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Related Experiment Videos

Health-based payment and computerized patient record systems.

M C Hornbrook1, M J Goodman, P A Fishman

  • 1Center for Health Research, Kaiser Permanente, Northwest Division, OR, USA.

Effective Clinical Practice : ECP
|September 4, 1998
PubMed
Summary
This summary is machine-generated.

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Health care information technology is rapidly evolving. Automating patient medical records in health maintenance organizations (HMOs) improves care quality and cost reduction, enabling better risk assessment for payments.

Area of Science:

  • Health Informatics
  • Health Services Research

Background:

  • Health care information technology is undergoing rapid transformation.
  • Clinicians are increasingly automating patient medical records to enhance quality and reduce costs.
  • Health maintenance organizations (HMOs) and affiliated practices are at the forefront of this adoption.

Purpose of the Study:

  • To explore the role of automated patient medical records in health maintenance organizations (HMOs).
  • To examine the utility of computerized patient record systems for risk-adjusted payment models.
  • To highlight the potential of health information technology in improving patient care and financial risk management.

Main Methods:

  • Analysis of data from computerized patient record systems within HMOs.
  • Evaluation of population-level data tracking for risks, diagnoses, care patterns, and outcomes.

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  • Assessment of the linkage between clinical services and provider-defined disease episodes.

    • Main Results:

    • Computerized patient record systems provide extensive clinical information, facilitating risk-adjusted and health-based payment calculations.
    • These systems are crucial for developing clinically meaningful risk-assessment models.
    • HMO technology, utilizing comprehensive patient data, is poised to shift risk coefficient calculations from traditional fee-for-service models.

    Conclusions:

    • Automated patient medical records in HMOs offer significant potential for improving the quality of care.
    • These systems enhance the ability to manage financial risks associated with patient populations, protecting against adverse selection.
    • The evolution towards using HMO technology for risk-based payment signifies a major advancement in healthcare finance and management.