Medicine and Health Sciences Commons^™

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.

Fundamentals Of Community Health Centers, Jessamyn Taylor

National Health Policy Forum

This background paper examines the dominant model of federal grant funding for primary care in the health care safety net: the community health center. It describes the history of the health center program and highlights key policy issues influencing health centers, such as Medicaid payment policies and medically underserved area designations. The paper also examines the recent presidential initiative to expand health centers, including a review of the process used to identify new grantees, an assessment of remaining gaps in capacity, an exploration of continuing challenges, and a discussion of unresolved policy questions.

A Report From The Forum Session "Implementing The New Medicare Drug Benefit: Challenges And Opportunities For States", Judith D. Moore

National Health Policy Forum

The National Health Policy Forum convened a meeting on July 22, 2004 to discuss state-based challenges associated with implementing the Medicare Prescription Drug, Improvement, and Modernization Act (MMA). The meeting brought together an extremely insightful and experienced group of current and former state officials and other experts to discuss key issues. In keeping with its tradition of promoting a frank, off-the-record exchange on health policy issues, NHPF does not normally prepare written summaries or reports of meetings. However, because this meeting provided vivid illustrations of the importance of state-federal collaboration for the successful implementation of the new Medicare drug benefit, …

Tick-Tock: Preparing For The Next Influenza Pandemic, Eileen Salinsky

National Health Policy Forum

This paper describes the nature of pandemic influenza and highlights key challenges for responding to this disease threat. It explains how an influenza pandemic would differ from annual influenza outbreaks and examines how a pandemic virus could emerge. It also explores important issues involved in pandemic preparedness capabilities, including disease surveillance, vaccine production and distribution, antiviral stockpiling, health care system readiness, and public health containment measures. The national pandemic preparedness plan is briefly reviewed, and unresolved policy issues related to the plan’s implementation are identified.

Fundamentals Of The Prescription Drug Market, Christie Provost Peters

National Health Policy Forum

This background paper is a primer on the prescription drug market. It provides information on the fundamentals of the pharmaceutical industry and various marketplace stakeholders, including manufacturers, retailers, consumers, regulators, researchers, and purchasers. This paper also examines the various ways the federal government interacts with the pharmaceutical market. Due to the breadth of material addressed, some complex issues and relationships are presented in broad conceptual terms without extensive technical detail.

Information Interface - Volume 32, Issue 3 - August/September 2004, 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 digital microscopes, Ovid OpenLinks and PubMed Linkout, library liaisons, and database search tips.

The Promise And The Reality Of Long-Term Care Insurance, Randy Desonia

National Health Policy Forum

The aging of the nation’s population will create a surge in the need for long-term care services, putting pressure on existing funding sources and fueling demand for more. This paper examines one financing option—private long-term care insurance—and summarizes its brief history and the several critical precedents that have influenced the products as currently sold. Other topics discussed include the challenges to encouraging sales growth as well as increasing the role of this type of insurance in paying for long-term care.

Medicaid Prescription Drug Spending And Use, Brian Bruen, Arunabh Ghosh

Health Policy and Management Issue Briefs

No abstract provided.

The Economics Of Quality: Changing Incentives In Cincinnati, Lisa Sprague, Nora Super

National Health Policy Forum

This site visit focused on private market dynamics and quality improvement initiatives. Cincinnati is characterized by strong players in all sectors of the market: employers such as Procter and Gamble and General Electric, hospital systems, health plans, and physician groups with the power to “push back” in contract negotiations. The city is a pilot site for Bridges to Excellence, a pay-for-performance initiative spearheaded by GE. Cincinnati Children’s Hospital Medical Center is a grantee under the Robert Wood Johnson Foundation’s Pursuing Perfection program. Among the issues explored were physician supply, incentive structures, specialty hospitals, and information technology.

Consumer Cost Sharing In Private Health Insurance: On The Threshold Of Change, Veronica V. Goff

National Health Policy Forum

Employers are asking employees to pay more for health care through higher premium contributions, share of contribution, and out-of-pocket maximums, along with variations in deductibles, copays, and coinsurance based on choice of providers, networks, drugs, and other services. This issue brief examines consumer cost-sharing trends in private insurance, discusses the outlook for cost sharing in employment-based benefits, and considers public policies to support health care markets for consumers.

Medicare's Chronic Care Improvement Pilot Program: What Is Its Potential?, Nora Super

National Health Policy Forum

This paper describes the voluntary chronic care improvement program under traditional fee-for-service Medicare as authorized by the Medicare Prescription Drug, Improvement, and Modernization Act (MMA) of 2003 (Public Law 108-173; section 721). This brief analyzes the emerging issues raised by this new program, including which chronic conditions and regional areas will be targeted, the types of entities that may participate, the physician’s role in care management, and the adoption and use of health information technology and evidence-based clinical guidelines.

Seize The Power: Librarian Roles In Developing And Implementing Enterprise-Wide Hipaa Training, Shelley Bader, Alexandra Gomes

Himmelfarb Library Faculty Posters and Presentations

Himmelfarb Health Sciences Library librarians collaborated to develop a web-based HIPAA training module for the medical center. Content was based on materials from an outside legal expert. Special attention was given to clinical scenarios illustrating key issues in HIPAA regulations. Librarians drafted the module which was then reviewed by legal consul, the George Washington University School of Medicine and Health Sciences, and the Graduate Medical Office. The final module was disseminated via the university's course management system. A corresponding module was developed for CME credit.

Information Interface - Volume 32, Issue 2 - May/June 2004, 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 medical publishing, AHEC summer program, a journals shift project, and database search tips.

Integration Of Medical Informatics Curriculum Into Problem-Based Learning (Pbl) Course For 1st Year Medical Students, Laura E. Abate, Anne Linton, Patricia Wilson

Himmelfarb Library Faculty Posters and Presentations

Himmelfarb Health Sciences Library librarians developed and taught "Introduction to Medical Informatics" to first-year medical students through the 2002/03 school year. In 2003/04, this course was restructured and integrated into the "Problem-Based Learning" (PBL) course taken by all first-year medical students. The goal was to improve resource selection and search skills, provide point-of-use learning and instruction, and to enhance the student experience. Librarians were assigned to individual PBL groups to act as advisors and guided the students through the informatics-related curriculum.

Empowering Faculty To Choose: Open Access And Alternative Publishing, Laura E. Abate, Leah Pellegrino, Anne Linton, Patricia Wilson

Himmelfarb Library Faculty Posters and Presentations

Himmelfarb Health Sciences Library librarians initiated an effort to increase awareness of alternative publishing venues which exist outside the commercial arena; to encourage faculty to investigate electronic publishing alternatives; and to provide a connection to open access initiatives. George Washington University now participates in four open access initiatives and interest is growing among GWU faculty.

Pda Power At The Bedside, Patricia Wilson, Richard Billingsley, Leah Pellegrino

Himmelfarb Library Faculty Posters and Presentations

Himmelfarb Health Sciences Library developed a pilot project to evaluate PDA use in medical education. A grant was secured to fund the purchase of medical reference software. The objective of the pilot project was to analyze usage of PDA software by medical students, residents, and physician assistant students in a clinical setting.

Veterans' Health Care: Balancing Resources And Responsibilities, Lisa Sprague

National Health Policy Forum

This paper looks at the health care benefits and services administered by the U.S. Department of Veterans Affairs. It examines management strategies adopted within the department to allocate resources, structure benefits, and improve quality. Some recommendations made by the General Accounting Office and the President’s Task Force to Improve Health Care Delivery for Our Nation’s Veterans are reviewed, in particular the emphasis of the latter on increased collaboration with the Department of Defense. Long-term proposals to balance service commitments and financing also are considered.

Necessary But Not Sufficient? Physician Volunteerism And The Health Care Safety Net, Eileen Salinsky

National Health Policy Forum

This paper examines the role of physician-sponsored charity care in meeting the health care needs of the uninsured. The paper provides an overview of current charity care levels by medical specialties and geographic regions, discusses limitations in available data, and describes the settings in which charity care is provided. The paper also summarizes the factors that motivate physicians to provide volunteer services, as well as the barriers that hinder volunteer activities, including malpractice insurance concerns. Also discussed are a range of public policies, both existing and considered, that support volunteer activities, with a particular emphasis on the expansion of Federal …

Consortia Purchasing: The Himmelfarb Experience, Patricia Wilson, Anne Linton

Himmelfarb Library Faculty Posters and Presentations

Most academic health sciences libraries are faced with either zero growth or shrinking budgets. At the same time, faculty, staff, and students are demanding access to more and more resources, and libraries are expected to support students in new and expanding programs in areas such as public health and genetics. The format of choice is electronic, and 24/7 service from any location is the expectation. The Himmelfarb Health Sciences Library found it was necessary to build a series of strategic alliances to meet these new demands in difficult financial times. Alliances have been formed with campus libraries, campus academic support …

The Health Care Safety Net In South Carolina: A Test Of Tenacity, Jennifer Ryan, Randy Desonia

National Health Policy Forum

This site visit to the state of South Carolina provided an opportunity to experience and understand the unique makeup of the health care safety net in a southern state. Site visitors had the opportunity to interact with health care providers, state officials, faith-based organizations and leaders of provider-driven volunteer initiatives. They also learned about the challenges of access to care in rural areas and among diverse population groups. The group visited the Sea Island Medical Center and Our Lady of Mercy Community Outreach and Wellness House; a migrant farm worker camp on Johns Island; and a “medical home” site, Medical …

Democratic Ideas To Address The Problem Of Americans Without Health Insurance, Jeanne Lambrew

Health Policy and Management Congressional Testimonies

No abstract provided.

2004 Mla Poster, Himmelfarb Staff

Himmelfarb Library Faculty Posters and Presentations

No abstract provided.

Environmental Risk Factors In Hospital Suicide., Daniel Z Lieberman, Harvey L P Resnik, Vicenzio Holder-Perkins

Psychiatry and Behavioral Sciences Faculty Publications

Suicide of hospitalized patients is the most common sentinel event reviewed by The Joint Commission on Accreditation of Healthcare Organizations. Shorter lengths of stay, sicker patients, and higher patient to staff ratios challenge the ability of the hospital to maintain safety. Risk factors associated with the physical environment of the inpatient psychiatric unit, cited as the most common root cause of inpatient suicide, may be neglected because evaluation of these factors is generally not included in medical education and training. Minimization of fixtures that can facilitate strangulation and other high risk aspects within the hospital environment is an important element …

Information Interface - Volume 32, Issue 1 - January/February 2004, 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 offsite journals, added features to MEDLINE/PubMed, new journal titles, and database search tips.