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B A Friedman

Publications and source records attributed to B A Friedman.

77 records · Page 5Linked to original sources
PubMedDate not supplied

Selecting and managing a professional consultant to a clinical laboratory.

Managers of clinical laboratories, like those in other complex organizations, will often seek the advice of external professional consultants to provide solutions to current problems. Optimizing the process of selecting and managing consultants to clinical laboratories is the topic of this article. A number of practical tips are offered, including a discussion of the use of nontraditional consultants. Special emphasis is placed on developing a request for proposal and evaluating responses to the request for proposal by the various consulting firms bidding for the engagement. The use of consultants in the health-care arena in general and clinical laboratories in particular will undoubtedly increase as financial and organizational challenges to the industry continue to proliferate.

Competitive Bidding↗
PubMedDate not supplied

The laboratory information float, time-based competition, and point-of-care testing.

A new term, the laboratory information float, should be substituted for turnaround-time when evaluating the performance of the clinical laboratory because it includes the time necessary to make test results both available (ready to use) and accessible (easy to use) to clinicians ordering tests. The laboratory information float can be greatly reduced simply by telescoping the analytic phase of laboratory testing into the preanalytic phase. Significant costs are incurred by such a change, some of which can be reduced by developing a mobile clinical laboratory (sometimes referred to as a "lab-on-a-slab" or "rolling thunder") to transport the analytic devices directly to patient care units. The mobile clinical laboratory should be equipped with an integrated personal computer that can communicate continuously with the host laboratory information system and achieve some semblance of continuous flow processing despite test performance in point-of-care venues. Equipping clinicians with palmtop computers will allow the mobile clinician to access test results and order tests on the run. Such devices can be easily configured to operate in a passive mode, accessing relevant information automatically instead of forcing clinicians to query the laboratory information system periodically for the test results necessary to render care to their patients. The laboratory information float of the year 2,000 will surely be measured in minutes through the judicious deployment of relevant technology such as mobile clinical laboratories and palmtop computers.

Clinical Laboratory Information Systems↗
PubMedDate not supplied

Orchestrating a unified approach to information management.

Articles in both business and healthcare literature make frequent reference to the need for integration in healthcare organizations. In healthcare, the term horizontal integration can refer to the purchase of one hospital by another in the same geographical area, particularly where the hospitals' services overlap. Services might be consolidated in this example or one hospital may totally shut down the acquired one. Vertical integration refers to a hospital exercising control of its inputs or outputs. In one sense, patients referred to a hospital can be considered inputs. A hospital that purchases physician practices or integrated delivery systems is an example. Purchasing a nursing facility by an integrated delivery system (IDS) is another. This article focuses on organizational or holographic integration, where an organization is understood and embedded--like a hologram--in each of its smaller components, and each operating unit has knowledge about the whole system in which it is embedded. Conceptually, a hospital can achieve organizational integration relatively easily. One way is to assign administrative responsibility for two departments, radiology and pathology, for example, to one person who will handle billing, budgeting and human resources issues. Organizational integration breaks down turf barriers between distinct functional areas (often known as stovepipes or the silo mentality) because the result is less energy expended to solve problems. Organizational integration must include the merging of information technology (IT) into a single computer system that can report results across several departments, for example, in order entry, result reporting, resource scheduling or billing. At the University of Michigan Health System, technical and organizational integration are taking place across the information systems of the radiology and pathology departments. Deployment of an intranet-based architecture for ancillary information systems will provide the means to achieve high level integration across previously heterogeneous and non-integrated department-based clinical information systems.

Cooperative Behavior↗
PubMedDate not supplied

Integrating laboratory processes into clinical processes, Web-based laboratory reporting, and the emergence of the virtual clinical laboratory.

References to integration occur frequently in the health-care literature. Integration in this context refers to the blending or merging of the separate components of a health-care organization to form a cohesive and seamless interoperating whole. The health-care industry is now in the process of reorganizing and consolidating through hospital mergers and the creation of provider networks. The stimulus for these activities, all integrative, has been the introduction of managed care as a replacement for fee-for-service reimbursement. Managed care was designed to introduce competition into health-care delivery, and it certainly has succeeded in this goal. The quest for integration in health care is thus a consequence of the shift to managed care and has been driven by the belief that integration will lead to greater efficiency and cost savings in the industry. The major vehicles for achieving integration in the clinical laboratories will be Web-based reporting and the emergence of the virtual clinical laboratory.

Clinical Laboratory Information Systems↗