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Biomedical subjects

M F Collen

Publications and source records attributed to M F Collen.

9 recordsLinked to original sources

A historical review of the Kaiser Permanente Medical Care Program.

The Kaiser Permanente Medical Care Program evolved from a series of major construction projects in the 1930s and from the World War II shipyards in the early 1940s. In the late 1940s, it became a community-based medical care program, and later in the 1970s, the prototype Health Maintenance Organization (HMO). Over the past five decades, Kaiser Permanente has developed its basic principles of prepaid, group practice for comprehensive-care services where physicians control their medical practice in a partnership of responsibility for the Health Plan, the Hospitals, and the Medical Groups. All of this is carried out with autonomy of its 13 regions in the United States.

California

A brief historical overview of hospital information system (HIS) evolution in the United States.

This paper describes the evolution of hospital information systems (HIS) in the United States of America from 1950 to the present and defines HIS within the context of a medical information system. After a concise review of HIS administrative functions, the paper focuses on HIS clinical functions, including the following: computer-based patient records; data entry and retrieval; text processing; data and system protection; networks; clinical subsystems (nursing and medical subspecialties); clinical decision support and quality assurance; and research databases. The paper surveys early examples of HIS and makes projections for HIS in the 1990s.

Hospital Information Systems

Cost analyses of alternative health examination modes.

Health examinations have become an essential service for a health maintenance organization to provide to ambulatory patients for determining their health status and care needs. Three methods were studied for providing health examinations to 6,285 examinees. Compared with the traditional physical examinations customarily provided by physicians, it was determined that either of two alternative systemized modes proved more economical with regard to both physician time and total resource costs for similar patient groups standardized by age, sex, and health status. The most efficient method of providing health examinations to large numbers of people used multiphasic health testing, followed by physical examinations provided by nurse practitioners supervised by physicians; this required 68% less physician time and resulted in a decrease in total examination costs of 30% as compared with traditional examinations.

Comprehensive Health Care

Evaluation of an ambulatory medical-care delivery system.

We designed a medical-care-delivery system specifically to relieve the impaired access to care that has invariably assompanied the elimination of personal fees by prepaid plans, Medicare and other third-party payment plans. The solution involved the entry of patients through a paramedically staffed health-evaluation servece that effectively separated patients into three basic health-status groups-the well and worried well (68.4 per cent); the asymptomatic sick (3.9 per cent); and the sick (27.7 per cent)--a process that permitted matching the needs of each group with appropriate services. The system achieved increased physician accessibility to new patients by 20 times, reduced the waiting time for new appointments from six to eight weeks to a day or two, saved physician time and costs for entry work to a day or two, saved physician time and costs for entry work-up by 70 to 80 per cent reduced total resources used throughout the year by +32,550 per 1000 entrants, and proved very satisfactory to patients and generally so to staff.

Ambulatory Care

Patient data acquisition.

Patient data are acquired in three ways: by direct interrogation; physiological measurements; and analysis of specimens, signals, and images. When computers are used to acquire information from the patient directly, difficulties arise from the lack of standardized patient medical history, the complexities of natural language processing, and the problems of man/machine communication (patient with computer terminal, and physician with computer-generated history). A great variety of data input devices have been used for the acquisition of the patient medical history. Most have been extensively used in multiphasic health testing programs, and this experience is freely drawn upon in this paper.

Computers