Discuss the most common technical clinical and organizationa

Discuss the most common technical, clinical and organizational problems medical directors face in using data to manage utilization, and what steps might be taken to deal with those problems?

Solution

The most common technical, clinical and organizational problems that medical directors will face, while using data to manage utilization, are as follows:

1. Patient Data Confidentiality: Confidentiality is an important factor when it comes to medical field. It is a very sensitive area where the organization will have to be extra careful in maintaining the data of their patients. Patients will only then develop a trust factor with the organization that maintains the records. Building trust is a key responsibility of all Medical Directors. This is a very common organizational problem in prevalent in the medical industry.

2. Validity and reliability of data: This is a type of technical problem that most of the Medical Directors face. The dara that they have should be valid and reliable. If the data entry people has wrongly entered the data of the patient then this will result in an invalid data and the reliability will be lost. Hence all the employees or executives down the line should work properly in order avoid technical problems.

3. Data Warehousing: This is a typical technical and clinical problem that most of the Medical Directors face. Data warehousing is storing the data at the right place and retrieving the data at the right time. These days patients are given a patient ID and their data is saved in the hospital. Whenever the patient returns, their record should be retrieved within the least time. Hence medical director should be extra cautious while maintaining data.

4. Claims data analysis: This is a type of organizational error that is inter-linked with data warehousing. Data should be anaysed in order to have a correct report on the claims made by the patients. This will help the Medical Director to analyse as to how many claims are being executed within a short span of time.

5. Risk Analysis: This is a type of organizational problem that each and every medical director will face. Risk analysis will involve the highest risk associated with each and every patient. If the hospital proceeds with the treatment and finally if they are not able to get the claim back from the vendor then it will turn out to be big risk for the hospital. Hence the Medical Director will have to analyse the risks associated with each patient.

6. Data Reporting: This is a type of technical, clinical and organizational problem that Medical Directors will face. Data reporting is essential since the management will be more interested in knowing the performance of the Hospital. Data reporting is vital for financial purpose and maintenance of Human Resource in the hospital.

These are the major and most common technical, clinical and organizational problems that medical directors will face, while using data to manage utilization.