This article empirically defines the formal pathways and processes that enable and frame hospital clinical classification in an activity-based funding environment. These structured actions include: learning and training; abstracting; clinical knowledge locating and confirming; coder-doctor communication; coder-coder communication; the complicated sub-set of code searching and decision-making processes that constitute practical clinical 'coding'; allocation to diagnosis-related groups; confirmation of financial reimbursement; auditing; and quality management practices to ensure the integrity of the multiple outputs and outcomes of clinical coding. An analogy of these complex, exacting, and knowledge-dense work practices is made with the 20th century avant-garde art movement of Cubism: the creation of Pablo Picasso's The three musicians is used as a metaphor for clinical/health classification work.
more than 600 graduate research training programs in the basic medical and clinical sciences. These programs received support totaling more than $41 million in fiscal year 1966.The NIGMS Policy Statement was issued to all current grantees and is made available to all applicants for graduate research training programs. In no sense does our statement direct that "once a graduate student is put on a fellowship supported by a training program he remain on that program throughout his graduate study" as stated by Bass. On the contrary, the NIGMS Policy Statement contains the statement that "research training grants are intended to provide a continuous source of support for the individual trainee throughout his research training period in order to enable him to concentrate on research training, and thereby shorten the time required." This is a statement of intent, but not a directive. In addition to providing a means for the improvement of graduate research training capability, our objective is to provide the opportunity for training program directors to assure support of a graduate student until his training is completed. Since the NIGMS policy permits a trainee to undertake appropriate course work, teaching, and research while fully supported by the training grant, it assures the very flexibility which is described in Wolfle's editorial of 1 April. (Wolfle's editorial sounds much like a superb justification for training grants!)The practice referred to by Bass of supporting all graduate students on a training grant for one or two years and then transferring their support to a fellowship or a research grant has several disadvantages. First, when a highly qualified predoctoral trainee, who is al-more than 600 graduate research training programs in the basic medical and clinical sciences. These programs received support totaling more than $41 million in fiscal year 1966.The NIGMS Policy Statement was issued to all current grantees and is made available to all applicants for graduate research training programs. In no sense does our statement direct that "once a graduate student is put on a fellowship supported by a training program he remain on that program throughout his graduate study" as stated by Bass. On the contrary, the NIGMS Policy Statement contains the statement that "research training grants are intended to provide a continuous source of support for the individual trainee throughout his research training period in order to enable him to concentrate on research training, and thereby shorten the time required." This is a statement of intent, but not a directive. In addition to providing a means for the improvement of graduate research training capability, our objective is to provide the opportunity for training program directors to assure support of a graduate student until his training is completed. Since the NIGMS policy permits a trainee to undertake appropriate course work, teaching, and research while fully supported by the training grant, it assures the very flexibility which is described in Wolfle's editor...
were present. The theme of the conference, which featured presentations that were both inspirational and thought provoking, was the development of health information management in the South East Asia region into the 21 st Century. Some of the challenges identified throughout the conference were unique to the Asia region but many were all too similiar to those faced by Health Information Managers (HIMs) in Australia on a daily basis.Many SEAR countries consist of small island provinces with large populations, where the delivery of healthcare and health information services can be problematic. Health information management positions are very new in many SEAR countries and although there is a need to develop this area throughout the region, shortages in financial and human resources create significant barriers to the achievement of this goal.Training of the current health information management workforce and the provision of supportive IT infrastructures and skills in the region are challenging. Many countries in the
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