Health affairs
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Provisions of the American Recovery and Reinvestment Act authorize incentive payments to hospitals and clinicians who become "meaningful users" of health information technology (IT). We argue that various private-sector entities--commercial payers, employers, consumer groups, health care ratings organizations, large provider organizations, and regulatory bodies--can further accelerate health IT adoption by implementing strategies that are complementary to the Medicare and Medicaid incentive programs. This paper describes these strategies and potential approaches to implementation.
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The first decade of the patient safety movement achieved some real gains, focused as it was on adverse events amenable to systemwide solutions, such as infections associated with health care and medication errors. However, diagnostic errors, although common and often serious, have not received comparable attention. ⋯ Health information technology, better training, and increasing acknowledgment of the problem hold some promise. As approaches to measuring, preventing, and mitigating harm from diagnostic errors are proven to work, it will be important to integrate these approaches into policy initiatives to improve patient safety.
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Comparative Study
Many emergency department visits could be managed at urgent care centers and retail clinics.
Americans seek a large amount of nonemergency care in emergency departments, where they often encounter long waits to be seen. Urgent care centers and retail clinics have emerged as alternatives to the emergency department for nonemergency care. ⋯ There is some evidence that patients can safely direct themselves to these alternative sites. However, more research is needed to ensure that care of equivalent quality is provided at urgent care centers and retail clinics compared to emergency departments.