Using Information Technology in Managed Care

Session: TA28
Date/Time: Tuesday 08:00-09:30
Type: Invited
Sponsor:
Track:
Cluster: Health Care Technology, Policy & Applications
Room: Executive
Chair: Douglas R. Wholey
Chair Address: Carnegie Mellon Univ., Dept. of Social & Dec. Sci., Pittsburgh, PA 15213 ,
Chair E-mail:

TA28.1 Prescription Drug Use Review Programs: Medicaid, Managed Care & Outcomes Measures Alan Lyles, Ilene Zuckerman --- John Hopkins Univ., Sch. Hygiene & Public Health, 615 N Wolfe St., Baltimore, MD 21205-2179, (alyles@phnet.sph.jhu.edu)
DUR identifies and corrects preventable drug therapy misuse. Current state waivers moving medical assistance patients into managed care plans increase the timeliness of valid and effective criteria for drug use profiling and interdicting potential hazardous exposures (prosective DUR) as well as profiling patterns of prescribing (retrospective DUR).

TA28.2 Physician Profiling in Group Practices Christopher P. Tompkins, Sarita Bhalotra --- Brandeis Univ., Inst. for Health Policy, Heller Grad. Sch., Waltham, MA 02254-9110, (tompkins1@binah.cc.brandeis.edu)
Profiling is a technique that multispeciality group practices can use to improve quality and efficiency. Groups can examine physician performance by calculating ratios of medical inputs to patient or population outputs. We analyze group claims data and suggest how physician profiling can help organizations balance clinical and economic considerations.

TA28.3 New Clinical Uses of Computerized Health Adminstration Data David Knutson --- Inst. for Research & Education, Health Systems Studies, 3800 Park Nicolleet Blvd., Minneapolis, MN ,
Mr. Knutson will describe new clinical uses of computerized health care data designed for patient enrollment, billing and budgeting. These include clinical epidemiological assessment of populations and episode of care specific process and assessment of conformance with clinical guidelines for external accountability and of practice variation for clinical process improvement.

TA28.4 The Current State of Information Systems in Health Maintenance Organizations Douglas R. Wholey, Rema Padman, Richard Hamer, Shawn Schwartz, Randi Stillman --- Carnegie Mellon Univ., Dept. of Social & Dec. Sci., Pittsburgh, PA 15213 , (wholey+@andrew.cmu.edu)
We present the results of a national survey on IT and development in health maintenance organizations. We describe functions supported, new technology utilization, costs and staffing, physician and purchaser support systems and data captured and maintained. Multivariate analyses show the effect of HMO characteristics on IT use.


INFORMS Online