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At least 505 records · Page 28Linked to original sources
PubMed1994

Managed cooperation, not competition: a proposal for implementing national health reform.

National health reform should be implemented in a policy framework that encourages cooperation--not competition--to promote efficiency while extending universal coverage. "Managed cooperation" is defined here as a national health system built on collaborative efforts between purchasers, providers, consumers, and government through voluntary collective action, like the structural cooperation seen in the Japanese economy between government and the private sector. Six partnerships are encouraged: (1) government-industry, (2) purchaser-provider, (3) physician-hospital, (4) public-private data sharing, (5) consumer-provider, and (6) community health. Structural and legal barriers to cooperation, such as antitrust and malpractice reform, should be reduced or eliminated to encourage collaborative initiatives under national health reform.

Antitrust Laws↗
PubMed1994

The standards movement builds momentum.

The success of efforts to build health information networks and to implement computerized patient records will hinge on the development of standards for the electronic format and content of financial and clinical transactions. Without standards, sharing data among disparate systems will be extremely cumbersome, and drawing conclusions based on research will prove difficult. For years, several volunteer groups have been toiling to develop these standards. These efforts are beginning to pay off. This special report summarizes the latest trends in standards development. This series of stories includes an update on efforts to develop standard data sets for financial and administrative transactions; a guide to the jargon of health care electronic data interchange, an overview of efforts to speed the development of standards for computerized records; and a case study of a hospital implementing one set of clinical standards.

Clinical Medicine↗
PubMed1991

Better MSP (Medicare secondary payer) process may boost payments.

Because the Federal government estimates large overpayments by Medicare, changes in the Medicare Secondary Payer (MSP) program may play a significant role in future Medicare budget cuts. A major contributor to MSP problems is providers' failure to adequately collect coverage information from Medicare beneficiaries. Along with data sharing between Federal agencies to help identify responsibility for Medicare claims, providers likely will face more pressure to properly collect Medicare beneficiary information. Because of MSP program payment structure, improving billing offices' procedures for collecting Medicare beneficiary information ultimately may increase providers' overall payments.

Admitting Department, Hospital↗
PubMed1995

Will CHINs hit the jackpot or break the bank?

Before providers, payers and others sign up to share data through community health information networks, they're asking for proof that savings will far exceed the cost. The fate of the CHIN movement may hinge on the evidence.

Community Networks↗
PubMed1997

Design and functional specification of the Synapses federated healthcare record server. Synapses Consortium.

Synapses is a project funded under the EU Health Telematics Framework IV Programme. Synapses sets out to solve problems of sharing data between autonomous information systems, by providing generic and open means to combine healthcare records or dossiers consistently, simply, comprehensibly and securely, whether the data passes within a single healthcare institution or between institutions. This paper presents the specification of the Synapses server, the kernel concept of Synapses. It describes the basis in the European prestandard for Electronic Healthcare Record Architecture, the interfaces to the Synapses server and different integration mechanisms for systems providing information to the server. The specification will be verified at a number of validation sites, and the final result will be in the public domain.

Computer Systems↗
PubMed1986

Catholic hospitals: strategy for survival.

The "ethic" of competition that pervades health care today has altered hospitals' traditional role, fostered alternative care systems, and created cost-containment pressures. If Catholic hospitals are to survive in this environment, they must act collaboratively. First, they must collect and share data relating to community, diocese, and market needs. Second, Catholic hospitals must create a structure for joint planning that enables them to network with each other as well as with community-based health organizations. Third, they must coordinate their efforts statewide so that they can reinforce each other's actions in the public policy arena. Finally, Catholic hospitals must continue to explore the potential of multihospital entities. The bishops' 1980 pastoral letter on health care--an invitation for dialogue calling for structural change in the health care system--was intended to renew the healing mission. Whether Catholic hospitals have the determination, the imagination, and the leadership to renew their mission, however, will depend on board members, chief executives, sponsoring communities, physicians, and staffs, who must address today's concerns in the contexts of faith and of Catholic health care's noble history.

Catholicism↗
PubMedDate not supplied

School-based/school-linked health centers expanding points of access.

Health providers and leaders in urban Milwaukee collectively acted to expand school-based health services to children attending Milwaukee Public Schools (MPS). This School-Based/School-Linked Health Centers' (SB/SLHCs) Collaboration was initiated to increase points of access for children, primarily to working-poor families, through mobilizing community resources among local leaders and statewide health systems. Systematic steps such as needs assessment, sharing data, seeking funds and prioritization of school-based sites facilitated the establishment of more than 30 additional SB/SLHCs. This has resulted in approximate 700% increase in school-based health care and health promotion services. This collaboration illustrates how communities and health care systems can effectively advocate and impact local services to benefit a population having high social risk factors. As welfare reform efforts evolve, SB/SLHCs have significantly advanced access to mainstream health services through effective local collaborations.

Adolescent↗
PubMedDate not supplied

Stand-alone database for an air transport program.

This case study demonstrates both the positive and the negative aspects of developing a stand-alone database for use by a small unit of a larger organization. The advantages center on the ability to tailor the program to the requirements of a single unit. The disadvantages relate to the inability to apply systemwide resources to the problem, the dependence upon a small group of experts who are able to modify and maintain the program, and the inability to share data across organizational units. Units that are contemplating the development of an isolated database to meet the needs of a small unit are advised to consider their development in light of the needs of the entire organization. A unit should explore all other options for meeting its and information management needs before embarking on an isolated database project. They also should identify a method for eventual consolidation of information resources. Finally, when at all possible, a solution should not center upon the talents of a single individual. This approach sets up the organization for problems when that individual leaves the organization or moves on to another position.

Aviation↗
PubMed2000

Building a demand-driven, vendor-managed supply chain.

Vendor-managed inventory (VMI) software can help both stand-alone and IDS-based hospitals significantly reduce supply-chain management costs. The software tracks an organization's actual supply demand and generates automatic purchase orders, providing the supplies on an as-needed basis. As a result, a hospital's inventory-carrying and purchase-order processing costs may be reduced significantly. To make optimum use of the VMI software, IDSs and hospitals first need to ensure that their methods of collecting data on supply consumption are efficient and accurate. They then need to either establish a relationship with a distributor offering VMI capability or, if the organization is a large IDS with its own distribution center, acquire the software for internal use. A collaboration with a distributor requires establishing effective electronic communications for data sharing.

Cost Control↗
PubMed1995

Workshop on pediatric AIDS rehabilitation: a summary.

The workshop offered the following recommendations for research on pediatric AIDS: (1) investigating cross-cutting issues such as pain and/or QOL; (2) identifying effective service delivery and associated cultural considerations; (3) promoting data sharing and standardized instruments; and (4) examining affected body systems.

Acquired Immunodeficiency Syndrome↗
PubMed2002

Designing an Internet-based collaboratory for biomedical research.

Several recent grants from the National Institutes of Health to the Universities of Wyoming, Idaho, and Montana have created a unique opportunity for collaboration in biomedical research among the three schools, as well as the community colleges in the region. NIH Center of Biomedical Research Excellence (COBRE) programs at Wyoming have been established to study the biological effect of nitric oxide and to investigate stressors that can contribute to the progression of cardiovascular disease. Funding from these and related grants have significantly upgraded Wyoming bioimaging and microscopy facilities, as well as provided support for faculty and students in a variety of research disciplines. In order to enhance these research efforts, the Center for Rural Health Research and Education at the University of Wyoming is spearheading an effort to create an Internet-based system for sharing data and research resources among the involved sites. This paper describes how such a "collaboratory" could be designed, using techniques developed for distributed research and development in the computer industry. The system, as envisioned, will support remote data acquisition, management, and visualization, while providing security in the form of authorization and authentication of users and virtual private networking for data transmitted between nodes of the network.

Computer Communication Networks↗
PubMed2002

Stretching the managed care dollar in the new millennium: the practice of detailing primary care physicians.

Pharmaceutical expenditures in this country are on the rise and the increase is expected to continue at double-digit rates in the foreseeable future. This study focuses on the ways in which the managed care industry can impact pharmaceutical costs through peer-to-peer data sharing or academic detailing. Making use of analysis in conjunction with a major Midwestern Health Maintenance Organization, we evaluate the immediate impacts of academic detailing efforts, and find it to have a substantial mitigating impact on pharmaceutical trends. Moreover, we find academic detailing to be cost-effective means of altering physician-prescribing behavior.

Advertising↗
PubMed2003

Clinical database. Structure, development strategies and expected clinical applications.

The paper provides the description of a data-base developed to include in a quite structured format most clinical data used for patient management in a hospital setting. The system was aimed at achieving a reasonable compromise between the significant but complex solutions the research offers and the real needs of medical practice. First of all, the paper defines the requirements for designing a computerized clinical database according to a patient-centered clinical approach. Then, it describes the structure of a prototype aimed at classifying clinical data as a hierachy and describing them according to a structural approach. Next, problems related to the management and upgrading of the system are identified and possible solutions described, with a particular emphasis or knowledge acquisition, refinement and specialization, and on problems related to the functional aspects required for clinical applications. Finally, some meaningful clinical applications are outlined, which use the computerized clinical database as the standard for knowledge organization and data sharing.

Database Management Systems↗
PubMed2003

Improving HIV/AIDS services through a network-based health information system.

RW CAREWare is a free Microsoft Accessâ-based application developed and distributed by the HIV/AIDS Bureau (HAB) in the Health Resources and Services Administration of the US Dept. of Health and Human Services. This presentation will demonstrate the main screens and functions of CAREWare, including the ability to generate a number of service and clinical outcome reports; produce lists of clients requiring specific follow-up for care and treatment; create custom fields; and produce longitudinal graphs of laboratory tests and medication regimens. The security features, data-sharing arrangements among network members, and flexibility of the.NET version will also be emphasized.

Acquired Immunodeficiency Syndrome↗
PubMed2004

Developing a local comprehensive environment and health tracking system: using what we know to improve health and the environment.

Recent national reports have highlighted the absence of a coordinated local, state, and national environmental health tracking system. Local environmental health agencies are struggling to design and implement data systems that will allow them to evaluate environmental exposures ecological trends, and health outcomes in order to formulate more effective prevention strategies. This paper articulates the need for local environment and health tracking systems, discusses efforts under way around the nation, and describes the initiative being undertaken in one county health department to address this need. It provides information on attributes of indicators to be included in such a system, sources of data, criteria for evaluating the usefulness of indicators, suggestions for involving the community and staff, management strategies for implementing a data system, and recommendations for resolving common barriers to data sharing and use. This information will be useful to agencies that wish to develop their own robust environment and health tracking systems to support the three core functions of public health and the 10 essential public health services.

Community Health Planning↗
PubMed2004

Integration of child health information systems: current state and local health department efforts.

Public health departments at the state and local levels are pursuing integration strategies to consolidate child health information systems to improve child health. Eighteen health departments were interviewed in this exploratory research study to gather information to describe their current activities related to integrating child health information systems. Results illustrate the common systems being brought together and the technical process for doing so, financing mechanisms, range of anticipated information-users and their method of access to the integrated system, and common internal and external challenges and strengths that the health departments face. The evidence suggests a trend towards more efficient and thoughtful use of the multiplicity of information systems within public health departments as programs consolidate and share data and expand electronic communication with their external partners in the health care delivery system to improve children's health.

Child↗
PubMed2004

Foundations need to be set to promote connectivity among healthcare organizations, providers.

Promoting good regional and national electronic data sharing in healthcare will not be possible unless two goals are accomplished: An electronic health record is widely adopted by healthcare providers and an infrastructure for information sharing is developed, according to a new report from a public/private collaborative called Connecting for Health.

Delivery of Health Care↗