The elephant in the room, however, is the question of how these technologies will shift provider roles and responsibilities and alter current treatment models.
Since ACOs intend to shift provider focus from procedure pricing to better health outcomes, the incentive for achieving this goal is financial compensation based on individual patient outcome.
For task shifting, providers explained that offering more than one service per client meant that each provider was experiencing an expanded client register as they now received a broader range of clients than in the previous vertical service provision format.
For example, during a more chaotic shift the providers may provide the best handover by simply focusing upon the brief preparatory phase and preparing to extend their time to the post-handover phase to finish their cases that are near a final disposition rather than hand the case(s) over.
For example, if the levels of service specified in Service Level Agreements (SLAs) drop, PAR#17 will then shift cloud providers.
That's slowly changing with the Affordable Care Act, as payment models shift so providers are rewarded if patients stay healthy, and penalized if they don't.
This shift in providers could create potential challenges in caring for chronically ill patients as discontinuity and fragmented care patterns might impact the quality of care received during the transition.
Thus, neither the shift in providers' internal norms vis-à-vis the entitlements of HIV patients, nor the improvements in HIV patients' capacity to 'voice' their needs, was sufficient to improve social enforceability in the health centres overall.
Despite a positive shift in providers' attitudes towards HIV-patients, and strengthened capacity of HIV-patients to invoke 'voice' sanctions, the scale-up of HIV services contained no specific activities designed to address the deeply rooted information and power asymmetries affecting social answerability and enforceability more broadly.
"Much of the traffic is shifting to providers who have large amounts of traffic, and that is exactly the characteristic of a scale-free distribution".
