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Journals and Conferences
While electronic medical records (EMRs) have long held the promise of improved efficiency and quality, they have not yet made significant inroads into ambulatory care. One reason may be attempted EMR implementation in "old paradigm" clinic models. Southeast Health Center (SEHC) in Indianapolis, Indiana, began by reengineering its clinic procedures; only… (More)
The electronic medical record in the ambulatory setting will be a force to be reckoned with during the 1990s. The increased quality of the medical record will lead to an increased quality of patient care at a fairly level cost (no long-term increase). With the new and increasing excitement about continuous improvement in health care, the electronic medical… (More)
A program to promote generic cimetidine as the preferred histamine H2-receptor antagonist (HRA) in the managed care organizations (MCOs) served by a pharmacy benefit management company is described. A pharmacy benefit management company conducted a literature review to substantiate the therapeutic equivalence of the HRAs and to set conservative criteria for… (More)
When asked to produce convincing evidence of quality, 281 ambulatory healthcare professionals suggested 98 different components of an ambulatory program. Obviously no overwhelming majority exists, nor is there a clear focus on what constitutes quality in the ambulatory setting. This demonstrates and highlights both the diversity of ambulatory care and the… (More)
Assessing the quality of ambulatory care is difficult because practitioners see patients for only a short time and because the goals of care are not always clearly defined. The ambulatory care department of Methodist Hospital of Indiana, Inc, has developed a system, called ambulatory care parameters, that helps ambulatory health care professionals sort… (More)
Ambulatory care has always been a stepchild. Hospitals have been and are the focal point of quality activity. Traditionally driven by Joint Commission decree and more recently inspired by market forces, hospitals find the resources to do quality. It was quality assurance in the '80s. It is quality management in the '90s. Some of this activity has oozed out… (More)
The culture of poverty impacts everything patients in this socioeconomic group think and do. If what poor patients say does not sit well with the way we think, that doesn't mean they are wrong. Physicians have to adjust their mental model and think in different cultural terms. The author recently completed his thirtieth year of a career dedicated to… (More)
This article on creating a world-class culture in primary care stresses the importance of customers. The concept of patients as external customers is addressed; the emphasis, however, is on healthcare professionals' responsibilities toward one another as internal customers.
As physician executives, what we need in ambulatory quality assurance is a very carefully thought out system that will enable us to monitor quality in such a way that we will also be able to measure it. Only if we have the capability to measure quality can we begin to manage it.
2009 i STATEMENT BY AUTHOR This thesis has been submitted in partial fulfillment of requirements for an advanced degree at The University of Arizona and is deposited in the University Library to be made available to borrowers under rules of the Library. Brief quotations from this thesis are allowable without special permission, provided that accurate… (More)