Medicine and Health Sciences Commons^™

Collaboration In Support Of Curricular Innovations, Shelley Bader, Alexandra Gomes

Himmelfarb Library Faculty Publications

This article explores the process, staff and faculty resources, and technological investments applied to migrate the traditional anatomy and pathology wet lab into a state-of-the-art digital classroom.

One Pill, Many Prices: Variation In Prescription Drug Prices In Selected Government Programs, Dawn Gencarelli

National Health Policy Forum

This paper updates a June 2002 National Health Policy Forum Issue Brief, "Average Wholesale Price for Prescription Drugs: Is There a More Appropriate Pricing Mechanism?" Since the release of that paper, Congress enacted the Medicare Prescription Drug, Improvement, and Modernization Act (MMA) of 2003, which created a new, comprehensive outpatient prescription drug benefit and reduced Medicare’s reliance on the average wholesale price (AWP) in paying for prescription drugs. This paper discusses the continued use of AWP as well as other pricing benchmarks that pertain to prescription drugs. It explains the relevance of these pricing mechanisms to different government programs and …

Clinical Preventive Services: When Is The Juice Worth The Squeeze?, Eileen Salinsky

National Health Policy Forum

This paper provides an overview of clinical preventive services, including a definition of such services and the role of the U.S. Preventive Services Task Force in recommending which services should be routinely offered to patients. It also describes efforts to analyze the cost effectiveness of clinical preventive services and reviews the insurance coverage policies of private and public payers. Barriers to increased uptake of appropriate services are discussed and policy relevant issues are summarized.

Caring For "Ryan White": The Fundamentals Of Hiv/Aids Treatment Policy, Jessamyn Taylor

National Health Policy Forum

This background paper provides an overview of the HIV/ AIDS epidemic in the United States and discusses how treatment of the disease and the populations most affected by it have changed over time. The federal government’s domestic and global efforts in prevention, research, and treatment of the disease are highlighted. The paper outlines the Ryan White Comprehensive AIDS Resources Emergency (CARE) Act, a set of programs that fund treatment services for uninsured and underinsured individuals living with HIV/AIDS, and places it in the context of other federal programs that fund treatment for HIV/AIDS. Policy issues for Ryan White’s potential congressional …

Keeping Track Of Care: Quality And Technology At Lifebridge Health System (Baltimore), Judith Moore

National Health Policy Forum

This one-day site visit focused on quality and technology in acute, post-acute and long-term care at Sinai Hospital and Levindale Hebrew Geriatric Center and Hospital, both components of LifeBridge Health System in Baltimore. Participants traced the treatment paths of hypothetical cardiac and cancer patients through the hospital and explored the range of home- and community-based as well as institutional care available through the geriatric center. The role of clinical information technology was highlighted in both settings.

Information Interface - Volume 33, Issue 3 - August/September 2005, George Washington University, Himmelfarb Health Sciences Library

Information Interface (1976 - 2009)

News and information about Himmelfarb Health Sciences Library of interest to users. Includes articles on the library renovation, new faculty publications, and database search tips.

Mental Health And Juvenile Justice: Moving Toward More Effective Systems Of Care, Jane Koppelman

National Health Policy Forum

This issue brief discusses the mental health needs of youth who are involved with the juvenile justice system, how they come into contact with the system, and the evidence of the availability and quality of mental health services for such youth. The paper also explores public policy options for avoiding dependence on the juvenile justice system as a last resort for treating youth with mental disorders.

Specialty Hospitals: Can General Hospitals Compete?, Laura A. Dummit

National Health Policy Forum

The rapid increase in specialty cardiac, surgical, and orthopedic hospitals has captured the attention of general hospitals and policymakers. Although the number of specialty hospitals remains small in absolute terms, their entry into certain health care markets has fueled arguments about the rules of “fair” competition among health care providers. To allow the smoke to clear, Congress effectively stalled the growth in new specialty hospitals by temporarily prohibiting physicians from referring Medicare or Medicaid patients to specialty hospitals in which they had an ownership interest. During this 18-month moratorium, which expired June 8, 2005, two mandated studies of specialty hospitals …

Local Coverage Initiatives: Solution Or Band-Aid For The Uninsured?, Jennifer Ryan

National Health Policy Forum

This issue brief surveys health coverage expansion initiatives that are operating on the county or local level, often without the benefit of federal funding. The paper explores the circumstances that have made these initiatives possible and considers the ongoing barriers that local policymakers face in sustaining the programs. Descriptions of four initiatives illustrate the range and variety of programs in operation today and offer both best practices and lessons learned for other communities. The paper also includes a brief analysis of the key elements that make up a successful coverage initiative. Finally, this issue brief considers the role of local …

Children With Special Health Care Needs: Minding The Gaps, Christie Provost Peters

National Health Policy Forum

This background paper examines the issue of children with special health care needs and their interaction with the health care system. Results from recent national and state surveys and studies were used to review the medical expenditures, utilization, and insurance coverage of these children. The paper also discusses weaknesses within the private and public delivery and financing systems that may hinder the access of certain families with children with special health care needs to important services.

Hospital Oversight In Medicare: Accreditation And Deeming Authority, Lisa Sprague

National Health Policy Forum

To be eligible to receive payment from Medicare, hospitals must be certified to meet certain conditions. Hospitals may gain such credentials by choosing to be reviewed by a state certification agency under contract to the Centers for Medicare & Medicaid Services or to be accredited by either the Joint Commission on Accreditation of Healthcare Organizations or the American Osteopathic Association. This issue brief looks at how accreditation of hospitals developed and how it continues to change. It considers the legal and practical reasons that a majority of hospitals choose accreditation and why some hospitals do not, along with broader consideration …

Information Interface - Volume 33, Issue 2 - May/June 2005, George Washington University, Himmelfarb Health Sciences Library

Information Interface (1976 - 2009)

News and information about Himmelfarb Health Sciences Library of interest to users. Includes articles on the humanities and health collection, course reserves, and database search tips.

How Diverse Librarians Increased Access To Electronic Journals, Developed A Print/Electronic Collection Development Policy And Preserved The Collection, Kathe Obrig, Patricia Wilson, Cynthia Swope, Laura E. Abate, Anne Linton

Himmelfarb Library Faculty Posters and Presentations

This poster reports on a project initiated to establish a framework for evaluating our serials collection in order to preserve the collection from a flat budget and ever increasing serial costs and to meet patron demand for expanded access to electronic resources. An additional outcome was the development of a combined print and electronic serials collection development policy. A Journals Committee was formed to assess the value and most appropriate format(s) of individual journal titles. Methods used included a mathematical formula calculating a title's relative value and a faculty survey soliciting most-used titles and preferred format. Faculty department heads were …

Reaching Out To All: Medical Informatics As Service To Diverse Populations In An Academic Medical Center, Patricia Wilson, Richard Billingsley

Himmelfarb Library Faculty Posters and Presentations

As an academic health sciences library in an urban area, the Himmelfarb Health Sciences Library is challenged to provide outreach services to a diverse user population and to the surrounding community. To respond to this challenge the librarians provide outreach services and programs to accomplish the following goals: Provide additional education to user groups within the medical center; Provide focused services at the point of need within the curricula and the hospital; Reach out to the surrounding health care community, offering medical information and consumer education; Promote consumer resources to underserved populations.

Changing Space Needs And Electronic Resources Migration: Moving Towards A Library For The 21st Century, Anne Linton, Kathe Obrig, Patricia Wilson

Himmelfarb Library Faculty Posters and Presentations

Himmelfarb Health Sciences Library underwent a major space renovation during the summer of 2005. Administration and librarians felt the need to modernize the environment to better reflect the needs of the users. This poster describes the planning, changes, and results of the "21st century" version of the library.

Health Insurance Coverage For Small Employers, Dawn Gencarelli

National Health Policy Forum

For workers of small employers, access to affordable health insurance coverage is a growing concern. This paper examines the problems these firms and their employees face in obtaining health insurance coverage they can afford. The degree to which these challenges become obstacles varies greatly, depending on, for instance, the size of the employer and the characteristics of its employees. Reviewed here are these challenges to access, as well as some of the efforts made through state and federal reforms to address them, including rules regarding guaranteed issue and guaranteed renewability. This paper also explores some of the more recent initiatives …

Fundamentals Of Underwriting In The Nongroup Health Insurance Market: Access To Coverage And Options For Reform, Mark Merlis

National Health Policy Forum

Although the majority of Americans with health insurance obtain coverage through their employers, many individuals must negotiate the nongroup insurance market alone. Insurers use a process called medical underwriting to identify applicants with current or recent medical problems. Because these applicants are likely to cost the insurer more in claims than a healthier person, insurers may charge them higher premiums or restrict or deny coverage. This background paper reviews the practice of underwriting, state and federal regulation of insurers offering nongroup health coverage, and several proposed options for improving access to coverage for applicants who are in poor health.

Health Savings Accounts: The Fundamentals, Beth Fuchs, Julie A. James

National Health Policy Forum

This paper explores the fundamentals of health savings accounts (HSAs). While not intended to be an exhaustive review of these accounts, it describes their intellectual and legislative origins and the mechanics of how they work, explores the early returns on how they are faring in the insurance market, and identifies major issues and controversies that they raise. The paper looks specifically at the basic rules for HSAs and the requirements for health insurance that qualifies as a high-deductible health plan (HDHP) for HSA purposes. Also considered are issues related to provider payments under HSAs and the administration of the benefit …

Exploring California's Rural Health System: From The Redwood Forests To The Baja Border, Eileen Salinsky, Jessamyn Taylor

National Health Policy Forum

This three day site visit to California explored the state’s rural health system with a particular focus on the financial health of inpatient and outpatient providers and how that affects access to care. The role of telemedicine as a tool for expanding access was explored as well as the special needs of vulnerable populations such as farmworkers. Participants learned how state and federal regulation and payment policies and state budget deficits impact the viability of rural health systems.

Clinical Characteristics Of Individuals Using An Online Alcohol Evaluation Program., Daniel Z Lieberman

Psychiatry and Behavioral Sciences Faculty Publications

Access to treatment for substance abuse disorders is limited, and practical strategies are needed to expand opportunities for individuals to receive effective interventions. Automated or semi-automated treatments have shown promise in other disorders. Identifying the characteristics of patients who will be able to benefit from this unconventional approach will increase the likelihood of success. The current study examined 1,297 individuals using an online alcohol evaluation program. Subjects had high scores on the Alcohol Use Disorders Identification Test (AUDIT) and a substantial amount of ambivalence about the possible harm that their drinking caused, but they also had very low levels of …

Childhood Overweight: What The Research Tells Us, The Center For Health And Health Care In Schools, School Of Public Health And Health Services, George Washington University Medical Center

Center for Health and Health Care in Schools

No abstract provided.

Information Interface - Volume 33, Issue 1 - January/February 2005, George Washington University, Himmelfarb Health Sciences Library

Information Interface (1976 - 2009)

News and information about Himmelfarb Health Sciences Library of interest to users. Includes articles on journal subscription renewals and database search tips.

Managed Mental Health Care: Findings From The Literature, 1990–2005, D. Richard Mauery, Lissette Vaquerano, Rachel Sethi, Joanne Jee, Lisa Chimento

Health Policy and Management Faculty Publications

No abstract provided.

Quality Improvement In Maryland: Partnerships And Progress, Judith D. Moore, Lisa Sprague

National Health Policy Forum

This one-and-a-half-day site visit to Easton, Maryland, explored the activities of the Delmarva Foundation, the Quality Improvement Organization (QIO) for Maryland and the District of Columbia. The program reviewed Delmarva’s responsibilities under their Medicare contract and the initiatives they have undertaken with hospitals and other providers to improve health care outcomes and to define, collect, and report quality data. Local hospital officials added their perspective on quality programs and working with Delmarva. Topics of particular interest were health information technology, patient safety, and quality reporting both to government agencies and to consumers.

Separate And Concomitant Use Of Lamotrigine, Lithium, And Divalproex In Bipolar Disorders., Daniel Z Lieberman, Frederick K Goodwin

Psychiatry and Behavioral Sciences Faculty Publications

Expert consensus emphasizes the need for better recognition and accurate diagnosis of bipolar disorder. Current research on lithium, divalproex, and lamotrigine provides new insight into the effective management of this illness. Advances in identifying the mechanism of action of mood stabilization has focused on signaling pathways within the cell that are associated with neurotrophic effects. Clinical research has led to confirmatory evidence of the efficacy of lithium in all phases of bipolar disorder, with the greatest effects seen in the treatment and prevention of mania. Compared to divalproex, lithium also has been found to have greater efficacy in the prevention …

The Effects Of Copayments On The Use Of Medical Services And Prescription Drugs In Utah's Medicaid Program, Leighton Ku, Elaine Deschamps, Judi Hilman

Health Policy and Management Faculty Publications

In recent years, a number of states have increased cost-sharing for low-income Medicaid beneficiaries as one approach to Medicaid cost-containment. While copayments have been most commonly applied to prescription drugs, they also have been assessed for other services, such as physician visits, hospital admission, or outpatient clinic use.

Prior research has found that when low-income patients are required to pay more for health care services or for prescription drugs, they use fewer services or medications.[2] In some cases, their health could deteriorate, with the result that they may subsequently require more expensive emergency room or inpatient hospital care. While …

The Provider System For Children's Mental Health: Workforce Capacity And Effective Treatment, Jane Koppelman

National Health Policy Forum

This issue brief examines two issues that are key to meeting children’s unmet needs for mental health care: ensuring that the provider supply is adequate and that the care delivered is effective. It describes the shortage of qualified providers to address children’s mental disorders, as well its possible causes; it describes how managed care, to a certain extent, drives practice patterns; and it discusses the gray areas in deciding which providers are most qualified to deliver what care. In addition, this paper introduces what is known about evidence-based care in children’s mental health, the extent to which it is being …

Skyrockets 24/7: A Response To Flat Budgets, Skyrocketing Serials Costs, And Patron Pressure For Increased Access To Electronic Journals, Cynthia Swope, Kathe Obrig, Laura E. Abate, Anne Linton

Himmelfarb Library Faculty Posters and Presentations

This poster represents the culmination of a year’s work by the Journals@Himmelfarb committee. This intra-library committee was formed to discuss the critical issues surrounding transitioning print journal subscriptions to electronic access only. In response to these discussions, collection development policies were created to reflect both print and electronic resources, a model electronic license was created, and faculty department heads were surveyed as to the usefulness and format preference for titles in their subject area. This resulted in improved understanding of the existing collection and assisted in developing the first steps for migrating from a print to an electronic collection.

Electronic Health Records: How Close? How Far To Go?, Lisa Sprague

National Health Policy Forum

This paper looks at the central role of the electronic health record (EHR) in health information technology. It considers the extent to which EHRs are in use and initiatives designed to increase their prevalence, as well as barriers to the widespread adoption of EHRs and efforts to surmount them. Particular attention is given to such obstacles as cost, the professional culture of physicians, standardization, and legal questions.

Medicaid's Disproportionate Share Hospital Program: Complex Structure, Critical Payments, Robert E. Mechanic

National Health Policy Forum

This background paper describes the history and political evolution of Medicaid’s disproportionate share hospital (DSH) program and examines DSH as it exists today. It highlights the importance of DSH payments for the viability of safety net hospitals and considers the consequences of states’ creative financing strategies for maximizing federal Medicaid matching funds. Finally, this paper reviews several options for improving the structure and effectiveness of the DSH program.