The enhanced availability of health information in an electronic format is strategic for industry-wide efforts to improve the quality and reduce the cost of health care, yet it brings a concomitant concern of greater risk for loss of privacy among health care participants. The authors review the conflicting goals of accessibility and security for electronic medical records and discuss nontechnical and technical aspects that constitute a reasonable security solution. It is argued that with guiding policy and current technology, an electronic medical record may offer better security than a traditional paper record.

The dental profession has recognized tobacco cessation as an important part of comprehensive dental care, yet implementation of the Public Health Service clinical practice guideline on "Treating Tobacco Use and Dependence" remains a challenge. This is especially the case for patients presenting in dental clinics for whom smoking represents a large financial burden. Many of these smoking-addicted patients also present with multiple risk factors: dental, medical, and psychiatric. Innovative approaches are necessary to reduce barriers to providing smoking cessation services to underserved and high-risk smokers. A tobacco cessation clinic in a dental school setting provides an opportunity for dental students to learn about the management of difficult-to-treat cases and to bring their enhanced intervention skills back into the primary care dental setting. This paper describes a multidisciplinary approach to tobacco cessation in a dental school clinic within an academic medical center.

Two million older adults are completely or mostly homebound, and another 5.3 million have difficulty or need help getting out of their homes (1). Several studies, including the Centers for Medicare & Medicaid Services (CMS) Independence at Home Demonstration, have proven that home-based primary care is effective in providing cost-saving, high-quality care to high-need, high-cost homebound older adults (2).Making home-based primary care available to frail older adults will require better financial incentives to encourage provision of this type of care. A potentially important opportunity for home-based primary care practices to enter into value-based care is to leverage performance payments available through the CMS Merit-based Incentive Payment System

No abstract