Book Description
A "textbook with passion", Hardwiring Excellence offers a road map and practical how-to guide for creating and sustaining a culture of service and operational excellence. In this book, author Quint Studer, CEO of Studer Group, draws on his personal experience as a former hospital executive who led two organizations to the top 1% in patient satisfaction and his experience coaching hundreds of healthcare organizations since.
Studer, a nationally acclaimed educator, coach, and thought leader in healthcare today, is a master storyteller, mixing "chicken soup style" stories with personal insight, simple tools, and in-depth recommendations on how good organizations can become great ones.
Based on Studer Group's Nine Principles SM, Quint Studer shows how to retain more employees; ensure better customer service; build strong leadership, align organizational values, goals, and results; increase communication; reward and recognize individual success while also requiring accountability; and move operational performance for better financials, market share, and growth.
At the core of the journey, he says, is a sense of purpose, worthwhile work and making a difference. When organizations learn how to harness this passion in their employees, they create a success spiral with ever increasing momentum.
In fact, Richard L. Clarke, FHFMA, President and CEO of Healthcare Financial Management Association says, "Quint Studer's Nine Principles of service and operational excellence provide the missing link between people power and strong financials. It's about courageous leadership."
Customer Reviews:
A Do-It-Yourself Manual to Leadership.......2007-09-19
Leadership and managment roled into one do-it-yourself manual. There are many books out there about management and leadership theory. Theory is important because creates the mindset that is the foundation for success. We are often then put to task creating our own application. Or we could read and implement the systems laid out in Hardwiring Excellence, the singule best book on HOW TO manage and lead to greatness. Could I be any more clear?
While Quint Studer focuses on what he know best, big healthcare, this book can and is being applied to every industry. (I have applied its systems to hospitality, customer service, and production.) The fact that Quint focused on what he does best is a great example of leadership, and an example of how Quint practices what he preaches.
I have the priviliege of living the same city as Quint Studer and interacting with his organization on a regular basis. I can attest that they practice everything they preach and have excelled wilding while doing it.
in anticipation.......2007-09-13
I just re-read this book in anticipation of Quint's new book, Results that Last (I think it's due out in October). The practical recommendations for healthcare leaders found in this book just make sense for leaders in any industry. I am really looking forward to seeing how he builds on these ideas in a book that is aimed at business in general.
Hardwiring Excellence.......2006-11-10
For health care executives who want to see positive, lasting changes in their organizations, a must read. This is a very thorough yet simple guide with explicit instructions and tools for how to get the right people in the right seat and continually doing the right thing for the right reasons. I was pleasantly surprised that the author was able to take such a complex organizational structure and develop simple procedures for achieving excellence. Want safety and quality in healthcare, adopt the principles of this book and you can achieve success. Reads like a novel, well worth the investment in money and time. Our entire management team has read this book and is adopting the principles to ensure all are doing worthwhile work and making a difference each day in someone's life.
Hardwiring Excellence: Purpose, Worthwhile Work, Making a Difference.......2006-11-10
Easy to read and very helpful information for those in the professional realm.
Realistic and Practical.......2006-08-13
This is one of the best "how to" books on management I have read in years. It captures the culture of hospitals (and health care facilities in general) very accurately and the realism lends credibility to the book. He gives authentic scenarios and tells how he and his managers dealt with them. Also, he is realistic in that he includes some tough remedies such as helping someone find opportunities outside the organization when she absolutely poisoned her departmental relationships and refused to change. If you are wanting to change the culture in your organization this book will certainly help you and give you a different perspective. And, although it will be most helpful to health care managers, it will also be applicable to managers in any setting that want to change their culture and become a better, more productive, and more satisfying place to work.
Customer Reviews:
Helpful Book.......2007-06-27
Helps provide a clear model for analyzing companies and developing corporate strategies. In many ways, it is a more accessible take on Porter's Competitive Strategy.
Key concept, straightforward and short.......2007-06-24
Treacy and Wiersema make the case that the value of a product or service to a customer can be categorized in terms of efficiency (eg. low cost, on-time delivery), innovation (eg. latest technology or fashion) and/or customer intimacy (eg. customized solutions). They go on to argue that delivering each kind of value requires a different organization and culture, and hence the most successful companies are those whose business strategy is focused on delivering a particular kind of value to the customers that appreciate it the most, while remaining competitive in other areas. The analysis is accompanied by case studies of AT&T Universal Card, Intel and Airborne Express. The core idea of the book is valuable and 200 pages is plenty to explore it in detail.
Foundational Approach to Strategy.......2007-06-03
ALthough this book has been in print for over a decade, it is one I constantly come back to when helping clients organize their thinking about how they can compete.
I have been a Michael Porter fan for decades. However, when he describes competing by being a differentiated producer, it often left folks scratching their heads about what that meant. Treacy and Wiersema defing "customer intimacy" in a way that was effective in helping companies define how they could pursue differentiation. I have found that this particular strategy has applied all the way down to 1 to 1 marketing.
So the definitions and examples for three competitive strategies are clearly articulated, but also frameworks for implementing these strategies are provided as well.
All-in-all, a clear, compelling and implementable framework for competitive strategy.
This should be a text book.......2007-02-28
Best Marketing book I have ever read, I will keep this book forever. This is a must read for anyone in the marketing field. This book provides great examples along with real life examples.
Staying focused on core value proposition.......2007-02-26
The book reemphasizes the importance of product or service leadership, customer intimacy, and operational excellence. Organizations willing to be "anything for a buck" will find they loose touch with their customers quickly as they thinly apply talent and resources to serve everyone averagely.
Unity of purpose is also essential; a successful firm must act together to consistently and successfully compete. The book is good reading for managers and marketing professionals that need to review their business focus and the alignment of tasks, processes and competencies supporting that focus. The book offers materials to be used in team exercises.
Average customer rating:
- Should health care be a right?
- Easy to read
- Outstanding overview of healthcare system in USA
- Understanding Health Policy
- This is a good book
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Understanding Health Policy
Thomas S. Bodenheimer , and
Kevin Grumbach
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Health Policymaking in the United States, Fourth Edition
ASIN: 0071423117 |
Book Description
"This highly readable text gives a broad but detailed picture of how health care is organized and dispensed in the United States." -Annals of Internal Medicine, on the First Edition
The #1 text on health policy, this well-known book provides a short introduction to U.S. health care policy by two leading experts who are themselves practicing physicians. The Fourth Edition features the latest information on cost containment, health insurance, managed care, hospital payment, and the new two-tier model of physician reimbursement.
Customer Reviews:
Should health care be a right?.......2007-08-22
Beware: This is an highly ideological text that starts with the assumption that health care is a right! It than goes on to say that in order to fulfill that right it is necessary to control the costs of health care. Obviously, cost control is a very problematic economic proposition that calls for state intervention and that sometimes has consequences that are the opposite of what is desired.
In the UK, where health care is a right, cost control has led to shortages, waiting lists and an overall degradation of health care. The UK, currently, has the highest mortality rates for oncological problems of all the EU countries and British people got used to flying to France and India for medical care. Canadians also have shortages and Canadians resort to the US.
Sometimes a "right" can easily turn into a "wrong"!
Easy to read.......2007-07-15
I got this book for a graduate class that I am taking. This book uses clear language when presenting the material and has many mini "case studies" for examples, which makes it easy to read. Though I am required to read this book, it is not the standard, wall-of-text, that I am use to reading.
Outstanding overview of healthcare system in USA.......2007-07-05
This is probably the best single text I have read on healthcare policy issues in the USA. The books addresses every relevant aspect of our system. Unlike other excellent books, such as Dr. Arnold Relman's book, A Second Opinion, which analyzes the system, then makes recommendations on how to reform it, the authors here mainly explicate. The format of the book includes brief, usually fictitious, vignettes about physicians, patients or administrators that illustrate the points the authors present. That format - combined with the simply-presented, clear narrative and analysis - works very well. I also find the references to be excellent. Aside from Dr. Relman's book, I recommend any of the books by Prof. Victor Fuchs, in particular Who Shall Live?, books by Prof. Theodore Marmor and the classic by Prof. Paul Starr, The Social Transformation of American Medicine. There are many other excellent books and articles by a wide range of insightful analysts. These kinds of books are invaluable for understanding the issues in healthcare. So much of the information that filters through to the average person via news reports, propaganda issued by parties with vested interests to protect and superficial proposals from polticians is inaccurate and misleading, usually grossly so. Reading a book such as this goes a very long way towards cutting through that clutter regardless of one's personal experiences and prejudices.
Understanding Health Policy.......2007-01-09
This book is a great basic review of how health care is delivered. The format and information is most useful for people who are going into medicine. There isn't really anything about the politics behind health care policy; instead the book focuses on defining key terms and outlining the structure of relationships between payers, receivers, and providers. The book also covers the differences between different types of insurance policies, as well as different national health plans of countries with more socialized medicine.
This is a good book.......2006-11-10
We use this book in the Health Care Policy class for which I am a teaching assistant. It is a good, basic introduction to most of the important issues in health policy and the students give it high marks for clarity and comprehensiveness. It is easy to read and to understand.
Book Description
The U.S. health care system is in crisis. At stake are the quality of care for millions of Americans and the financial well-being of individuals and employers squeezed by skyrocketing costs--not to mention the stability of state and federal government budgets.
In Redefining Health Care, internationally renowned strategy expert Michael E. Porter and innovation expert Elizabeth Olmsted Teisberg reveal the underlying and largely overlooked causes of the problem and provide a powerful prescription for change. The authors argue that participants in the health care system have competed to shift costs, accumulate bargaining power, and restrict services rather than create value for patients. This zero-sum competition takes place at the wrong level--among health plans, networks, and hospitals--rather than where it matters most: in the diagnosis, treatment, and prevention of specific health conditions.
In spite of competition among these systems, the patient care cycle is poorly coordinated. The fractured system undermines both efficiency and quality of outcomes.
Redefining Health Care lays out a breakthrough framework for redefining health care competition based on patient value over the full cycle of care—from prevention and diagnosis through recovery or long-term disease management. With specific recommendations for hospitals, doctors, health plans, employers, and policy makers, this book shows how to move to value-based competition on results that will unleash stunning improvements in quality and efficiency.
Customer Reviews:
How sick is US Healthcare.......2007-10-17
Interesting view on the actual US healthcare and a challenging way to solve the mailaise
Excellent analysis with some weak points.......2007-09-01
This book has received probably disproportionate attention due to Prof. Porter's notoriety as a strategic thinking theorist. There are better overall books on healthcare policy available. In particular I recommend the Bodenheimer/Grumbach books, one on healthcare policy and one on primary care, Dr. Arnold Relman's book, A Second Opinion, Strained Mercy, an outstanding and thorough analysis of healthcare economics with particular regard to Canada's healthcare system, among others.
I find the analysis of the USA healthcare system by Profs. Porter and Teisberg to generally be excellent, although I find it wanting in regard to their disparagement of a single-payer/single-insurer system and to their description and analysis of healthcare systems outside the USA. From my perspective private health plans play only a net negative role in the system. The authors' analysis of how the health insurance market works is quite good. However their recommendation that a system of private insurers should persist is refuted by their own analysis! A single payer/insurer system will not cure the problems of the US system, as they clearly point out, but it does remove the inherently dysfunctional characteristics of private insurance, not least of which is its failure to meet the needs of the uninsured - a very large number - and its inherent propensity to exclude the very people who need coverage and care. The authors rightly point out that mandatory health insurance along with risk-pooling among insurers to spread the costs of those insured individuals who generate the highest costs is a "solution" to the current non-functioning system, but the same result, at lower cost and with much greater simplicity, can be achieved through a single payer/insurer.
The other key aspect of healthcare - how it is delivered - is ultimately more important than the financing/insurance side. The authors provide excellent analysis and recommendations in this regard. They correctly address the aspects of the healthcare market that prevent its functioning as a "competitive" market, specifically the abysmal lack of patient information on prices for services, on outcomes of actions by providers, comparative statistics on provider performance and similar. They also provide an interesting report by the Cleveland Clinic on outcomes, i.e. results, of the Clinic's heart surgery activity. They appropriately use this as an example of the kind of reporting that is needed.
The authors' analysis of healthcare systems outside the USA is skimpy and inaccurate in my opinion. The authors underplay the demonstrated efficacy of government-funded systems that outperform the USA system almost across the board in gross measures of outcomes (infant mortality and longevity) and vastly outperform the US system in regard to cost. They gloss over the fact that per capita costs in the USA are 2.5 times! the average of other OECD countries. It is not as though the costs are say 10% above the average with comparable outcomes. They are 150% higher with worse outcomes. Instead of noting this and analyzing it thoroughly, the authors assert that waiting times and rationing of care are significant problems in those countries, assertions which are simply not borne out by a closer examination of the facts. Also the fact that (mostly) single-payer/insurer systems function well universally does not fit the authors' main thesis, so rather than revise the thesis based on this evidence they choose to ignore the evidence.
As a consequence of these limitations I rate the book with 4 stars rather than 5. Too bad, because most of the book is excellent.
Redefining Health Care.......2007-05-23
Book Review
Redefining Health Care by Michael Porter
I am writing this review to help share some excellent ideas on the availability and quality of medical treatment in the United States and on the U.S. economy which is being dragged down by ever-increasing medical costs. The economic impact is not just on corporate profits and stock prices but also on U.S. employment because everything that raises costs makes it harder for U.S. manufacturers to compete with foreign suppliers and makes it harder for U.S. manufacturers to sell in foreign markets.
Unfortunately, the book is long, turgid, and full of details, which help to substantiate his conclusions and also provide guidance on implementing improved policies. I am afraid the book does not appeal to executives, politicians, or doctors. It also proposes radical changes in all aspects of the medical system and its financing and operation. Dr. Porter proposes major changes on the part of all parties involved in delivering and paying for health care.
The book begins with a review of health indexes and health care throughout the world and shows, while the U.S. has the greatest expenditures by any set of measurements, it does not have the best results.
Then, Dr. Porter introduces his most important concept: that any medical treatment should be measured by its results; how much lost time and discomfort did the patient have, is he or she completely cured, or how much disability measured over the entire span of the illness or even the life of the patient. We tend to think of an operation as being successful if the patient left the hospital in good condition. But how much additional recovery time, disability, or reoccurrence was there? If the patient doesn't come back to see him, a doctor doesn't know whether he was cured by the treatment or if the patient was so dissatisfied he went to another doctor or simply gave up on a series of treatments. The goal is to develop a scoring system for each group of illnesses that can be compared with the cost of each individual's treatment and their results to determine what is the best set of procedures and the best doctor or group of doctors to do the work can be used to guide providers and treatments. Porter has some reason to believe that the best treatments are generally less costly even though the individual item costs may be more, the greater effectiveness and the less chance of complications reduces overall cost. Included in the overall cost should be lost wages, which is a reasonable proxy for the patient's time.
The goal is to develop a health plan that pays for results not for treatments. In many cases, that would be a single payment to the provider for a whole series of treatments from diagnosis on through operations, post-operative care, and follow ups which could extend over a long period of time. This is a radical change from the present system which pays for treatments and tends to produce more treatments and does not have any effective means for either the insurers, or the employers, or the patients even to compare one treatment option with another. This is an extreme, radical change and would take a long time to implement, but there are pieces of the program in operation. A number of these are explained at length. Health insurance companies could hire these firms for their specialized expertise and would not have to do the work on their own. An example of what is done is how the firm studies the history of heart transplant patients and will give an insurance company a single payment for the entire course of treatment providing it is done in the manner and by people they specify. They would particularly focus on caregivers who have an outstanding record of success. It appears that for most illnesses, there are organizations that are substantially better than others and this program could be extended broadly.
Another area of development would be to have counselors which would be part of the function of the insurer to advise a company's employees with a list of particularly well qualified doctors and suggest treatment elements.
Government would seem to be poorly adapted to facilitating these changes because they are radically different from Medicare. Medicare seems to promote cheap, but not necessarily effective treatments and set arbitrary pay scales which do not allow the better providers to charge more for their services and thus encourage more providers to be in the high performance category. Companies that pay for the insurance are the ones that have to put pressure on the insurers to implement the above changes. This could not be done over a short period of time but would eliminate a lot of the wasted time that is now involved in the payments for each little step of the process and for each treatment step.
Chapter 8 is a detailed discussion of how to implement the aforementioned concepts using modifications of Medicare and other laws. This is too complex to summarize here but it appears doable if Congress and the Executive are sufficiently motivated. It is likely that few people would understand what is happening, but the benefits to cost ratio is sufficiently great that the changes would probably be supported and accepted. On the other hand, the situation is so complex, it is questionable whether lawmakers and administrators would be willing to undertake the many complex tasks required. On the other hand, the downside risk appears quite small.
Porter approaches the whole subject from the points of view of business strategy and the problems of decisions with very imperfect information. While the government frequently acts with very imperfect information, its strategy for doing so is not well developed and poorly applied.
Redefining Health Care: Creating Value-Based Competition on Results
A new look.......2007-05-20
Though a little dry, and at times repetitive, this book offers practical information. In a mess of books describing the massive problems in healthcare today, this book was at once motivating and up-lifting. I bought it for a class, but it is one of the books I'll be keeping instead of passing along at the end of the quarter.
Disappointed but Some Might Find Value.......2007-04-05
I'm a big fan of Porter, but I was somewhat disappointed by this book. Let me be frank. The first problem I have with the book is that the authors try to capture as large of an audience as possible, being careful not to place blame on certain providers within the health care system. That approach might get better reviews and sell more copies, but it is not delivering real value. One cannot escape mention of the realities of corruption and fraud by every player in health care and expect to address the problems.
The second problem I have is that Porter fails to recognize that health care is distinct from any other industry in America because it is highly politically influenced. Much of the health care system is public (government funded). This is a main reason why competition in this industry is highly ineffective. How can you have a pure competitive environment when poor performing providers continue to receive government-funded contracts? How can you have full competition when Washington merely fines providers for fraud with no jail time? How can you have competition that creates value when Washington places the burden of increasing costs upon taxpayers, letting the industry charge what it needs to deliver earnings that Wall Street expects?
Overall, by failing to address the harsh realities of politics and big money within America's health care industry, Porter's book is too idealistic and therefore falls short of offering a real solution. Regardless, it is a quality book and at least does what no other has in trying to approach the problems from a reasonable standpoint. I expected more from him, but clearly this book is a view from academia and is far detached from many realities of big industry in America. There are many good points in the book, but without addressing the main problems of a system whereby lobbyist groups who control health care policy, very little will change.
Book Description
The definitive book on improving healthcare quality, this book compiles the most current information on a vast array of quality issues, tools, and strategies. The book's core premise is that the key to effective improvement is centering all efforts on the needs of patients. With the future of healthcare revolving around the patient, this book will be a valuable resource for years to come.
The editors have assembled a nationally prominent group of contributors to provide the best available thinking in each area of quality. Topics covered include: collecting data and the various sources that feed into quality improvement; approaches for analyzing data to measure performance improvement; establishing measures to assess physician performance; assessing patients' experiences within important dimensions of care; developing balanced scorecards or dashboards; clinical IT capabilities needed to support efforts to improve complex clinical processes; the relationship of the law to quality improvement; leading quality-improvement efforts and managing change; and understanding the work of the two major accrediting bodies in healthcare quality.
This book is copublished with the American Society for Quality and includes Forewords by Stephen M. Shortell, Ph.D.,FACHE, and Gail Warden, FACHE.
Contributors to this book include: A. Al-Assaf, David Ballard, Donald Berwick, Troyan Brennan, John Byrnes, Francois de Brantes, Susan Edgman-Levitan, Frances Griffin, Carol Haraden, Maulik Joshi, Narendra Kini, Robert Lloyd, Jerod Loeb, David Nash, Greg Pawlson, Michael Pugh, Scott Ransom, Jim Reinertsen, Paul Schyve, Stephen Shortell, Mike Stoecklein, Richard Ward, Gail Warden, Valerie Weber, and Leon Wyszewianski.
Customer Reviews:
Great.......2006-02-25
The quick service of getting this book for a college course was great. Thanks for being quick.
Book Description
This exciting new textbook provides exceptional coverage of the essential topics taught in a modern operations management course. Its highly current coverage includes contemporary and relevant service theory and applications. Appropriate manufacturing applications and theory are included where relevant. The book's modern/strategic approach addresses OM from a cross-functional perspective, which views operations as linked to all other functional areas of an organization, such as marketing and finance. The strategic approach takes into consideration the integration of technology and how it changes the way a firm operates. Recognition of this current trend is the main differentiating factor for this Collier/Evans text. The book provides equal coverage of manufacturing and services theory and applications, while placing an emphasis on the integration of the value chain.
Customer Reviews:
Insightful frameworks for an effective PSO .......2007-05-27
This book is absolutely the best! It provides frameworks to structure and implement an effective professional services organization (PSO) for an IT product vendor. A product company PSO matures over time through various phases characterized by the types of services it offers. This book is full of practical yet winning strategies and tactics to maneuver the high risk waters of professional services. There are clear directions on how to manage key levers that increase profitability but it also sets realistic expectations. Although the book provides the `recipe' for a sample $100 million professional services organization, it lists all the necessary `ingredients' to cook up a PSO of any size.
I liked the fact that it is written in a style that is free of any jargon. Authors are professionals who clearly understand the industry from inside. My least favorite part are the diagrams and illustrations which are at best adequate but could be better. Highly recommend this book!
Building professional services in a product-based company.......2005-01-10
This is the absolutely best book devoted to building pro services organization in a product-based company. While there are a lot of sources on managing stand-alone pro services firm (i.e. accounting, law), this book addresses the common pitfalls in moving into services for product-oriented companies.
The book is easy to read, well organized, and packed with sound practical advice you can start applying right away, whether you're in delivery, sales, or marketing -- you'll be going back to it often.
You will sleep with this book.......2004-08-17
This book absolutely is the best book I've ever ready regarding professional services. They describe a pragmatic approach from their experience at SGI services. This book will take you through planning an PS organization, development of various groups, reporting strucutures, templates for tools to help you.
It's focus in on a PS organization of a product company but you can take much away from this book if you are purely a services organization.
What I like the most is that it helps you do begin to address the various challenges where other books gloss over these topics and leave it to you.
Excellent pragmatic approach.......2004-01-23
This book as become my day-to-day bible to managing a professional service division within our product-oriented company. If you have your objectives and strategy clear, this book will help you getting organized with the tactics.
Required Reading.......2003-07-19
This book is "just what the doctor ordered" for anyone trying to develop a Professional Services(PS) organization that is aligned with other functional groups and the overall mission of a product company. It also should be required reading for any leader moving for the first time from a stand-alone PS company to head up a PS organization within a product company.
I found it to provide easy to read, practical guidance on what the components of the PS organization should be, what the mission and profitability drivers should be, key organizational interfaces and how it should be measured.
Also, this book was reviewed, chapter by chapter, by all PS leaders as well as other functional leaders within the company, to develop a "lessons learned" document as part of a services strategic planning process. Invaluable assistance!
Customer Reviews:
This book will not get you there.......2001-12-10
This book is written as the product of an Institute of Medicine initiative to reduce the mortality and morbidity from errors in the American healthcare system. The Institute of Medicine is a private organization created by congressional charter to advise the federal government on specific matters. Their mission statement is to "advance and disseminate knowledge to improve human health." This book is the final report of the Committee on the Quality of Health Care in America. Their homepage is available by searching the Internet using the full committee name. Membership of the committee and sponsors of the project are available at that web site.
The format of the book is to present evidence for quality problems in healthcare in America and make recommendations. The operational definition of quality used in the book is "The degree to which health care services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge." There are thirteen recommendations presented initially and are discussed in relevant chapters. The recommendations vary in scope from suggesting that multiple parties need to be committed to quality as a way to decrease the burden of disease to suggestions that specific agencies fund pilot studies to look at how reimbursement can be aligned with quality. Six major parameters are discussed as guiding quality and it is suggested that 15 specific conditions be a focus for improving quality.
There is no difficulty in identifying literature studies that demonstrate quality problems in hospital and clinical populations. A survey of current research is included in Appendix A. A review of the tables in this appendix show the types of quality markers that are typically studied in the literature. The authors make the argument that errors due to quality lapses or deficiencies need to be actively worked on and that the current high error rates are not acceptable. Health care has become a major political issue and the political factions are shaping up to be government and business on one side and physicians and other health care providers on the other. There has been a major revamping of the health care system in the past decade to control costs. That required the active cooperation of the insurance industry and government. There is still medical inflation and limited access with 40 million Americans uninsured. Should we believe that another cooperative effort between industry and government will improve quality any more than it has controlled cost or improved access?
The authors acknowledge weaknesses in their suggestions about changing the face of American medicine, but they minimize the adverse impact of the current funding mechanisms for medical care and the issue of information systems integration and security. A good example can be found in their application of engineering principles to clinical settings - - where teams see patients for four hours of direct contact time and the remaining time is for documentation and returning calls. That plan would not be economically feasible in many settings. The high cost and lack of flexibility of the current reimbursement schemes are not mentioned as a potential reason why these plans won't work.
Information technology is seen as a way to enhance both productivity and safety. The authors suggest that e-mail can lead to productive exchanges between physicians and patients. Many physicians have been doing this for years. Many have also stopped with the advent of security concerns about medical privacy. With larger IT systems the critical issue is backward compatability with older systems. That usually requires custom designs that are extremely expensive. Those problems usually need to be solved before bedside computing and decision support can be developed. Security is acknowledged as a problem that needs to be solved. In spite of a federal initiative in this area, the important precedent to remember is how the financial privacy of Americans was protected. The authors point out that medical privacy requirements need to be more stringent than other industries. At the same time they point out that some opinions suggest that there is a trade off between privacy protections and the need to advance information technology in health care. If they are suggesting that the Internet should be at the heart of this infrastructure and the Internet is not secure, what does that mean?
A practical approach might be to focus on the areas where data is entered into computer systems and make sure that non-human analysis occurs at those levels. For example, all hospitals enter pharmacy orders into computer systems. Many hospitals require that physicians write separate discharge orders. Both of these points are areas where there could be immediate improvements in accuracy. A focused study and solution could be engineered now. The necessary software and hardware requirements could be placed on a central web site and available for download by hospital and clinic IT staff. Existing reviewers could be charged with documenting the baseline level of errors and the degree of improvement.
This book succeeds as a broad survey of what has been done about quality in certain settings. It contains some interesting ideas about what can possibly be accomplished by applying conceptual advances from other fields. It does not discuss the significant drawbacks of evidence based medicine. It lacks a practical plan for transitioning to a new system and in effect creates a new chasm. With a work like this, whether you like the conclusions depends a lot on your interpretation of the evidence and your personal experience. As a practicing physician and a previous quality reviewer I have significant areas of disagreement with what is presented in this book. Areas of controversy are not elaborated upon. I suppose you could say that level of analysis is not required, but recommendations about the future of health care in America should at least meet the criteria of "evidence based" and all the evidence should be discussed.
George Dawson, MD
Essential Reading for Everyone in Health Care.......2001-12-02
If you are in anyway involved in health care, this is essential reading. Physicians, hospital administrators, purchasers, health plan execs, and grad students must immediately put this on the top of their reading list. Lives may depend on it.
In it, the highly respected Institute of Medicine builds a powerful case for how the current health care system is severely broken and how it has produced a "chasm" between what we known must be done for patients (based on current science of medicine) and what is actually done. The information conveyed is shocking but true. Even more importantly, the Institute gives us a plan for building a new, more accountable quality-driven approach to health care.
Read it and perhaps you too will be motivated to take action to improve health care delivery in America.
Book Description
Here's everything students must know about computed tomography to excel in the classroom, score big on the ARRT exams, and thrive in clinical practice. Covers the full range of topics--ultrasound interaction with tissue, the ultrasound beam and image, quality control, the biological effects of ultrasound, image artifacts, and more.
Customer Reviews:
New book just like ad described.......2007-09-28
THis book was new just like the ad described and I received it very quickly. THanks a bunch.
Computed Tomography by Stewart Bushong.......2007-01-13
I am very impressed by Stewart Bushong's books. This book is concise, easy to follow and presented in a way that keeps your interest. The last time I performed a CT scan was in 1987. I am preparing to work on a 16 slice unit and this is one of the books I chose to help me get up to par in CT. I have been doing MRI since '87...lots have changes have occurred in CT imaging and I know Bushong can help me catch up!
NICE BOOK.......2007-01-09
I PASSED MY REGISTRY SO I GUESS IT WORKED. LOVE BUSHONG SINCE I TOOK HIS COURSE IN RAD SCHOOL IN HOUSTON. HE IS VERY SMART BUT SOMETIMES CAN BE A LITTLE OVER MY HEAD. STILL A GREAT BOOK TO STUDY FROM.
only covers part of the registry.......2006-11-11
good review of important physics of CT.
This however is only a small part of the registry.
If you want to prepare for the registry get Medical Imaging Consultants book.
Good for someone who is just beginning to study CT.......2006-02-22
I purchased this book for a quick review. I have already passed my boards and wanted a refresher. This book was not the book to use for that. It was written elementarily. I think if you only knew little about CT it could be helpful. Or if you didn't understand something, maybe it would help explain things better.
Book Description
Sidestep VoIP Catastrophe the Foolproof
Hacking Exposed Way
"This book illuminates how remote users can probe, sniff, and modify your phones, phone switches, and networks that offer VoIP services. Most importantly, the authors offer solutions to mitigate the risk of deploying VoIP technologies." --Ron Gula, CTO of Tenable Network Security
Block debilitating VoIP attacks by learning how to look at your network and devices through the eyes of the malicious intruder.
Hacking Exposed VoIP shows you, step-by-step, how online criminals perform reconnaissance, gain access, steal data, and penetrate vulnerable systems. All hardware-specific and network-centered security issues are covered alongside detailed countermeasures, in-depth examples, and hands-on implementation techniques. Inside, you'll learn how to defend against the latest DoS, man-in-the-middle, call flooding, eavesdropping, VoIP fuzzing, signaling and audio manipulation, Voice SPAM/SPIT, and voice phishing attacks.
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Find out how hackers footprint, scan, enumerate, and pilfer VoIP networks and hardware
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Fortify Cisco, Avaya, and Asterisk systems
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Prevent DNS poisoning, DHCP exhaustion, and ARP table manipulation
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Thwart number harvesting, call pattern tracking, and conversation eavesdropping
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Measure and maintain VoIP network quality of service and VoIP conversation quality
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Stop DoS and packet flood-based attacks from disrupting SIP proxies and phones
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Counter REGISTER hijacking, INVITE flooding, and BYE call teardown attacks
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Avoid insertion/mixing of malicious audio
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Learn about voice SPAM/SPIT and how to prevent it
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Defend against voice phishing and identity theft scams
Customer Reviews:
Invaluable VoIP Security Handbook.......2007-08-11
In this book David Endler and Mark Collier have pulled together a vast wealth of material about hacking VoIP networks at every possible level. More than this, they have also created new value in the form of software test tools, which they have published on an accompanying website. It really is a must-have reference book for anyone working in VoIP.
Chapter 1 talks about Google hacking, or in other words, using the Internet to find out things about a target network. They show that Google can be a crucial tool in finding out what type of hardware and software you use in your VoIP networks, and in some cases will give vital clues even about how to login to the management systems of your network from the Internet. If this doesn't scare the bejesus out of you, then proceed on to further chapters about more VoIP-specific issues.
Chapters 2 and 3 detail the kind of tools a hacker might use to scan your network and enumerate all the devices, i.e. build their own map of how your network is laid out, right down to the telephone numbers and MAC addresses of desktop phones. Chapter 4 talks about Denial-of-Service, and the kind of attack resources that hackers might use to cripple a telephony network.
Chapter 5 is on VoIP eavesdropping, talking about some existing tools that can be used for this (Oreka, Wireshark and the unpleasantly named vomit), and as in the earlier chapters, some suggestions on how to defend against such a type of threat. Chapter 6 goes further to explain how a VoIP man-in-the-middle attack might be mounted, giving the possibility not just to listen, but to modify, replace or remix the audio stream.
Chapters 7, 8, 9 talk about specific platform threats, namely to Cisco Unified CallManager, Avaya Communication Manager and the Asterisk PBX. The vendors have added their own comment to these chapters, at the request of the authors. Chapter 10 takes in Softphones, including Google Talk, Gizmo, Yahoo and of course the ever popular Skype.
Chapter 11 describes VoIP fuzzing, or in other words, testing protocol stacks for flaws, so this is useful for those developing VoIP systems and applications. Chapter 12 talks about disruption of networks using flooding techniques and chapter 13 talks about Signaling and Media Manipulation.
The final section of the book is entitled Social Threats, and talks about SPAM over Internet Telephony (SPIT) in Chapter 14, followed by Voice Phishing in Chapter 15. Neither of these threats are in frequent use yet, but their use is certain to increase in the future, so this is a good moment to get to grips with what this means.
This is a highly technical book, but for managers responsible for IT security but not immersed in the details I would say this: buy the book, and read the case studies. There are five sections to the book, and each starts with a short case study. Invest 20 minutes in reading these, and you will start to get an appreciation for how important VoIP Security will be in the future. Then pass the book on to your hands-on security guy and tell him to read it from cover to cover.
A great Hacking Exposed and VoIP security book.......2007-05-07
Hacking Exposed: VoIP (HE:V) is the sort of HE book I like. It's fashionable to think HE books are only suitable for script kiddies who run tools they don't understand against vulnerable services they don't recognize. I like HE books because the good ones explain a technology from a security standpoint, how to exploit it, and how to defend it. I thought HE:V did well in all three areas, even featuring original research and experiments to document and validate the authors' claims.
HE:V is a real eye-opener for those of us who don't perform VoIP pen testing or assessments. It's important to remember that the original HE books were written by Foundstone consultants who put their work experience in book form. HE books that continue this tradition tend to be successful, and HE:V is no exception. Good HE books also introduce a wide variety of tools and techniques to exploit weaknesses in targets, and HE:V also delivers in this respect. HE:V also extends attacks beyond what most people recognize. For example, everyone probably knows about low-level exploitation of VoIP traffic for call interception and manipulation. However, chapter 6 discusses application-level interception.
HE:V goes the extra mile by introducing tools written by the authors specifically to implement attacks. In at least one case the authors also provide a packet capture (for the Skinny protocol) which I particularly appreciate. HE:V also looks ahead to attacks that are appearing but not yet prevalent, like telephony spam and voice phishing. Taken together, all of these features result in a great book. You should already be familiar with the common enumeration and exploitation methods found in HE 5th Ed, because the HE:V authors wisely avoid repeating material in other books (thank you).
If you want to understand VoIP, how to attack it, and how to defend it, I highly recommend reading HE:V. The book is clear, thorough, and written by experts.
Books:
- History: Fiction or Science? (Chronology, No. 1)
- History: Fiction or Science? (Chronology, No. 1)
- How to Audit ISO 9001:2000
- Implementing Six Sigma: Smarter Solutions Using Statistical Methods, Second Edition
- Implementing Six Sigma: Smarter Solutions Using Statistical Methods, Second Edition
- Implementing Six Sigma: Smarter Solutions Using Statistical Methods, Second Edition
- Inside Microsoft SQL Server 2005: T-SQL Querying (Solid Quality Learning)
- Interest Rate Models - Theory and Practice: With Smile, Inflation and Credit (Springer Finance)
- Introduction to Probability and Statistics (with CD-ROM)
- Introduction to Statistical Quality Control
Books Index
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