Shifts in the environment can compel health care organizations to change their strategies. However strategic change frequently fails because individuals do not adopt the behaviors necessary to successfully implement the new strategy. Purpose: This study explores how three variables—agreement with new strategy, leaders’ actions, and groups’ general orientation toward change—can influence…
In response to a request from the National Library of Medicine (NLM), and with support from the Warren Grant Magnuson Clinical Center of the National Institutes of Health and from the Massachusetts Health Data Consortium, the Computer Science and Telecommunications Board (CSTB) initiated a study in October 1995 on maintaining privacy and security in health care applications of the national info…
The Internet has great potential to improve Americans’ health by enhancing communications and improving access to information for care providers, patients, health plan administrators, public health officials, bio- medical researchers, and other health professionals. Ongoing research and development (R&D) efforts, such as the federal government’s Next Generation Internet (NGI) initiative an…
Health services research (HSR) exemplifies some of the greatest hopes and greatest fears for collecting and analyzing computerized personal health information. Information routinely collected in the course of providing and paying for health care can be used by researchers to investigate the relative effectiveness of alternative clinical interventions, of alternative methods of organizing, deliv…
Health care reform has changed the financial base upon which the modern academic medical center is structured. The cost-containment efforts of managed care organizations have reduced the institutions' net revenues from the provision of clinical care that have traditionally been used to support research and training. Concomitantly, the amount of time that faculty can spend conducting research an…
Historically, coastal development in the United States was dominated by major urban regions oriented to commercial ports and defense installations. Elsewhere, coastal settlements were typically quiet fishing villages, vacation refuges, and older seaside resorts gradually evolving into year-round communities. Since the advent of the Interstate Highway System in the 1960s, increasing demand for c…
The knowledgeable health reporter for the Boston Globe, Betsy Lehman, died from an overdose during chemotherapy. Willie King had the wrong leg amputated. Ben Kolb was eight years old when he died during “minor” surgery due to a drug mix-up.1 These horrific cases that make the headlines are just the tip of the ice- berg. Two large studies, one conducted in Colorado and Utah and the other in …
Exhaust products emitted by the current subsonic-transport fleet may influence tropospheric ozone and clouds, and thus Earth’s climate. Such emissions in the upper troposphere may affect climate at the surface of the Earth by means of many chemical and meteorological processes. Some of these processes are poorly understood, and thus cannot be quantified with much certainty. NASA’s Atmo- …