Health plans, provider groups and the information technology sector are collaborating on ways to standardize some administrative tasks such as credentialing and patient benefit determination, and to expedite other tasks by replacing paper-based data exchange with electronic tools.

The connection of medical liability premium subsidies to health insurance expansion has led to a political impasse, which could cost Pa. health care providers billions of dollars over the next ten years and severely impair efforts to recruit physicians to the state for years to come.

Reality has outpaced the debate over nurse practitioner autonomy and scope of practice, given the intensifying shortage of primary care providers and health care workforce demands that place a premium on collaboration with physicians.

Concerns about time, cost and liability persist, while use of electronic communication raises issues including privacy and security regulations under HIPAA, efficiency, efficacy, care coordination, care documentation, practice marketing potential, and the patient-physician relationship.

While the hospitalist model has gained widespread acceptance within the health care delivery system, research remains surprisingly inconclusive as to whether it has improved the efficiency and quality of patient care, or lowered costs; while concerns remain about its potential erosion of continuity of care, the physician-patient relationship, and the supply of office-based general internists.