CLMA research initiative: moving into the 21st century with leadership in knowledge. CLMA Research Advisory Committee.
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Guideline Adherence↗
Biomedical subjects
K M Peddecord
Publications and source records attributed to K M Peddecord.
The state of automated information systems in ambulatory health care.
The development of moderately priced microprocessors has led to a new and complex set of information processing alternatives within the healthcare sector. Small group practices and some solo practitioners now find it technologically possible and economically feasible to automate some parts of their information system. With the introduction of this new and highly complicated technology comes a series of opportunities and problems for the healthcare consumer and provider. The article examines a number of the issues related to computer utilization in the ambulatory care setting.
Computers↗
Operational and legal implications of preferred provider organizations.
The healthcare marketplace of the 1980s is competitive. Federal policymakers, private insurers, and businesses have formulated innovative ways to increase price competition within the healthcare sector. The 1980s have been characterized by a shift from a regulatory emphasis to one including both regulation and competition in an effort to contain healthcare costs. This article examines preferred provider organizations (PPOs) and differentiates them from health maintenance organizations (HMOs) and exclusive provider organizations (EPOs). It also reviews alternate PPO models and discusses operational and legal implications.
Economic Competition↗
T-lymphocyte immunophenotyping blind proficiency testing: a model system for CD4+ T-cells.
OBJECTIVE: To develop and evaluate methods and results for blind proficiency testing for CD4+ T-cells by T-lymphocyte immunophenotyping. DESIGN: A model system was developed to submit duplicate specimens for T-lymphocyte immunophenotyping as if they were routine patient specimens rather than proficiency specimens. Testing results were compared both interlaboratory and intralaboratory. The model system was designed to gather information on not just the analysis, but other segments of the total testing process. SETTING: Research facilities at the Graduate School of Public Health, San Diego State University, San Diego CA. PARTICIPANTS: 1) A healthy adult volunteer donating one pint of blood. 2) Laboratories offering T-lymphocyte immunophenotyping. MAIN OUTCOME MEASURES: 1) Feasibility of blind proficiency so that PT specimens are received, analyzed, and reported by laboratories without being identified as 'proficiency specimens.' 2) The ease and cost of such a system. 3) The comparability of results and report content among laboratories. RESULTS: A total of twenty-two laboratories received blind proficiency specimens. The model developed to submit specimens and receive results proved feasible. The interlaboratory coefficient of variation for CD4+ count for the four survey years ranged from 10% to 66% and for the CD4+ percent ranged from 4% to 15%. The per specimen cost in this blind proficiency testing was $437.65, approximately seven and a half times the cost for nonblinded proficiency testing or performance evaluations. CONCLUSIONS: Blind proficiency as a tool to compare laboratory test results for T-lymphocyte immunophenotyping is feasible but adds costs. The model system is useful to examine more of the laboratory total testing process than the analysis segment.
Blood Specimen Collection↗
Primary care and health promotion: a model for preventive medicine.
This paper examines the potential role of the primary care physician in health promotion, specifically the use of behavioral change technologies to modify risk behavior. The primary care physician's strategic position to help people modify risk behavior is discussed, and the available data on the health promotion attitudes and services of these physicians are reviewed. The principles and procedures of behavior modification underlie not only the model proposed for risk assessment and reduction, but are applied to the task of changing and maintaining physician behavior as well. Cost-effectiveness research and the role of reimbursement for primary care prevention services are discussed. Recommendations are made for future health policies, practices, training, and research that might encourage preventive behavioral services in primary care.
Attitude of Health Personnel↗