Seamless Delivery Research Articles

Departments of internal medicine: Upright or supine?

In closing, I would reiterate that with the inevitable restructuring of departments of internal medicine, now is the time to develop innovative, interdisciplinary strategies to manage across boundaries. Strategies of vertical and horizontal integration within an academic health center and its alliance with the communities it serves. Strategies that will enhance our missions in patient care, education, and research. Recreate the environment that will once again allow nature to flourish. D During this time of reform we are not strapped with sustaining the status quo. Opportunities for innovation abound. Innovation demands an ability to reallocate and adapt. Abandon old paradigms. Seize the occasion to reformulate, restructure, revitalize, and revamp—to write a new chapter. We are limited only by our creative potential and entrepreneurial spirit, or willingness to take risk. I ask you, who better than academic health centers to succeed in managed care? Corporate relationships between medical school and hospital already exist, and with innovative restructuring seamless delivery of high-quality care is a reasonable expectation. Seize the opportunity. I ask you, who better than departments of internal medicine to provide innovative answers to seamless delivery of primary and specialty care? But vision begets responsibilities. In formulating plans of reform we must rise to the challenge of solving critical societal needs. Medically underserved populations should be targeted for high-quality health care. Community-based patient-centered programs of education, research, and preventive medicine must be provided. Research can be the friend of cost containment. In placing a premium on synergies that will increase our potential, our productivity, and effectiveness in a culture of cooperation, common purpose, and mutual education, new knowledge for the twenty-first century will emerge and of which we can be justifiably proud. It will guarantee our viability. It will be our legacy.

Competing On Service: Technology and teamwork in supplementary services

Do your customers experience a seamless delivery of your products and services? Or are they frustrated by thoughtless employees or cumbersome processes? Evaluate your deliveiy of supplementary services using the “Flower of Service” as a guide.

Utilization Managers in Medicare Risk Contract HMOs: From Control to Collaboration

A study of utilization management (UM) practices in 13 health maintenance organizations (HMOs) with Medicare members was undertaken as part of an evaluation of the Medicare Risk Contract strategy. Although there were significant variations among HMOs, the common challenges of managing care for this particular population also led to important similarities. Most notable was the emphasis on redirecting the focus of control-oriented utilization review to promotion of continuous improvement in care management. The multiple medical and social service needs of Medicare beneficiaries have forced HMOs to cultivate close collaboration with physicians and UM personnel. Thus, UM personnel are involved throughout the continuum of care and play an important role in assisting HMOs to approach the "seam-less delivery system" ideal. HMOs report that the experience of managing care for Medicare members has made them more responsive to serving all of their members and to promoting long-term partnerships with their physicians.