[Hematology: large steps followed by a time of small steps].
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The debate over which mechanism for health care delivery will provide the widest, most efficient access has reached a crescendo. While the debate on the macro level accelerates, many significant approaches continue to be discussed and implemented on a micro level. Among these activities are imminent release of the final rule on "Criteria and Procedures for Making Medical Services Coverage Decisions that Relate to Health Care Technology--Medicare," implementation of the Safe Medical Devices Act of 1990 by the FDA, and a proposal that payers establish a cooperative national technology assessment program.
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The demand for mid-level providers, especially physician's assistants, is on the rise, according to authors Robin W. Singleton and Norman Kilburn, P.A., of Tyler and Co. They offer tips on determining need, finding and screening candidates, interviewing and extending the offer.
In an effort to prepare one's facility for certain change, management is looking to "partner" with vendors/manufacturers in an effort to reduce the total cost of supplies. Several opportunities exist, as long as goals and expected outcomes can be identified and realized by both parties. Much thought and work are involved before making such a commitment; however, the payback is certainly worth the investment.
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Participants at a community health information network in Glens Falls, N.Y., have come face-to-face with obstacles that could have meant the end to this rural health network that the New York Department of Health and the John A. Hartford Foundation helped launch more than two years ago. Instead, John Laliberte, Glens Falls Hospital's director of information systems, and the rest of the IS team are recovering from some setbacks and preparing to increase the CHIN's capabilities.
As mental health services shift from institutional to community-based care, the psychiatric caseload for home care providers has increased. To satisfy the quality measurement demands of managed care organizations, providers can implement care paths for psychiatric home care programs.
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