The struggles of some high-profile CHIN initiatives have damaged the reputation of community networks. But proponents believe that integrated delivery systems and the Internet will aid their cause in the long run.

Community Networks↗

PubMed1996

1997 forecasts. Market pressures will continue to fuel networking.

Explore the source record for details and available documents.

Community Networks↗

PubMed1996

1997 forecasts. A shift to an outpatient focus for electronic records.

Explore the source record for details and available documents.

Ambulatory Care Information Systems↗

PubMed1995

The risk of adenomatous polyps in asymptomatic first-degree relatives of persons with colon cancer.

BACKGROUND & AIMS: Increasing evidence indicates that inherited susceptibility is important in the pathogenesis of colorectal neoplasia. The aim of this study was to clarify whether having only one first-degree relative with colorectal cancer increases the risk of developing adenomatous polyps and whether total colonoscopy is an appropriate screening measure in these patients. METHODS: The frequency of such a history was evaluated in 397 asymptomatic patients who underwent total colonoscopy. Of these patients, 155 had colorectal polyps and the remaining 242 did not have polyps. RESULTS: Among polyp cases, 27 of 155 (17.4%) had a positive history; among those without polyps, 12 of 242 (5.0%) had a positive history. Alternatively expressed, 27 of 39 patients (69%) with family history and 128 of 358 patients (36%) without family history had adenomas. The estimated risk for polyps associated with family history was 1.9. Among polyp cases, 14 of 27 patients (51.9%) with family history and 32 of 128 patients (25.0%) without family history had only proximal polyps (chi 2 test; P = 0.006; odds ratio, 3.2), In the same groups, frequency of high-grade dysplasia was 8 of 27 patients (29.6%) and 16 of 128 patients (12.5%), respectively (chi 2 test; P = 0.04; odds ratio, 2.9). CONCLUSIONS: Relative to subjects with no family history, asymptomatic patients with one first-degree relative with colorectal cancer had nearly double the risk of developing adenomatous polyps, greater frequency of severely dysplastic lesions, and significantly higher frequency of proximal polyp location. This suggests that total colonoscopy screening is indicated in these subjects.

Adenomatous Polyposis Coli↗

PubMed1995

Hospitals seek strength in numbers.

Six Iowa hospitals that don't have a common owner are banding together to form a health information network using a software system that they couldn't have afforded individually. The network will provide easy access to electronic records throughout a broad, rural area.

Computer Communication Networks↗

PubMed1995

Will on-line adjudication fit the need?

On-line claims adjudication would provide the virtually immediate, paperless determination of who owes what to whom for the delivery of health care services. Proponents point to the potential cost savings from the elimination of paperwork and increasing efficiency. But skeptics question whether physicians will use the service. They say that the growth of capitated managed care plans could eliminate the market for on-line claims.

Computer Communication Networks↗

PubMed1995

Mergers create a challenging puzzle.

Market forces are pushing more health care organizations into mergers. This urge to merge has brought pressure to bear on information departments, which face the huge task of tying together disparate information systems, and doing it quickly while holding the line on expenses.

Automation↗

PubMed1995

Will CHINs be able to mesh with enterprise networks?

The current proliferation of enterprisewide information networks developed by integrated delivery systems wasn't foreseen when the community health information network concept was spawned. Now, many are wondering how enterprise networks will mesh with CHINs and whether there will be needless and expensive duplication of services.

Community Health Planning↗

PubMed1995

Designing a place for automation.

Re-engineering is a hot topic in health care as market forces increase pressure to cut costs. Providers and payers that are redesigning their business processes are counting on information systems to help achieve simplification and make large gains in efficiency. But these same organizations say they're reluctant to make large upfront investments in information systems until they know exactly what role technology will play in the re-engineered entity.

Automation↗

PubMed1995

Clinical protocols: the next automation frontier. Computerized records will play a key role in the implementation of clinical guidelines.

Interest in creating clinical protocols has surged in recent years, and experts say computer-based patient records represent the most practical way to put these guidelines to use. Economic forces, particularly the growth of managed care, will push clinicians to identify the most cost-effective ways to deliver care. Electronic records will serve as a useful source of information on which to base and refine guidelines.

American Medical Association↗

PubMed1995

The allure of the Internet.

Health care providers are just beginning to devise uses for the emerging information superhighway. The Internet, a vast network of computer networks, provides inexpensive ways to gain easy access to a wealth of health information. The Internet's growing popularity, including the e-mail boom, boosts the likelihood that the broader health care networking movement will pick up speed.

Computer Communication Networks↗

PubMed1995

Demonstrating how automation can improve outcomes.

Automation is playing a key role in the study of the outcomes of medical treatment to determine what delivery methods are most effective. Several organizations that are using technology to facilitate outcomes research are gaining tangible results.

Efficiency, Organizational↗

PubMed1995

CHINs (community health information networks) go head-to-head for big city markets.

Competition between community health information networks already is brewing in several cities. Some say that competition could speed network development and keep costs in check. But others worry that competition could dilute anticipated CHIN benefits.

Chicago↗

PubMed1995

CHIN building, step one: create a consensus.

The Big Three automakers long have wanted Michigan health care providers to give them outcomes data so the care companies could gauge the cost-effectiveness of the care their workers get in the Detroit area. At first, the car companies saw the fledgling Michigan Health Management Information System as the way to finally get the data they've wanted. Eventually, though, after long discussions with other network participants, the carmakers opted to scale back expectations, agreeing that the network should focus first on moving administrative transactions between health care purchasers, payers and providers.

Community Networks↗