Using computer systems to enhance case management

This article describes how an on-line computer system can enhance case management by improving communication within internal departments and adding consistency and objectivity to the referral process. At PacifiCare, the computer system has supported case management's efforts to provide members with cost-effective medical care and has improved satisfaction with the health plan.     

Implementing health management information systems: measuring success in Korea's health centers

This article analyses the effects that the introduction and adoption of a health management information system (HMIS) can have on both the productivity of health center staff as well as on user-satisfaction. The focus is upon the service provided by the Kwonsun Health Center located in Suwon City, Korea. Two surveys were conducted to measure the changes in productivity and adoption (knowledge, persuasion, decision, implementation and confirmation) of health center staff over time. In addition, a third survey was conducted to measure the effects of HMIS on the level of satisfaction perceived by the visitors, by comparing the satisfaction level between the study health center and a similar health center identified as a control. The results suggest that HMIS increased the productivity and satisfaction of the staff but did not increase their persuasion and decision levels; and, that is also succeeded in increasing the levels of visitors' satisfaction with the services provided.     

Physician practice management companies: implications for hospital-based integrated delivery systems

Physician practice management companies (PPMCs) are one of the most visible entrants into the industry of managing physician practices, and anywhere from 100-150 are already in operation. Although PPMCs and hospital-based integrated delivery systems (IDSs) differ from each other in many ways, they share a number of common features, including the pursuit of capitation contracts from payors. As a result, PPMCs pose a growing, direct threat to hospital systems in competing for managed care contracts that cover physician service. PPMCs also provide an alternative to hospital-based IDSs at the local market level for physician group consolidation. This article looks at the structure, operation, and strategy of PPMCs and examines what implications their growth will have for hospital-based IDSs.     

计算机在医疗设备管理中的应用——医疗设备管理信息系统

随着医院对医疗设备投入的加大，对医疗设备进行科学的管理显得愈加重要。为此，我们设备管理人员组织开发了此系统，提高了工作效率，对于设备管理的信息化建设做出了努力。     

Policies to enhance coordination in hospital-based case management programs

Social work practitioners in health and social services are expected to develop and implement programs and client care plans that require cooperation and coordination with numerous other individuals and programs. Such cooperation and coordination often are accomplished through informal networking. As programs develop, these relationships may be formalized in written policy agreements. In this article, the authors examine four policies designed to improve cooperation and coordination at different levels in hospital-based case management systems. Implications for social work practice are discussed.     

Exploring information systems outsourcing in U.S. hospital-based health care delivery systems

The purpose of this study is to explore the factors associated with outsourcing of information systems (IS) in hospital-based health care delivery systems, and to determine if there is a difference in IS outsourcing activity based on the strategic value of the outsourced functions. IS sourcing behavior is conceptualized as a case of vertical integration. A synthesis of strategic management theory (SMT) and transaction cost economics (TCE) serves as the theoretical framework. The sample consists of 1,365 hospital-based health care delivery systems that own 3,452 hospitals operating in 2004. The findings indicate that neither TCE nor SMT predicted outsourcing better than the other did. The findings also suggest that health care delivery system managers may not be considering significant factors when making sourcing decisions, including the relative strategic value of the functions they are outsourcing. It is consistent with previous literature to suggest that the high cost of IS may be the main factor driving the outsourcing decision.     

Health information management in the computer era

Medical record professionals are confronted with change at practically every front. Technologic advancements are changing the technical aspects of our job responsibilities. These advancements also have implications for the interpersonal aspects of our jobs. The effect of new technology on working relationships is exacerbated by the introduction of TQM, which also encourages a change in organizational relationships through a move away from traditional heirarchical management by fostering teamwork and staff empowerment. The changes that are transforming health care organizations can be viewed in two lights: (1) as unwanted hindrances to accomplishment or (2) as opportunities to enhance accomplishment. Medical record professionals are presented with unprecedented opportunities to enhance our accomplishments and maximize our position in health care facilities. We cannot long for the way things were or be satisfied with the status quo. Such action (or lack thereof) will only ensure that our role on the health care team will be taken over by someone else. To capitalize on the opportunities presented, medical record professionals must hone the knowledge and skills we already possess, gain other knowledge and skills necessary to function in the computerized environment, and, most of all, be proactive rather than reactive. Such action will ensure that we truly become health information managers.     

Strategic planning for health care management information systems

Using a planning methodology and a structured design technique for analyzing data and data flow, information requirements can be derived to produce a strategic plan for a management information system. Such a long-range plan classifies information groups and assigns them priorities according to the goals of the organization. The approach emphasizes user involvement.     

A cost-benefit analysis for materials management information systems

The cost-benefit analysis provided the system planners with valuable information that served many purposes. It answered the following questions: Why was the CCF undertaking this project? What were the alternatives? How much was it going to cost? And what was the expected outcome? The process of developing cost-benefit the document kept the project team focused. It also motivated them to involve additional individuals from materials management and accounts payable in its development. A byproduct of this involvement was buy-in and commitment to the project by everyone in these areas. Consequently, the project became a team effort championed by many and not just one. We were also able to introduce two new information system processes: 1) a management review process with goals and anticipated results, and 2) a quality assurance process that ensured the CCF had a better product in the end. The cost-benefit analysis provided a planning tool that assisted in successful implementation of an integrated materials management information system.     

Implementing a new health management information system in Uganda

This paper reports on research investigating the health management information system (HMIS) implementation process in Uganda, utilizing the diffusion of innovation and dynamic equilibrium organizational change models. Neither perspective guided the HMIS development process. Instead, technological issues, rather than wider organizational issues, dominated the planned change. The need to consider the organizational context when changing information systems arises because the process is more complex than some practitioners have realized, when attempting to understand the causes of information management problems and developing HMIS in low-income countries. In particular, information system developers had not acknowledged that they were promoting an informational approach to management when they promoted a change from a centralized reporting system to a HMIS supporting use of information at the level of collection. Strategies to facilitate this approach were not advocated. Organizational theory can contribute to the diffusion of innovation framework. It has yielded an integration of Rogers's diffusion of innovation framework and Leavitt's concept of organizational forces in equilibrium. The diffusion framework describes the process, but the organizational model has given the context and reason for aspects of the process. The diffusion model does not predict what needs to change within the organization when a particular innovation is introduced, or how much. The addition of the organizational model has helped. These frameworks can facilitate the introduction of future information management innovations and allow practitioners to perceive their introduction as a staged process needing to be managed. Implications for practice are identified.     

Development of an evaluation model for computer foodservice management systems

Business evaluation practices were used to develop a model for postimplementation of a computer system in a foodservice. Four levels of success with a corresponding indicator for evaluation were identified as: I. Management Action--management implements data and reports; II. Management Change--management initiates use of system to find solutions to problems; III. Management Uses Analytical Approach--management uses system as a routine part of problem-solving; and IV. Management Change in Task-management's role changes as a result of the computer system. Five computer functions were identified for evaluation: integrity, performance, use, efficiency, and effectiveness. Criteria, measurements, standards, and actual sections were then developed for each function. An instrument was developed on the basis of the evaluation, including forms, questionnaires, learning experiences, and scenarios. The instrument was then applied to two computer foodservice management systems--a custom-designed system and a packaged software system. The instrument was applied to software systems by the scenario method. Five criteria with key indicators were developed to determine successful application of the instrument. The evaluation model and the final instrument developed and applied in this study should be useful to dietitians evaluating a computer system 6 to 12 months after implementation in their foodservice.