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Related Concept Videos

Integrated Healthcare System01:20

Integrated Healthcare System

An integrated healthcare system (IHS) is a set of organizations that provides for or arranges to provide coordinated and continuous service to a defined population. The IHS takes responsibility for that particular population's health status and outcome, both clinically and fiscally. An integrated healthcare system is a well-organized, well-coordinated, and collaborative network. The integrated delivery system is a network that connects different healthcare providers to deliver organized,...
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Digital Home-Monitoring of Patients after Kidney Transplantation: The MACCS Platform
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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
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Summary

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.

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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.
  • 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.