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PubMed2002

Health care in the information society: evolution or revolution?

This brief article is a commentary on the Haux et al. paper on Health Care in the Information Society: a prognosis for the year 2013. The commentary concentrates in particular on the underlying assumptions, which are at the core of the Haux et al. vision for healthcare in 2013. They assume that while there will be a shift towards increased patient-centred, community-based shared care, the underlying healthcare system will remain essentially the same. This commentary suggests that this is a conservative view and indeed questions its validity. Radical financial pressures to control costs as well as demands for equity fueled by more knowledgeable and better informed patients have the potential to bring about fundamental changes, with consequences for the way in which healthcare is delivered and in turn in how information and communications technologies are utilised.

Community Health Services↗
PubMed2005

An international comparison of information in adverse events.

PURPOSE: Aims to describe the growing importance of information and its governance within public services. The paper starts by considering how scandals in three national public health systems have focused public attention on information issues. It describes a theoretical framework for improving information governance, and its practical implementation as a management tool. The paper concludes with a discussion of the benefits of the approach, and the consequences of not improving information governance. DESIGN/METHODOLOGY/APPROACH: The framework brings together a number of existing methodological approaches, principally the maturity model approach to process improvement, first described in the Software Engineering Institute's capability maturity model, and the novice-to-expert approach to competency. FINDINGS: The paper describes how these approaches can be synthesised into an integrated framework to manage organisational change and how that can be used to improve information governance within public sector organisations. RESEARCH IMPLICATIONS: The paper compares the framework and its practical implementation with existing solutions, arguing that existing solutions provide only partial solutions. ORIGINALITY/VALUE: Considers how plans for future service improvements will be restricted unless information governance issues can be addressed.

Australia↗
PubMed2001

Information on the Internet found to be usually accurate but also incomplete.

As hospitals, health systems, and health plans look toward strengthening their Web sites, they may want to keep in mind findings from a recent study that notes that while much of the information that consumers find on the Internet is accurate, many users find it incomplete and difficult to understand.

Consumer Behavior↗
PubMed2001

Development and evaluation of a nursing service management and administration information system at district hospital.

The rapid development of information technology and the multiple usage of Information Systems make indisputable their appliance in all the sectors including the Nursing Service area. Information Systems that have been developed for the Nursing Service Administration are extremely useful in the processing and the categorisation of a large number of information, providing significant advantages such as information storage, information availability, information precision and reliability. In addition, the appliance of Information Systems provides important advantages in the administration of the nursing personnel's data, contributing to the improvement of the operating effectiveness of the Nursing Service. This paper describes the development and the evaluation of an Information System for the Nursing Service Administration that classifies all the information related to the nursing personnel and helps the administration to handle the appropriate nursing data. The method of Life Cycle Model was decided as the most appropriate for the development of the System, because of the important advantages that it offers. For the evaluation of our own designed system we based on the standards, which are used for evaluating Information Systems in general. The evaluation of this Information System is carried out by a survey among the undergraduate and the postgraduate students of the Nursing Department of the University of Athens and the Nursing Personnel of a number of Hospitals. Useful conclusions have been derived concerning those characteristics, which should be fulfilled by the system. Important conclusions have been also drown out concerning the dependencies of the variables under study, the future readjustments of the system, and the general perception of the newcomers in health profession towards the application of the information technology.

Age Factors↗
PubMed2002

Medicare payment changes and physicians' incomes.

An effort to control the physician portion of Medicare expenditures and to narrow the income gap between primary care and procedure-based physicians was effected through t he enactment of the Medicare Fee Schedule (MFS). To determine whether academic and private sector physicians' incomes had demonstrated changes consistent with payment changes, we collected income information from surveys of private sector physicians and academic physicians in six specialties: (1) family practice; (2) general internal medicine; (3) psychiatry; (4) general surgery; (5) radiology; and (6) anesthesiology. With the exception of general internal medicine, the anticipated changes in Medicare revenue were not closely associated with income changes in either the academic or private sector group. Academic physicians were underpaid, relative to their private sector counterparts, but modestly less so at the end of the period examined. Our findings suggest that using changes in payment schedules to change incomes in order to influence the attractiveness of different specialties, even with a very large payer, may be ineffective. Should academic incomes remain uncompetitive with private sector incomes, it may be increasingly difficult to persuade physicians to enter academic careers.

Academic Medical Centers↗
PubMed2002

Healthcare information systems: analysis of healthcare software.

The need to manage medical information in healthcare delivery requires that information technology be optimized in diagnosing disease; in planning and administering treatment; and in monitoring patient outcomes, services, and costs. The goals of this article are twofold: (1) to identify healthcare-specific software that addresses specific parameters set forth by the World Health Organization (WHO) for healthcare information systems and (2) to identify issues that managers should keep in mind when choosing an integrated information systems software package. For our analysis, we gathered, through Internet research, information about more than 400 software products from more than 200 companies.

Decision Making, Organizational↗
PubMedDate not supplied

An HL7 (Health Level Seven) overview.

HL7 is an organization with a short history and more activity now than ever before. Opportunities abound within HL& to assist in the development of the automation of healthcare and the deployment of information systems that create and support the electronic medical record. Finally, the continual advances in information systems technology enable HL7 to do more to meet the healthcare industry's needs.

Computer Communication Networks↗
PubMedDate not supplied

The mental health needs of Mexican-American agricultural workers.

We used three measurement procedures to produce a comprehensive profile of the mental health needs of Mexican-American farmworkers and to determine what kinds of mental health services were required to meet those needs. These measurement procedures were a field survey, a key informant survey, and a nominal group process. The results of the field survey indicated that rural Mexican Americans are not being served by mental health providers, despite their having higher symptom levels than would be expected in the general population and their substantial use of rural primary health clinics and private physicians. The key informant survey included mental health providers, health providers, and community agency personnel. According to these informants, the mental health sector is unable to provide services for the farmworkers; and the ability of other providers to reach them depends on a number of factors, including the nature of the services offered and the socioeconomic characteristics of the farmworkers themselves. Key informants identified the environmental conditions implicated in the farmworkers' psychosocial problems and recommended types of services, sites, and key personnel. Key informants concurred that general health settings and multiservice agencies were the most appropriate for reaching Mexican Americans, and that mental health services must include bilingual and bicultural staff members. Key informants disagreed, however, about the relative value of certain kinds of mental health services. The nominal group process identified 32 design criteria that could be used to improve mental health services for farmworkers.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed2004

Coming soon to a health sector near you: An advance look at the new Ontario Personal Health Information Protection Act (PHIPA).

This is Part I of a two-part article that provides a broad overview of the new health sector privacy legislation in Ontario, and compares this legislation to personal health legislation in other provinces. In Part I, we discuss the objectives, structure and scope of, as well as the substantive rights and obligations created by, the Ontario Act. In Part II, which will appear in the Fall 2004 issue, we will discuss the administrative obligations under the Ontario Act, as well as the provisions relating to enforcement and remedies. We will also discuss the approach to the protection of personal health information taken by other provinces, including Alberta, Saskatchewan and Manitoba, which have already enacted legislation that is similar in many respects to the Ontario Act.

Confidentiality↗
PubMed2001

[Patient information. First evaluation].

The recent harmonisation of the jurisprudence between the Court of Appeal and State Council has affected medical responsibility because it is now the physician's obligation to prove that the information to the patient has been properly given: it is, therefore, a current issue. A first evaluation was undertaken to determine the modalities of patient information in cardiology by an enquiry of cardiologists working in the public and private sectors. The results show that information to patients was given concerning complementary investigations such as exercise stress testing, transoesophageal echocardiography, coronary angiography and cardiac pacing; the information was more often given for invasive procedures. In the great majority of cases (92%), it is the prescribing or operating physician who gives this information, usually the day before the procedure, with complementary oral explanations in about 90% of cases. Patient information, therefore, seems to be well done by cardiologists. However, the proof of information is not always easy, written consent, signed by the patient, not being compulsory at present.

Adult↗
PubMed1998

How to optimize an MSO's financial performance.

Many hospitals and health systems create financial and strategic alignments with physicians to increase market share. One way to implement such an alignment is to form a management services organization (MSO). Forming an MSO, however, does not automatically guarantee success. To avoid financial losses, executives of hospitals and health systems need to diagnose potential problem areas in their MSOs and take control of problems before the organization and the physicians suffer financial losses. Among the areas that should be evaluated are the business scope of the MSO, the nature of practice acquisitions, physician compensation, governance, management skills, management information systems capabilities, organizational structure, and fee structure. Fee structures, in particular, can be used to align physician and MSO incentives.

Efficiency, Organizational↗
PubMed2004

IT standards. Speaking a common language.

Health care trails other fields in the application of information technology primarily because it lacks uniform standards and protocols. This month's gatefold looks at various initiatives now under way by the government and within the health care field.

Federal Government↗
PubMed2001

What do we know about the voluntary healthcare sector in Scotland?

OBJECTIVE: To document sources of information available to the National Health Service in Scotland (NHSiS) which relate to the health voluntary sector. DESIGN: Interrogation of the databases of the Charities Register in Scotland (CRIS) and Health Education Board for Scotland (HEBS) for information on health voluntary organisations and a retrospective review of information held on health voluntary organisations recently funded by health boards. SETTING: National Health Service in Scotland and the Scottish Council for Voluntary Organisations RESULTS: Nine hundred and fifty six health voluntary organisations in Scotland were registered with the CRIS database. Five hundred and forty five (57%) of these had annual incomes of less than 100,000 Pounds and two thirds of them (630) operated at a local level. Information on 3,106 health and support organisations was present on the HEBS database. In 1997-98 Scottish Health Boards grant funded 278 voluntary organisations. Eighty seven (31%) of these had information held on the CRIS database and another 87 (31%) with the HEBS database. Funding was much more likely to be given to organisations dealing with adult physical health and alcohol problems. Organisations dealing with specific diseases were less likely to be funded. Of the 87 funded organisations registered with CRIS, health boards typically contributed less than 10% of annual funding. CONCLUSIONS: Health planning decisions are made difficult by a deficiency of useful information on the existence, activities and financial positions of voluntary organisations. Construction of accurate and comprehensive national databases to inform these decisions would be expensive. However, the development of appropriate local databases by health boards and the voluntary sector would facilitate the development of a constructive partnership.

Databases, Factual↗
PubMed2005

Coming soon to a health sector near you: an advance look at the new Ontario Personal Health Information Protection Act (PHIPA): part II.

This is Part II of a two-part article that provides a broad overview and comparative study of the new Ontario health sector-specific privacy legislation. In Part I, which appeared in the previous issue of Healthcare Quarterly, we discussed the objectives, structure and scope of, as well as the substantive rights and obligations created by, the new Ontario Act. In Part II, we discuss the administrative obligations created by the Ontario Act, as well as the provisions relating to the enforcement of, and remedies available under, the Act. We also contrast the Ontario Act with the various approaches to the protection of personal health information that has already been adopted by other provinces, including Alberta, Saskatchewan and Manitoba.

Canada↗