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Planning factors for developing an enterprise-wide picture archiving and communication system maintenance program

JOURNAL OF DIGITAL IMAGING 2000年第2期13卷 228-229页

作者： Staley, S Romlein, J Chacko, AK Wider, R InformaTech Inc Telemed Serv Frederick MD 21703 USA Med Res & Mat Command Ft Detrick MD USA

Picture archiving and communication system (PACS) maintenance on an individual site basis has historically been a complex and costly challenge. With the advent of enterprise-wide PACS projects such as the Virtual Radiology Environment (VRE) project, the challenge of a maintenance program with even more complexities has presented itself. The approach of the project management team for the VRE project is not one of reactive maintenance, but one of highly proactive planning and negotiations, in hopes of capitalizing on the economies of scale of an enterprise-wide PACS maintenance program. A proactive maintenance program is one aspect of life-cycle management. As with any capital acquisition, life-cycle management may be used to manage the specific project aspects related to PACS. The purpose of an enterprise-wide warranty and maintenance life-cycle management approach is to maintain PACS at its maximum operational efficiency and utilization levels through a flexible, shared, yet symbiotic relationship between local, regional, and vendor resources. These goals include providing maximum operational performance levels on a local, regional, and enterprise basis, while maintaining acceptable costs and resource utilization levels. This goal must be achieved without negatively impacting point of care activities, regardless of changes to the clinical business environment. Copyright (C) 2000 by W.B. Saunders Company.

关键词：费用效益分析信息管理/经济学维修/经济学卫生服务使用研究/经济学质量控制放射学信息系统/经济学人类

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Adoption of alternative financing strategies to increase the diffusion of picture archiving and communication systems into the radiology marketplace

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JOURNAL OF DIGITAL IMAGING 2000年第2期13卷 108-113页

作者： Reiner, B Siegel, E McKay, P Univ Maryland Amer Radiol Serv Leonardtown MD 20650 USA Vet Affairs Med Ctr Baltimore MD USA Univ Maryland Sch Med Baltimore MD 21201 USA Amer Radiol Serv Baltimore MD USA Natl Vet Affairs Headquarters Washington DC USA

The objective of the study was to evaluate current marketplace conditions and strategies employed by major picture archiving and communication systems (PACS) vendors in the creation of alternative financing strategies, to enhance the diffusion of filmless imaging. Data were collected from the major PACS vendors in the forms of survey questionnaires and review of existing leases. Topics evaluated in the survey included current financing options available, foreseeable changes in PACS financing, role of third-party financiers, and creation of risk-sharing arrangements. Generic leases were also reviewed evaluating the presence or absence of several key variables including technology obsolescence protection, hardware/software upgrades, end-of-term options, determination of fair market value, functionality/acceptance testing, uptime guarantees, and workflow management consulting. Eight of the 10 PACS vendors surveyed participated in the data collection. The vast majority of current PACS implementations (60% to 90%) occur through direct purchase, with conventional leasing (operating or capital) accounting for only 5% to 30% of PACS installations. The majority of respondents view fee-for-lease arrangements and other forms of risk sharing as increasing importance for future PACS financing. The specific targets for such risk-sharing arrangements consist of small hospital and privately owned imaging centers. Leases currently offered range in duration from 3 to 5 years and frequently offer technology obsolescence protection with upgrades, multiple end-of-term options, and some form of acceptance testing. A number of important variables frequently omitted from leases include uptime guarantees, flexibility in changing financing or vendors, and incorporation of expected productivity/operational efficiency gains. As vendors strive to increase the penetration of PACS into the radiology marketplace, there will be a shift from conventional financing (loan or purchase) to leasing. Fee-

关键词：费用分担成本及成本分析/统计学和数值数据经济学医院/统计学和数值数据筹资组织/经济学租赁财产/经济学卫生服务使用研究/经济学采购科医院/经济学放射科医院/经济学放射学信息系统/经济学人类

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You and your vendor - Tips on what to look for and how to find it

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POSTGRADUATE MEDICINE 1999年第4期105卷 31-+页

作者： Bergeron, BP

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关键词：计算机系统/经济学计算机/经济学卫生服务使用研究/经济学卫生服务使用研究/标准研究美国人类

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The effect of hospital competition on marketing strategies

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Journal of Hospital Marketing 1991年第2期5卷 95-109页

作者： McKinney, Roger M. Memphis State University Department of Marketing Memphis TN 38152 United States

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Pricing health care services: applications to the health maintenance organization

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Health Marketing Quarterly 1986年第1期4卷 47-64页

作者： Sweeney, Robert E. Franklin, Stanley P. Memphis State University United States Memphis State University United States

This article illustrates how management in one type of service industry, the health maintenance organization (HMO), have attempted to formalize pricing. This effort is complicated by both the intangibility of the service delivered and the relatively greater influence in service industries of non-cost price factors such as accessibility, psychology, and delays. The presentation describes a simple computerized approach that allows the marketing manager to formally estimate the effect of incremental changes in rates on the firm's projected patterns of enrollment growth and net revenues. The changes in turn reflect underlying variations in the mix of pricing influences including psychological and other factors. Enrollment projections are crucial to the firm's financial planning and staffing. In the past, most HMO enrollment and revenue projections of this kind were notoriously unreliable. The approach described here makes it possible for HMOs to fine-tune their pricing policies. It also provides a formal and easily understood mechanism by which management can evaluate and reach consensus on alternative scenarios for enrollment growth, staff recruitment and capacity expansion.

关键词：按人收费/方法费用和收费/方法健康维护组织/经济学卫生服务使用研究/经济学模型理论软件美国

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The role of the physician and the present and emerging health care channel

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Journal of Hospital Marketing 1997年第1期12卷 1-22页

作者： Westbrook, K.W. [a] Department of Marketing University of Memphis USA

The author examines the position of physicians in the health care channel on the basis of Transaction Cost Analysis. Propositions are offered that explain recent vertical integration. Moreover, a conceptual model of t... 详细信息

关键词：按人收费社区网络/经济学社区网络/组织和管理竞争性医疗计划/经济学竞争性医疗计划/组织和管理合同业务成本及成本分析卫生保健部门/发展趋势医院医生关系保险健康补偿卫生服务使用研究/经济学卫生服务使用研究/发展趋势模型经济学医师的作用医生病人关系专业业务/经济学专业业务/发展趋势美国人类

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Of markets, technology, patients and profits

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Health Care Analysis 1994年第2期2卷 101-109页

作者： Loewy, Erich H. Department of Medicine The University of Illinois College of Medicine at Peoria Peoria 61658-1649 Illinois Box 1649 United States

In this paper I: (1) Describe something of the present situation in the United States and briefly contrast this with the state of affairs in other nations of the industrialised world. I emphasise health care but also allude to other social conditions: health care is merely one institution of a society and, just as do its other institutions, the system of health care reflects the basic world-view of that society. (2) Sketch the world-view and the philosophy which underwrites the use of a market system in distributing what are acknowledged to be critically important social goods like health care and higher education. I show that a well-functioning market can indeed be useful when it comes to distributing some, but not when distributing other goods. (3) Suggest that when competition and the market are used to 'regulate' health care, technology-instead of being used to benefit patients-is apt to be used primarily to maximise individual profit: it becomes a weapon between what is often painted as 'warfare' among health care providers and institutions. I argue that this state of affairs is based on an undue emphasis upon the demands of individual freedom to the detriment of the community. Finally (4) I suggest an alternative approach to balancing individual with communal interests, an approach which is neither based on a predominance of one with neglect of the other, nor on a dialectic balance between them, but rather upon an approach which sees both individual and communal interests as modifying forces in a complex homeostatic balance. Individual success, in any civilised sense of the term, is possible only in a viable and well-functioning community, and a well-functioning community is not possible without individual success: the two are inevitably interdependent and linked. © 1994 John Wiley & Sons, Ltd.

关键词：慈善资本主义经济竞争卫生服务滥用/经济学收入卫生服务使用研究/经济学个人独立社会正义社会责任社会经济因素工艺学医学/经济学美国

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COMPETITION AMONG HOSPITALS

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JOURNAL OF HEALTH ECONOMICS 1988年第3期7卷 259-284页

作者： NOETHER, M ABT ASSOCIATES INC CAMBRIDGEMA 02138 USA

The traditional view of hospital competition has posited that hospitals compete primarily along 'quality' dimensions, in the form of fancy equipment to attract admitting physicians and pleasant surroundings to entice patients. Price competition among hospitals is thought to be non-existent. This paper estimates the effects of various hospital market characteristics on hospital prices and expenses in an attempt to determine the form of hospital competition. The results suggest that both price and quality competition are greater in markets that are less concentrated, although the net effect of the two on prices is insignificant. It appears, therefore, that, despite important distortions, hospital markets are not immune to standard competitive forces.

关键词：卫生服务范围/经济学数据收集经济竞争经济学经济学医院/统计学和数值数据评价研究(主题) 费用和收费/统计学和数值数据卫生服务使用研究/经济学模型统计学卫生保健质量/经济学回归分析美国

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Preparing the financial/business plan for marketing the group practice

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Health Marketing Quarterly 1983年第1期1卷 29-40页

作者： Enderlein, William P. Graduate School of Management Golden Gate University United States

No abstract available for this article.

关键词：预算成本及成本分析财务管理联合开业/经济学卫生服务使用研究/经济学

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Creating a Global Health Care Company

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Journal of Business Strategy 1992年第2期13卷 4-7页

作者： Bauman, Robert P. chief executive of SmithKline Beecham PLC in London United Kingdom

Global pharmaceutical mergers have spread the huge costs of research and enabled companies to sell their products in countries where they previously lacked a presence. Here's how the Beecham-SmithKline Beckman marriage was developed to propel the organization into a position as a worldwide player in the drug industry. © 1992 MCB UP Limited

关键词：制药工业/经济学制药工业/组织和管理效率管理委员会大不列颠国际合作卫生服务使用研究/经济学卫生服务使用研究/组织和管理组织目标规划技术美国

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