Fast-tracking: Benefits vary

Do hospitals really save money by giving patients lighter anesthesia so they can wake up and go home earlier? It depends on which institution, according to a study at the University of Iowa in Iowa City. Franklin Dexter, PhD, MD, associate professor of anesthesia, found that financial benefits depend heavily on the institution’s labor payment structure. Fast-tracking can decrease an institution’s costs because less staffing time is required. Patients wake up more quickly and can leave the operating and recovery rooms sooner.

If a facility pays its ambulatory surgery staff by the hour, and if fast-tracking reduces substantial overtime costs, the savings can be significant. On the other hand, if ambulatory surgery staff is on a set salary, savings do not materialize.

Dexter says fast-tracking is here to stay. "From the patient’s point of view, it’s an advantage because it gets them out of the hospital quicker so they can be at home." From the hospital’s perspective, the technique can increase productivity because it frees staff to do other tasks. "It may not decrease costs but rest assured that it is going to increase productivity."

For more information, contact Jennifer Cronin, University of Iowa Health News. Telephone: (319) 335-9917. E-mail:

Tech Watch

(With this issue, QI/TQM introduces a new column, Tech Watch, which will report on new and developing technological products and processes. We are also planning another new column, Data Watch, to keep you informed about new or improved data sources. Both will rotate with Grass-Roots QI and will usually appear on the last page of each issue.)

The Health Insurance Portability and Accountability Act of 1996, also known as the Kassebaum-Kennedy bill, has mandated the overhaul of medical privacy rules. Final provisions of the law will come out after Feb. 21, and take effect two years hence. Insiders predict it probably will involve as much or more infrastructure change for health care as Y2K. Anybody who’s been behind the scenes of Y2K initiatives knows such change involves heavy cash outlays. Estimates run as high as $250,000 for many hospitals. One health care technology company, QuadraMed, based in Richmond, CA, has anticipated the security challenges the regulations will almost certainly raise. Its solution complies with the proposed national medical privacy rules outlined last October.

OneLook is a security device based on biometric identification as the access vehicle to patient records. Instead of a password or user name, a user scans his or her thumbprint into the computer. OneLook customizes an individual’s access to files and programs, keeping certain parts of the network closed as desired.


• Combines security with flexibility of access for individual users.

• Identifies which emergency room physicians are on duty at any given time.

• Offers each user a menu of the network areas to which he or she has access privileges.

• Functions on various operating systems.


• Eliminates the need to remember passwords and user names.

• Resolves security breaches from sharing passwords or user names.


Potential problem

• Users might raise legitimate objections to having their thumbprints on file with one or more health care networks.

Who uses OneLook?

• Burdette Tomlin Memorial Hospital, a 242-bed facility in Cape May, NJ.

Cost: Approximately $5 to $10 per seat, per month.

Information: Victoria A. Goldberg, Sterling Hager Inc., Waterton, MA 02472. Telephone: (617) 926-6665, ext. 237. E-mail: