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7 The Clinical Perspective
Pages 38-43

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From page 38... ... First, the knowledge must have attributes that are important to the provider; second, it must be readily accessible; third, it must facilitate patient involvement; fourth, financial incentives must be in line with the directions suggested by the new knowledge; and finally, as I see it, the problem of unbalanced regulation within the health care industry must be corrected. MEETING PHYSICIANS' NEEDS The first requirement bears on the credibility and usefulness of the information to the provider. Read the entire page →
From page 39... ... Another reason for the generation of disease-specific data bases that span time and are not age-limited is that these data will require years to amass and to evaluate. We presume, at least we hope, that by that time universal access to health care will have been achieved. Read the entire page →
From page 40... ... It is one thing to impart a few salient points in a peer-reviewed journal; it is quite another to provide a comprehensive data base from which to extract information bearing on the many variables that need to be considered for diagnostic or management decisions regarding an individual patient. We are all aware of prepackaged information currently available for use in a personal computer. Read the entire page →
From page 41... ... Among the results are unnecessary hospitalizations, most of which are not picked up through utilization review; unhealthy competition; unnecessary duplication of technology and other health resources; and, perhaps most important, a slowing down of change in the way services should be organized and delivered to take advantage of out-of-hospital alternatives to care and to enhance continuity of care. Twenty-five years ago, the medical chief resident at Yale-New Haven Hospital, Eli Schimmel, wrote an article published in the Annals of Internal Medicine under the title, "The Hazards of Hospitalization." I have always carried that article with me, physically and in my mind. Read the entire page →
From page 42... ... After all, the Effectiveness Initiative can address only a limited number of illnesses, perhaps 20, perhaps 50. While better knowledge regarding treatment of these conditions will obviously improve quality and limit health care inflation, it will still account for only a very small fraction of total health care. Read the entire page →
From page 43... ... Pp. 179-189 in Electiveness and Outcomes in Health Care. Read the entire page →

From page 38...

... First, the knowledge must have attributes that are important to the provider; second, it must be readily accessible; third, it must facilitate patient involvement; fourth, financial incentives must be in line with the directions suggested by the new knowledge; and finally, as I see it, the problem of unbalanced regulation within the health care industry must be corrected. MEETING PHYSICIANS' NEEDS The first requirement bears on the credibility and usefulness of the information to the provider.

Read the entire page →

From page 39...

... Another reason for the generation of disease-specific data bases that span time and are not age-limited is that these data will require years to amass and to evaluate. We presume, at least we hope, that by that time universal access to health care will have been achieved.

Read the entire page →

From page 40...

... It is one thing to impart a few salient points in a peer-reviewed journal; it is quite another to provide a comprehensive data base from which to extract information bearing on the many variables that need to be considered for diagnostic or management decisions regarding an individual patient. We are all aware of prepackaged information currently available for use in a personal computer.

Read the entire page →

From page 41...

... Among the results are unnecessary hospitalizations, most of which are not picked up through utilization review; unhealthy competition; unnecessary duplication of technology and other health resources; and, perhaps most important, a slowing down of change in the way services should be organized and delivered to take advantage of out-of-hospital alternatives to care and to enhance continuity of care. Twenty-five years ago, the medical chief resident at Yale-New Haven Hospital, Eli Schimmel, wrote an article published in the Annals of Internal Medicine under the title, "The Hazards of Hospitalization." I have always carried that article with me, physically and in my mind.

Read the entire page →

From page 42...

... After all, the Effectiveness Initiative can address only a limited number of illnesses, perhaps 20, perhaps 50. While better knowledge regarding treatment of these conditions will obviously improve quality and limit health care inflation, it will still account for only a very small fraction of total health care.

Read the entire page →

From page 43...

... Pp. 179-189 in Electiveness and Outcomes in Health Care.

Read the entire page →

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7 The Clinical Perspective Pages 38-43

7 The Clinical Perspective
Pages 38-43