Payment. Prudent payments.
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Publications and source records attributed to Richard Haugh.
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Few places have the potential to dramatically change the clinical and financial landscape."Cath labs are turning hospitals and health care upside down right now" says Skip Meador, director of cardiology for Centra Health, Lynchburg, Va."It's sure a different animal now than it was even seven or eight years ago" Cardiovascular programs--which increasingly rely on procedures performed in the cath lab--have long been the linchpin of hospital profitability, and have tended to prop up other money-losing areas. But critical issues threaten that profitability, such as the cost of technology, operating expenses and payer reimbursement. Likewise, such other technology as implantable cardiac defibrillators, biventricular pacemakers and ventricular assist devices bring more potential to change the landscape of cardiac care delivery. A case in point: the advent of primary angioplasty.
Hospitals are at the epicenter of creating an electronic health record, but big obstacles stand in the way of linking with physicians. The good news: It's starting to happen.
Executives who thought their hospitals were qualified to offer high-level stroke care are taking a second look-and taking action. By developing a clearly delineated plan to treat patients, including setting up acute stroke teams and taking better advantage of technology, experts say U.S. hospitals can improve care and save millions of dollars a year.
The number of children and adolescents needing mental health services has surged; yet state mental hospitals are closing and private for-profit psychiatric facilities are getting out of the business. Hospitals that still offer inpatient psychiatric beds are often full, with long waiting lists. So who fills the breach? The hospital emergency department.
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The operating room has become a hotbed for hospital technology. Headset-wearing surgeons issue voice commands to adjust lighting, reposition cameras and raise or lower the operating table. Surgical robots on wheels move from one OR to the next. Decision-support tools alert clinicians to the possibility of error.
Mind-bending increases in medical malpractice insurance rates are driving physicians out of certain regions or out of medicine altogether, forcing hospitals to make tough choices such as eliminating services or cutting staff. Hospitals desperate to keep physicians are trying a number of strategies, from banding together to start their own insurance companies to reducing the amount of insurance they require their doctors to carry.
The Food and Drug Administration issued a proposed rule in March requiring bar codes on all medications. Most expect that the technology will be commonplace in hospitals before the FDA's three-year window. A handful of systems are leading the way.
Volume is rising at a healthy pact. Technology is improving patient care. Many organizations have, out of necessity, strengthened business fundamentals, controlled costs and refined their focus. Yet not-for-profit hospitals are squeezed by a cash crunch that has balance sheets under pressure and credit downgrades outpacing upgrades--the result of shrinking investment income, rising pension obligations, low government reimbursement and other threats to operational stability. N&HN looks at the challenges, including recent fallout from the most pressing issues, how some systems have responded, and the pros and cons of borrowing now.
If terrorists attack America's health care info-tech systems, it probably won't be one big blow but rather a series of small incursions that are much more difficult to detect. How can your hospital protect its IT system before and after such insidious attacks.
With overcrowding the single-most difficult issue now confronting emergency departments, innovative hospitals are experimenting with everything from new technology to redeploying staff to redesigning processes and work areas.
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