HMO practice / HMO Group
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HMO practice / HMO Group · May 1991
After-hours telephone triage. Recruitment, training and retention of personnel.
Harvard Community Health Plan's nighttime telephone triage program, currently known as Telecommunications, has evolved through several stages, corresponding to HCHP membership growth, technological enhancements, and changes in the medicolegal environment. Recruiting, training, and retaining staff for nighttime telephone triage are discussed.
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The costs of an after-hours triage service and potential savings for a medium-sized (90,000 member) division of an HMO are presented. Other benefits are also described, including access to member medical records and coverage information, direct-linked telephone conferencing, and more personalized and continuous care.
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Internists (IM), subspecialty internists (SS), and family practitioners (FP) were surveyed regarding their opinions of ten of the Blue Cross Blue Shield Association/American College of Physicians diagnostic test use guidelines applied to the asymptomatic periodic health exam. The majority of 390 respondents agreed with the guidelines (59% of all responses). There was at least 40% disagreement with seven of ten guidelines. ⋯ The number of years in practice had a negative correlation with agreement for five guidelines. HMO physicians tended to agree with guidelines that discouraged test ordering. Results indicate that these guidelines for test use, based on research data and developed cooperatively by physicians, are a starting point for guidelines to testing during the periodic health examination.