Utah healthcare system watches over Olympians and spectators

For the first time in Olympic history, a single organization was tapped to provide medical services when Intermountain Health Care (IHC), Salt Lake City, was named for the 2002 Olympic and Paralympic Games in Utah. IHC, a charitable, community owned, integrated, not-for-profit healthcare system serving patients in Utah and Idaho, spent four years developing and implementing a plan to deliver medical services to both Olympians and spectators. Nearly 350 IHC doctors, nurses, physical therapists and other professionals donated their services for the Olympics without compensation as part of their not-for-profit mission. In addition, about 1,000 IHC employees applied to be general volunteers during the games.

Assistance in the palm of your hand. Portable technology can free physicians from billing and coding chains

PROBLEM

Paper-based billing system required unmanageable amount of paper, time and work.

SOLUTION

Integration of handheld devices with ASP-based charge capture service.

RESULTS

Increased accuracy in billing information, reduced incidence of denied claims, faster reimbursement, more accurate view of financial status.

KEYS TO SUCCESS

The technology's ease of use, varied capabilities and early benefits.

Sport and exercise medicine: building the foundations of a new discipline

New disciplines emerge as medicine evolves. But, to be recognised as a clinical discipline we must be prepared to measure ourselves against established criteria; there should be consensus on the core content of the discipline and an identifiable body of knowledge to allow us to deal with common clinical problems. At this developmental stage in our evolution we have general agreement on what defines sport and exercise medicine but, as most of our clinical skills developed empirically, research is relatively underdeveloped. The volume and quality of this research does not yet reflect a vibrant research culture. The validity of our clinical method is supported by research evaluating the sensitivity and specificity of clinical tests but the evidence supporting other areas of clinical practice is uncertain. Some aspects of prevention have become integrated into clinical practice without sufficient evidence and, screening has been introduced without critical evaluation. To ensure the future success of our discipline and achieve recognition of its value in the wider medical community, we must nurture an evaluative culture and ensure that clinical practice is built on firm foundations of research evidence.

[The status of and developmental outlook for sports medicine and therapeutic physical exercise in Ukraine]

The sports medicine service in Ukraine, its structure, priority tasks, manpower potential, extent and quality of care-giving to sportsmen and those individuals engaged in physical culture over the period 1997-1998 are detailed. Case follow-up findings are submitted together with indices for medical and biological supplies to sportsmen. Ways for further improvement of the sports medicine service are outlined.

The Australian hockey team's bid for gold--dealing with the medical challenges

How does one find himself in the privileged position of working with the Kookaburras? In my case, in the days prior to a team camp, the incumbent doctor unfortunately required major surgery and did not recover adequately to continue team travel duties. Phone canvassing sifted through sport physicians available at short notice. Medical screening at the camp provided the opportunity to familiarize a doctor coming 'off the bench' with playing and management personnel and vice versa.

Medical care at the Super Bowl

Although coordinating medical care at the Super Bowl is something that we look forward to and have a lot of fun doing, we take it very seriously and understand the importance of delivering medical care at what many people consider to be the greatest sporting event in the world. It is certainly one of the most watched and recognized events in the world and because of this, we attempt to set up a system that will allow for the best medical care available and standardization of this medical care through our experience within Medical Sports Group.

Medical issues relating to the Sydney Olympic Games

The Sydney Olympic Games in 2000 represent a significant medical and sporting challenge. Prior planning is the key to optimal performance, and team medical staff should be familiar with major medical and injury concerns of athletes and officials well prior to departure. A comprehensive team medical kit should be organised. Travel will be over great distances for many teams, so particular attention to optimising sleep and hydration is essential. The Olympic village experience can be overwhelming for some athletes, and medical staff should provide informed advice on food, transport and safety issues. Heat is less likely to be an issue than at recent summer Olympic Games, but should not be ignored completely. Major incidents can occur at any major sporting festival, and team medical staff should be appropriately prepared for these. All team medical staff should be aware of the current list of banned substances, and seek to minimise drug use by their athletes. After the event, an appropriate debriefing session should be held with a view to planning improvements for the future.

General practitioners' training for, interest in, and knowledge of sports medicine and its organisations

OBJECTIVES

To assess the training and interest of a group of general practitioners in the area of sport and exercise medicine, and the organisations representing the specialty.

DESIGN

A postal questionnaire using a Likert scale in a previously piloted set of questions.

SUBJECTS

275 general practitioners registered with the Northampton Regional Health Authority.

MAIN OUTCOME MEASUREMENTS

Responses to questions designed to assess training and interest in sport and exercise medicine.

RESULTS

A response rate of 87.6% was achieved. It was found that 72.7% of the responding general practitioners felt inadequately trained to practice sport and exercise medicine. Some 76.0% would welcome more training and 36.4% felt that their undergraduate orthopaedic training was of no use in primary care. Many (63.6%) of the general practitioners believed that the current NHS cannot sustain sport and exercise medicine, and there was uncertainty as to whether it is currently a recognised specialty, although 60.4% felt that it should be. General practitioners listed lack of facilities (53.1%), lack of training (42.9%), and lack of time (38.2%) as the main problems in practicing sport and exercise medicine in primary care within the current NHS.

CONCLUSIONS

General practitioners feel undertrained in sport and exercise medicine at both undergraduate and post-graduate level; they have a perceived need for more training and show an interest in the subject. There is scope for improving the value of undergraduate orthopaedic training. General practitioners wish to see sport and exercise medicine recognised as an NHS specialty but fear that this is not sustainable under current conditions. There is confusion among general practitioners about the current sport and exercise medicine organisations.

The integration of primary care sports medicine into an academic emergency medicine practice: academic and revenue enhancement

OBJECTIVES

To determine whether integrating primary care sports medicine into academic emergency medicine (EM) can enhance both revenue and the academic program.

METHODS

A retrospective descriptive review of all patients seen in a primary care sports medicine practice at a university hospital sports medicine clinic was done over a 24-month period. All patients seen initially in the ED for a sports injury either by the author or by another EM faculty member with follow-up by the author in the sports medicine clinic were included in the study group. The study group was analyzed for diagnoses, payor mix, and revenue generated by the ED follow-up sports medicine clinic visits.

RESULTS

There were 199 patients who met the inclusion criteria. This resulted in 483 ED follow-up sports medicine clinic visits. The author practiced 13 hours/week in the ED and 16 hours/week in the primary care sports medicine practice, which resulted in 1,536 sports medicine clinic hours. The study group accounted for 20% of the total patient volume in the author's primary care sports medicine practice. There were 111 lower-extremity injuries (knee 52%, foot/ankle 40%, hip/pelvis 8%), 81 upper-extremity injuries (hand/wrist 48%, shoulder 43%, elbow 9%), and seven spine injuries. Payor mix was 47% traditional indemnity, 45% HMO, 4% self-pay, and 4% Medicare/Medicaid. Total charges for the ED follow-up sports medicine clinic visits were $44,767 ($92.68/visit) and net receipts were $30,276 ($62.68/visit). This represented 20% of the total charges and 16% of the net receipts in the author's sports medicine practice during this period. Revenue generated by the ED follow-up sports medicine clinic visits could have supported 12% of the equivalent cost of the base pay for a full-time EM faculty position.

CONCLUSION

The integration of primary care sports medicine into an academic EM faculty practice can enhance revenue through the establishment of an ED follow-up sports medicine clinic while also providing an opportunity to expand resident learning experiences.

Sports medicine and the eye care professional

BACKGROUND

There are more than 40,000 eye injuries every year in the United States--many of which are sports-related. Sports injuries are a common cause of severe vision loss. Today, contact sports, racket sports, and other high-risk athletic activities are more popular on an organized and informal level. Those engaging in these activities should wear the proper eye and facial protection, so as to minimize the risk of severe injury and potential vision loss.

CASE REPORTS

Case studies are used to illustrate examples of sports-related clinical experiences encountered in a primary care practice. A description of protective devices, a discussion of product liability, the standard of care, and the doctor's responsibility to the patient complement the case scenarios. Emphasis is placed on prevention and particular attention should be paid to the patient at high risk and to the one-eyed patient.

CONCLUSION

Sports-related eye injuries have a high risk for ocular morbidity and subsequent severe vision loss. Many sports related injuries are preventable and the primary care practitioner can provide important information and education regarding protection and avoidance for those participating in high-risk activities. The provider should promote compliance and be adequately informed as to product liability, standards, manufacturers of the devices, and indications for the use of specific devices.