Security model for picture archiving and communication systems.

The modern information revolution has facilitated a metamorphosis of health care delivery wrought with the challenges of securing patient sensitive data. To accommodate this reality, Congress passed the Health Insurance Portability and Accountability Act (HIPAA). While final guidance has not fully been resolved at this time, it is up to the health care community to develop and implement comprehensive security strategies founded on procedural, hardware and software solutions in preparation for future controls. The Virtual Radiology Environment (VRE) Project, a landmark US Army picture archiving and communications system (PACS) implemented across 10 geographically dispersed medical facilities, has addressed that challenge by planning for the secure transmission of medical images and reports over their local (LAN) and wide area network (WAN) infrastructure. Their model, which is transferable to general PACS implementations, encompasses a strategy of application risk and dataflow identification, data auditing, security policy definition, and procedural controls. When combined with hardware and software solutions that are both non-performance limiting and scalable, the comprehensive approach will not only sufficiently address the current security requirements, but also accommodate the natural evolution of the enterprise security model.

Current issues in multispecialty group practice: the Lahey Hitchcock Clinic merger experience.

The merger of two large not-for-profit multispecialty group practices in 1995 forced the two founding organizations into a deeper understanding of their heritage and mission. Common features of Lahey Hitchcock and similar organizations of their vintage are discussed. Issues addressed include governance, desirable leadership characteristics and growth, "incentivizing change," and workforce planning.