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Three or four years ago, St. Johns Health Center in Santa Monica, CA, would typically receive one letter every week or two complaining about some aspect of care in the ED; perhaps once a month, it might get a letter complimenting that service. Today, We get one letter a week complimenting the staff, and I mean a great letter, says Russ Kino, MD, FACEP, FACEM, medical director of emergency services.
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Many of the new skills ED managers can use to oversee their departments more effectively and engender more fruitful relationships with upper management are offered in a new continuing medical education course from the Dallas-based American College of Emergency Physicians (ACEP) the Emergency Department Directors Academy (EDDA).
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Six in 10 emergency physicians surveyed report the increase in psychiatric patients is negatively affecting access to emergency medical care for all patients, causing longer wait times, fueling patient frustration, limiting the availability of hospital staff, and decreasing the number of available ED beds.
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With less than a year left before the HIPAA Security Rule goes into effect, a study by URAC has shown that the majority of health plans are not prepared.
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An automated calling system reminding members to get preventive health care services has paid off for Horizon Blue Cross Blue Shield of New Jersey (BCBSNJ). Instead of receiving a postcard reminding them to go for immunizations, cancer screenings, prenatal and postnatal care, and other preventive health care services, members who are eligible for the services receive a computer-generated telephone call.
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A system that rates cases by acuity level helps case managers at BlueCross and BlueShield of Oklahoma (BCBSOK) keep their workload evenly distributed. Cases are stratified by complexity, with Level 1 being the lowest acuity and Level 5 the highest.
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A system to help identify patients who are at risk for suicide, chemical dependency, or premature treatment termination is a great adjunct to traditional psychiatric care, asserts Daryl E. Quick, PhD. Quicks organization, Western Psychological and Counseling Services, uses the ALERT Predictive Modeling and Outcomes Management System from PacifiCare Behavioral Health.
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When QMed contracts with a health plan to manage its coronary artery disease, heart failure, or diabetes population, the Laurence Harbor, NJ, disease management firm does more than just rely on claims data to come up with a treatment plan for members identified for disease management. The company also sends a team of specialists into individual physician offices to extract data from the patient files of members identified for the program, often coming up with clinical information and medical histories that arent available from the insurance carrier.
