The Integrated Healthcare Association, a California-based group that focuses on health policy and
managed care issues, has announced the implementation of a new program designed to financially reward doctors who receive positive feedback from their patients.
The Pay for
Performance program has been adopted by six California health plans--Aetna, Blue Cross of California, Blue Shield of California, CIGNA HealthCare of California Inc., Health Net and
PacifiCare--serving more than 8 million Californians. Each organization will use a common scorecard to measure the performance of their physician groups and pay incentives based on the scores.
"These health plans are showing real leadership," comments Beau Carter, executive director of the IHA. "In an otherwise highly competitive marketplace, where health plans
naturally want to differentiate themselves, these plans have seen this as the right thing to do: measure and reward quality of service and care."
Physician groups will be
scored on a selection of measures, such as care for asthma, diabetes and coronary heart disease, breast cancer and cervical cancer screening, childhood immunizations and overall patient
satisfaction. Clinical measures make up 50 percent of the screening. After an independent entity validates the data and publishes the results, physician groups are rewarded accordingly.
"Pay for Performance will improve the quality of health care for millions of Californians, focus national attention on a new paradigm of promoting accountability for results and
rewarding excellence, and re-establish the partnership between health plans and physician groups in managing care," Carter adds.
"We have finally created a business case for
quality at the physician group level," notes Steve McDermott, president and CEO of Hill Physicians Medical Group and chair of the IHA board of directors. "We now have an opportunity for
significant financial rewards if we do a good job. Our patients will be healthier, and our physicians will be happier."
The program, which has been under development for more
than a year, will be managed by a steering committee of businesses, HMOs, physician groups and consumer representatives under the direction of the IHA. A technical committee, working on
continuous improvement of specific performance measures, includes members of the National Committee on Quality Assurance, the UC Berkeley Center for Health Research and the UC San Francisco
Institute for Health Policy Studies.
"Purchasers are very interested in making standardized, comparative quality data available to consumers and in rewarding better quality,"
says Peter Lee, president and CEO of the Pacific Business Group on Health. "This initiative does both in ways that are significant for both patients and doctors."
All six HMOs
will fully integrate the system by 2003. Learn more at the IHA Web site at www.iha.org.
Court Sides With ISO Concerning Domain Names Used in Bad Faith
domain names that were being used by a private company have been transferred to the International Organization for Standardization after the Arbitration and Mediation Center of the World
Intellectual Property Organization deemed them "confusingly similar" to ISO's trademark.
The three Web addresses--isostandards.org, isostandards.net and iso-qa.com--were being
used, according to WIPO, "in bad faith" by Schwartz Chemical, a Long Island, New York-based company. WIPO acknowledged that the ISO mark is "highly regarded and carries with it a reputation for
The WIPO ruling stated that the use of "ISO" in conjunction with the word "standards" evoked the nature of ISO's business, while linking "ISO" with "qa" (for
"quality assurance") evoked an unwarranted implication of standards compliance assessments.
In addition, WIPO added that references to ISO standards compliance on the Schwartz
Chemical Web site increased the impression that the site was affiliated with ISO and indicated that the private company was aware of ISO's reputation and function at the time it registered the
ISO had argued that the company intentionally attempted to attract Internet users to its Web site by using ISO's name, with the likelihood of creating confusion
as to the source, sponsorship, affiliation or endorsement of its Web site or products. ISO does not authorize the use of its name in Internet domain names by any organization other than its
members. ISO's policy states: "Such use could mislead third parties into believing that the organization concerned represents ISO, or has been approved or authorized to act on behalf of ISO.
Therefore, ISO will take whatever actions it considers necessary to prevent the misuse of its name."
Although this was the first case to warrant official arbitration over
misuse of its name in Internet domain names, ISO had recently been successful in resolving several other examples, notes Evgueni Patrikeev, the ISO manager dealing with the protection of ISO's
name. They include iso.org, isoaudit.com, isoauditor.com, isoexperts.com and isowebsite.com.
"Our going to the WIPO Arbitration and Mediation Center when the matter could not
be resolved amicably shows that we are serious in taking measures to prevent the misuse of the ISO name," explains Patrikeev. "This precedent should help us in any similar future cases which may
rise, whether before WIPO or in civil courts. Companies or individuals who have previously ignored our requests to stop using our name, or who may be tempted to use it in the future, will need to
ISO's Web page is located at www.iso.org.
Who Says the IRS Isn't Friendly?
According to a December 2001 report from the American Customer Satisfaction Index, showing the highest level of improvement from 2000 among services
offered by federal government agencies, filing taxes has become a more tolerable experience for Americans.
The ASCI shows that the score for the Internal
Revenue Service has improved 11 percent from 2000 and 22 percent since 1999. Although still relatively low, the IRS score of 62 (out of a possible 100) is higher
than the airlines' score of 61. (The ASCI airline score was compiled in the first quarter of 2001, before the Sept. 11 attacks and the subsequent impact on air travel.)
"These would be noteworthy improvements for any organization in any industry, but they are even more notable in view of the business of the IRS," says Claes
Fornell, professor of business and director of the University of Michigan Business School's National Quality Research Center, which compiles and analyzes the
ACSI data. "It's difficult to imagine a society in which people would be more satisfied with tax collection than with competing companies from which purchases
are neither mandatory nor without alternatives of choice."
Fornell notes that a major portion of satisfied customers are individuals filing tax
returns electronically--who view the process as simple and efficient and who generally receive tax refunds faster.
"The IRS has adopted some of the private sector's techniques, such as actively listening to their customers, then changing processes, reallocating resources and
focusing technology to enhance the overall tax-filing experience," says Jack West, past president of the American Society for Quality, a partner in producing the ACSI.
Although the IRS showed the biggest improvement, most government agencies included in both the 2001 and 2000 reports showed improvement in customer
satisfaction. The exceptions were the Food and Drug Administration, whose score remained at 68, and the Social Security Administration, whose score dropped
from 84 to 82 (but is still among the highest-rated agencies).
The overall ACSI score for government agencies increased to 71 points, up from
68.6 in 2000. Federal services pertaining to benefits, public information and recreational land use fared well, with scores ranging from the 70s to the 90s.
Regulatory agencies, including the FDA, the Occupational Safety and Health Administration and the Federal Aviation Administration, generally scored in the
50s and 60s. "These agencies face a more complicated challenge, as they have both an enforcement task as well as a service mission," explains Fornell. "The
latter can legitimately be subjected to feedback in the form of customer satisfaction, but the enforcement task is more intricate and issues other than individual satisfaction come into play."
Overall, Fornell says that high satisfaction levels pertaining to government services leads to increased public trust. "Contrary to the private sector, the dissatisfied
recipient of government services can rarely punish a faltering service provider by taking his or her business elsewhere or by demanding a lower price," he says.
"There's no market feedback that forces the service provider to improve."
"Similarly, as government expenditure as a percentage of national income
declines, it becomes essential to allocate public resources in such a way that better service can be provided to a growing number of citizens," he adds.
Although the Sept. 11 attacks had no bearing on the most recent results, Fornell says that 2002 customer satisfaction levels might increase because of "greater
effort and understanding from both service providers and recipients, as the country unites against a common foe."
The ASCI is a national economic indicator of customer evaluations of the quality of goods and services available to household consumers in the United States. It is
updated each quarter with new measures for different sectors of the economy. The federal government scores are updated every December. Agency participation is
voluntary; in 2001, 53 customer groups served by 39 agencies were measured.
The index is produced through a partnership of the University of Michigan
Business School, ASQ and the CFI Group. A complete list of agency scores can be found at the U-M Business School Web site at www.bus.umich.edu/acsi and
ASQ's Web site at www.asq.org.
NIST Takes X-Ray Imaging a Step Further
he term "ultra small angle X-ray scattering" sounds like something straight out of an X-Men comic book. However, this new technology, called USAXS for short, is far from fictional
and has recently been developed as a vision tool for detecting minute voids, tiny cracks and other nearly indiscernible flaws in a wide range of materials over a 3-D expanse.
USAXS imaging, which detects flaws in materials, including metals, ceramics and biological specimens, functions like a highly specialized film camera. As a sort of
"flash bulb," the newest USAXS uses the Advanced Photon Source at the Argonne National Laboratory near Chicago. This APS facility produces an
abundance of extremely uniform, high-energy X-rays that make the new imaging technique work properly.
Although USAXS is already an established research technique, its utilization of APS is new, yielding plots of data points that correspond to angles and intensities
of X-rays scattered by a specimen. With the new system, graphed curves become high-resolution pictures that--when taken from multiple perspectives--can be assembled into 3-D images.
To learn more about NIST's latest technological developments, visit www.nist.gov .
BSI Acquisition Makes It Largest North American Registrar
The British Standards Institution has acquired the U.S. and Canadian ISO
registration business of KPMG, a global professional services provider. The move doubles the size of BSI's North American business, making it the largest registrar
in North America and increasing the company's sales to about $361 million a year and its total worldwide workforce to more than 4,900. After the acquisition, BSI's
number of registrations jumped from 3,000 in North America to more than 7,700.
"KPMG's ISO registration business is part of, and managed by, our American
company, and it will help us deliver an enhanced range of services with broader local and global coverage," notes Nick Moy, the UK-based managing director of BSI Management Systems.
KPMG built a successful ISO registration practice in North America with representation and delivery capability across Canada and the United States. The
company made the acquisition as part of its international expansion strategy, aimed at making it the world's preferred supplier of management system registration and
inspection services. BSI is reinforcing this new phase in its development with a strong focus on the automotive industry.
"We are already well-established in the United States, Asia, Europe, the Middle East and Africa, and we now have more than 41,700 clients in more than 100
countries who choose BSI as their preferred management systems partner," comments Vivian Thomas, chairman of the BSI Group of Companies. "This
acquisition follows our highest-ever profits of last year and places BSI in an excellent position for future growth." BSI announced a 16-percent increase in
revenue and a 48-percent boost to profits in April, 2001. Group turnover increased from about $256.3 million in 1999 to about $297.2 million in 2000,
while operating profit was the highest ever at about $24.4 million, compared to about $16.5 million in 1999.
BSI changed its Royal Charter in March 1998 to allow acquisitions. The company then acquired Inspectorate PLC, a leading international inspection and
testing company, which gave BSI a presence in more than 90 countries. Other acquisitions followed, further increasing the service offering and regional coverage of the BSI Group.
KPMG will focus its business on its established risk management, tax and legal, and consulting and financial advisory services. The transaction does not include KPMG's Six Sigma practice.
New ISO Standard Assesses Environmental Consequences of Business Activities
Businesses seeking to assess the environmental impacts of their activities now have a new resource in the form of an ISO standard.
ISO 14015, Environmental assessment of sites and organizations, will help business and financial managers measure the environmental consequences of their
business activities. These assessments take place during a number of business situations, including compliance with legislation, improving environmental
performance, reducing pollution, risk assessment, obtaining loans and insurance, property evaluations, and acquisitions and mergers.
Environmental assessments are increasingly being conducted in connection with the granting of credit facilities, prior to contracting insurance or as a part of a
property evaluation. The environmental assessment of sites and organizations, or EASO, might be one of an organization's operational activities, carried out when
one company acquires another or divests its assets, or conducted as a part of a broader business assessment, often referred to as "due diligence."
The basic aim of an EASO is to discover correlations between environmental aspects of an enterprise or location and their business consequences (financial or
other) as part of preparations for a proposed business transaction. For example, ISO 14015 includes references and information sources on the identification of
environmental issues connected to waste water discharge, gas emissions and waste generation.
The standard is the product of work from the ISO technical committee ISO/TC
207, Environment management. It's available for about $50 from any ISO national member institute or by e-mailing the ISO central secretariat at email@example.com .
Learn more at www.iso.org.
Quality Consulting Companies Join Forces
riel, a Madison, Wisconsin-based quality management consulting company, will become part of The SAM Group, a quality improvement consulting and
training organization that controls STAT-A-MATRIX Inc., STAT-A-MATRIX Institute and STAT-A-MATRIX FDA Services Inc.
The acquisition provides STAT-A-MATRIX clients with a wider range of offerings through public seminars, and Oriel will expand its books and materials
offerings to include STAT-A-MATRIX products. STAT-A-MATRIX will also expand its global reach by offering Oriel's services through its offices in Japan, Brazil and China.
"Oriel's culture is quite similar to STAT-A-MATRIX's in that we both have a
long history of providing quality management consulting before it was popular to do so," says Patricia
Klossner, Oriel's president. "We will continue to focus
on meeting customer needs by creating effective consulting methodology and courses, and by hiring consultants who have substantial corporate experience."
Part of the deal stipulates that no employees on either side will be terminated as a result of the acquisition. All STAT-A-MATRIX companies will maintain their
global headquarters in Edison, New Jersey, and Oriel will remain in Madison and will be called Oriel Inc., a SAM Group Co. Alan S. Marash will remain president,
and Stanley A. Marash will continue his role as chairman and CEO. Klossner will retain presidency of Oriel and will become a vice president of STAT-A-MATRIX.
Learn more at the STAT-A-MATRIX Web site at www.stat-a-matrix.com.
Quality Digest Wins Golden Page Award
uality Digest has been honored with Emerald's (formerly Anbar) 2002 Golden Page Award in the categories of General Readability and Managerial Application.
This is the third consecutive year that the magazine has won in the readability category.
To be eligible for an award, a periodical must be selected by the Emerald
Management Review's Top 400 accredited list by its accreditation board, which comprises experts from academia and industry. Specialists then review and score
each published article. The award categories include Best Research Implications, Best Practical Implications, Most Original Content and Most Readable Content
across all major management disciplines.
You can help Quality Digest in its effort of continuous improvement by filling out
the reader survey on page 54. Let us know how you think we're doing.
In our January Quality Sourcebook, two errors were inadvertently published. The correct address for BSI Inc. is 12110 Sunset Hills Road, Suite 140, Reston, VA
20190. CyberMetrics Corp.'s toll-free number is (800) 777-7020.
BABT Accredited for JATE Testing
BABT, the telecommunications division of TÜV America, has received accreditation to perform testing to Japanese Approvals
Institute for Telecommunications Testing Equipment regulatory requirements for telecom terminal equipment.
"The bottom line is that with this accreditation, BABT can save our clients additional accreditation costs and expand their market windows by introducing
them to the Japanese market quicker," notes Garry Hojan, vice president of west branch operations and North American director of telecom/international compliance management.
For more information, visit www.tuvglobal.com .
High Resolution in a Small Package
Cognex Corp., a supplier of machine vision systems, has released the CDC-100, the world's smallest high-resolution (1,280 x 1,024) digital CMOS
camera designed specifically for machine vision applications. Roughly half the size and weight of conventional machine vision cameras, the new camera merges digital
technology with CMOS image sensing.
For applications requiring high-speed acquisition, Cognex also offers its new
CDC-50 standard format (640 x 480 resolution) digital camera. It can capture full-frame images at rates up to 60 frames per second and is sized for use on
robotic arms and in space-constrained environments.
New Software for Cadpak Win Users
Open CASCADE software has been chosen by the European
division of Mitutoyo Corp. for the next development phase of Cadpak Win, as an optional software for the off-line programming of mechanical part inspection.
Open CASCADE functions enable Cadpak Win to read data from a number of CAD systems in various formats and improve measuring quality by filtering the
imported geometric entities, encouraging optimal positioning of the probe head and automatically adapting to the default parameters of the program. Details are available at www.opencascade.com .
Camstar and AssurX Develop Medical Partnership
Camstar, a provider of collaborative manufacturing
execution solutions, and issue management and quality assurance systems provider AssurX, have partnered to create a fully-integrated quality solution for medical device manufacturers.
The new system links Camstar's InSiteLive CME system with AssurX's CATSweb Corrective and Preventative Action system to maximize value for
medical device manufacturers by enabling simultaneous compliance with both federal regulations and international quality standards. For more details, visit www.assurx.com and www.camstar.com.