Computers in healthcare最新文献

A report by the Environmental Science and Policy Institute paints a picture of a healthcare telecommunications "super highway" system with on and off ramps leading directly to the most disaffected in our society. It offers an inviting tour into the possibilities of tomorrow, but is it realistic?

Unless the HL7 standards group acts soon to develop timely, enforceable standards, they may be overtaken by the public outcry to contain healthcare costs immediately. Federal government representatives addressed a recent HL7 plenary session and warned that the public finally understands that information is a vital link in controlling runaway costs. They want standards now.

The skillful design of an information architecture that suits a healthcare organization is a top priority for information managers. But they have been hampered both in their conceptual approach to managing information flow and their technological capabilities for designing that flow. Information--both clinical and administrative--must be fluid and accessible. These key success factors lie in the increasingly prevalent database repository approach. And the technology is here to make it happen.

Late in 1991, Health and Human Services Secretary Louis Sullivan challenged health insurers and providers to increase the number of claims moved electronically by 10 percent each year. [See "Electronic claims are smart way to trim costs, share outcomes," January 1992 Computers in Healthcare, p. 52.] "Eventually, to receive care, every American patient will need only to present a health insurance card issued by a private or government plan to a hospital or doctor," according to Sullivan. "Patients will know how much their insurance will pay and what cost they are responsible for....Ultimately, patients should not have to fill out insurance forms." Numerous companies are striving to do away with those ever-present paper forms. Approximately 40 electronics claims firms listed here are specializing in claims management--from the standpoint of the clearinghouse, the physician's office or the hospital. We asked them about their best-selling electronics claims product, its price and any new products they now have for electronic claims or electronic data interchange. We hope this listing helps boost this year's electronic claims beyond Sullivan's 10 percent mark.

Two patient floors are now up and running with Mercy Hospital and Medical Center's CARE 2000 plan for restructuring and decentralizing patient care, and patient satisfaction has already made measurable leaps forward. The new management plan at the San Diego hospital increases nursing time with patients, moves formerly centralized services right onto the patient floor, decreases the number of caregivers a patient must see and makes "care partners" of ancillary staffers. Also, bedside information systems design goes hand-in-glove with new management concepts that are working well.

Public demand for healthcare cost reductions has not only risen to the top of the political agenda this fall, it has become strident. Legislators are under pressure to act quickly. Suddenly, electronic claims submission is being understood for its ability to lop billions off of the staggering cost of healthcare administration. Several initiatives are now in the works that are set to bring ECS into widespread use.

A big move meant big change for Emergency Department personnel at John Peter Smith Hospital, part of the Tarrant County Hospital District, Forth Worth, Texas. Implementing a patient tracking system has allowed ED managers and clinicians to assess outcomes, reengineer patient flow and investigate clinical issues, ultimately resulting in better, more timely care.

Two way-communication between users and developers is a must when creating a truly functional computer-based patient record. The solution for tackling this daunting task may be to use structured requirements analysis supported by CASE tools.

Electronic data interchange has the potential to save billions of healthcare dollars--that's the gospel according to Joe Brophy. The Travelers Insurance Company president and co-chair of the Health and Human Services Workgroup on Electronic Data Interchange is taking this sermon to the people.

The word "change" is on everyone's lips this year. The desire for change in patient-care information applications is very strong, too, according to a recent Computers in Healthcare patient-care systems survey. Three nursing executives have studied the CIH survey results and give their view on why strategic planning for patient-care systems is so poor when the desire for these applications is so great.