The Americans with Disabilities Act: prescription for tax relief.

As employers, healthcare organizations must comply with Title I of the Americans with Disabilities Act of 1990-Employment Discrimination by Private Entities-which covers virtually all aspects of employment and prohibits employers from discriminating against otherwise qualified job applicants and workers who have disabilities or who become disabled. Further, healthcare organizations must comply with the provisions of Title III of the act-Nondiscrimination on the Basis of Disability by Public Accommodations and in Commercial Facilities-which requires places of public accommodations and commercial facilities to be designed, constructed, and altered in compliance with the accessibility standards of the act. While compliance with the ADA can be costly, four specific sections of the Internal Revenue Code offer tax relief to organizations that meet the guidelines of Titles I and III.

Routine restaurant inspections and education of food handlers: recommendations based on critical appraisal of the literature and survey of Canadian jurisdictions on restaurant inspections and education of food handlers.

Inspection of restaurants and education of food handlers are two methods used by regulatory agencies to ensure food served in restaurants is safe to eat. The variation which exists in the implementation of these programs suggests that the programs' effectiveness is lacking or is not clear. Recommendations based on the Community Health Practice Guideline methodology, the results of a critical review of the literature, the results of a survey of practices, and expert opinion were developed. The recommendations include: continuation of routine inspections at a frequency of one to two inspections per year per restaurant and the continuation of education programs. The evidence on which these recommendations are based is scant and more research is needed to ensure programs are needed, effective and efficient.

From chart tracking to workflow management.

The current interest in system-wide integration appears to be based on the assumption that an organization, by digitizing information and accepting a common standard for the exchange of such information, will improve the accessibility of this information and automatically experience benefits resulting from its more productive use. We do not dispute this reasoning, but assert that an organization's capacity for effective change is proportional to the understanding of the current structure among its personnel. Our workflow manager is based on the use of a Parameterized Petri Net (PPN) model which can be configured to represent an arbitrarily detailed picture of an organization. The PPN model can be animated to observe the model organization in action, and the results of the animation analyzed. This simulation is a dynamic ongoing process which changes with the system and allows members of the organization to pose "what if" questions as a means of exploring opportunities for change. We present, the "workflow management system" as the natural successor to the tracking program, incorporating modeling, scheduling, reactive planning, performance evaluation, and simulation. This workflow management system is more than adequate for meeting the needs of a paper chart tracking system, and, as the patient record is computerized, will serve as a planning and evaluation tool in converting the paper-based health information system into a computer-based system.