Despite its benefits, the computerisation of Australian general medical practices has been delayed, partly due to user concerns about the format of data dictated by available software and the portability of such data....
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Despite its benefits, the computerisation of Australian general medical practices has been delayed, partly due to user concerns about the format of data dictated by available software and the portability of such data. This article proposes certain essential criteria for practice management software, which may provide a framework for its evaluation by users. A set of simple guidelines for database maintenance is also proposed. The author believes that users should become familiar with basic software architecture and drive the market to develop packages that conform to these minimal criteria.
Reports in the literature that describe the use of prepaid settings for medical education are typically anecdotal. Synthesis of this information was accomplished using the case survey method, an approach that uses a c...
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Reports in the literature that describe the use of prepaid settings for medical education are typically anecdotal. Synthesis of this information was accomplished using the case survey method, an approach that uses a common conceptual framework to combine case studies. A total of 18 references published between 1973 and 1986, describing the educational activities in 12 HMOs, were identified. Each reference was analyzed using a checklist composed of forced-choice items grouped into five categories: classification of HMO, type and extent of teaching program, organizational relationship between HMO and medical school, "scholarly" focus of HMO, and involvement of trainees in monitoring resource utilization. Many gaps were identified in the literature, especially those related to the mechanisms of financing the educational program and the types of organizational linkages between the medical school and the HMO. These gaps indicate the need for more systematic research to aid planners of future educational programs.
The article discusses the resident-initiated seminar titled 'Human Rights and Psychiatry' at the Cambridge Hospital in Massachusetts. The purpose of the said clinical teaching facility is to encourage a psychi...
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The article discusses the resident-initiated seminar titled 'Human Rights and Psychiatry' at the Cambridge Hospital in Massachusetts. The purpose of the said clinical teaching facility is to encourage a psychiatric training program. According to the author, the primary activity of the seminar is to develop a better understanding on the mental heath state of many clinic patients, particularly the refugees and the immigrants who are applying for a political asylum in the U.S.
The paper describes an example of good practice in the establishment of multidisciplinary library services at a Trust hospital. In 1995, City Hospitals Sunderland NHS Trust commissioned a survey to determine their nee...
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The paper describes an example of good practice in the establishment of multidisciplinary library services at a Trust hospital. In 1995, City Hospitals Sunderland NHS Trust commissioned a survey to determine their needs for library services for all staff. The results of the survey and the recommendations are described. The Trust's further actions are briefly noted. This case study is set into the wider context of the need for well-resourced library and information services within the NHS. The constraints under which such developments operate are listed.
This article provides an overview of the possible uses of information technology to support a perioperative medicine service and describes the required investment for various solutions and the current issues confronte...
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This article provides an overview of the possible uses of information technology to support a perioperative medicine service and describes the required investment for various solutions and the current issues confronted by the application of information tech nology in a health care environment. The extent to which a perioperative medicine practice requires information technology support for data management varies widely with the goals of the practice. The informational goals may range from the simple tracking of sentinel event rates or outcomes, such as ICU admission rates or hospital length of stay, to using a complete electronic medical record encompassing all aspects of patient care. Because the human and financial resource demand is orders of magnitude between these two extreme solutions, an honest assessment of the informational requirements and the available information technology support is a crihcal first step.
Objectives: To summarise the findings from a comprehensive review of research on the effects of the three main elements of the quasi-market reforms of the UK National Health Service (NHS) introduced in 1991/92: - Gene...
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Objectives: To summarise the findings from a comprehensive review of research on the effects of the three main elements of the quasi-market reforms of the UK National Health Service (NHS) introduced in 1991/92: - General practices becoming fundholders by volunteering to purchase elective care for their patients;- Health authorities becoming purchasers of emergency, unplanned and elective services, together with a range of alternatives to fundholding operating under their auspices;- The conversion of providers of hospital and community health services to NHS trusts separate from their local health authorities. Methods: Published and unpublished studies which included any data on the impact of the three main planks of the quasi-market changes, produced between 1991 and late 1998, were identified using a combination of electronic databases, library catalogues at the King's Fund, London, bibliographies, reference lists of individual studies, a survey of NHS directors of public health and consultations with subject area experts. Each main element of the quasi-market was assessed in relation to its impact on: efficiency (primarily productivity);equity;quality;choice and responsiveness;and accountability. Results: There was relatively little measurable change that could be related unequivocally to the core mechanisms of the quasi-market. Conclusions: The incentives were generally too weak and the constraints too strong to generate the consequences predicted by either proponents or critics of the quasi-market. On the other hand, the way in which the NHS operates was changed irrevocably by the reforms.
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