapid

advancements in IT technologies. Medical professionals are unable to keep up with the rapid

evolution of technology incorporation in healthcare ("3 Challenges of Technology

Implementation in Healthcare | USC EMHA Online", 2019), due to the gap between the rate of

advancements and the incorporation of these advancements in training programs. They are

unable to effectively comply with the numerous requirements by over-sighting authorities such

as HIPAA and the like.

The result of this slow compliance and alignment creates another challenge faced

by healthcare providers about technology. The healthcare industry has faced a lot of cyber

breaches and cyber-attacks due to the growing heavy use of technology in the provision of its

services. In 2018 alone, there were nearly 50 reported and disclosed cases of cyber-attacks and

data breaches in healthcare provision systems (Davis, 2018). As a result of the same, the medical

records of millions of Americans and foreign nationals seeking medical treatment in America

HEALTHCARE TECHNOLOGY AND FINANCE 3

were compromised. This growing risk and vulnerability of cyber-attacks on healthcare

technological systems are the biggest and most severe hurdle healthcare policymakers face.

The Influence of American Cultural Beliefs and Values in the Use of

Technology in Medicine

America is largely a liberal society. The culture of freedom and respect for rights

is an integral part of American society. As such, legislation such as the Fourth Amendment,

which discourage what the law describes as ‘unreasonable and unwarranted searches and

seizures’ were enacted. These laws, as well as similar policies like the Right to Privacy,

constitute the values of American society. Americans love their privacy and would do everything

to protect it. These values of freedom and respect for rights have led to the diluted acceptance of

the use of technology in the US. The Right to Privacy, more so the conditions that dictate

disclosure of American Citizens' health records is a polarizing issue in the US. The older

generations do not necessarily feel the ease and convenience of health records should validate the

use of technology in healthcare, especially in record keeping because of the increased

susceptibility of unauthorized persons to access such records ("American Attitudes Towards

Tech: Embracing Current Technologies But Wary of New Ones", 2018). Also, a cultural debate

on the one of the emerging requirement for people who wants to bear arms (disclosure of

medical records, more so psychological and mental health records) to the over-sighting

authorities has also garnered its fair share of debate and controversy. The ultimate result is the

subtle unwillingness of a portion of the American populous, especially the older conservative

generation from accepting and supporting the use and incorporation of technology in healthcare.

HEALTHCARE TECHNOLOGY AND FINANCE 4

References

Accredited Website

3 Challenges of Technology Implementation in Healthcare | USC EMHA Online. (2019).

Retrieved from https://healthadministrationdegree.usc.edu/blog/3-challenges-of-technology-

implementation-in-healthcare/

Accredited Website

American Attitudes Towards Tech: Embracing Current Technologies But Wary of New Ones.

(2018). Retrieved from https://medium.reinvent.net/american-attitudes-towards-tech-embracing-

current-technologies-but-wary-of-new-ones-c262798ed43b

Accredited Website

Davis, J. (2018). The biggest healthcare data breaches of 2018 (so far). Retrieved from

https://www.healthcareitnews.com/projects/biggest-healthcare-data-breaches-2018-so-far

HEALTHCARE TECHNOLOGY AND FINANCE 5

Outline Healthcare Technology and Finance

The Challenges Posed By the Growing Use of Technology in the US- Explores how challenges such as

increasing cost of technology application, skillset gap and susceptibility to cyber-attacks affect the use of

technology in healthcare.

The Influence of American Cultural Beliefs and Values in the Use of Technology in Medicine- Explores

how the liberal culture and similar values of the American society affects incorporation of technology in

healthcare.

Running head: STUDENT REPLIES

Student Replies

Student’s name:

Institution:

Date:

STUDENT REPLIES

Governance, Compliance and Health Policy Reply

The healthcare field is slowly shifting from traditional methods of administering treatment

to a digital age where most medical processes are completed electronically. This is not only

applicable to medical practitioners but also patients (Sullivan, 2017). The contemporary healthcare

industry is increasingly providing patients with health electronics systems such as the personal

health record system (PHR) to aid them to manage their conditions at the comfort and privacy of

their homes (Greer, 2011 p.190). PHR system has the ability to tether the progress and records of

the patient to that of their healthcare provider. First, this electronic system simplifies work for the

patients that use it for they do not have to visit their healthcare providers all the time. It enables

them to administer treatment on themselves especially those with chronic health conditions such

as COPD and diabetes.

However, there is a great concern regarding the ability of patients to use PHR due to

individual factors that influence performance or even how to manage the prescribed tasks for their

health conditions. Health literacy is very essential for the successful administration of the PHR

system and for the achievement of the system’s objectives. This is because numerous people whose

conditions can be managed through the use of PHR are still experiencing significant difficulties in

completing self-management by the use of the PHR system.

Hence, the healthcare industry needs to come up with a form of governance, compliance

and health policy that informs the use of PHR. This will help them identify and address areas of

needs in the medical field especially those revolving around the administration and use of the PHR

system (Ruger, 2012 p.37). For instance, healthcare practitioners could come up with methods of

ensuring health literacy among their patients to reduce the difficulties that they experience with

the use of various electronic health equipment.

STUDENT REPLIES

Thus, healthcare providers need to come up with a policy or system that defines governance

in the field, manages risk factors, and addresses adverse effects of events related to the use of

electronic health systems. Since the primary goal of healthcare providers should be to provide

quality care, their health policies should place the patient first (Ruger, 2012 p.39). Putting the

patient first means the medical practitioners should ensure that patients are health literate. For

example, they should ensure that patients can efficiently use PHR systems before they make the

patient use it for self-management.

As James 5:14-15 states, "Is anyone among you sick? Let them call the elders of the church

to pray over them and anoint them with oil in the name of the Lord. And the prayer offered in faith

will make the sick person well; the Lord will raise them up. If they have sinned, they will be

forgiven", medical practitioners are the elders upon whom patients rely for medical situations and

answers.

References

Greer, S. L. (2011). The weakness of strong policies and the strength of weak policies: Law,

experimentalist governance, and supporting coalitions in European Union health care

policy. Regulation & Governance, 5(2), 187-203.

Ruger, J. P. (2012). Global health justice and governance. The American Journal of

Bioethics, 12(12), 35-54.

Sullivan, L. M. (2017). Essentials of biostatistics in public health. Jones & Bartlett Learning.

STUDENT REPLIES

Health Literacy and Patient’s Decision to Adopt PHR Reply

"Dear friend, I pray that you may enjoy good health and that all may go well with you,

even as your soul is getting along well." 3 John 1:2. Other than just wishing friends and people

good health, it is essential to encourage health literacy so that they can understand various aspects

of medical treatment as well as the materials that physicians and other healthcare providers

administer. This is because not everyone has the ability to understand many of the elements of

healthcare.

Various factors contribute to this, and they include age, income, and educational level

among other demographics. Health literacy is important particularly for patients dealing with

chronic conditions that require self-managing. Diseases such as chronic obstructive pulmonary

disease (COPD) need complex handling strategies that require the patients to have the abilities to

access, comprehend, and evaluate the multiple available sources of health information (Sullivan,

2017). The personal health record system (PHR), is essential for the effective attainment of self-

management by such patients. PHR is an electronic system that enables patients to maintain and

manage their health information in a confidential, secure and private environment. Similarly, it

also allows people to keep such health records of others such as family or loved ones.

Whereas the system provides a simple way of maintaining health by patients, very few

people can use it due to the barrier of health literacy. The key objective of PHR is to offer

healthcare benefits particularly to the marginalized and undeserved patients who may have worse

health outcomes or are at risk of receiving less effective healthcare services (Hemsley et al, 2018).

However, it is this group of people that usually have little to no literacy regarding their medical

conditions. This negatively impacts the patient’s decision to adopt PHR as the system requires

literacy in text, technical and health aspects. Hence, the patients for whom the system was designed

STUDENT REPLIES

for viewing PHR as less suitable and disadvantageous to them. This is a setback on the set

objectives and the desired achievements of PHR (Hemsley et al, 2018). Whereas it is supposed to

improve healthcare by encouraging personal focus, it has failed to do this because of the existing

gap between the patient’s knowledge and the functionality of the machine.

People tend only to embrace something they are familiar with. Therefore, the adoption of

PHR by patients is mostly impossible due to the unfamiliarity that most patients experience with

it. This factor is a setback in decongesting hospitals and improving the health of those with chronic

hospitals (Noblin et al, 2012). Congested hospitals limit quality care and the more people visit

hospitals for cases they can personally manage the more hospitals will continue to crowd. Hence,

there is a need to improve health literacy in patients before introducing the use of PHR to the

patients for self-management of their medical conditions.

References

Hemsley, B., Rollo, M., Georgiou, A., Balandin, S., & Hill, S. (2018). The health literacy demands

of electronic personal health records (e-PHRs): An integrative review to inform future

inclusive research. Patient education and counseling, 101(1), 2-15.

Noblin, A. M., Wan, T. T., & Fottler, M. (2012). The impact of health literacy on a patient's

decision to adopt a personal health record. Perspectives in Health Information

Management/AHIMA, American Health Information Management Association, 9(Fall).

Sullivan, L. M. (2017). Essentials of biostatistics in public health. Jones & Bartlett Learning.

STUDENT REPLIES

Healthcare Providers and Professions Reply

"Surely he took up our pain and bore our suffering, yet we considered him punished by

God, stricken by him, and afflicted. But he was pierced for our transgressions; he was crushed for

our iniquities; the punishment that brought us peace was on him, and by his wounds, we are

healed." Isaiah 53:4-5. Despite the healing stated in the above Bible verse, it is undeniable that

people still crucially need the intervention of healthcare providers for their day-to-day medical

conditions. This is the reason for the existence of various categories of healthcare practitioners to

deal with these conditions at different levels.

The healthcare field needs more than a doctor to function effectively. Regardless of the

issue, addressing a medical condition often calls a team that consists of more than one healthcare

practitioner. The most commonly known group of medical practitioners are doctors. Doctors

present primary care providers who explain they spend the highest number of years studying

(Elaine & Padjen, 2010 p.390). At the same time, it is mandatory that this type of healthcare

providers spend a few more years after studies to gain experience before they can be allowed to

actually practice as doctors. Other categories also exist within the doctor's category. They include

general or physician practitioners who deal with first-level diagnoses and treatments. Another

category includes specialists (Sullivan, 2017). For this group, they usually specialize in a field

after the completion of their normal medicine studies. Examples are pediatricians, oncologists,

cardiologists, chiropractors, dentists, and neurologists among others.

The next group of healthcare practitioners is nurses. Practitioners in this category not only

practice in hospitals but could also be found in the offices of doctors. The roles of nurses are

usually more important for recovery purposes of the patient than treatment. Thus, they work more

closely with patients to conduct activities such as drawing blood and testing the blood pressure

STUDENT REPLIES

and blood sugar of the patients among other roles (Trotochaud et al, 2015 p.911). This category of

healthcare providers also has different groups based on their academic qualifications and

experiences.

Pharmacists present another group of healthcare practitioners. They mainly study about

medicines, chemicals, toxins, and the potential side effects upon administration on a patient; hence

their education often takes longer. Pharmacists work closely with doctors since the latter refer

patients to the former for the administration of prescribed medicine for the patient’s condition

(Elaine & Padjen, 2010 p.391). Consequently, they advise doctors on what to prescribe to patients

to avoid potentially serious side effects. Lastly, pharmacists offer advice to patients and answer

their questions about various medications.

Other groups of medical practitioners include the administrative staff, technologists and

technicians, and therapists among others. They are all significant in the healthcare field in unique

ways as no one group can perform all the tasks that are required in providing quality care to

patients.

References

Elaine Daily, R. N., & Padjen, P. (2010). A review of competencies developed for disaster

healthcare providers: limitations of current processes and applicability. Prehosp Disaster

Med, 25(5), 387-395.

Sullivan, L. M. (2017). Essentials of biostatistics in public health. Jones & Bartlett Learning.

Trotochaud, K., Coleman, J. R., Krawiecki, N., & McCracken, C. (2015). Moral distress in

pediatric healthcare providers. Journal of pediatric nursing, 30(6), 908-914.

STUDENT REPLIES

Comparing Medical Doctors and Osteopathic Doctors Reply

In as much as Exodus 15:26 tells people that, "He said, “If you listen carefully to the LORD

your God and do what is right in his eyes, if you pay attention to his commands and keep all his

decrees, I will not bring on you any of the diseases I brought on the Egyptians, for I am the LORD,

who heals you”, the contemporary world is still characterized by millions of people suffering from

varied illnesses. There is even an increase in diseases as well as their severity which forces people

to seek medical attention from health care practitioners. The kind of medical attention that people

seek also differs since it could be offered by a Medical Doctor (MD) or an Osteopathic Doctor

(DO).

Both categories of doctors are often licensed to practice in the healthcare field. Similarly,

they are also educated and certified to perform their duties. However, there are major differences

between these two types of practitioners. First, there is a difference in the training and philosophy

of patient care between an MD and a DO. Also, DOs are not as common as MDs since nine out of

ten practicing doctors are either allopathic physicians or medical doctors (Liliedahl et al, 2010

p.641). However, recent times have witnessed an exponential growth of the osteopathic medical

profession.

The osteopathic approach to intervention is often more about letting the body try to heal

itself and less about conducting medical procedures and prescribing medications to the patient

(Sullivan, 2017). In other words, osteopathic doctors engage in activities that are concerned with

treating the body, mind, and spirit of the patient. This is because DOs believe that the body is an

integrated whole; hence the focus should not only be on the treatment of the symptoms, rather the

treatment of the entire body. This is opposed to how MDs administer treatment since they usually

pay attention to symptoms only to which they refer to drug or surgery remedies (Young et al, 2015

STUDENT REPLIES

p.15). Also, DOs address patients’ medical conditions both from lifestyle and medical

perspectives. They believe that a patient’s unique concerns, family, and lifestyle play a vital role

in informing the health condition as well as the medical treatment of the patient.

The MDs, on the other hand, receive traditional training that informs their approach to

treating patients. This is contrary to the osteopathic training doctors receive where they learn more

on physical manipulation of a patient’s body and not direct medical treatment. This type of training

for DOs is also referred to as osteopathic manipulative treatment (OMT) (Young et al, 2015 p.19).

However, despite the differences between the two categories of physicians, the patients make the

choice of who to visit for their medical conditions. Nonetheless, they should not see them as very

different for both treatments usually have almost similar outcomes.

References

Liliedahl, R. L., Finch, M. D., Axene, D. V., & Goertz, C. M. (2010). Cost of care for common

back pain conditions initiated with chiropractic doctor vs medical doctor/doctor of

osteopathy as first physician: experience of one Tennessee-based general health

insurer. Journal of manipulative and physiological therapeutics, 33(9), 640-643.

Sullivan, L. M. (2017). Essentials of biostatistics in public health. Jones & Bartlett Learning.

Young, A., Chaudhry, H. J., Pei, X., Halbesleben, K., Polk, D. H., & Dugan, M. (2015). A census

of actively licensed physicians in the United States, 2014. Journal of Medical

Regulation, 101(2), 7-22.

STUDENT REPLIES

Randomized Controlled Trial Reply

Healthcare research is critical; hence the choice of study designs is an essential process that

significantly impacts the outcome of the experiment. The randomized controlled trial (RCT) is one

of the clinical study designs that have proved useful. It is one of the most rigorous methods that

examine intervention and an outcome to determine whether there is a cause-effect relationship

between the two (Bonell et al, p.585). The primary strength of this study design is found within its

ability to randomize which makes it a unique study design when compared to the rest of the clinical

study trials. A randomized controlled trial creates two groups of randomly picked study

participants. The two groups consist of the experimental group for the testing of the intervention

and another group for comparison. The latter group receives a placebo or rather a conventional

treatment (Sullivan, 2017). The researchers then closely follow the two groups for purposes of

prospective assessment and comparison of the effectiveness of the intervention as well as the

placebo or standard treatment.

The randomness in allocating the participants in the RCT study design ensures similarity

in all aspects between the intervention and the control groups. This is also known as the equal

distribution of confounding factors where exceptions only occur in the testing of preventive

measures or therapeutic measures. At the same time, the RCT study design uses an existing

standard or placebo treatment that resembles in all respects the intervention treatment that is

administered to one of the groups (Bonell et al, p.586). Exceptions are however made when the

intervention treatment does not contain active ingredients. Thus, the key goal of randomization in

the RCT study design is to ensure that the differences in observations are not influenced by biases

or confounding. Rather, the differences in the treatment groups should be solely based on the

intervention treatment or the Placebo. In other words, randomization brings about all aspects of

STUDENT REPLIES

similarities between the two groups with the only difference being the intervention that is under

experimentation.

The randomized controlled trial appears more complex than the crossover trial. While there

is the randomness similarity in the choice of participants, crossover, as opposed to RCT, involves

the administration of more than one intervention treatments to the same group. The study entails

the crossing over of participants from one treatment to another in search for the most effective

intervention for most chronic diseases (Copas et al, 2015 p.584). In many occasions, the subjects

of crossover studies act as their own control which infringes on the feasibility of the study

outcomes. Therefore, the crossover trial has more limitations that adversely impact the outcomes

of the study in comparison to the RCT study design. RCT is more effective in trying to test a new

intervention treatment than the crossover study even though they both rely on randomizing

participants. "And my God will meet all your needs according to the riches of his glory in Christ

Jesus." Philippians 4:19.

References

Bonell, C. P., Hargreaves, J., Cousens, S., Ross, D., Hayes, R., Petticrew, M., & Kirkwood, B. R.

(2011). Alternatives to randomisation in the evaluation of public health interventions:

design challenges and solutions. Journal of Epidemiology & Community Health, 65(7),

582-587.

Copas, A. J., Lewis, J. J., Thompson, J. A., Davey, C., Baio, G., & Hargreaves, J. R. (2015).

Designing a stepped wedge trial: three main designs, carry-over effects and randomisation

approaches. Trials, 16(1), 352.

STUDENT REPLIES

Sullivan, L. M. (2017). Essentials of biostatistics in public health. Jones & Bartlett Learning.

Study Designs Reply

A case-control study is a study design commonly used in hospitals. It revolves around

retrospective examination through the comparison of patients with and patients without a disease

or outcome of cases or interests. After that, the study looks back to determine the frequency of a

risk factor exposure in each of the groups to find the relationship between the disease and the risk

factors (Bonell et al, 2011 p.582). Thus, case-control studies are usually observational because it

does not attempt to alter the course of the disease and it does not administer any form of

intervention during the study. Doing this would interfere with the goal of the study which is to

estimate the odds of getting a disease through exposure to a risk factor. This research design is

useful for studying rare conditions. At the same time, it allows the researchers to simultaneously

study multiple risk factors of the respective disease.

A crossover trial or study, on the other hand, refers to the administration of different

medicines on a patient randomly but at intervals. Just like the name suggests, the experimental unit

of this study design or rather the patient crosses over from one treatment to another during the

study. Whereas the crossover trial design requires fewer patients for the experiment, it is usually

effective since it yields more treatment comparisons than the other clinical studies. However, there

is a limitation to this study design (Bonell et al, 2011 p.584). For example, treatment A curing a

patient in the first instance means that even if treatment B is administered to the same patient, it

will be difficult to obtain its effectiveness. Hence, the crossover trial can only be used for chronic

illnesses that do not have cures such as asthma. This allows the patients to cross over from one

form of treatment to another in a bid to find the cure to his/her disease.

STUDENT REPLIES

A cross-sectional survey is another way of measuring epidemiology that involves

examining the relationship between a health-related state or disease and a population’s existing

variables over a short period or at a single point in time (Copas et al, 2015 p.352). In other words,

cross-sectional studies provide a snapshot of health-related characteristics or the frequency of a

disease of a population at a particular time. Hence, this study design is mostly used to assess a

population’s burden of health needs and diseases. After that, the information obtained is

particularly applied in the planning and allocation of health resources. Consequently, this study

design is also purposeful in determining the relationship between a risk factor in health and its

outcome (Sullivan, (2017). However, it experiences a limitation in this ability due to the incapacity

of the study design to draw valid conclusions regarding the putative risk factor and the health

outcome association. "Heal me, O Lord, and I will be healed; save me, and I will be saved, for you

are the one I praise." Jeremiah 17:14.

References

Bonell, C. P., Hargreaves, J., Cousens, S., Ross, D., Hayes, R., Petticrew, M., & Kirkwood, B. R.

(2011). Alternatives to randomisation in the evaluation of public health interventions:

design challenges and solutions. Journal of Epidemiology & Community Health, 65(7),

582-587.

Copas, A. J., Lewis, J. J., Thompson, J. A., Davey, C., Baio, G., & Hargreaves, J. R. (2015).

Designing a stepped wedge trial: three main designs, carry-over effects and randomisation

approaches. Trials, 16(1), 352.

Sullivan, L. M. (2017). Essentials of biostatistics in public health. Jones & Bartlett Learning.

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