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PubMedDate not supplied

Computers in case management. Advancing health care delivery through technology.

Fast efficient access to patient information is an essential management tool in the current healthcare environment. The clinical case management computer module at Stanford Health Services provides and integrates essential patient data elements to facilitate clinical case coordination and assist the nurse case managers with documentation of clinical data for discharge planning and utilization review. Information systems such as this one are critical to the provision of comprehensive, cost-effective patient care management.

Case Management↗
PubMed1998

[Reproductive health: integral part of human development].

The concept of reproductive health has changed throughout the years until it has come to be understood as a constant that goes beyond biological concerns and is related to the values, culture, and personal fulfillment of each human being. It encompasses, therefore, a wide range of action in individual and family life as well as in the collective development of populations. Promoting and maintaining reproductive health requires quality services with equitable access. PAHO has cooperated in this field with Member States for over 30 years, during which maternal and child mortality has diminished, the notion of integral adolescent health has been disseminated, the subject has been added to professional health curriculums, pertinent activities have been integrated into the health services, and new data have been gathered to inform policies and activities on reproductive health. The present situation of national health sector reforms presents a unique opportunity for approaching anew old problems related to reproductive health, to examine policies and strategies, and to implement changes that reaffirm the commitments made in international forums.

Female↗
PubMed1999

Use of a Web-based process model to implement security and data protection as an integral component of clinical information management.

Delivery of health care at Scott and White, a large integrated health care delivery system, is supported by an Electronic Medical Record (EMR) system repository of six million SGML-based documents. Control of document access is currently based on standard commercial security and confidentiality methodologies. Given the planned release in Fall 1999 of new federal security and confidentiality requirements, we have developed a web-based security process model that "wraps" existing EMR documents with HTML-compliant security attributes. Resulting logical documents are filtered regarding user queries by mapping the security attributes of the data to specific user role characteristics. A key virtue of our approach is that source EMR data do not undergo alteration by the imposition of the security process. It also places no additional work load or query pressure on the existing EMR system.

Computer Security↗
PubMed2003

Position of the American Dietetic Association: Oral health and nutrition.

It is the position of the American Dietetic Association (ADA) that nutrition is an integral component of oral health. The ADA supports the integration of oral health with nutrition services, education, and research. Collaboration between dietetics and dental professionals is recommended for oral health promotion and disease prevention and intervention. Scientific and epidemiological data suggest a lifelong synergy between nutrition and the integrity of the oral cavity in health and disease. Oral health is an integral part of systemic and nutritional health. Two primary oral infectious diseases are directly influenced by diet and nutrition. Dental caries or tooth decay is modulated by numerous factors, including diet composition and frequency. Periodontal or gum disease is associated with malnutrition. Chronic diseases such as diabetes and cardiovascular disease that are modulated by diet and nutrition intervention have oral sequelae. As we advance in our discoveries of the links between oral and nutrition health, practitioners of both disciplines must learn to provide screening, baseline education, and referral to each other as part of comprehensive client/patient care. The future of dietetics practice requires dietetics professionals to provide medical nutrition therapy (MNT) that incorporates a person's total health needs, including oral health. Inclusion of both didactic and clinical practice concepts that illustrate the role of nutrition in oral health is essential in both dental and dietetic education programs. Collaborative endeavors between dietetics and dentistry in research, education, and delineation of health provider practice roles are needed to ensure comprehensive health care to persons with oral infectious disease and/or oral manifestations of systemic diseases.

Dental Caries↗
PubMedDate not supplied

Parents, infants and health care: utilization of health services in the first 12 months of life.

OBJECTIVE: To describe patterns of health-service use in the first 12 months of life. METHODS: In this prospective cohort study, 173 first-born infants and their families living in two middle socio-economic urban areas of Melbourne were enrolled consecutively when presenting for their initial maternal and child health nurse (MCHN) visit (at approximately 4 weeks of age). Families kept a daily "health diary" for the entire 12-month period, recording use of all health services for their infant, and reasons for the contact. RESULTS: There was an 87% completion rate of diaries. The mean number of visits to any health service, including medical, hospitals, MCHN services, pharmacists, allied health services and naturopaths, was 35.7 (95% CI 34.7-36.6) during the 12 months. Of these, 31% (mean 10.9 visits) were visits to a general practitioner (GP) and 41.5% (mean 14.3 visits) were visits to the MCHN. Infants' visits to the MCHN were far more frequent in the first 6 months of life compared with the second 6 months (10.3 vs 3.6, P < 0.001). Rates of GP use were constant over the same periods (5.3 vs 5.7, P = 0.8). CONCLUSIONS: In a universal health-care system, this high rate of health-service use equates to approximately one visit to a health service every 2 weeks in the first year of life. The majority of these visits appeared unrelated to illness. This previously undocumented data has implications for future integrated service delivery, health-professional training and policy development for this age group.

Adult↗
PubMed2006

[Contributions of university hospitals to local health integration networks].

The use of ICT (Information and Communication Technology) has supported the widespread sharing of healthcare data. Collaboration among medical or health facilities in the community using a telemedicine infrastructure has been promoted by the Strategy of IT-related Structural Reform (the Acceleration and Advancement of e-Japan Priority Policy Program) of the Japanese government. Many university hospitals have been playing leading roles of facilitating collaboration with community healthcare. Through advances in broadband networking and security technology, we have made great progress from the trial stage to the practical stage in the electronic sharing of clinical data. Although many efforts are being made spread the cooperation areas or widen the scope of information sharing for utilization in disease prevention or clinical trials of newly developed drugs as well as medical information, university hospitals have to continue working on these areas to support patients and staff as core hospitals in the community.

Computer Communication Networks↗
PubMedDate not supplied

Championship management for healthcare organizations.

Stakeholders will put increasing pressure on integrated health systems (IHS) for measured performance, demanding data on quality and patient satisfaction, while simultaneously pressing for lower cost. The changes to Joint Commission on Accreditation of Healthcare Organizations (Joint Commission) and the growing importance of the National Committee on Quality Assurance (NCQA) are simply forerunners of an intensifying trend. Quality of care in particular will face increasing scrutiny. Achieving competitive targets in these areas will also require measures addressing demand and worker satisfaction. "Balanced scorecard" approaches will allow IHS and their accountable work groups to track performance on several dimensions and establish integrated goals or targets. Those with consistently good scores will be labeled "champions." Champions will support the multidimensional measures with improved decision processes. About eight major processes will be central--governance/strategic management, clinical quality, clinical organization, financial planning, planning and marketing, information services, human resources, and plant services. It is possible to map these processes to the criteria of the Joint Commission, NCQA, and Malcolm Baldrige Quality Award. The processes themselves can be measured and common weaknesses identified and corrected. Champions share some common characteristics that seem to arise from the combination of processes and measures. Among these characteristics are service line orientation, extensive partnering with other organizations, and the possibility of outsourcing organizational components.

Decision Making, Organizational↗
PubMed1984

A new approach to the design of information systems for foodservice management in health care facilities.

An organizational framework for integrating foodservice data into an information system for management decision making is presented. The framework involves the application to foodservice of principles developed by the disciplines of managerial economics and accounting, mathematics, computer science, and information systems. The first step is to conceptualize a foodservice system from an input-output perspective, in which inputs are units of resources available to managers and outputs are servings of menu items. Next, methods of full cost accounting, from the management accounting literature, are suggested as a mechanism for developing and assigning costs of using resources within a foodservice operation. Then matrix multiplication is used to illustrate types of information that matrix data structures could make available for management planning and control when combined with a conversational mode of computer programming.

Accounting↗
PubMed2006

The WPI's review of Wisconsin's managed care climate for pain management: opportunities for improvement.

BACKGROUND: Reimbursement obstacles, such as inadequate insurance coverage, have been identified as barriers to adequate pain management. The purpose of this study was to determine Wisconsin insurers' and managed care organizations' (MCOs) policies and practices regarding pain treatment and MCO medical directors' perceptions of barriers to providing effective pain management for their enrollees. METHODS: A descriptive qualitative design was used with semi-structured interviews of 6 administrative executives of commercial health management organizations' products from the major insurers in Wisconsin. RESULTS: None of the companies interviewed had systematically tracked data or had processes in place to allow them to track, analyze or trend data specific to pain management. Chronic noncancer pain is recognized more frequently as an insurance coverage issue because of high drug costs. Pharmacologic and interventional therapies are routinely covered compared with nonpharmacologic therapies with some prior authorizations, especially for newer medications. A uniformly identified barrier was lack of a comprehensive, interdisciplinary, integrated approach to pain management and inadequate data on the cost effectiveness of various approaches. CONCLUSIONS: Opportunities exist to educate and improve communication between health care professionals, purchasers of health care (employers), primary care providers and pain specialists. The economics of pain management needs to be made more "visible" through the development of coding and tracking mechanisms.

Data Collection↗
PubMed1978

Information management in clinical practice.

Information management is essential for optimal delivery of health care services to individuals and the community. Current information techniques--largely dependent on the individual patient record--cannot effectively store, process, retrieve, and communicate the vast amount of data and information which is integral to the comprehensive health care process. Computerized techniques similar to those which are an indispensable part of almost all scientific, commercial, and administrative sectors of society are urgently needed to support a fully effective health care system.

Ambulatory Care↗
PubMed2000

When should I do an OASIS assessment?

All Medicare-certified home health agencies are required to integrate the OASIS data set in their patient assessment. All will be held accountable for patient outcomes. All will soon be paid using a prospective payment methodology. Thoughtful implementation of OASIS activities, integrated closely with outcome-based quality improvement and reimbursement functions, will optimize the agency's ability to achieve desired clinical and financial goals.

Home Care Services↗
PubMed1998

Growth rate of integrated systems shows huge rise in last two years.

The number of integrated health systems is increasing rapidly across the country as hospitals realize these are the key to their survival. Just how influential are these systems? Here are a few facts: The number of highly integrated health systems rose to 228 in 1997, a 20.6% increase from 1996. Integrated hospitals reported an average occupancy rate of 52.2%. Hospitals that are not integrated reported an average occupancy rate of 48.1%.

Catchment Area, Health↗
PubMed2000

Planning for successful outcomes in the new millennium.

The complexity of the health care environment will increase in the next millennium. Organizations must adopt an approach of selecting outcomes management solutions that are focused on data capture, analysis, and comparative reviews and reporting. They must decisively and creatively implement, in a phased approach, integrated solutions from existing robust systems, while considering future systems targeted for implementation. Outcomes management solutions must be integrated with the organization's information systems strategic plan. The successful organization must be able to turn business-critical data into information that supports both business and clinical decision-making activities. In short, health care organizations will have to become information-driven.

Benchmarking↗