As part of a pilot test, Cambridge, MA-based Harvard Community Health Plan has patients in about 150 households using home computers to receive medical advice and general health information. The system should better educate patients, improve quality of care and lower costs, according to its developers.

It's been long known that EDs in the nation's largest cities routinely provide non-emergent primary care. But a new study by the AHA and several allied hospital associations has found that a very high proportion of ED visits in each of the four communities studied could have been handled outside the ED.

Access to specialized expertise and the ability to staff hard-to-fill jobs continue to surpass all other reasons for use of contract management services, according to the annual CEO survey conducted by Hospitals. And most CEOs who use contract services say they're satisfied with them.

Multiculturalism means different things to different people. For hospital executives, there are a number of major implications inherent in the rapidly expanding diversity of the United States. Beginning on page 23, we look at the ethnic diversity issues hospitals face as employers. A consensus has developed that more minority young people must be encouraged to enter health care administration and clinical care; but there are a variety of obstacles to be overcome. Then, beginning on page 29, we examine the many challenges hospitals struggle with as their patient populations become more and more diverse, and in many cases, change very quickly. Problems in dealing with an array of languages, cultures and backgrounds can put up major barriers to effective patient care. Providers must understand the cultural assumptions that patients bring with them.