Health information exchange: Using metrics to address quality of care and return on investment

Health Information Exchange (HIE) will play a key part in our nation’s effort to improve healthcare. The evidence of HIEs transformational role in healthcare delivery systems is quite limited. The lack of such evidence led us to explore what exists in the healthcare industry that may provide evidence of effectiveness and efficiency of HIEs. The objective of the study was to find out how many fully functional HIEs are using any measurements or metrics to gauge impact of HIE on quality improvement (QI) and on return on investment (ROI).^ A web-based survey was used to determine the number of operational HIEs using metrics for QI and ROI. Our study highlights the fact that only 50 percent of the HIEs who responded use or plan to use metrics. However, 95 percent of the respondents believed HIEs improve quality of care while only 56 percent believed HIE showed positive ROI. Although operational HIEs present numerous opportunities to demonstrate the business model for improving health care quality, evidence to document the impact of HIEs is lacking. ^

A return-on-investment framework to identify conservation priorities in Africa

Environmental conservation activities must continue to become more efficient and effective, especially in Africa where development and population growth pressures continue to escalate. Recently, prioritization of conservation resources has focused on explicitly incorporating the economic costs of conservation along with better defining the outcomes of these expenditures. We demonstrate how new global and continental data that spans social, economic, and ecological sectors creates an opportunity to incorporate return-on-investment (ROI) principles into conservation priority setting for Africa. We suggest that combining conservation priorities that factor in biodiversity value, habitat quality, and conservation management investments across terrestrial, freshwater, and coastal marine environments provides a new lens for setting global conservation priorities. Using this approach we identified seven regions capturing interior and coastal resources that also have high ROI values that support further investment. We illustrate how spatially explicit, yet flexible ROI analysis can help to better address uncertainty, risk, and opportunities for conservation, while making values that guide prioritization more transparent. In one case the results of this prioritization process were used to support new conservation investments. Acknowledging a clear research need to improve cost information, we propose that adopting a flexible ROI framework to set conservation priorities in Africa has multiple potential benefits.

The Impact of BIM on the Distribution of Cost and Return on Investment in UK Construction Projects

It has been widely documented that when Building Information Modelling (BIM) is used, there is a shift in effort to the design phase. Little investigation into the impact of this shift in effort has been done and how it impacts on costs. It can be difficult to justify the increased expenditure on BIM in a market that is heavily driven by costs. There are currently studies attempting to quantify the return on investment (ROI) for BIM for which these returns can be seen to balance out the shift in efforts and costs to the design phase. The studies however quantify the ROI based on the individual stakeholder’s investment without consideration for the impact that the use of BIM from their project partners may have on their own profitability. In this study, a questionnaire investigated opinions and experience of construction professionals, representing clients, consultants, designers and contractors, to determine fluctuations in costs by their magnitude and when they occur. These factors were examined more closely by interviewing senior members representing each of the stakeholder categories and comparing their experience in using BIM within environments where their project partners were also using BIM and when they were not. This determined the differences in how the use and the investment in BIM impacts on others and how costs are redistributed. This redistribution is not just through time but also between stakeholders and categories of costs. Some of these cost fluctuations and how the cost of BIM is currently financed are also highlighted in several case studies. The results show that the current distribution of costs set for traditional 2D delivery is hindering the potential success of BIM. There is also evidence that stakeholders who don’t use BIM may benefit financially from the BIM use of others and that collaborative BIM is significantly different to the use of ‘lonely’ BIM in terms of benefits and profitability.

Commentaries on equity pleadings, and the incidents thereof : according to the practice of the courts of equity, of England and America /

Mode of access: Internet.

A treatise on equity jurisprudence, as administered in the United States of America; adapted for all the states, and to the union of legal and equitable remedies under the reformed procedure,

The title of v. 6 (combined table of cases and index) is the same as the added titles of v. 4 and 5.

A treatise on equity jurisprudence, as administered in the United States of America; adapted for all the states, and to the union of legal and equitable remedies under the reformed procedure,

Paged continuously.

Cases on equity jurisdiction ...

Mode of access: Internet.

Cases on equity : jurisdiction and specific performance /

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A selection of cases on equity jurisdiction,

Mode of access: Internet.

Washington State Surplus, Creating a Larger Return on Investment of Tax Payer Dollars

The topic of this study is Washington State vehicle surplus and whether a higher yield on tax payer investment in the purchase, sale and use of state motor vehicles can be achieved. The hypothesis that will be addressed is: Can Washington State create a higher return on investment from tax payer dollars by donating vehicles to automotive training programs? I explore this topic by asking, a) What is the current policy? b) What is the perception of automotive educators on that policy? c) What are the returns currently and could they be improved through policy change? The methodology for testing is by obtaining quantitative data from the state and other entities on vehicle purchases, costs, and responses to surveys by automotive educators in the state. Qualitative data will be explored in context to the policies, and education then incorporating it into a Cost/Benefit analysis on the return on investment to taxpayers.

Can minority language proficiency pay: a study on the return on English-Spanish fluent bilingualism in South Florida

This thesis studies the economic return for fluent-bilingualism in South Florida among native-born whites using IPUMS (Integrated Public Use Microdata Series) data for Miami-Dade County (1990). Previous mainstream-oriented theories focus on the benefit in English acquisition for immigrants and their descendants, either denying or ignoring the possible benefit of minority language retention in addition to English acquisition. An alternative literature, on the other hand, suggests that minority language retention can be beneficial in at least three areas: 1) enhancing cognitive ability; 2) accessing community-level social capital; and 3) serving as human capital. This study assesses economic returns in employment and earnings, using logistic and OLS (Ordinary Least Square) regression respectively. The results, countering the mainstream-oriented theories, suggest that fluent bilingualism does have economic consequences. Rather than fully supporting the positive effects thesis, the patterns shown are much more complicated, contingent on an individual's ethnic membership and educational level. Theoretical and substantive implications are discussed and suggestions for future research are made.

Social Return on Investment: Valuing Health Outcomes or Promoting Economic Values?

Interventions and activities that influence health are often concerned with intangible outcomes that are difficult to value despite their potential significance. Social Return on Investment is an evaluation framework that explores all aspects of change and expresses these in comparable terms. It combines qualitative narratives and quantitative measurements with a financial approach to enable outcomes that can otherwise be overlooked or undervalued to be incorporated appropriately. This article presents Social Return on Investment as an effective tool for supporting the development of a holistic appreciation of how interventions impact on the health and well-being of individuals, communities and societies.