Release 0.0: Clinical Information Technology in the Real World

Health Affairs

Volumn 17, Issue 6, 1998, Pages 23-38

  Kleinke, J D ^a  

^a NONE

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; ATTITUDE TO COMPUTERS; COMPUTER PROGRAM; ECONOMICS; HEALTH PERSONNEL ATTITUDE; HUMAN; INDUSTRY; INFORMATION SYSTEM; MEDICAL RECORD; PHYSICIAN; PSYCHOLOGICAL ASPECT; UNITED STATES;

ATTITUDE OF HEALTH PERSONNEL; ATTITUDE TO COMPUTERS; HUMANS; INDUSTRY; INFORMATION SYSTEMS; MEDICAL RECORDS SYSTEMS, COMPUTERIZED; PHYSICIANS; SOFTWARE; UNITED STATES;

EID: 0348136434     PISSN: 02782715     EISSN: None     Source Type: Journal    
DOI: 10.1377/hlthaff.17.6.23     Document Type: Article

References (27)

1. Comments in public discussion, 1993.
2. The historical absence of quality and cost data in health care is the premise of M.L. Millenson, Demanding Medical Excellence: Doctors and Accountability in the Information Age (Chicago: University of Chicago Press, 1997).
3. This is the core thesis of J.D. Kleinke, Bleeding Edge: The Business of Health Care in the Next Century (Gaithersburg, Md.: Aspen Publishers, 1998).
4. A.C. Gallo and V.J. Lee, Health Care Information Technology: Keeping Health Care Wired, Research Report (Baltimore: Alex. Brown, 5 May 1998), 1.
5. Ibid., 3.
6. R. Levin et al., Quantitative Approaches to Management, 8th ed. (New York: McGraw-Hill, 1992).
7. This includes physician-profiling software from GMIS, HCIA, and HPR; clinical pathway analysis software from Cerner Corporation, HBO and Company, HCIA, Iameter, Mediqual, Premier, Summit Medical Systems, TSI, and VHA; and plan performance software from Applied Healthcare Informatics, Corporate Health Strategies, HCIA, and Medstat.
8. I discuss the optimization software market in detail in J.D. Kleinke, "Deconstructing the Columbia/HCA Investigation," Health Affairs (March/April 1998): 7.
9. A. Stoline and J. Weiner, The New Medical Marketplace: A Physician's Guide, 2d ed. (Baltimore: Johns Hopkins University Press, 1993), 122.
10. From normative data compiled in The Comparative Performance of U.S. Hospitals: The Sourcebook, 1997 ed. (Baltimore: HCIA, 1997), 102.
11. Hospital-profiling products sold by Cerner Corporation, CHIPS, HBO and Company, HCIA, Inforum (division of Medstat), Premier, TSI, VHA, and numerous state hospital associations.
12. This reflects my professional observation. Data sets I examined while at HCIA for potential acquisition and product development tended to lack encounter detail for capitated patients, thus representing not only the absence of a key type of data but a skewing in this absence as healthier patients tend to choose lower-cost, higher capitation-based health plans.
13. T. Erkinjuntti et al., "The Effect of Different Diagnostic Criteria on thePrevalence of Dementia," New England Journal of Medicine 337, no. 23 (1997): 1667.
14. Ibid.
15. L.I. Iezzoni, "Risk and Outcomes," in Risk Adjustment for Measuring Healthcare Outcomes, 2d ed., ed. L.I. Iezzoni (Chicago: Health Administration Press, 1997).
16. This also reflects my professional observation. Hospitals still represent the bulk of revenue sources for the HIT sector, with HMOs trailing closely and physician groups representing only a small fraction.
17. Professional observation. Physicians at hospitals usually possess, and frequently use, the power to kill the sale of HIT products that hospital administrators want to purchase.
18. Gallo and Lee, Health Care Information Technology, Preface.
19. Interview with Allan Khoury, associate medical director for medical information, Kaiser Permanente of Ohio, 17 September 1998.
20. Professional observation. Despite its size, Kaiser was not known as a reliable prospect among HIT vendors; it preferred to build its own clinically oriented HIT products rather than buying "off the shelf."
21. Professional observation of EMR installations around the United States.
22. R. Evans et al., " A Computer-Assisted Management Program for Antibiotics and Other Antiinfective Agents," New England Journal of Medicine 338, no. 4 (1998): 232-238.
23. Ibid., 236.
24. R.A. Garibaldi, "Computers and the Quality of Care - A Clinician's Perspective" (Editorial), New England Journal of Madecine 338, no. 4 (1998): 260.
25. K. Hamid, Rx for Investing in a Volatile Group, Research Report (New York: Bear Stearns, 17 December 1996), 9.
26. J. Morrissey, "On the Same Page," Modern Healthcare (6 July 1998): 35.
27. Professional observation. The expectation of all HIT companies seeking stock market funding was the preestablishment of profitability on going-forward operations.