What does “patient centricity” really mean and how is it actually done? This was the driving question of the DayOne Experts Meeting in Basel, co-hosted by Arcondis.
Digital medicine technologies like ingestible sensors and connected digital platforms have the potential to revolutionize healthcare by improving medication adherence and returning patients to the center of their own care. Preliminary clinical studies show these digital medicines can achieve near-perfect adherence rates even in high-risk patient groups and lead to significantly improved health outcomes, such as getting 98% of hypertension patients to their blood pressure goal after 12 weeks. The data from these connected digital platforms also enables more effective care by healthcare teams through targeted interventions and recommendations informed by real-time medication ingestion and response insights. As the technologies continue to miniaturize and costs reduce per Moore's Law, digital medicines may help address the worldwide problem of poor medication adherence and its huge impacts on patient
How to design effective and efficient real world trials TB Evidence 2014 10.2...Todd Berner MD
This document discusses strategies for designing effective and efficient real-world clinical trials. It covers topics such as using real-world evidence to inform clinical trial design, the differences between efficacy and effectiveness, challenges in defining quality metrics, and strategies for improving performance within healthcare systems. The document provides information on pragmatic clinical trials and how real-world evidence could reduce costs compared to traditional clinical trials.
Precision medicine usage has tripled over the last 5 years, with 26% of US hospitals having procured a solution and 22% having gone live. General medical hospitals make up the majority of installations currently. Adoption is highest among multi-hospital nonprofit health systems and larger academic/specialty hospitals. Barriers to further growth include difficulties integrating genomic and other patient data into clinical systems and quantifying return on investment. The document examines trends in precision medicine adoption and provides insights on market leaders, barriers to growth, and signals that could indicate further expansion in the coming years.
This document discusses the patient-centered medical home (PCMH) model and its benefits. It provides examples of how the PCMH approach coordinates care through a team-based approach focused on managing patient populations, uses data to drive decisions and improve outcomes, and shifts care away from episodic visits to proactive health management. Studies show the PCMH approach can reduce costs through lower utilization of emergency rooms, hospitals, and specialty care while improving quality of care and patient outcomes.
Healthcare delivery in the periphery workshop outputDayOne
This document summarizes a tri-national workshop on healthcare delivery in peripheral regions. The workshop brought together participants from Germany, France, and Switzerland to identify challenges in peripheral healthcare, develop collaborative projects to address these challenges, and plan next steps. Three priority projects were selected: 1) A platform for hospitals to share best practices and develop an adherence app, 2) A workshop on technological solutions to attract physicians to peripheral areas, and 3) An exchange program for nurses and nursing students to collaborate with technology companies and work towards harmonizing training across borders. Immediate next steps included reporting outcomes to relevant conferences and planning an expert workshop in early 2020.
This document discusses value-based care for home healthcare providers. It defines value-based care as outcomes that matter most to patients divided by the total cost of care. This framework helps healthcare providers collaborate to maximize value for patients over their entire care cycle by measuring outcomes and costs in order to iterate and improve over time. Key aspects of implementing value-based care for home health providers include organizing care around patient conditions, measuring outcomes and costs for each patient, enabling integrated technology, and moving to bundled payments for full care cycles.
Clinicians Satisfaction Before and After Transition from a Basic to a Compreh...Allison McCoy
Healthcare organizations are transitioning from basic to comprehensive electronic health records (EHRs) to meet Meaningful Use requirements and improve patient safety. Yet, full adoption of EHRs is lagging and may be linked to clinician dissatisfaction. In depth assessment of satisfaction before, during, and after EHR transition is rarely done. Using an adapted published tool to assess adoption and satisfaction with EHRs, we surveyed clinicians at a large, non-profit academic medical center before (baseline) and 6-12 months (short-term follow-up) and 12-24 months (long-term follow-up) after transition from a basic, locally-developed to a comprehensive, commercial EHR. Satisfaction with the EHR (overall and by component) was captured at each interval. Overall satisfaction was highest at baseline (85%), lowest at short-term follow-up (66%), and increasing at long-term follow-up (79%). This trend was similar for satisfaction with EHR components designed to improve patient safety including clinical decision support, patient communication, health information exchange, and system reliability. Conversely, at baseline, short-term and long-term follow-up, perceptions of productivity, ability to provide better care with the EHR, and satisfaction with available resources, were lower at both short- and long-term follow-up compared to baseline. Persistent dissatisfaction with productivity and resources was identified. Addressing determinants of dissatisfaction may increase full adoption of EHRs. Further investigation in larger populations is warranted.
The Aging Well Catalyst Project would involve a series of 5 workshops bringing together stakeholders from areas like healthcare, technology, and senior care to identify innovation opportunities for an aging society. The outputs would be published in a series of white papers and culminate in a public event. The Aging Well Accelerator would select and accelerate the top 3 startups in technologies supporting healthy aging over 6 months to help their path to market. Both projects aim to drive innovation and collaboration around aging well.
Patient-Centered Care Requires Patient-Centered Insight: What We Can Do To C...Health Catalyst
Health systems and providers are inundated with measurement systems and reporting. Why would we want to add to the measurement mayhem? The real question is, “Are we measuring what matters?”
Carolyn Simpkins MD, PhD, chief medical informatics officer, will discuss how putting the patient at the center of the measurement matrix can bring coherence and completeness to the picture of care delivery performance across the patient journey, and therefore the performance of the healthcare ecosystem.
She will describe the building blocks for patient-centered measurement and how other metrics, patient-reported outcomes, and patient satisfaction fit into this approach. Carolyn will also review the challenges that have kept health systems from completing a patient-centered outcomes approach and why we are poised to break through. Finally, she will share case studies of organizations who have begun to pioneer the use of patient centered metrics to improve care and outcomes.
Generating Quality Data through Collaborative Research with an ACOTodd Berner MD
This document summarizes a presentation about generating quality data through collaborative research with an ACO. The number of public and private ACOs is growing rapidly, with over 250 CMS MSSP ACOs covering 4 million Medicare beneficiaries. The goal of the collaborative research is to disseminate valued information on effectiveness and costs of care to payers and policymakers. Real-world evidence studies can provide insights beyond randomized controlled trials by observing patient outcomes across delivery system models. Measuring quality requires considering multiple stakeholder perspectives to identify metrics that drive improvement and have utility.
Nearly 20% of Medicare patients are readmitted to the hospital within 30 days of discharge. Many readmissions appear preventable and add substantial costs to the Medicare system. Reducing readmissions requires understanding factors leading to initial admissions and coordinating care between inpatient and outpatient providers, through interventions like transitional care programs, self-management education, and coordinated care models. No one strategy will be effective - hospitals must work with nursing homes, physicians, and other providers to address readmissions.
Edwina Rogers, executive director of Patient-Centered Primary Care Collaborative, began her presentation by highlighting the movement to advance medical homes.
With the U.S. being the number one in the world for the cost of healthcare and ranked number 37 in the quality category, something needs to change. Rogers discussed the broad stakeholder support and participation for the movement, as well as the incredible volunteer involvement. The four ‘centers’ include: the Center to Promote Public-Payer Implementation, the Center for Multi-Stakeholder Demonstration, the Center for eHealth Information Adoption and Exchange and the Center for Health Benefit Redesign and Implementation. Medical Homes will provide superb access to care, patient engagament in care, clinical information systems, care coordination, team care, patient feedback and publically available information.
Edwards explained that the Obama administration believes the medical homes concept is the best way to approach healthcare reform. The U.S. House of Representatives has showed great support for the movement and is helping develop and allocate funds for a five-year pilot program. She expressed her enthusiasm for the movement and her prediction that the medical home model is certainly the future of health care.
A complete version of Rogers’ presentation on the Patient-Centered Primary Care Collaborative is available online.
Paul Grundy is a leading expert in patient-centered medical homes (PCMHs). He has extensive experience implementing PCMHs across multiple healthcare systems and countries. Studies show PCMHs reduce costs through lower hospitalization, ER visits, and specialty care costs while improving outcomes for patients with chronic conditions. PCMHs transform care delivery through principles like proactive planning for patient needs, care coordination teams, evidence-based guidelines, and measuring quality improvements.
This document summarizes a presentation on improving patient experience. It discusses measuring patient experience through surveys, analyzing feedback to identify pain points, and translating insights into improvements. Key challenges include engaging staff, measuring experience across different settings, and demonstrating the benefits of improved experience such as better outcomes, safety, and cost savings. The presentation provides a framework of 6 E's to guide experience improvement efforts: capturing experiences, understanding emotions, engaging stakeholders, executing on insights, benchmarking excellence, and continuous evolution.
Advancing Chronic Care with eHealth Technologies in JapanSteve Brown
Nations around the world can use similar approaches – including deploying home health monitoring technologies for people with chronic illness. Presentation: “Advancing Chronic Care with eHealth Technologies in Japan: Proving Global Solutions for an Aging Population” from the annual Asia-Europe Meeting (ASEM) Conference on eCommerce in London.
http://www.brown2020.com
This document discusses issues related to aging, death, and dying. It references statistics from the National Vital Statistics Reports regarding mortality rates in the United States in 2010. Specifically, it cites data on pages 8 through 10 of Volume 58, Number 14 from March 2010 and data on page 5 of Volume 58, Number 21 from June 2010 that provide statistical information about hospice.
The document discusses issues in aging and provides interactive maps from the U.S. Census Bureau and American Community Survey on aging-related demographic data from 2005-2009. The maps allow users to view thematic maps on topics related to aging using census data on older populations.
This is the updated slideshow for the 2011 NFMBR presentation of Geriatrics. We apologize sincerely for the error in the manual, you can both view the slideshow online or download it to your computer and view with PowerPoint.
- The document discusses the aging process and increasing life expectancy. It notes physiological changes that occur with aging, such as decreased organ function and increased risk of injury.
- Trauma is a leading cause of death for the elderly, who account for a disproportionate number of injuries and trauma deaths. Injuries from falls and motor vehicle accidents are most common.
- Physiological changes from aging can complicate trauma care for the elderly. Assessment and treatment may require special considerations to avoid further injury.
Constance Johnson & Randy Brown - Supporting Chronic Disease Management in a ...SeriousGamesAssoc
Randy Brown, VP, Virtual Heroes Division Manager, ARA
Constance Johnson, Associate Professor and Senior Research Faculty in the Center for Nursing Research, Duke University School of Nursing
This presentation was given at the 2016 Serious Play Conference, hosted by the UNC Kenan-Flagler Business School.
Since little is known about the efficacy of health interventions in a VE, this study, conducted by Duke and Virtual Heroes, constitutes an innovative step in exploring how this type of environment can be suused to facilitate self-management behaviors in those with chronic diseases, in this case, diabetes. This program has good potential to improve care in an easily disseminated model that promotes cost-effective resource utilization.
Risk Factors for many Chronic Diseases can begin early in life. Evidence shows that making Lifestyle Changes can Prevent Disease Progression and delay the Aging Process.
Jak Zostać AWS Certified Solutions ArchitectMirek Burnejko
Nowi specjaliści z certyfikacją AWS Certified Solutions Architect Associate powstają w Polsce każdego dnia. I dobrze. Są bardzo potrzebni. Jeżeli nie wiesz jak zacząć przygotowania, to zapraszam do prezentacji. Tu szybkie wideo - https://www.youtube.com/watch?v=4d7KPpqVNWc
This document discusses developing a national telemedicine network in New Zealand to improve access to specialist healthcare for remote and rural regions. It describes the New Zealand TelePaediatrics Service (NZTPS) network that was established, connecting over 120 sites across the country. The NZTPS network is now used for various clinical, educational, and administrative purposes, facilitating specialist care, training, and collaboration. Principles of effective telemedicine emphasize overcoming barriers through communities of interest, clinical leadership, and integrating telemedicine into existing healthcare services.
Incentives and Disincentives in General Practice Chronic Disease ManagementStat Health
1. The document reports on a study that explored the impacts of chronic disease management incentives on general practices in Australia. It examined how incentives and disincentives influence care management and physician practices.
2. Key findings included issues with Medicare incentives and requirements, concerns about financial viability of chronic care, and variability in care quality and patient outcomes across practices.
3. Recommendations focused on improving Medicare incentives to better support nursing roles, providing training and systems support before new policies, and considering alternative funding models based on quality outcomes.
The document summarizes healthcare challenges in China and the potential for telemedicine to help address them. Key points include:
1) Rural areas in China have limited access to specialty healthcare due to low incomes and physician shortages while urban areas face issues of overcrowded hospitals and quality of care issues.
2) The Chinese government has established guidelines for a national telemedicine network to connect rural clinics to urban hospitals to provide remote consultations, education, and data sharing in order to improve rural healthcare access and reduce costs.
3) The company described in the document has provided telemedicine services globally and could help China establish effective telemedicine solutions tailored to the country's needs and regulations.
Tailoring Software Process Capability/Maturity Models for Telemedicine SystemsLuigi Buglione
Developing high-quality asynchronous store-and-forward telemedicine systems (ASFTSs) remains a challenge. However, there is no accepted understanding as to what are the important quality characteristics for this type of software system and/or what defines a mature software process for producing high-quality ASTFSs. Through adopting a multi-step research methodology, we define a quality model for ASFTSs indicating relevant quality characteristics and their priority for this specific type of software system based upon ISO/IEC 25010. We, then, propose an extended software process capability/maturity model based on ISO/IEC 15504 and ISO/IEC 12207 to meet these particular quality requirements. The resulting model can be used to both guide the development and the evaluation of such systems. We expect that the availability of such a customized model will facilitate the development of high-quality ASFTSs, reducing related risks and improving the quality of telemedicine services.
mHealth Israel_ AI Assisted Lifestyle Modification in Prevention and Manageme...Levi Shapiro
This document summarizes a presentation on using AI and mobile health technologies to help prevent and manage chronic diseases like asthma. It discusses how a 55-year-old patient's asthma worsened due to developing allergies and becoming non-compliant with treatment. Obesity, inactivity, and air quality are identified as important factors influencing asthma. Trends showing rising obesity and declining activity in the US are presented. Research demonstrating weight loss and exercise can improve asthma symptoms and control is summarized. Barriers to effective mHealth apps and a need for more motivational models that appeal to emotions are discussed. The concept of "Wellth creation" to promote sustained well-being using technology is introduced.
Linkcare is a Patient Centric, Case Management Oriented Open Health Care Model.
Linkcare’s open source platform provides interconnectivity between home curators, nurses, physiotherapists, general practitioners, and medical specialists and their patients.
Linkcare protocols are designed by prestigious committees in the areas of Chronic Disease, Fragility, End of Life Care, Wellness, Reproduction & Neonatology, and Clinical Research, to be shared and improved by the Linkcare community.
Linkcare provides connector for most Electronic Health Record (EHR), Primary Care I (PCIS), Hospital (HIS) and Enterprise Resource Programming (ERP) Information Systems under an Open Source Creative Commons license.
Participating patients may help to improve integrated care protocols by voluntarily endorsing an anonymous clinical data donation program.
The document discusses implementing chronic disease prevention and management frameworks in Canada. It notes that chronic diseases are a major cause of death and disability in Canada, costing $45 billion annually. The goals of chronic disease prevention and management frameworks are to reduce care discontinuities, increase prevention behaviors, improve population health, and reduce costs through a coordinated, systems approach. However, the document outlines several issues with implementing these frameworks in Canada, including a lack of governance to support inter-organizational collaboration, incomplete examples and evidence to support all aspects of the frameworks, and discontinuities in care due to a lack of integration between organizations.
Implementing The Chronic Disease Management Framework - Shared Care - M Goulb...
Similar to Transformation In Chronic Disease Management Through Technology: Improving Productivity And Quality In The Shift From Acute To Home Based Settings
HIMSS 16 Connected Health Experience Presentation on Telehealth in Population...Donna Cusano
This document summarizes a presentation about using remote patient monitoring technologies to improve outcomes for patients in accountable care organizations (ACOs). It discusses how the Veterans Health Administration has used remote monitoring successfully for over 12 years, improving outcomes and saving money. Remote monitoring is well-suited for ACOs seeking to improve quality and lower costs by focusing on high-risk patients. The document outlines a pilot program between an equipment provider and two physician-led ACOs to study the impact of remote monitoring on costs, utilization, and outcomes for high-risk patients with chronic conditions. Preliminary findings suggest remote monitoring shows potential for cost avoidance and reducing emergency room and hospital visits while improving patient satisfaction.
This document discusses the importance of collaborative care and care coordination for healthcare delivery systems. It notes that solo practice is no longer a sustainable business model and that fee-for-service payments have limitations. The document provides evidence that care coordination can reduce costs through fewer hospital admissions and readmissions without worse health outcomes. It also shows that patients experience a lack of communication and information sharing between their different doctors. To improve care coordination, mobile access to patient data and collaborative workflows are seen as critical, as mobile devices are increasingly how physicians access information. The right devices and secure mobile computing are needed to enable these new care coordination models.
The document discusses strategies for transforming healthcare delivery through population health management, care coordination, and virtual care technologies. It provides examples of how partnerships between healthcare organizations and technology companies have implemented programs utilizing telehealth, remote patient monitoring, and digital platforms to improve outcomes, lower costs, and enable aging in place. Case studies demonstrate how these approaches have reduced hospital admissions and lengths of stay, ICU transfers, mortality rates, and costs while improving quality of life.
DASHBOARD BENCHMARK
Miatta Teasley
Capella University
Running Head: DASHBOARD BENCHMARK
DASHBOARD BENCHMARK
April 19,2022
DASHBOARD BENCHMARK
Second Quarter Hypertension Intervention Compliance at Med for adults presenting with Diabetes
Intervention
Needed
Completed
Compliance Percentage
Initial Lactate within 3 hours
30
30
100%
Blood cultures were drawn before antibiotics
22
17
77%
Antibiotics administered within 3 hours
22
20
91%
Fluid resuscitation if in septic shock within 2hours
19
12
63%
Vasopressors if hypertension persists after fluid or lactate >4mmoL/L within 6 hours
12
7
58%
Overall
105
86
82%
Second Quarter Dialysis Intervention
Compliance and Inpatient Mortality
Patient ID
Number of Interventions needed
Number of Interventions completed
Inpatient Mortality
2000
4
2
0
2014
3
3
1
2098
2
1
0
2134
5
4
0
2156
3
4
1
2245
4
2
0
2345
3
3
1
2567
5
4
1
2676
4
1
1
2935
3
2
0
Note: The Staffing benchmark for the nurse staffing unit is 3 patients per nurse. The average monthly staffing for the unit is 3 nurse workloads. The average number of patients in the unit per month in the third quarter was 5.75.
The data above is a review regarding the compliance of Dialysis measures and interventions compliance and the sample of the second quarter inpatient mortality. The information below entails evaluating the data, which indicates that various departments need to be improved, and a proposal for a specific area and target for improvement.
Evaluation of Dashboard Metrics
There are several inefficiencies in regards to dialysis measures at Med. From the dashboard concerning the compliance of executing the arranged measures and procedures, the two stand out at the 77% compliance rate on drawing blood cultures before running antibiotics and 58% compliance rate on administering vasopressors for those patients that require them. As per Medicare.Gov (n.d), the national average for meeting dialysis guidelines is 72%, and the state of Minnesota is 60% which indicates that Med is performing at 82% overall testing. Higher percentages are required to ensure the advanced quality of life for residents of the healthcare institution (Morfín et al., 2018).
Failure to complete blood draws for cultures before running broad-spectrum antibiotics; there will be an incapability to authorize contamination and the responsible pathogen. This can result in an inefficient or ineffective intervention for aiding a patient. Moreover, by failing to confirm infection from the start, unnecessary and wasteful care interventions could be performed or ordered for patients (Morfín et al., 2018). As per the failure to administer vasopressors, the institution is gambling with the patient's life. As the reinforcement for the dialysis unit states, vasopressor therapy is needed to sustain and uphold perfusion in the wake of life-threatening hypertension. The needed nature of compliance concerning administering this intervention can be seen in the samp.
The document discusses the role of telehealth technology in caring for people with chronic illnesses. It describes how remote patient monitoring systems like Health Buddy can help manage patients at home by monitoring health data, providing education and feedback, and connecting patients to care providers. Studies show telehealth reduces hospitalizations and healthcare costs while improving clinical outcomes and patient satisfaction.
Chronic Care Improvement: How Medicare Transformation Can Save Lives, Save Mo...Steve Brown
Presentation by Steve Brown and Harris Miller introducing the ITAA Whitepaper: Chronic Care Improvement: How Medicare Transformation Can Save Lives, Save Money, and Stimulate an Emerging Technology Industry
Telehealth Failures & Secrets to Success Conference 2017 by VSee Speaker Series
Karyn DiGiorgio (University of California)
More info at: vsee.com/conference
Dr Jonathan B Perlin President, Clinical Services and Chief Medical Officer, HCA (USA) on 'Learning healthcare and clinical leadership in an accountable environment'
Question of Quality Conference 2016 - Jonathan B. PerlinHCA Healthcare UK
This document summarizes two case studies from HCA Healthcare that demonstrate how a large healthcare system can leverage electronic health records and data to drive quality improvement and clinical research. The first case study describes the REDUCE MRSA trial, a cluster randomized trial across 43 HCA hospitals that found universal decolonization was most effective at reducing central line-associated bloodstream infections in ICUs. The second case study found that outcomes varied for babies delivered between 37-39 weeks gestation, with 39-week babies faring best, indicating a need to carefully consider timing of elective deliveries. Both examples illustrate how HCA is able to answer important clinical questions and drive practice changes using the data and infrastructure enabled by its electronic health records
Dr Jonathan B Perlin, President, Clinical Services and Chief Medical Officer, HCA (USA) keynote presentation on learning healthcare and clinical leadership in an accountable environment.
Introducing the New Care Management Suite: A Comprehensive, Data-Driven ApproachHealth Catalyst
Because approximately 75 percent of U.S. healthcare costs are attributed to patients with chronic diseases, care management has emerged as a critical improvement strategy. Yet, fragmented workflows, incomplete data sources, and a lack of transparency into typical “black box” solutions leave care teams feeling frustrated and struggling to track success. These challenges are exacerbated in the dynamic, new normal of COVID-19.
Health Catalyst is pleased to introduce our new care management solution. Leveraging a transparent, data-informed approach, the Health Catalyst® Care Management Suite enables quick identification and response to the changing needs of patient populations.
In this webinar, we share the current state of the care management landscape and discuss trends from across the country that highlight risk model biases, the impacts of COVID-19, and the importance of evaluating program ROI. Our Care Management Suite has the capabilities and flexibility to adjust to the ever-changing health environment by identifying the most impactable patients, supporting the entire clinical care pathway, and optimizing program ROI and profitability.
During this webinar, we discuss how our solution does the following:
-Provides a rich, more comprehensive data set—including the ability to look across a wide variety of data sources combining clinical and claims data.
-Offers a patient-centric view—optimized for care management workflows.
-Supports a wide range of analytic capabilities—algorithm transparency and flexibility enabling users to confidently explain, demonstrate, and continuously optimize care management processes.
Tele-Health Carts, Servers, and Monitoring: Market Shares, Strategies, and Fo...ReportsnReports
The document provides details about a report on the tele-health carts, servers, and monitoring market from 2012 to 2018. It analyzes market shares and forecasts, strategies of major companies, and discusses how tele-health improves treatment of chronic diseases and reduces healthcare costs. The global tele-health equipment market is expected to grow rapidly due to improving care for patients with chronic conditions through more standardized remote monitoring and treatment. Major companies discussed include Bosch, Bayer, Philips, Honeywell, and GlobalMed.
The document discusses challenges that health systems face in managing costs under new bundled payment programs and global budgets. It provides an example from a pilot program in Maryland where costs have been capped and prices set in an effort to cut Medicare spending. The document outlines some of the key areas health systems need to address in both acute and post-acute care settings, such as optimizing patient mix and readmission rates, in order to successfully meet budget targets and quality measures. It provides details on specific strategies used by one Maryland health system to improve performance, such as reducing readmission rates from over 23% to less than 7%.
Telehealth offers convenient virtual care that can reduce costs while improving outcomes. It allows patients to access care remotely through video or phone instead of visiting physical offices. This saves money by reducing unnecessary emergency room visits and tests. It also improves productivity and wellness by making care more accessible. Telehealth is highly satisfactory to patients and can help prevent medical issues by facilitating preventative care. Its 24/7 availability makes telehealth a valuable option for employers and insurers to include in health plans.
Cognitive Computing: Company presentation by Avner Halperin, Co-Founder & CEO of EarlySense at the NOAH Conference 2019 in Tel Aviv, Hangar 11, 10-11 April 2019.
Patient Centered Medical home talk at WVUPaul Grundy
To employers the cost of healthcare is now a business issue and this talk is about what one large buyer IBM did to drive transformation via broad coalition with other large employers to form the Patient Centered Medical Home movement and the covenant between buyer and provider away from the garbage we now buy episodic uncoordinated disintegrated care. In the change of convenient conversation we have worked with the Primary care providers to give us coordinated, integrated, accessible and compressive care with a set of principles know as the Patient centered medical home.
A Patient Centered Medical Home (PCMH) happens when primary care healers keeping that core healing relationship with their patients step up to become specialists in Family and Community Medicine. The move is to the discipline of leading a team that delivers population health management, patent centered prevention, care that is coordination, comprehensive accessible 24/7 and integrated across a deliver system. PCMH happens when the specialists in Family and Community Medicine wake up every morning and ask the question how will my team improve the health of my community today?
All over the world three huge factors are in play that is driving the concept of Patient Centered Medical Home. They are:
1) Cost and demography
2) Information technology and data (information that is actionable will equal a demand for accountability by the payer or buyer of the care)
3) Consumer demand to engage healthcare differently (at least as well as they can their bank- on line) have a question about lab results why not e-mail?
But at its core it is a move toward integration of a healing relationship in primary care and population management all at the point of care with the tools to do just that.
Similar to Transformation In Chronic Disease Management Through Technology: Improving Productivity And Quality In The Shift From Acute To Home Based Settings (20)
This review by the National Data Guardian for Health and Care (NDG), Dame Fiona Caldicott, makes recommendations to the Secretary of State for Health. These are aimed at strengthening the safeguards for keeping health and care information secure and ensuring the public can make informed choices about how their data is used.
The NDG proposes new data security standards for the NHS and social care, a method for testing compliance against the standards, and a new opt-out to make clear how people’s health and care information will be used and in what circumstances they can opt out.
Dame Fiona’s report argues that the public should be engaged about how their information is used and safeguarded, and the benefits of data sharing, with a wide-ranging consultation on her proposals as a first step.
A letter from Dame Fiona Caldicott and David Behan, Care Quality Commission Chief Executive, to the Health Secretary outlines the common themes between the NDG review and a review of data security in the NHS carried out by the CQC.
The Global Social Impact Investment Steering Group (GSG) was established in August 2015 as the successor to the Social Impact Investment Taskforce, established by G8. The GSG is continuing the work of the Taskforce in catalysing a global social impact investment market across a wider membership. Its members include 13 countries plus the EU, as well as active observers from government and from leading network organisations supportive of impact investment.
Across the world, attitudes are changing. Old certainties about tightly defined roles for government, civil society and business are dissolving. Social sector organisations are becoming more business-like, and business is looking ever more to delivering sustainable value.
Using a Shared Electronic Patient Record to Develop and Assess e-Consultation...Mohammad Al-Ubaydli
The document discusses a study where medical and pharmacy students communicated electronically with volunteer patients to develop e-consultation skills. Students quickly adapted to communicating online and behaved professionally. The permanent online record of interactions provided valuable feedback on students' consultation skills. More work is needed to identify key skills for effective online communication with patients.
This document discusses a new system that allows general practitioners (GPs) and specialists like nurses or carers to instantly invite local GPs to view patient data, with the goal of improving collaboration and ensuring smoother transfers of care between providers like Great Ormond Street Hospital and St Mark's Hospital. It also mentions scanning and uploading past patient x-rays as well as working with charities.
This document discusses patient access to medical records and the effects of increased access. It finds that there is a lack of clear evidence on how increased access affects outcomes and that there are competing rationales for and against greater access. The document also examines how healthcare is being impacted by the information revolution, including how it may change relationships between patients and providers and impact quality of care, professional responsibilities, privacy, health inequalities, and the roles of alternative providers and the private sector. Overcoming barriers will require interventions to realize the potential benefits of increased access to medical records.
This document discusses tips for clinicians working with patients online, including definitions of key terms like personal health records and patient portals. It recommends that clinicians only work with patients they know, assume all communications could be publicly read, respond promptly to patient access requests, apologize and express gratitude to patients, learn from patient experiences, protect patient privacy but involve family/caregivers when appropriate, develop basic computer skills, consider asking patients to help cover costs, and use available software tools to facilitate online care. The document concludes by thanking the audience and inviting questions.
Personal health records presentation at Cambridge RefreshMohammad Al-Ubaydli
The document discusses personal health records and communicating about chronic diseases online. It notes that while the internet is great for communication, many people are not using it to communicate about chronic illnesses due to genuine security concerns, confusing consent with security, only considering one aspect of security, and not knowing how or that they can communicate online. It provides examples of security risks and privacy issues but also resources that people can use to communicate about their health online in a private and secure manner.
Meeting healthcare challenges: what are the challenges and what is the role o...Mohammad Al-Ubaydli
The document discusses the challenges facing healthcare systems and the role that e-health can play in addressing these challenges. The major challenges are quality and safety, access, responsiveness, and affordability. E-health can help by providing access to electronic patient records, reducing complexity, optimizing information processing, and increasing efficiency. It can also help with navigation through the healthcare system and engaging patients in their own health. The document advocates for free access to research information and using data to identify at-risk patients in need of care.
Patients Know Best is a company that created the world's first patient-controlled medical records website to give patients access to and control over their own health records. Their system provides a complete electronic health record that can store any medical data while complying with various privacy regulations. Several UK healthcare organizations have already implemented the system, including the NHS, Bupa, and Great Ormond Street Hospital, allowing for online consultations, prescribing, and saving clinician's time by providing detailed explanations directly to patients.
Long Term Conditions: Long Term Conditions What’s wrong and what do we need?Mohammad Al-Ubaydli
This document discusses challenges facing long-term condition (LTC) care in the NHS East of England region. It notes that funding cuts are projected, while demand is increasing. Current LTC care is seen as too medicalized and not personalized enough. Variation in services and costs between areas is also a problem. To address these issues, the document advocates for a more personalized, integrated approach centered around self-care and personal health planning. It proposes alternative payment models, like a "pathway hub" provider managing entire care pathways and budgets. The overall vision is to empower patients and provide the right care at the right time in a sustainable way.
Darren Umbers (UK Sales Director, Philips Respironics) (pictured)
Darren will talk about both devices and support services Philips is offering in the UK for sleep apnoea patients. This will include CPAP devices to aid breathing and nebulizers able to report compliance. He will also talk about “back office” support for these devices. Darren will therefore pick up on the references that Steve will make to monitoring devices and treatment and cover patient support to some extent.
Home health care & long-term conditions: How to succeed with personal health ...Mohammad Al-Ubaydli
Dr Mohammad Al-Ubaydli (CEO of Patients Know Best)
Dr Al-Ubaydli is author of the book "Personal health records: A guide for clinicians", in which he surveyed the different ways in which patients can work with their clinical team using software. A new generation of tools allows patients to manage their health and Mohammad will cover some of these in his talk, including products by large US companies like Google and Microsoft, as well as the UK software industry. He will also describe the experiences of his own company, Patients Know Best, which integrates its patient-controlled medical records platform into the NHS secure network.
The document discusses how clinicians can leverage online communities to better connect with key stakeholders. It describes 8 types of online communities and provides statistics on social media usage. It then outlines a 6 phase relationship cycle for using communities as a relationship building tool, including researching needs, setting goals, developing a community plan, acquiring members, measuring results, and maintaining engagement. The key is using communities for transparent, engaged, consistent collaboration and celebrating successes to build trusted relationships.
1) The document provides information on various direct-to-consumer genomics companies and their offerings, including 23andMe, deCODEme, Navigenics, and others.
2) It discusses the declining prices of whole genome sequencing from $99,500 down to $48,000.
3) The document also briefly describes next-generation DNA sequencing technologies like Pacific Biosciences that can read DNA in real time.
The document discusses patient access to medical records and the effects of increased access. It finds that there are different drivers for increased access, and a lack of clear evidence on how access affects outcomes. It also discusses how healthcare is changing with new information technologies and relationships between patients and providers. Some issues that need further focus are ensuring public and private health, quality healthcare, professional cultures, privacy, addressing inequalities, and the roles of alternative providers and the private sector.
The NHS Number Programme aims to improve patient safety by minimizing clinical risks caused by misallocation of patient information and resolving barriers to safely sharing information across healthcare settings. Incidents of patient confusion and errors due to reliance on local hospital number systems have endangered patient safety. Priority settings for implementing the NHS Number include general practice, secondary care, ambulance services, and social care. Current projects include developing published standards for general practice and secondary care, as well as social care standard development and a public awareness campaign.
The document discusses enabling patients to access their electronic health records. It notes that doing so can help rebuild trust after a high-profile murder case, as patients are able to verify their records. It describes building partnerships with patients by giving them online access to records, appointments, and medical information through a patient portal. Studies show patient record access improves communication, patient outcomes and satisfaction. The document advocates a blended approach combining patient access with tools like HealthSpace and Google Health.
EXPERIMENTAL STUDY DESIGN- RANDOMIZED CONTROLLED TRIALRishank Shahi
Randomized controlled clinical trial is a prospective experimental study.
It essentially involves comparing the outcomes in two groups of patients treated with a test treatment and a control treatment, both groups are followed over the same period of time. Prepare a plan of study or protocol
a. Define clear objectives
b. State the inclusion and exclusion criteria of case
c. Determine the sample size, place and period of study
d. Design of trial (single blind, double blind and triple blind method)
2. Define study population: Most often the patients are chosen from hospital or from the community. For example, for a study for comparison of home and sanatorium treatment, open cases of tuberculosis may be chosen.
3. Selection of participants by defined criteria as per plan:
Selection of participants should be done with precision and should be precisely stated in writing so that it can be replicated by others. For example, out of open cases of tuberculosis those who fulfill criteria for inclusion may be selected (age groups, severity of disease and treatment taken or not, etc.)
Randomization ensures that participants have an equal chance to be assigned to one of two or more groups:
One group gets the most widely accepted treatment (standard treatment/ gold standard)
The other gets the new treatment being tested, which researchers hope and have reason to believe will be better than the standard treatment
Subject variation: First, there may be bias on the part of the participants, who may subjectively feel better or report improvement if they knew they were receiving a new form of treatment.
Observer bias: The investigator measuring the outcome of a therapeutic trial may be influenced if he knows beforehand the particular procedure or therapy to which the patient has been subjected.
Evaluation bias: There may be bias in evaluation - that is, the investigator(Analyzer) may subconsciously give a favorable report of the outcome of the trial.
Co-intervention:
participants use other therapy or change behavior
Study staff, medical providers, family or friends treat participants differently.
Biased outcome ascertainment:
participants may report symptoms or outcomes differently or physicians
Investigators may elicit symptoms or outcomes differently
A technique used to prevent selection bias by concealing the allocation sequence from those assigning participants to intervention groups, until the moment of assignment.
Allocation concealment prevents researchers from influencing which participants are assigned to a given intervention group.
All clinical trials must be approved by Institutional Ethics Committee before initiation
It is mandatory to register clinical trials with Clinical Trials Registry of India
Informed consent from all study participants is mandatory.
A preclinical trial is a stage of research that begins before clinical trials, and during which important feasibility and drug safety data are collected.
Following points high.
Hepatocarcinoma today between guidelines and medical therapy. The role of sur...Gian Luca Grazi
Today more than ever, hepatocellular carcinoma therapy is experiencing profound and substantial changes.
The association atezolizumab (ATEZO) plus bevacizumab (BEVA) has demonstrated its effectiveness in the post-operative treatment of patients, improving the results that can be achieved with liver resections. This after the failure of the use of sorafenib in the already historic STORM study.
On the other hand, the prognostic classification of BCLC is now widely questioned. It is now well recognized that the indications for surgery for patients with hepatocellular carcinoma are certainly narrow in BCLC and no longer reflect what is common everyday clinical practice.
Today, the concept of multiparametric therapeutic hierarchy, which makes the management of patients with hepatocellular carcinoma much more flexible and allows the best therapy for the individual patient to be identified based on their clinical characteristics, is gaining more and more importance.
The presentation traces these profound changes that are taking place in recent years and offers a modern vision of the management of patients with hepatocellular carcinoma.
JMML is a rare cancer of blood that affects young children. There is a sustained abnormal and excessive production of myeloid progenitors and monocytes.
Chair and Presenter, Stephen V. Liu, MD, Benjamin Levy, MD, Jessica J. Lin, MD, and Prof. Solange Peters, MD, PhD, discuss NSCLC in this CME/MOC/NCPD/AAPA/IPCE activity titled “Decoding Biomarker Testing and Targeted Therapy in NSCLC: The Complete Guide for 2024.” For the full presentation, downloadable Practice Aids, and complete CME/MOC/NCPD/AAPA/IPCE information, and to apply for credit, please visit us at https://bit.ly/4bBb8fi. CME/MOC/NCPD/AAPA/IPCE credit will be available until July 1, 2025.
Join the leading All Range PCD Pharma Franchise in India and grow your business with a trusted partner. We offer an extensive range of high-quality pharmaceutical products, competitive pricing, and comprehensive marketing support. Benefit from our expertise, wide distribution network, and excellent customer service. Elevate your pharma business with See Ever Healthcare's proven PCD franchise model.
https://www.seeeverhealthcare.com/all-range-pcd-pharma-franchise-in-india/
Chair, Benjamin M. Greenberg, MD, MHS, discusses neuromyelitis optica spectrum disorder in this CME activity titled “Mastering Diagnosis and Navigating the Sea of Targeted Treatments in NMOSD: Practical Guidance on Optimizing Patient Care.” For the full presentation, downloadable Practice Aids, and complete CME information, and to apply for credit, please visit us at https://bit.ly/4av12w4. CME credit will be available until June 27, 2025.
Chemical kinetics is the study of the rates at which chemical reactions occur and the factors that influence these rates.
Importance in Pharmaceuticals: Understanding chemical kinetics is essential for predicting the shelf life of drugs, optimizing storage conditions, and ensuring consistent drug performance.
Rate of Reaction: The speed at which reactants are converted to products.
Factors Influencing Reaction Rates:
Concentration of Reactants: Higher concentrations generally increase the rate of reaction.
Temperature: Increasing temperature typically increases reaction rates.
Catalysts: Substances that increase the reaction rate without being consumed in the process.
Physical State of Reactants: The surface area and physical state (solid, liquid, gas) of reactants can affect the reaction rate.
Case presentation of a 14-year-old female presenting as unilateral breast enlargement and found to have a giant breast lipoma. The tumour was successfully excised with the result that the presumed unilateral breast enlargement reverting back to normal. A review of management including a photo of the removed Giant Lipoma is presented.
Chair and Presenter, Stephen V. Liu, MD, Benjamin Levy, MD, Jessica J. Lin, MD, and Prof. Solange Peters, MD, PhD, prepared useful Practice Aids pertaining to NSCLC for this CME/MOC/NCPD/AAPA/IPCE activity titled “Decoding Biomarker Testing and Targeted Therapy in NSCLC: The Complete Guide for 2024.” For the full presentation, downloadable Practice Aids, and complete CME/MOC/NCPD/AAPA/IPCE information, and to apply for credit, please visit us at https://bit.ly/4bBb8fi. CME/MOC/NCPD/AAPA/IPCE credit will be available until July 1, 2025.
Causes Of Tooth Loss
PERIODONTAL PROBLEMS ( PERIODONTITIS, GINIGIVITIS)
Systemic Causes Of Tooth Loss
1. Diabetes Mellitus
2. Female Sexual Hormones Condition
3. Hyperpituitarism
4. Hyperthyroidism
5. Primary Hyperparathyroidism
6. Osteoporosis
7. Hypophosphatasia
8. Hypophosphatemia
Causes Of Tooth Loss
CARIES/ TOOTH DECAY
Causes Of Tooth Loss
CAUSES OF TOOTH LOSS
Consequence of tooth loss
Anatomic
Loss of ridge volume both height and width
Bone loss :
mandible > maxilla
Posteriorly > anteriorly
Anatomic consequences
Broader mandibular arch with constricting maxilary arch
Attached gingiva is replaced with less keratinised oral mucosa which is more readily traumatized.
Anatomic consequences
Tipping of the adjacent teeth
Supraeruption of the teeth
Traumatic occlusion
Premature occlusal contact
Anatomic Consequences
Anatomic Consequences
Physiologic consequences
Physiologic Consequences
Decreased lip support
Decreased lower facial height
Physiologic Consequences
Physiologic consequences
Education of Patient
Diagnosis, Treatment Planning, Design, Treatment, Sequencing, and Mouth Preparation
Support for Distal Extension Denture Bases
Establishment and Verification of Occlusal Relations and Tooth Arrangements
Initial Placement Procedures
Periodic Recall
Education of Patient
Informing a patient about a health matter to
secure informed consent.
Patient education should begin at the initial
contact with the patient and should continue throughout treatment.
The dentist and the patient share responsibility for the ultimate success of a removable partial denture.
This educational procedure is especially important when the treatment plan and prognosis are discussed with the patient.
Diagnosis, Treatment Planning, Design, Treatment, Sequencing, and Mouth Preparation
Begin with thorough medical and dental histories.
The complete oral examination must include both clinical and radiographic interpretation of:
caries
the condition of existing restorations
periodontal conditions
responses of teeth (especially abutment teeth) and residual ridges to previous stress
The vitality of remaining teeth
Continued…..
Occlusal plan evaluation
Arch form
Evaluation of Occlusal relationship through mounting the diagnostic cast
The dental cast surveyor is an absolute necessity in which patients are being treated with removable partial dentures.
Mouth preparations, in the appropriate sequence, should be oriented toward the goal of
providing adequate support, stability,
retention, and
a harmonious occlusion for the partial denture.
Support for Distal Extension Denture Bases
A base made to fit the anatomic ridge form does not provide adequate support under occlusal loading.
The base may be made to fit the form of the ridge when under function.
Support for Distal Extension Denture Bases
This provides support
Hemodialysis: Chapter 8, Complications During Hemodialysis, Part 3 - Dr.GawadNephroTube - Dr.Gawad
- Video recording of this lecture in English language: https://youtu.be/pCU7Plqbo-E
- Video recording of this lecture in Arabic language: https://youtu.be/kbDs1uaeyyo
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Hemodialysis: Chapter 8, Complications During Hemodialysis, Part 3 - Dr.Gawad
Transformation In Chronic Disease Management Through Technology: Improving Productivity And Quality In The Shift From Acute To Home Based Settings
1. Cambridge Health Network Molly Joel Coye, MD, MPH Founder and CEO Health Technology Center June 22, 2009 Transformation In Chronic Disease Management Through Technology: Improving Productivity And Quality In The Shift From Acute To Home Based Settings
2. A “Blockbuster” Is Discovered… 72% reduction in HF hospitalizations 63% reduction in cardiac-related hospitalizations 0.51 1.82 0.81 2.20 2.18 2.73 RR=0.28 p=0.03 RR=0.37 p=0.029 RR=0.80 p=NS Heart Failure All Cardiac All Reason for Hospitalization Hospitalizations/Patient-Yr Intervention Control
3. Frustrated Deployment of a Transformational Technology 72% reduction in HF hospitalizations 63% reduction in cardiac-related hospitalizations SPAN-CHF II: Tufts-New England Medical Center; Lahey Clinic; Beth Israel-Deaconess Medical Center; Rhode Island Hospital. Weintraub et al AHA 2005 0.51 1.82 0.81 2.20 2.18 2.73 RR=0.28 p=0.03 RR=0.37 p=0.029 RR=0.80 p=NS Heart Failure All Cardiac All Reason for Hospitalization Hospitalizations/Patient-Yr Intervention = Remote Patient Management Control
5. We Can Make Good Care Far Less Expensive – Relatively Quickly The most pressing task of health policy is to make care effective and affordable, and particularly so in the case of chronic disease. A series of technologies, including in-home monitoring and communications and medication optimization, have been demonstrated to reduce the use of hospitals and skilled nursing facilities by substituting patient self-management and support from lower levels of clinical and nonclinical providers. Large scale deployment has lowered the net cost of care by more than 20%. Presentation: Chronic care: The medical mystery and the 20% solution. The failure of policy to effectively drive implementation of technology-enabled models. Three goals that can be accomplished with modest investment: efficiency, productivity, and satisfaction.
6. Early Trials of a Transformative Technology: Remote Patient Management Home-based Telemedicine for Uninsured, High-risk Diabetic Population Inpatient Admissions 32% Emergency Room Encounters 34% Outpatient Visits 49% (Diabetes Technology & Therapeutics Journal, 2002) Asthma Self-management for High-risk Pediatric Population Activity Limitation (p = .03) High Peak Flow Readings (p = .01) Urgent Calls to Hospital (p = .05) (Arch Pediatr Adolesc Med. 2002) Care Coordination: Hypertension, Heart Failure, COPD, and Diabetes Emergency Room Visits 40% Hospital Admissions 63% Hospital Bed Days of Care 60% Nursing Home Admissions 64% Nursing Home Bed Days of Care 88% (Disease Management, 2002)
7. Why Remote Patient Management Transforms Chronic Care Early intervention – monitoring patients’ physiological, mental, and functional status early enough to detect deterioration and intervene before the need for unscheduled and preventable services Integration of care – exchange of data and communication across multiple co-morbidities, multiple providers, and complex disease states, in contrast to disease management programs that often target a single disease Coaching – motivational interviewing and other techniques to encourage patient behavioral change and self-care Trust – patient reports of satisfaction and feeling of ‘connectedness’ with providers Workforce – shift to lower levels of healthcare workers, including medical assistants, community health workers and social workers for much of the interaction with the patient Productivity – more effective use of provider time at each level of worker None of these can be accomplished by merely connecting a sensing device in the home. All of them require substantial reorganization of systems of care, and financing that rewards discontinuous leaps forward in performance.
8. The Early Adopter Experience: Veterans Health Administration The VA’s Care Coordination/ Home Telehealth (CCHT) program began in 2001. VHA attributes the rapidity and robustness of its implementation to the “ systems approach ” taken to integrate the elements of the program. Findings from 2006-07 comparative studies: 25% reduction in bed days of care 20% reduction in numbers of admissions 86% mean satisfaction score rating A total of 43,430 patients have been enrolled s ince VHA implemented CCHT in 2003. VHA will increase these services 100% above 2008 levels to reach 110,000 patients by 2011 (only 50% of projected need).
10. Estimated Savings For Congestive Heart Failure = $6.4 Billion/Y In U.S. Estimated cost savings for all Class III and Class IV heart failure patients: 60% reduction in readmissions vs. standard care 50% reduction vs. disease management without remote monitoring Potential to prevent 460,000 - 627,000 CHF-related hospital readmissions / year New England Healthcare Institute, Research Update: Remote Physiological Monitoringa, 2009 Net savings due to RPM: Vs. disease management = $3,703 / pt / yr Vs. standard care = $5,034 / pt / yr
11. Many Enabling Technologies: Medication Management “ Smart” Pill Bottles Rex Talking Pill Bottle - offered at over 140 N orthern California Kaiser Permanente pharmacies and health care facilities Remote Medication Dispensing Med-eMonitor – improved adherence rates in diverse chronic illnesses from baseline levels of 35-55% to levels in excess of 90% Improved from a baseline of 52% (prior to using device) to over 94% (3-months usage) in patients with schizophrenia Medication Adherence Rates improvement from 40% to over 92% and reduction of HbA1c levels by 18.5% (p=.002) in rural diabetes patients 94% medication compliance rate in CHF VA patients
12. What Are The Transformative Technologies in Chronic Care? Remote patient management Caregiver communication Video interpretation Social networking among patients, caregivers, and health workers Examples: Claims-based decision support systems linked to EBM 19% reduction in hospitalizations, and >50% reduction in total inpatient charges. Physician-patient emails popular, not abused, reduced visits by 25% 2004-2007 in Kaiser Permanente; by 2007, only 66% of visits were in person Medication management Cognitive assessment Remote training and supervision of health workers Data mining
13. February 2009: The State Of The Union And Budget Proposal “… Hospitals with high rates of readmission will be paid less if patients are re-admitted to the hospital within the same 30-day period… saving roughly $26 billion of wasted money over 10 years .”
14. Policy Levers On The Near Horizon In The U.S. Reimbursement alignment Reduce or eliminate payment for hospital readmissions Bundled payments for: Episodes of care Chronic care management Investment in Electronic Medical Records Much of “20% solution” gains made in absence of full EMR - no reason to wait for integration Full EMR boosts power of RPM systems Redistribution of risk Gain-sharing Accountable Care Organizations (allow physicians and hospitals to conspire, accept risk) Medicare HMO subset: Special Needs Plans (SNIPs) focus on 20% most severe home-bound Pause for chaos… Comparative Effectiveness Research The specter of NICE
15. Policies That Would Be Required For Successful Implementation Clear statement of goals and expectations “ A national drive to reduce ED and hospital use for CHF, pneumonia and AMI patients by 20% in 3-5 years” Redirect investments in professional education – shift resources to re-training and re-deployment Investment in workforce training Create a new workforce of home health and community health workers – 16-24 week training, remote supervision, consultation and continuing education Invest in social services to prevent deterioration Build networked “hubs” for monitoring and responding to patients enabled with RPM National coordinating center – predictive modeling, patient segmentation and other policies Protocols for staff training, patient management and education Test adaptations to local needs and disseminate successful models Technology investment and on-going field R&D as new capabilities emerge Do not let EMR implementation and integration challenges distract from cost-reduction goals Remember – innovation should target successful adoptions that have rapid cycle impacts on costs and the independence of patients
16. Molly Joel Coye, MD, MPH Founder and CEO 415.537.6960 phone 415.537.6969 fax [email_address] Health Technology Center 524 Second Street, 2 nd floor San Francisco, CA 94107 www.healthtech.org
17. HealthTech: Technology and Transformation A non-profit research organization and expert network that develops forecasts and planning tools for emerging technologies in healthcare, and works with a broad range of stakeholders to advance their adoption. Represents approximately 20% of hospital capacity in the U.S. Created in response to the IOM Crossing The Quality Chasm report: an average of 17 years elapses between demonstration that a new technology represents a significant advance and the widespread adoption of that technology. Our Vision: Innovations and technologies are adopted rapidly across the industry to make healthcare better and reduce the cost of care Our Mission: To make healthcare better, safer, more satisfying and more affordable – by building partnerships across the industry to research and accelerate the adoption of transformative technologies In 2009, HealthTech will move into the public domain, and merge with the Public Health Institute, based in Oakland, California.
Editor's Notes
SPAN-CHF II: Tufts-New England Medical Center, Lahey Clinic, Beth Israel-Deaconess Medical Center; Rhode Island Hospital. Weintraub et al AHA 2005 Dozens of small hospital-sponsored demonstrations around the country have proven that coordinated care can improve quality and drastically cut ED use, hospitalizations, and SNF days. But nowhere has this been taken to scale – that is, used to produce substantial decreases in expenditures for large populations. This is the kind of impact that will be needed to reliably reduce estimates for future hospital capacity requirements.
SPAN-CHF II: Tufts-New England Medical Center, Lahey Clinic, Beth Israel-Deaconess Medical Center; Rhode Island Hospital. Weintraub et al AHA 2005 Dozens of small hospital-sponsored demonstrations around the country have proven that coordinated care can improve quality and drastically cut ED use, hospitalizations, and SNF days. But nowhere has this been taken to scale – that is, used to produce substantial decreases in expenditures for large populations. This is the kind of impact that will be needed to reliably reduce estimates for future hospital capacity requirements.
Scale of the impact. Visicu – 20-40% improvement in mortality, 30% drop in LOS and costs CHF Solutions – elimination of ICU charges, decrease ED charges for one of the largest and most expensive patient groups currently utilizing hospital services.
VHA CCHT (Care Coordination/Home Telehealth) program involves the use of health informatics, disease management and home telehealth technologies to provide routine non-institutional care (NIC) and chronic care management services to veteran patients with diabetes, congestive heart failure, hypertension, posttraumatic stress disorder, chronic obstructive pulmonary disease and depression. The majority (85%) of technology utilized was messaging/monitoring services, 11% video-telemonitors and 3% videophones.
Smart Pill MedivoxRx. Wizzard Software, MedivoxRx Technologies Announces Plans to Further Enhance Rex-The Talking Bottle and Rex Pharmacy System, Other Recent Events. Press Release August 16, 2006. http://www.wizzardsoftware.com/pr/show_news.php?misc=search&subaction=showfull&id=1155732273&archive=1159802122 Remote Medical Dispensing Schizophrenia Trial - Dr. Dawn Velligan, PHD and Dr. Alec Miller, MD; UTHSCSA (University of Texas Health Center in San Antonio). http://www.informedix.com/professional/results/schizophrenia1.pdf Diabetes Trial - Underserved Diabetes population – St. Vincent Healthcare, Billings, Montana. http://www.informedix.com/professional/results/diabetes.pdf CHF - CHF in VA Population – Wayne State http://www.informedix.com/professional/results/chf_va.pdf
Barbara Harvath, Steve DeMello and Andrew Broderick are continuing work in this area for us, and they’d welcome questions and comments.