Originally published in English in 1986, these volumes are far more than the story of the life of a powerful statesman. The name Bismarck sums up the entire political, social, economic and intellectual development of central Europe in the second half of the 19th Century and the internal and external shape that Germany then assumed. This book analyses how much of this was Bismarck's personal achievement or whether he was the man who put the nation on the disastrously wrong course that reached its fateful culmination in 1933? It examines whether Bismarck's success was precisely because he implemented policies for which the time was ripe and did so in ways that were in harmony with the historical evolution of central Europe.

Analyzing Form, Function, and Financing of the U.S. Health Care System tells the story of the U.S. health care system by using a narrative approach identifying function rather than the more common data-driven focus on structure. It presents policy decisions we have made about our health care system and analyzes some of their consequences to better understand the choices we have. To facilitate this, the book is divided into four major sections. Section I is mostly "about" the health care system. It describes several theoretical models that provide a foundation for the structure of the U.S. health care system. Section II provides a description of the form, or organization, of the U.S. health care delivery system. It presents a comprehensive overview of the entire health care delivery system, including identifying all levels of care. Section III focuses on financing, beginning with a description of the economic and political values that determine how we finance our system. It describes health insurance, from the perspective of both the consumer and the provider, and discusses how money moves through the system. It concludes with a discussion and analysis of cost and cost control efforts. Section IV describes some of the more important efforts in health care reform, including several targeted programs that are a significant part of the U.S. health care system, such as Medicare and Medicaid. It also describes other targeted programs within the U.S. health care system and explores how other countries with economies similar to that of the United States organize and finance their health care systems.

Advances in health information technology (health IT) have the potential to improve the quality of healthcare, to increase the availability of health information for treatment, and to implement safeguards that cannot be applied easily or cost-effectively to paper-based health records. However, the digitization of health information is also raising new privacy risks and concerns. Sensitive health information in digital form is more easily aggregated, used, and shared. In addition, the rising cost of healthcare and the search for efficiency may create incentives to use the information in new ways. Research has consistently shown that while the public sees the potential value of health information exchange and technological advancements, it remains gravely concerned about the privacy of their sensitive health information. As a result, it is becoming increasingly clear that ensuring public trust will be critical to the successful implementation of nationwide health information exchange. The purpose of this second edition is two-fold: 1) to educate readers about privacy concepts and 2) highlight key privacy issues facing the nation and the healthcare community as it moves towards electronic health records and health information exchange. The first three chapters are descriptive in nature, defining privacy and distinguishing it from security, defining the complex legal landscape for health information privacy, and setting the stage for the following chapters by describing the current landscape of the evolving healthcare environment. The following chapters discuss specific privacy issues and challenges in detail. The book concludes with a chapter providing a view to the future of healthcare and the association privacy implications. This is an updated version of one of HIMSS' best-selling books on information privacy.

China witnessed an unprecedented economic boom in the past four decades but will soon see the end of "demographic dividend". With shrinking labor, improving the quality of human capital could be one way to maintain China's remarkable growth. The population in rural China accounts for 41% of the total population in China but the human capital development in rural China lags far behind the urban cities. This book selects four major reforms on education and health in rural China and evaluates the impact of these reforms on human capital development. Through rigorous econometric analysis, the book looks at factors of the rural-urban gap in human capital and the causal relationship between the reforms and the human capital development. This book will be a useful reference for developing economies which are facing similar issues in the labor market.

Healthcare IT is a complex and rapidly evolving field. Success in this arena requires the ability to create a vision, set a strategy, foster collaboration, develop a plan and execute flawlessly every day. This book provides a clear, concise roadmap for professionals who currently manage, direct or oversee healthcare IT. Through case studies and examples, the author includes highly relevant topics such as delivering and communicating HIT values, managing information security, and connectivity challenges, as well as organizational strategy, alignment and vision of HIT, risk management, performance management and process improvement using Lean methodologies.

Transformation and Your New EHR offers a robust communication and change leadership approach to support electronic health record (EHR) implementations and transformation journeys. This book highlights the approach and philosophy of communication, change leadership, and systems and process design, giving readers a practical view into the successes and failures that can be experienced throughout the evolution of an EHR implementation.

A multiplicity of factors converging together suggest the long term/post-acute care (LTPAC) provider community (e.g. nursing homes, behavioral health facilities, home health agencies, etc.) will accelerate in importance within the healthcare ecosystem during the next few years. The challenge for many LTPAC providers in this emerging environment will be to advance their clinical health information technologies (health IT) capabilities in order to "play" with other providers in the healthcare "sandbox." This book is designed to assist LTPAC leaders in identifying and exploring the array of critical issues one needs to consider in order to operate within an advanced clinical health IT ecosystem. This book surveys key issues surrounding the use of clinical health IT in LTPAC settings, to include providing readers with a suggested strategic plan and roadmap for selecting and installing digital health technologies in LTPAC organizations. Though the focus of the book primarily centers on the U.S. LTPAC provider's experience, the authors also spend time addressing global and future LTPAC considerations.

The US political system has come to depend upon money too much. The US health care industry spends the most on political lobbying among all the 13 industrial sectors in the US economy. The government regulatory agencies at both federal and state levels have been "captured" by the health industry interest groups meaning that the regulatory agencies respond to the interests of the industry but not those of citizens. This book employs a broad theoretical framework of crony capitalism to understand US health care system dysfunction. This framework has not been applied before in any serious manner to understand the shortcomings in the US health care system. Specifically, the book examines the role of seven key players using this framework - politicians/interest groups, pharmaceutical companies, private health insurers, hospitals/hospital networks, physicians, medical device manufacturers, and the American public. Crony capitalism is a destructive force and is rampant in US health care system, causing much waste, inefficiencies, and malaise in the system. Current efforts and initiatives, such as patient-centered medical homes and precision medicine, for improving/reforming the system are of mere academic interest and tantamount to taking aspirin to treat cancer. They do not even pretend to address the root cause of the problem, namely, crony capitalism. Offering prescriptions to fix the U.S. health care system based on a comprehensive diagnosis of the dysfunction, this book will be of interest to researchers, academics, policymakers, and students in the fields of health care management, public and non-profit management, health policy, administration, and economics, and political science.

Winner of a 2016 Shingo Research and Professional Publication Award! A recent article published in the Journal of Patient Safety estimated that more than 400,000 lives are lost each year due to preventable patient events in American hospitals. Preventable patient safety events are the third leading cause of death in the United States. While most health care organizations know they need to improve patient safety, most lack an understanding of the steps required to develop and implement an effective patient safety program. Baylor Scott & White Health has successfully created a strong culture of patient safety. In 2013, Baylor Health Care System published the book Achieving STEEEP Health Care, which describes its quality improvement journey via the STEEEP framework of delivering care that is Safe, Timely, Effective, Efficient, Equitable, and Patient-centered. This book provides a detailed overview of the Baylor Scott & White Health approach to the delivery of safe care, the leading aim of the STEEEP quality and patient safety framework. It presents real-life examples, practical approaches, and tools for improving patient safety. The book is structured around some of the key components of patient safety such as the importance of strategic efforts in categories of culture, processes, and technology. Maintaining a focus on human factors in patient safety and health care, the book explains the need for advanced analytics along with long-term learning and corporate resources. This book describes how to develop appropriate goals, formulate strategies to meet those goals, and implement techniques to improve patient safety based on the experience of Baylor Scott & White Health.

While many health care organizations need to improve health care quality and lower costs, most lack specific strategies and tactics for implementing these changes. Baylor Scott & White Health has established and continues to develop an accountable care organization (ACO) called the Baylor Scott & White Quality Alliance (BSWQA) to improve the quality of care and decrease health care costs through clinical integration. Accountable: The Baylor Scott & White Quality Alliance Accountable Care Journey tells the story of the BSWQA and its clinical network and payers who are committed to delivering accountable, value-based patient care. It describes the need for ACOs in today's health care environment and details the framework and requirements needed to establish one. The book provides readers with essential background information about accountable care, including the Triple Aim and population health management. It outlines the infrastructure and governance framework needed to establish a successful ACO and supplies real-world examples from the ACO owned by Baylor Scott & White Health, the largest not-for-profit health care system in Texas. The book explores the concept of accountability for all stakeholders in today's complex care systems, as well as the role of personal and organizational accountability in managing patient populations. It also includes detailed outlines to guide you in developing your own accountable care organization-from step-by-step details of legal requirements to an outline of the role of payers in this model.

Research shows that the importance of patient-reported outcomes, improved decision support, and care coordination is growing rapidly as new payment models transform healthcare delivery. This has led to the use of new measures and communication techniques, including shared decision-making and motivational interviewing. Using patient-reported outcomes at the point of service helps providers identify what matters most to the patient in front of them now. Describing treatment options and deciphering a patient's preferences effectively is a process, which has been likened to arriving at a diagnosis. Providers make a medical diagnosis by discerning a patient's primary complaints, past history, exam findings, and test results. A preference diagnosis can be thought of similarly. Providers work with their patients to identify what matters most to them, discuss the risks and benefits of the available treatment options, and support the patient as needed through the decision-making process. Once informed of their options, patients frequently chose treatments that require modifying their habits. Motivational interviewing helps patients and providers understand what matters most now and design care plans that provide appropriate support. While many healthcare providers and leaders may be familiar with patient-reported outcomes from research articles, and have heard of shared decision-making and motivational interviewing, few have experience using them. Fewer still understand how each relates to the other. This book helps leaders and healthcare providers better understand how to use patient-reported data to their advantage at the point of service. The book provides the background for developing shared knowledge and shared language, along with extensive examples of dialogue between providers and patients. In addition, the book contains personal interviews of subject matter experts who have significant experience using these measures. The result is a comprehensive understanding of how these measures and techniques can help providers, organizations, and patients navigate this modern healthcare management opportunity.

Healthcare Workforce Transitioning shares with educators and healthcare professionals alike the awareness, integration, and partnership that results from a successful process of framing a Healthcare Management Program around core competencies. To transition toward a successful healthcare career requires proficiencies in communication, leadership, professionalism, knowledge of the healthcare environment, and business skills. Competencies provide context to curriculum construction and build awareness of the role this standard plays in a career-ready workforce. Integrating professional development and service learning into co-curricular activities further strengthens outcomes. Partnering with healthcare professionals through ongoing World Cafe conversations, contributes a touchstone about expectations and accountabilities to be successful in a career. This book draws on the World Cafe methodology, guidelines, and vignettes in developing performance assessment, coaching, training, and performance reviews. The author provides lessons learned throughout the text to illustrate the points made in the chapters. It also provides a proven participatory methodology applied to competency exploration, application, and authentication.

Concierge medicine represents a relatively novel health care delivery model that is becoming more appealing both to providers and patients because of its potential to improve quality and value in health care. A gap exists in the current literature regarding the benefits and challenges associated with concierge medicine as well as best practices for developing and sustaining a successful, patient-centered concierge practice. This book aims to close the gap by discussing the role of concierge medicine in the context of the evolving U.S. healthcare system and the changes produced by the Affordable Care Act. It will address questions about affordability, access, quality, value, communication, technology, and patient-centered care, and will include real-world best practice examples from a successful concierge medicine practice.

Carter's Psychopathology is an accessible, engaging, and well-organized text covering the study, understanding, diagnosis, treatment, and prevention of psychological disorders. Fully integrating gender and culture in the presentation of mental disorders, and using a sensitive and inclusive language to encourage an empathic approach to psychopathology, this introductory textbook offers students a strong foundation of the socio-cultural factors influencing how we treat mental disorders. Featuring: boxes such as 'the power of words', promoting the use of respectful, empathic language, and 'the power of evidence', demonstrating that scientific evidence can answer questions about psychopathology treatments; real-world case studies and examples; 'concept checks' questions to test the student's mastery of the material covered in each section; chapter summaries listing the 'take-home' points discussed; and key terms and glossary highlighting terms that students will need to understand and become familiar with, this textbook provides a hands-on approach to the study of psychopathology.

With the use of electronic health records (EHR) transforming the healthcare industry, the use of information technology in the maintenance of personal health records poses a range of issues and opportunities for every medical organization, The Cyber Patient expertly walks readers through the elements required for an efficient, well-run healthcare record management system, while reflecting the U.S. government's goal of achieving widespread adoption of interoperable electronic health records to improve the quality and efficiency of healthcare while maintaining the levels of security and privacy that consumers expect. The author also provides an update as to where the industry stands in their push of interoperability and the increased use of data as an analytic tools. Providing an application readers can adopt as a model, this important book examines the infrastructure of electronic health records and how government criteria have impacted and will continue to impact both private and public marketplaces. This valuable resource also addresses how auditors, controllers, and healthcare providers can keep up with the market's continued move towards an interoperable e-health world, without neglecting clinical and financial accountability in the delivery of healthcare. As e-health continues to develop and transform, The Cyber Patient thoughtfully prepares professionals to plan and implement an effective EHR as wel as internal controls system within any clinical setting.

Medical practice and research are inconceivable today without electronic computing and communication tools. Digital machines do many tasks orders-of-magnitude better, faster and more accurately than humans. Still, there are functions critical to the healthcare endeavor that people do much better than machines, things like: understanding and using natural language; perceiving what is unexpressed; taking into account values, culture, ethics, and human relationships; touching and healing. For the foreseeable future, the "smartest" computers will be no match for human beings when it comes to performing these most anthropic functions. American healthcare is at a critical juncture. Providers and patients are increasingly frustrated by degradation of the human relationships that lie at the core of the medical practice. Technologies, such as the computerized medical record, get much of the blame for intrusion into the patient-provider relationship. However, it is not technology itself that is to blame. The fault lies with how systems are conceived, designed, and deployed. This book analyzes how to organize the work of healthcare in a way that uses machines to do what they do best, thereby freeing humans to do what we do best. Smart use of electronic technology is crucial to the success of any bid to fulfill the Institute for Healthcare Improvement's triple aim to make healthcare more effective, efficient, and humane.

Authentic leadership is an approach to leadership that emphasizes building the leader's legitimacy through honest relationships with followers which value their input and are built on an ethical foundation. By building trust and generating enthusiastic support from their subordinates, authentic leaders are able to improve individual and team performance. Many scholars and practitioners of authentic leadership say that the number one quality of an authentic leader is self-awareness. Self-aware leaders are transformational. Armed with self-awareness they build engaging, cooperative teams. How to gain and sustain self-awareness is the focus of the book. This book addresses current leadership challenges in health care and gives leaders guidelines for finding, living and sharing their authentic voice at home and at work. It is a much needed handbook to give current leaders perspective and practical tips to being more authentic, communicating more effectively while building engaging rapport across the organization. Additionally, a focus of the book is patient satisfaction. With a focus on nurse and physician leadership, this book provides new perspectives and action plans to increase patient satisfaction through communication that speaks to the needs of the patient in authentic and engaging ways.

This third edition presents and dissects a wide variety of HIT failures so that the reader can understand in each case what went wrong and why and how to avoid such problems, without focusing on the involvement of specific people, organizations, or vendors. The lessons may be applied to future and existing projects, or used to understand why a previous project failed. The reader also learns how common causes of failure affect different kinds of HIT projects and with different results. Cases are organized by the type of focus (hospital care, ambulatory care, and community). Each case provides analysis by an author who was involved in the project plus the insight of an HIT expert. This book presents a model to discuss HIT failures in a safe and protected manner, providing an opportunity to focus on the lessons offered by a failed initiative as opposed to worrying about potential retribution for exposing a project as having failed. Access expert insight into key obstacles that must be overcome to leverage IT and transform healthcare. Each de-identified case study includes an analysis by a group of industry experts along with a counter analysis. Cases include a list of key words and are categorized by project (e.g. CPOE, business intelligence). Each case study concludes with a lesson learned section. Thought provoking commentary chapters add additional context to the challenges faced during HIT projects, from social and organizational to legal and contractual.

Issues surrounding business complexity plague organizations throughout the world. This situation is particularly true of the numerous complex projects and programs upon which organizations embark on a regular basis. Current project management processes and standards are based on Newtonian/Cartesian principles, such as linearity, reductionism, and single source problem causation. However, complex projects exhibit both Newtonian/Cartesian characteristics and complex systems characteristics, such as emergence, self-organization, non-linearity, non-reductionism, and multi-source problem causation. To conduct successful projects, complementary ways of approaching projects are required, and new competencies for those who manage projects and for those on project teams are required as well. There are a number of books available to help project managers and teams address the issue of systems behavior. However, there are none that approach complex projects from a neuroscience-based approach to human behavior and ambiguity. This book does exactly that in order to reduce project complexity and thereby increase the probability of project success. Cognitive Readiness in Project Teams looks to the concept of cognitive readiness (CR), first developed by the United States Department of Defense to better prepare and manage teams of individuals in complex battlefield situations. Its intent is to make project managers and teams more focused, responsive, resilient and adaptive through self-mastery and the mastering of interpersonal relationships. It introduces a CR framework for project managers and teams. This framework has neuroscience fundamentals and theorems as the foundation for the three pillars of CR: mindfulness, emotional intelligence, and social intelligence. The book is a compendium of chapters written by renowned authors in the fields of project management, neuroscience, mindfulness, and emotional and social intelligence.

Blockchain technology is poised to revolutionize more than just payment and crypto-currency. Many vertical industries will be reshaped by the new trusted data models enabled and inspired by the blockchain - healthcare is no exception. In fact, healthcare may hold the greatest opportunities for meaningful use of the technology. Early pioneers have explored some of the first use cases for medical payments, electronic health records, HIPAA/data privacy, drug counterfeiting, and credentialing of healthcare professionals. We have only begun to scratch the surface in how to automate the complexities of today's healthcare systems and design new systems which focus on trust, transparency and the alignment of incentives. Metcalf, Bass, Dhillon, and Hooper have curated a collection of examples based on the fundamentals of blockchain that build upon the early successes and examples that point to the future. After a brief introduction to bitcoin, blockchain and the protocols available, a getting-started guide is presented specific to health and healthcare. The authors discuss the complexities and possibilities of smart contracts and some of the early consortia that are exploring the possibilities. Examples and use cases are found throughout the book, with specific sections that cover the more sophisticated and far-reaching examples which have the potential to scale at the industry-level. In addition, a discussion of integrating blockchain technology into other advanced healthcare trends and IT systems - such as telemedicine, artificial intelligence, machine learning, the Internet of Things, value-based payments , patient engagement solutions, big data solutions, medical tourism, and precision medicine/genetic therapies among many others are presented. The final section provides a glimpse into the future using blockchain technology and examples of research projects that are still in labs across the globe. The appendices may prove particularly useful for additional details on how to get started, including resources and organizations specifically focusing on blockchain and distributed ledger solutions.

Never before in the healthcare industry has there been such intense emphasis and open debate on the issue of quality. The steady rise in the cost of healthcare coupled with the need for quality have combined to put the healthcare industry at the top of the national agenda. Quality, costs, and service are not just socially provocative ideas. They are critical criteria for decision-making by patients, physicians, and many key constituents of healthcare organizations. The pursuit of improved performance has driven a host of executives and managers in search of techniques for structuring, rehabilitating, redesigning, and reengineering the organizations they serve. Unfortunately, the narrow-mindedness with which programs are implemented and the discontinuity in their application weaken the promise of success. The process of quality improvement can become an undisciplined search for illusions rather than reality. For many years, healthcare managers have embraced the narrow definition of performance solely in the context of financial success. Forward-thinking executives now realize that the road to financial success begins with success in quality and service. Quality and service are no longer separate issues - they are the same. Neither one by itself will bring about lasting success. The ultimate measure of performance is in an organization's ability to create value for its customers, and true performance must be measured in the context of the customers' total experience. This book is about how to manage performance in the context of value to the customer or patient. It brings together the many pieces of the performance improvement puzzle - quality, technology, costs, productivity, and customer service. The author also covers process improvement tools including Lean and Six Sigma, and how to create a culture of continuous improvement as well as how to improve the patient experience and productivity improvement strategies. The book is filled with examples, illustrations, and tools for improving key aspects of a healthcare organization's performance.

Like other critical organizational assets, information is a strategic asset that requires high level of oversight in order to be able to effectively use it for organizational decision-making, performance improvement, cost management, and risk mitigation. Adopting an information governance program shows a healthcare organization's commitment to managing its information as a valued strategic asset. Information governance serves the dual purpose of optimizing the ability to extract clinical and business value from healthcare information while meeting compliance needs and mitigating risk. Healthcare organizations that have information governance programs will have a competitive edge over others and contributes to safety and quality of care, population health, operational efficiency and effectiveness, and cost reduction initiatives. This is a much-needed book in the healthcare market space. It will explain, in clear terms, how to develop, launch, and oversee an Information Governance program. It also provides advice and insights from leading IG, cybersecurity and information privacy professionals in healthcare.

Healthcare economics is a topic of increasing importance due to the substantial changes that are expected to radically alter the way Americans obtain and finance healthcare. Understanding Healthcare Economics, 2nd Edition provides an evidence-based framework to help practitioners comprehend the changes already underway in our nation's healthcare system. It presents important economic facts and explains the economic concepts needed to understand the implications of these facts. It also summarizes the results of recent empirical studies on access, cost, and quality problems in today's healthcare system. The material is presented in two sections. Section 1 focuses on the healthcare access, cost and quality issues that create pressures for change in health policy. The first edition was completed just as the Patient Protection and Affordable Care Act (PPACA) was debated and passed. This new edition updates the information about access, cost, and quality issues. It also discusses the pressure for change that led to the passage of the PPACA, evidence that shaped the construction of the act, evidence on the impacts of the PPACA, and evidence on the pressures for future changes. Section 2 focuses on changes that are underway including: changes in the Medicare payment system; new types of healthcare delivery organizations such as ACOs and patient-centered medical homes. It also discusses the current efforts to help patients build health such as wellness programs and disease management programs. And finally, health information technology will be discussed. The new edition will maintain the current structure; however each chapter will be updated to discuss post-PPACA evidence on each type of type. In addition to the updates previously mentioned, the authors will present a series of data explorations to several chapters. Most of the new data explorations present summarized statistical information based on de-identified data from one hospital electronic data system. These data explorations serve two purposes. First, they illustrate the impacts of the pressures for change - and some of the changes - on healthcare providers. For example, the data illustrates the financial impact of pre-PPACA uncompensated care. Second, explanation of the data will require explanations of standard coding systems that are used nationwide (DRGs, CPT, ICD) codes. Other data explorations provide detail about other sources of data useful for health policy analysis, and for healthcare providers and insurers.

Healthcare transformation requires us to continually look at new and better ways to manage insights - both within and outside the organization today. Increasingly, the ability to glean and operationalize new insights efficiently as a byproduct of an organization's day-to-day operations is becoming vital to hospitals and health systems ability to survive and prosper. One of the long-standing challenges in healthcare informatics has been the ability to deal with the sheer variety and volume of disparate healthcare data and the increasing need to derive veracity and value out of it. Demystifying Big Data and Machine Learning for Healthcare investigates how healthcare organizations can leverage this tapestry of big data to discover new business value, use cases, and knowledge as well as how big data can be woven into pre-existing business intelligence and analytics efforts. This book focuses on teaching you how to: Develop skills needed to identify and demolish big-data myths Become an expert in separating hype from reality Understand the V's that matter in healthcare and why Harmonize the 4 C's across little and big data Choose data fi delity over data quality Learn how to apply the NRF Framework Master applied machine learning for healthcare Conduct a guided tour of learning algorithms Recognize and be prepared for the future of artificial intelligence in healthcare via best practices, feedback loops, and contextually intelligent agents (CIAs) The variety of data in healthcare spans multiple business workflows, formats (structured, un-, and semi-structured), integration at point of care/need, and integration with existing knowledge. In order to deal with these realities, the authors propose new approaches to creating a knowledge-driven learning organization-based on new and existing strategies, methods and technologies. This book will address the long-standing challenges in healthcare informatics and provide pragmatic recommendations on how to deal with them.

This book reveals and describes the leadership and culture change required to remove waste from healthcare processes and eliminate the root cause of soaring costs, poor quality and safety, and limited access. The book's delivery strategy revolves around personal and organizational stories and case studies told by physician and administrative leaders, all students of the Toyota Production System. This revised edition uniquely blends updated case studies with practical theory to describe how the healthcare value proposition can be changed by reducing waste, variation and complexity in healthcare. New to the book are chapters on clinical standard work and integration of lean and safety.