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M Ruffin

Publications and source records attributed to M Ruffin.

At least 37 records · Page 2Linked to original sources

Getting the most benefit from information systems consultants.

Consultants are usually well-meaning people who enjoy the variety of organizations and problems they face in their work. Most do not like to get bogged down in fruitless and wasteful consulting engagement any more than managers of health care organizations like to supervise them, but at least the consultants are paid for their time. The health care organization that defines a project poorly, does not know what it wants from consultants, or does not direct consultants will pay the price in increasingly scarce resources squandered. The tips in the following article for managing an information systems consulting engagement apply to most consulting engagements and to the use of other expensive advisers, such as attorneys and engineers. But information systems is a field particularly foreign, and often threatening, to most administrators and physician executives, so the risk of wasting money on unsuccessful consulting engagements is high.

Consultants↗

On being digital.

Explore the source record for details and available documents.

Analog-Digital Conversion↗

Capitation and informatics.

When physicians, hospitals, and allied health professionals bill for services they render, their information processing requirements are relatively simple, at least compared to those of capitated organizations. When payers (insurers or employers) accept financial risk for the health care services of beneficiaries, they have usually invested in claims processing, membership tracking, and, under managed care, utilization review and provider profiling systems. But payers, for the most part, have not invested in electronic collection of clinical information about beneficiaries, nor have they tended to keep all claims they have processed in electronic form for study after accounts are settled and payments disbursed. In this article, we will explore why informatics is so important to capitated organizations and why payers that have traditionally taken financial risk for insuring the health care costs of populations are also learning about the importance of informatics.

Capitation Fee↗

New governance for a new era: issues and challenges for integrating systems.

In this first part of a two-part column, Dr. Ruffin introduces seven key factors that will govern the operations of integrated systems. It is important to understand, he says, that, in the movement from a fee-for-service payment mechanism, in which the various elements of the health care field bill for their services independently and according to rules designed for their benefit, to an intregrated system, in which such independence can only lead to confusion in information systems, very substantial changes will be required in the governance of our health care institutions and organizations. In the second part of the column, Dr. Ruffin will elaborate on the seven factors that must be considered in the transition.

Capitation Fee↗

New governance for a new era: issues and challenges for integrating systems.

In this second part of a two-part column, Dr. Ruffin provides greater detail on seven key factors that he believes will govern the operations of integrated systems. Successful systems, he says, will be those that attract and retain physicians, have disciplined governance, integrate care through sharing of information among system elements, conserve capital, ensure strategic growth, control costs, and are proficient at processing information. It is important to understand, he says, that, in the movement from a fee-for-service payment mechanism, in which the various elements of the health care field bill for their services independently and according to rules designed for their benefit, to an integrated system, in which such independence can only lead to chaos, very substantial changes will be required in the governance of our health care institutions and organizations.

Cost Control↗

Physician profiling: trends and implications.

Every professional is subject to profiling, and most are profiled more rigorously, more thoroughly, and more dispassionately than are physicians. Profiling occurs when society has the technologies and the economic incentives to perform profiling. In the first of this two-part article, we will consider trends in profiling all professionals and those in profiling physicians. We conclude in the second part of the article with a discussion of the specific methodologies and vendors used in profiling the practice habits of physicians.

Medical Staff, Hospital↗

Telemedicine: where is technology taking us?

Five years ago, a few zealots in Switzerland, at the CERN Laboratory, were contemplating using the Internet for hypertext and for transfer of still images, recorded sounds, and compressed video files. Five years later, the World Wide Web defines a set of standards for packaging and routing information over the Internet that involve millions of people and personal computers and that allowed a start-up Netscape to enjoy a capitalization of more than $2 billion when it sold stock to the public recently. Now, video-conferencing and multimedia electronic mail over the Internet are the fascinations of engineers at NASA, and the MBONE Information Web, the province of technophiles with UNIX workstations. Five years from now, you may be participating in telemedicine sessions frequently, from your workstation, and think nothing of it.

Computer Communication Networks↗

Physician profiling: trends and implications.

In the October 1995 issue of Physician Executive, the author discussed the general notions of profiling of professionals, comparing the emerging methods of profiling of physicians to methods already in place for profiling professional athletes, investment bankers, and others. In this issue, the author provides details on specific methodologies in place for profiling physicians. While the science of profiling may be in its infancy, managed care organizations and third-party payers are clearly demanding more precise and useful information on the practice patterns of the physicians they hire or contract with.

Databases, Factual↗

Managed care information needs: a summary perspective.

The key to survival in managed care is management of financial risk. You need to know what is in your contract and what you are obligated to do for which population during which period. Information systems can be an enormous help in managing managed care contracts and the financial risks they entail, but poorly selected and configured information systems will do little good for the organization that licenses them. The most important activity of a physician executive who is moving his or her organization into managed care contracting is to lead the process to define the functional requirements for information the organization will need to manage managed care contracts successfully.

Capitation Fee↗

Preparing for managed competition.

Without the demands of managed competition or economic incentives to control costs, providers have little reason to invest in systematic data analysis about their patients. Information technologies in the hands of health care managers and physician executives primarily are tools for cost control, and, if cost control is not an important issue for them, they do not learn how to do it. The rules of the game have already changed for providers where managed care dominates the medical community and will change for the entire nation under managed competition. Managed competition gives providers strong incentives to identify the costs of care and unnecessary variations in those costs, to introduce new processes of care to reduce unnecessary administrative and clinical costs, to implement practice guidelines to reduce variations in outcomes of care, and to document statistics indicating excellent quality.

Computer Communication Networks↗

The importance of data warehouses for physician executives.

Soon, most physicians will begin to learn about data warehouses and clinical and financial data about their patients stored in them. What is a data warehouse? Why are we seeing their emergence in health care only now? How does a hospital, or group practice, or health plan acquire or create a data warehouse? Who should be responsible for it, and what sort of training is needed by those in charge of using it for the edification of the sponsoring organization? I'll try to answer these questions in this article.

Databases, Factual↗

The Informatics Institute: why do we need it?

Why should physician executives care about medical informatics? For that matter, what is medical informatics anyway? Broadly defined, medical informatics is the study of the collection, storage, retrieval, and analysis of data and information in health care to support clinical and administrative decision making. Informatics is important because, in the past 10 years, powerful computer, software, and information technologies have been developed to enable health care organizations to automate some of the work of decision making, for improved quality of care and cost control, and for successful managed care contracting. This new emphasis on informatics in health care was the impetus for the founding by ACPE earlier this year of The Informatics Institute, which will be involved in educational and research activities in the growing area of medical informatics. In this new column in Physician Executive, Dr. Marshall Ruffin, President and CEO of the Institute, will discuss the role of medical informatics in health care delivery and financing and its relation to physician executives.

Academies and Institutes↗

Analysis of length-of-stay differences between investor-owned and voluntary hospitals.

In contrast to assertions that investor-owned (I-O) hospitals are more efficient than voluntary hospitals, this study finds no significant difference between I-Os and voluntaries where the efficiency measure is length of hospitalization (LOH). The data base used is a national probability sample of hospitals and patients. The analysis accounts for variation in LOH by controlling for hospital characteristics other than ownership, and in particular it utilizes a new case-mix index to control for the case-mix portion of heretofore suggested differences.

Bed Occupancy↗