The Affordable Care Act and the future of clinical medicine: the opportunities and challenges.
ABSTRACT The Affordable Care Act is a once-in-a-generation change to the U.S. health system. It guarantees access to health care for all Americans, creates new incentives to change clinical practice to foster better coordination and quality, gives physicians more information to make them better clinicians and patients more information to make them more value-conscious consumers, and changes the payment system to reward value. The Act and the health information technology provisions in the American Recovery and Reinvestment Act remove many barriers to delivering high-quality care, such as unnecessary administrative complexity, inaccessible clinical data, and insufficient access to primary care and allied health providers. We hope that physicians will embrace the opportunities created by the Affordable Care Act that will enable them to provide better care for their patients and lead the U.S. health system in a more positive direction. To fully realize the benefits of the Affordable Care Act for their practices and their patients, physicians will design their offices for seamless care, employing new practice models and using technology to integrate patient information with professional society guidelines to keep patients with chronic conditions healthy and out of the hospital. Under the Affordable Care Act, physicians who effectively collaborate with other providers to improve patient outcomes, the value of medical services, and patient experiences will thrive and be the leaders of the health care system.
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ABSTRACT: Physicians have increasingly given up private practices to become members of, and key stakeholders in, large healthcare systems. These systems are currently transforming to meet the Triple Aim: guaranteeing the equitable provision of high-quality, evidence-based care at a reasonable cost. Participatory leadership is an organizational change theory that engages key stakeholders as architects in the transformation process. This review highlights the utility of this leadership strategy in designing care for women's health.Current opinion in obstetrics & gynecology. 10/2014;
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ABSTRACT: Our specialty is seeking to establish the value of imaging in the longitudinal patient-care continuum. We recognize the need to assess the value of our contributions rather than concentrating primarily on generating revenue. This recent focus is a result of both increased cost-containment efforts and regulatory demands. Imaging 3.0 is a value-based perspective that intends to describe and facilitate value-based imaging. Imaging 3.0 includes a broad set of initiatives addressing the visibility of radiologists, and emphasizing quality and safety oversight by radiologists, which are new directions of focus for us. Imaging 3.0 also addresses subspecialty imaging and off-hours imaging, which are existing areas of practice that are emblematic of inconsistent service delivery across all hours. Looking to the future, Imaging 3.0 describes how imaging services could be integrated into the framework of accountable care organizations. Although all these efforts may be essential, they necessitate manpower expenditures, and these efforts are not directly covered by revenue. If we recognize the urgency of need in developing these concepts, we can justify the manpower and staffing expenditures each organization is willing to shoulder in reaching Imaging 3.0.Journal of the American College of Radiology: JACR 08/2014;
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ABSTRACT: Quality measurement is important to stakeholders in providing valid information for improvement, and has been associated with hospital accreditation in most countries. The commonly used categories of indicators are structure, process, and outcome. Outcome indicators are of foremost importance as they reflect the effect of health care; structure indicators are commonly used for assessing capacities or facilities available for providing services, whereas process indicators assess how well the service is delivered, and provide essential and important information for quality improvement. For a process indicator to be valid, it should be linked to an outcome, whereas a structure indicator must be linked to a better outcome. Although there are no strict rules for usage or selection of indicators, it is important to ensure adequate coverage of relevant domains of the health care services intended to be evaluated. Because the trends in health care services and management are changing, it is time to have a paradigm shift in health care quality measurement. Although evaluating the quality had also been extended to include quality of life and patient satisfaction, the ultimate aim of health care services should be “staying healthy, getting healthy, and living healthy.” It is important for physicians to learn how to use these clinical indicators for improving service performance and organizational growth.Journal of the Formosan Medical Association 10/2014; · 1.70 Impact Factor