Lessons from life. The biology of business transformation

Biology and business face similar challenges when it comes to change. Living organisms experience constant change. And successful health care organizations must be ready and willing to embrace transition if they are to survive. Take an in-depth look at the biology-to-business metaphor and see how to better manage information technology changes in your organization.     

Data-Based Modeling of the Failure Rate of Repairable Equipment

A databaseof failures of many types of medical equipment was analysed,to study the dependence of failure rate on equipment age andon time since repair. The intention was to use this large datasetto assess the validity of some widely-used models of failurerate, such as the power-law and loglinear Poisson processes,and so to recommend simple and adequate models to those practitionershaving little data to discriminate between rival models. Theaim is also to illustrate a methodology for computing policycosts from failure databases. The power-law process model wasfound to fit slightly better overall than did the loglinear andlinear processes. Some related models were created to fit anobserved peaking of failure rate. The data showed a decreasinghazard of (first) failure after repair for some equipment types.This can be due to imperfect or hazardous repair, and also todiffering failure rates among a population of machines. Two simplemodels of imperfect repair were used to fit the data, and anEmpirical Bayes method was used to fit a model of variable failurerate between machines. Neglect of such variation can lead toan over-estimate of the hazardousness of repair.     

'Second generation' Internet e-health: the gladiator for HIPAA compliance?

The Health Insurance Portability and Accountability Act (HIPAA) is intended to simplify administrative processes and improve health information security. There are a number of traditional ways to address the expense and complexities of simplification, but none of them are bargains or beauties to behold: (1) Do-it-yourself encryption; (2) new back-end system purchases; (3) legacy system re-programming; or (4) onerous paper documentation. The good news is that 'second generation' e-health solutions are emerging that act as internal "wrappers" for health plan or provider data systems. They provide both an interface for end-users and a layer of security for organizational information and allow detailed patient-related data to remain at the system owner's physical location. These second generation solutions don't just 'connect,' data, they actually 'understand' the information, and can use data elements to invoke necessary rules, processing pathways, or personalization for specific stakeholders as required by HIPAA.     

Peer cluster theory and adolescent alcohol use: an explanation of alcohol use and a comparative analysis between two causal models

This study tests the premise of peer cluster theory as it applies to individual alcohol use, and makes a comparative analysis between its ability to explain alcohol use and marijuana use. Using the results of a 1996 drug and alcohol survey of 1312 Western Kentucky University students, path analysis was used to measure the influence of six of peer cluster theory's psychosocial characteristics on the percentage of the respondent's college friends who use alcohol. All of these variables were then regressed on the respondent's alcohol use. The results of the causal models did show some support for peer cluster theory. The direct effect of the student's association with alcohol-using peers on individual alcohol use was shown to have the strongest direct influence on this outcome variable. However, a few limitations of this theoretical perspective were identified. The causal model for alcohol use showed that the indirect influence of two of these psychosocial characteristics (parental attitudes on alcohol use and success in school) was weaker than their direct influence on individual alcohol use. And, the comparative analysis showed that peer cluster theory is better suited to explain the use of marijuana than the use of alcohol.     

Maternal child care preferences for infants,toddlers, and preschoolers: the disconnect between policy and preference in the USA

While much research exists looking at parental preferences for child care, much of that research uses child care choice as a proxy for preference. In an effort to examine the types of care mothers prefer if no constraints were placed on their decision, this quantitative study investigated how family demographic factors and family role ideology relate to the types of child care (parental and non-parental forms) mothers prefer ‘in an ideal world’ using a sample of 345 employed mothers of children under 6 years of age in a suburb of a large metropolitan area in the southern USA. Participants completed a questionnaire examining the types of care they viewed as ideal for infants (0–12 months old), toddlers (13–30 months old), and preschoolers (31–72 months old) if no constraints were placed on the decision. Results indicated that the preferences for type of care for mothers in this sample varied according to the child's age, with a large majority of mothers preferring parental care for their children. Ideological and demographic factors predicting preferences for first and second choice of child care were also explored through binary and multinomial logistic regression, revealing the influence of ethnicity, education, and family role ideology to preferences for infant care. These results add to the existing literature by confirming previous findings about the influence of child age to child care preferences, as well as highlighting the disconnect between these preferences and the way family policies are structured in the USA.     

Implications of government funding of advocacy for third‐sector independence and exploration of alternative advocacy funding models

This paper examines the effect of funding contracts on the capacity of third‐sector organizations to effectively advocate. The relationship is not simple or obvious, with some organizations reporting 'mature relationships' with particular (state) departments, and others reporting difficulty with state or federal government jurisdictions. The paper spells out the negative effects of conflating service funding and advocacy. The paper concludes by exploring alternative institutional arrangements for the resourcing of advocacy including the establishment of a Public Interest Fund administered independently of any government department, one not requiring specific service contracts but rather evidence that it is advocating for the broader public good.     

Status of personal health requirement for graduation at institutions of higher education in the United States

Objective: The purpose of this study was to examine the proportion of higher education institutions in the United States that require a personal health course (PHC) for graduation and to describe the nature of such requirements. Participants: This study included a random sample of public and private institutions of higher education (IHE) with undergraduate programs within the United States (N = 310). Data were collected between September 2014 and May 2015. Methods: University catalogs were accessed from the institutions' public Web sites to determine whether a PHC was offered, and whether it was exclusively or optionally required for graduation. Results: The majority (55.8%) of the sample offered at least 1 PHC, with only 10% exclusively requiring the course and an additional 10% optionally required the course. Conclusions: Although the utility of undergraduate students completing a PHC is clear, the majority of institutions do not require such a course for degree conferral.