Intraoperative magnesium administration does not improve neurocognitive function after cardiac surgery.

Background And Purpose: Neurocognitive decline occurs frequently after cardiac surgery and persists in a significant number of patients. Magnesium is thought to provide neuroprotection by preservation of cellular energy metabolism, blockade of the N-methyl-D-aspartate receptor, diminution of the inflammatory response, and inhibition of platelet activation. We therefore hypothesized that intraoperative magnesium administration would decrease postoperative cognitive impairment.

Predictors of inotrope use during separation from cardiopulmonary bypass.

Objective: To identify the demographic, clinical, and echocardiographic features that predict the use of inotropic support at separation from cardiopulmonary bypass (CPB).

Design: Retrospective study of consecutive patients undergoing coronary artery bypass graft (CABG) surgery.

Setting: Referral center for cardiothoracic surgery at a university hospital.

The need to manage and reconcile capitation payments.

As capitation becomes a more common method of paying providers, healthcare financial managers must determine if these payments are being made correctly. The reconciliation process under capitation contracts is new for most financial managers. Standard industry conventions for payers and providers are needed to reduce the associated administrative costs for this type of payment.

Using EDI (electronic data interchange) to improve the accounts payable department.

Additional paperwork, escalating costs, and an outdated accounts payable system at St. Joseph Health System forced management staff to alter the way the accounts payable department operates. This article describes the process the health system used to automate one of its accounts payable departments by using electronic data interchange/electronic funds transfer (EDI/EFT) technology.

EDI experts realistic and optimistic.

Recently, Healthcare Financial Management contacted five EDI experts to discuss a variety of issues related to EDI and the healthcare industry. Their answers to our questions, presented below, are both optimistic and realistic. Our experts feel that EDI can transform the healthcare industry into a model of efficiency, but their enthusiasm is tempered by the realization that politics, bureaucracy, budgets, and resistance to change can take a toll on even the most ardent of EDI supporters.

Taming the remittance beast electronically.

The next step in coralling the back-office-beast is automating remittance processing. Before taking any steps in that direction, healthcare providers need to establish new procedures for cash management and patient accounting. Opportunities exist for related uses of electronic data interchange (EDI), which will provide additional benefits but will also trigger fundamental changes in the way healthcare providers do business.