Book Review: Funding Virtue: Civil Society Aid and Democracy Promotion,Marina Ottaway and Thomas Carothers (eds.), Carnegie Endowment for International Peace,Washington, DC, 2000

VOLUNTAS: International Journal of Voluntary and Nonprofit Organizations -     

Book Review: Civil Society: Old Images,New Visions,by John Keane. Stanford University Press,Stanford, 1998

VOLUNTAS: International Journal of Voluntary and Nonprofit Organizations -     

Capitation and informatics

When physicians, hospitals, and allied health professionals bill for services they render, their information processing requirements are relatively simple, at least compared to those of capitated organizations. When payers (insurers or employers) accept financial risk for the health care services of beneficiaries, they have usually invested in claims processing, membership tracking, and, under managed care, utilization review and provider profiling systems. But payers, for the most part, have not invested in electronic collection of clinical information about beneficiaries, nor have they tended to keep all claims they have processed in electronic form for study after accounts are settled and payments disbursed. In this article, we will explore why informatics is so important to capitated organizations and why payers that have traditionally taken financial risk for insuring the health care costs of populations are also learning about the importance of informatics.     

Managed care information needs: a summary perspective

The key to survival in managed care is management of financial risk. You need to know what is in your contract and what you are obligated to do for which population during which period. Information systems can be an enormous help in managing managed care contracts and the financial risks they entail, but poorly selected and configured information systems will do little good for the organization that licenses them. The most important activity of a physician executive who is moving his or her organization into managed care contracting is to lead the process to define the functional requirements for information the organization will need to manage managed care contracts successfully.     

Health care technology--information technology/Part 4. Why will the Internet be important to clinicians?

As the popularity of the Internet's World Wide Web exploded in 1994 and 1995, corporations began adopting the browser software called Mosaic (and its derivatives) for their networks. Why? That same software can be used to "surf" the Internet. Since Intranets are easier to maintain and less expensive, they are replacing the more expensive "groupware" applications based on client-server architectures that corporations installed over the past five years. These Intranets are based on widely-available technologies designed for the Internet, not proprietary software designed for a relatively few customers. Organizations with communication networks integrated with their transaction systems and electronic medical records will be more effective in managing health care resources--and more attractive to employers and insurers for managed care contracting.     

Where does informatics fit in health care organizations?

Why is medical informatics important to health care leaders? As an emerging science, informatics focuses on applying computing and communication technology to decision making for clinicians and managers. It enhances the understanding of how information and communication systems can impact the work health care managers must accomplish. As the cost of technology for digital information management continues to decline, organizations and individuals will look for ways to offset the human costs of managing and conveying information. The way of the paper medical record is being replaced by the less expensive and more efficient digital information systems. Leaders of health care organizations need to look for every opportunity to deploy networks and computers to reduce the labor costs of data collection, storage, retrieval, and analysis.     

Haunts on the Web for physician executives

Listed here are some medical management and health care related Web sites on the Internet worth visiting, as well as favorite search engines and how to use them. From health care systems and hospitals, to health plans and insurers, the industry is using Web technology to promote programs and outcomes, and to provide information on health and wellness.