The Experts below are selected from a list of 4392 Experts worldwide ranked by ideXlab platform
Stephen N. Kahane - One of the best experts on this subject based on the ideXlab platform.
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Designing an Emergency Medicine Physician workstation to support risk management in decision making.
Proceedings : a conference of the American Medical Informatics Association. AMIA Fall Symposium, 1996Co-Authors: Donald W. Rucker, Richard S. Johannes, Scott W. Finley, Stephen N. KahaneAbstract:The practice of Emergency Medicine requires rapid decision making. The speed of decision making in the face of limited information contributes to the high risk of medical malpractice suits. We explore design approaches to an Emergency Physician electronic medical record product, EMstation, that may reduce the risk of adverse medical events by providing cues and tools while the patient may still be in the Emergency department. EMstation is an Emergency Medicine Physician Workstation base on a Microsoft Windows 3.1 user interface. Because adaptation and adaptability to Physician needs are critical to user acceptance, design to workflow, multisite end user customization, and integrated database support are used to support risk management documentation in EMstation. This article describes techniques that can be incorporated into electronic medical products which may prevent adverse medical events.
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Aspects of risk management support for an Emergency Medicine Physician Workstation.
Proceedings. Symposium on Computer Applications in Medical Care, 1994Co-Authors: Donald W. Rucker, Richard S. Johannes, Scott W. Finley, Stephen N. KahaneAbstract:Abstract Emergency departments are high risk sites for malpractice events. EMstation™ is an Emergency Medicine Physician Workstation that incorporates tools to reduce malpractice risk in near real time (at the time of documentation). Based on a Microsoft Windows 3.1 interface, Physicians are led through color-coded templates addressing known failure modes in Emergency Medicine. Risk management opportunities available at the time of charting when the patient is often still in the department allowing real time risk reduction are explored.
Martin A Makary - One of the best experts on this subject based on the ideXlab platform.
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variation in Emergency department vs internal Medicine excess charges in the united states
JAMA Internal Medicine, 2017Co-Authors: Tim Xu, Ge Bai, Sarah Joo, Ambar Mehta, Susan Hutfless, Gerard F. Anderson, Angela Park, Martin A MakaryAbstract:Importance Uninsured and insured but out-of-network Emergency department (ED) patients are often billed hospital chargemaster prices, which exceed amounts typically paid by insurers. Objective To examine the variation in excess charges for services provided by Emergency Medicine and internal Medicine Physicians. Design, Setting, and Participants Retrospective analysis was conducted of professional fee payment claims made by the Centers for Medicare & Medicaid Services for all services provided to Medicare Part B fee-for-service beneficiaries in calendar year 2013. Data analysis was conducted from January 1 to July 31, 2016. Main Outcomes and Measures Markup ratios for ED and internal Medicine professional services, defined as the charges submitted by the hospital divided by the Medicare allowable amount. Results Our analysis included 12 337 Emergency Medicine Physicians from 2707 hospitals and 57 607 internal Medicine Physicians from 3669 hospitals in all 50 states. Services provided by Emergency Medicine Physicians had an overall markup ratio of 4.4 (340% excess charges), which was greater than the markup ratio of 2.1 (110% excess charges) for all services performed by internal Medicine Physicians. Markup ratios for all ED services ranged by hospital from 1.0 to 12.6 (median, 4.2; interquartile range [IQR], 3.3-5.8); markup ratios for all internal Medicine services ranged by hospital from 1.0 to 14.1 (median, 2.0; IQR, 1.7-2.5). The median markup ratio by hospital for ED evaluation and management procedure codes varied between 4.0 and 5.0. Among the most common ED services, laceration repair had the highest median markup ratio (7.0); Emergency Medicine Physician review of a head computed tomographic scan had the greatest interhospital variation (range, 1.6-27.7). Across hospitals, markups in the ED were often substantially higher than those in the internal Medicine department for the same services. Higher ED markup ratios were associated with hospital for-profit ownership (median, 5.7; IQR, 4.0-7.1), a greater percentage of uninsured patients seen (median, 5.0; IQR, 3.5-6.7 for ≥20% uninsured), and location (median, 5.3; IQR, 3.8-6.8 for the southeastern United States). Conclusions and Relevance Across hospitals, there is wide variation in excess charges on ED services, which are often priced higher than internal Medicine services. Our results inform policy efforts to protect uninsured and out-of-network patients from highly variable pricing.
Christopher J. Gottsegen - One of the best experts on this subject based on the ideXlab platform.
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Acromioclavicular joint injuries and reconstructions: a review of expected imaging findings and potential complications
Emergency Radiology, 2012Co-Authors: George Matcuk, Dakshesh Patel, John Itamura, Deborah Forrester, Eric White, Christopher J. GottsegenAbstract:Shoulder injuries, including acromioclavicular (AC) joint separations, remain a common reason for presentation to the Emergency room. Although the diagnosis can be made apparent through proper history and physical examination by the Emergency Medicine Physician, ascertaining the degree of injury can be difficult on the basis of clinical evaluation alone. While there is consensus in the literature that low-grade AC joint injuries can be treated with conservative management, high-grade injuries will generally require surgical intervention. Furthermore, the treatment of grade 3 injuries remains controversial, making it incumbent upon the radiologist to become comfortable with distinguishing this diagnosis from lower or higher grade injuries. Imaging of AC joint injuries after clinical evaluation is generally initiated in the Emergency room setting with plain film radiography; however, on occasion, an alternative modality may be presented to the Emergency room radiologist for interpretation. As such, it remains important to be familiar with the appearance of AC joint separations on a variety of modalities. Another possible patient presentation in both the emergent and nonemergent setting includes new onset of pain or instability in the postsurgical shoulder. In this scenario, the onus is often placed on the radiologist to determine whether the pain or instability represents the sequelae of reinjury versus a complication of surgery. The purpose of this review is to present an anatomically based discussion of imaging findings associated with AC joint separations as seen on multiple modalities, as well as to describe and elucidate a variety of potential complications which may present to the Emergency room radiologist.
Donald W. Rucker - One of the best experts on this subject based on the ideXlab platform.
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Designing an Emergency Medicine Physician workstation to support risk management in decision making.
Proceedings : a conference of the American Medical Informatics Association. AMIA Fall Symposium, 1996Co-Authors: Donald W. Rucker, Richard S. Johannes, Scott W. Finley, Stephen N. KahaneAbstract:The practice of Emergency Medicine requires rapid decision making. The speed of decision making in the face of limited information contributes to the high risk of medical malpractice suits. We explore design approaches to an Emergency Physician electronic medical record product, EMstation, that may reduce the risk of adverse medical events by providing cues and tools while the patient may still be in the Emergency department. EMstation is an Emergency Medicine Physician Workstation base on a Microsoft Windows 3.1 user interface. Because adaptation and adaptability to Physician needs are critical to user acceptance, design to workflow, multisite end user customization, and integrated database support are used to support risk management documentation in EMstation. This article describes techniques that can be incorporated into electronic medical products which may prevent adverse medical events.
-
Aspects of risk management support for an Emergency Medicine Physician Workstation.
Proceedings. Symposium on Computer Applications in Medical Care, 1994Co-Authors: Donald W. Rucker, Richard S. Johannes, Scott W. Finley, Stephen N. KahaneAbstract:Abstract Emergency departments are high risk sites for malpractice events. EMstation™ is an Emergency Medicine Physician Workstation that incorporates tools to reduce malpractice risk in near real time (at the time of documentation). Based on a Microsoft Windows 3.1 interface, Physicians are led through color-coded templates addressing known failure modes in Emergency Medicine. Risk management opportunities available at the time of charting when the patient is often still in the department allowing real time risk reduction are explored.
Tim Xu - One of the best experts on this subject based on the ideXlab platform.
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variation in Emergency department vs internal Medicine excess charges in the united states
JAMA Internal Medicine, 2017Co-Authors: Tim Xu, Ge Bai, Sarah Joo, Ambar Mehta, Susan Hutfless, Gerard F. Anderson, Angela Park, Martin A MakaryAbstract:Importance Uninsured and insured but out-of-network Emergency department (ED) patients are often billed hospital chargemaster prices, which exceed amounts typically paid by insurers. Objective To examine the variation in excess charges for services provided by Emergency Medicine and internal Medicine Physicians. Design, Setting, and Participants Retrospective analysis was conducted of professional fee payment claims made by the Centers for Medicare & Medicaid Services for all services provided to Medicare Part B fee-for-service beneficiaries in calendar year 2013. Data analysis was conducted from January 1 to July 31, 2016. Main Outcomes and Measures Markup ratios for ED and internal Medicine professional services, defined as the charges submitted by the hospital divided by the Medicare allowable amount. Results Our analysis included 12 337 Emergency Medicine Physicians from 2707 hospitals and 57 607 internal Medicine Physicians from 3669 hospitals in all 50 states. Services provided by Emergency Medicine Physicians had an overall markup ratio of 4.4 (340% excess charges), which was greater than the markup ratio of 2.1 (110% excess charges) for all services performed by internal Medicine Physicians. Markup ratios for all ED services ranged by hospital from 1.0 to 12.6 (median, 4.2; interquartile range [IQR], 3.3-5.8); markup ratios for all internal Medicine services ranged by hospital from 1.0 to 14.1 (median, 2.0; IQR, 1.7-2.5). The median markup ratio by hospital for ED evaluation and management procedure codes varied between 4.0 and 5.0. Among the most common ED services, laceration repair had the highest median markup ratio (7.0); Emergency Medicine Physician review of a head computed tomographic scan had the greatest interhospital variation (range, 1.6-27.7). Across hospitals, markups in the ED were often substantially higher than those in the internal Medicine department for the same services. Higher ED markup ratios were associated with hospital for-profit ownership (median, 5.7; IQR, 4.0-7.1), a greater percentage of uninsured patients seen (median, 5.0; IQR, 3.5-6.7 for ≥20% uninsured), and location (median, 5.3; IQR, 3.8-6.8 for the southeastern United States). Conclusions and Relevance Across hospitals, there is wide variation in excess charges on ED services, which are often priced higher than internal Medicine services. Our results inform policy efforts to protect uninsured and out-of-network patients from highly variable pricing.