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Biomedical subjects

D E Detmer

Publications and source records attributed to D E Detmer.

At least 19 recordsLinked to original sources
PubMed2001

A new health system and its quality agenda.

This article reviews recent work on healthcare quality, highlights findings and recommendations of the Institute of Medicine (IOM) reports on medical errors and quality, and describes response to the reports to date. In it, Detmer, chair of the IOM's Board of Health Care Services and a member of its Committee on Quality of Health Care in America, identifies implications of the reports for healthcare delivery organizations and professionals and outlines ways organizations and professionals can improve the six dimensions of patient quality defined by the IOM. Sustained efforts at the point of care and in policy development are needed to overcome cultural inertia, realign incentives, support innovation, and address technical and human resource issues. Success requires that healthcare executives embrace the goal of transforming the healthcare sector into a true system and provide leadership for their organizations and communities in this most fundamental of challenges for twenty-first century healthcare.

Delivery of Health Care↗
PubMed2001

Transforming healthcare in the Internet Era.

Healthcare services will be transformed in the Internet Era by developments in biotechnology, bioinformatics, health informatics, assimilation of modern business processes, and changing policy expectations. Discoveries in biology and communications technology offer the potential for improvements in health status of individuals and populations. Improved access to information about health and disease will typify early progress. Care in hospitals will shift toward palliation and end-of-life care; curing and prevention will increase in outpatient settings and/or within the home or workplace. Barriers include resistance to change and a lack of a global health information infrastructure that includes financing, standards, and coherent policy.

Community Health Planning↗
PubMed1998

Veterans Affairs residency realignment and National Graduate Medical Education policy.

The supply of physicians in the United States is affected by a variety of complex factors. Given the current abundance, if not oversupply, of physicians and the dramatic changes under way in the US health care delivery system, policy makers have renewed efforts to implement strategies that will lead to an appropriate balance of physicians in the United States. Several organizations have recommended specific strategies for achieving that goal. The Veterans Health Administration has already decided to change the number and distribution of its residency training positions. These changes cannot, however, be viewed in isolation. The Veterans Health Administration plays an important role in the graduate medical education of many physicians in the United States, and the magnitude of the intended changes could have a significant impact on residency opportunities.

Education, Medical, Graduate↗
PubMed1997

Anatomical dissection of the deep posterior compartment and its correlation with clinical reports of chronic compartment syndrome involving the deep posterior compartment.

Patients with clinical presentation of deep posterior chronic compartment syndrome (CCS) frequently have symptoms limited to either proximal or distal components of the deep posterior compartment. In this study the posterior aspect of 15 cadaver legs was dissected to document anatomical separations and delineate boundaries, if any, of the deep posterior compartment and to correlate the findings to these patients. Origins of flexor hallucis longus (FHL), flexor digitorum longus (FDL), and tibialis posterior (TP), as well as whether TP existed in its own osseofascial compartment, were noted. Ten specimens had an identifiable distinct layer of tissue separating the deep posterior compartment into two potentially clinically relevant components. Much of this layer was derived from origins of FDL and its anatomical position in relation to the TP muscle. In seven of these cases, FDL had a significant fibular origin in addition to the well-established tibial origin. This essentially compartmentalized the distal third of the tibialis posterior as it descends anterior and medial to FDL in the lower one-third of the leg in five specimens. No cadaver possessed a significant fascial septum encasing TP and separating it from other deep posterior muscles. This study confirms the existence of a proximal and distal sub-compartment of the deep posterior compartment as a variant and supports the most frequent clinical presentation of deep posterior CCS as involving either the distal or proximal deep compartment, rather than the entire deep posterior compartment. The anatomic arrangement of muscles in the deep posterior compartment creates sub-compartments, which may explain the successful outcomes following a deep compartment release limited to symptomatic portion(s) of the deep compartment.

Anatomy, Artistic↗
PubMed1996

The computer-based record: patient moving from concept toward reality.

In 1991 the Institute of Medicine issued a report on improving patient records which has proven to be a landmark for the many individuals and institutions involved in the development of computer-based patient records (CPRs). The report called Computer-based Patient Records: An Essential Technology for Health Care, recommended that CPRs become the primary form for patient records, and urged widespread implementation of CPRs within a decade. It also provides a framework for reviewing the current status of CPRs. In reviewing progress that has been made toward CPRs since the Institute of Medicine (IOM) report was released, it is useful to look beyond the IOM report's major focus on efforts in the USA and include international activities related to CPR development and implementation. Looking forward, CPR efforts are likely to be expedited through greater collaboration.

Computer Communication Networks↗