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.

While these Web 2.0 technologies facilitate rapid access and exchange of medical information, democratizing the promulgation of that information requires more vigilance to vet its credibility and potential bias, as sources may be anonymous and/or have commercial ties to industry that are not immediately apparent.

As the number of uninsured grows, the strain on the health care safety net intensifies. Inherent weaknesses of that safety net – maintaining adequate resources and coordinating patients’ specialty care needs – may be reaching a critical point.

Definitive causes of persistent health disparities remain elusive, but recent research from key agencies sheds new light on the issue, as well as which models of intervention may hold the most promise for closing the health status gap, and those models are being applied at the state and local level.

The problem is more prevalent than one would expect, while adequate support services for physicians are often unavailable, and physicians do not use available services for a variety of personal and professional reasons.

Although still defined partly by acrimonious confrontation over reimbursement issues, the relationship has seemingly taken on a more cooperative style, as illustrated by several recent developments affecting Pennsylvania and New Jersey physicians.

The health court concept is being treated with a new level of seriousness, enjoys growing support from new quarters, and now occupies a conspicuous place in medical liability reform policymaking.

Many physicians may find the PQRI appealing, as they stand to gain extra reimbursement for reporting data that they may already capture in their patients’ clinical charts, although participation will likely entail workflow changes, and few expect the 1.5 percent bonus to cover a practice’s additional cost for capturing and reporting the data.

Experiences from this project are expected to help shape the nationwide value-based purchasing program authorized under the 2006 Deficit Reduction Act and scheduled to be launched in fiscal year 2009.