Decision support system in a patient-centered medical home

Lack of sufficient primary care to manage chronic diseases has been quoted as a major drawback of the healthcare system within the United States. Patient-Centered Medical Home is a care delivery model to transform how primary care is delivered. The information technology revolution has brought about several advancements and solutions for medicine and care delivery, and medical homes are no exception to this. However, it is only through a robust decision support system that these medical homes can in fact provide truly coordinated and patient-centered care. The paper describes preliminary work that has been completed at the University of Missouri Health System and next steps in achieving high quality care delivery through a decision support system implementation. Originally presented at the IEEE HealthCon Medial Home conference in June 2011

El porqué de la economía en salud

El papel de la economía en la atención sanitaria nunca ha sido definido en su totalidad ni aceptado en su totalidad. En el pasado las características estructurales del sistema de salud hacían de los recursos disponibles para el mismo virtualmente ilimitados, minimizando en consecuencia la necesidad de economizar en el proceso de toma de decisione

Necessary Conditions for Supporting a General Surgeon in Rural Areas

Loss of a general surgeon in a rural community can alter the referral patterns, the image and utilization of the local hospital, and even the market share of local primary care physicians. Prior research has not defined the necessary and/or sufficient conditions for a rural county to be able to support a local general surgeon. Based upon empirical analysis of 96 rural Missouri counties and the limited literature available on rural surgeons and physician referral rates, a first approximation of those conditions are offered. We conclude that a rural county with a hospital, a population base of more than 15,000 people, and at least 11 potential referring physicians has sufficient conditions to enable it to support a local general surgeon. Among those rural Missouri counties not meeting the above conditions but having a general surgeon in 1984, we estimate that 8 to 10 potential referring physicians appear to be the minimum necessary condition for supporting a rural general surgeon through patient referral. From those conclusions, we argue that any rural hospital currently without a surgeon should re-examine its situation. To prepare for a competitive future, such a hospital should take every opportunity to expand the referral base necessary to support a full-time local surgeon rather than place long-term reliance upon itinerant general surgeons

Necessary Conditions for Supporting a General Surgeon in Rural Areas

Loss of a general surgeon in a rural community can alter the referral patterns, the image and utilization of the local hospital, and even the market share of local primary care physicians. Prior research has not defined the necessary and/or sufficient conditions for a rural county to be able to support a local general surgeon. Based upon empirical analysis of 96 rural Missouri counties and the limited literature available on rural surgeons and physician referral rates, a first approximation of those conditions are offered. We conclude that a rural county with a hospital, a population base of more than 15,000 people, and at least 11 potential referring physicians has sufficient conditions to enable it to support a local general surgeon. Among those rural Missouri counties not meeting the above conditions but having a general surgeon in 1984, we estimate that 8 to 10 potential referring physicians appear to be the minimum necessary condition for supporting a rural general surgeon through patient referral. From those conclusions, we argue that any rural hospital currently without a surgeon should re-examine its situation. To prepare for a competitive future, such a hospital should take every opportunity to expand the referral base necessary to support a full-time local surgeon rather than place long-term reliance upon itinerant general surgeons

Patient satisfaction with teledermatology services.

We collected data on patient satisfaction with the use of teledermatology services. During a 27-month study, a single dermatologist saw a total of 321 patients via telemedicine. The patients completed 483 surveys, although not all questions were answered on all surveys. There was a high level of satisfaction among patients using teledermatology: 88% of 258 respondents said that they were satisfied with their telemedicine session. In terms of the eight questions on the questionnaire, 84% of the responses were in the top two positive categories on a seven-point Likert scale. In addition, access to dermatology appeared to increase with the availability of the telemedicine service