This document outlines a reference architecture for creating the next generation of mHealth apps. It discusses challenges such as information asymmetry and low credibility of patient data that prevents adoption of mHealth apps. A solution is proposed that embeds the patient-physician relationship, uses behavior change models, and ensures bi-directional integration of apps with electronic medical records to collect and use patient experience and outcome data to improve care. The authors applied their criteria to review 201 diabetes apps but found none met all criteria, highlighting a need for higher quality, clinically-integrated apps.
HXR 2016: The Health IoT: Remote Care and Mobile Solutions -Manu Varma, PhilipsHxRefactored
The digital transformation of healthcare is collecting millions of data points from connected devices that monitor patients. Chronic conditions are increasing globally and healthcare spending is rising unsustainably. Digital technologies enable moving from reactive to proactive health by providing a longitudinal personalized overview of patients through monitoring, informatics and connected care. Philips partners with healthcare organizations to implement telehealth programs that have led to faster discharge rates from hospitals and ICUs, as well as significant cost savings through reduced readmissions. Digital technologies are transforming healthcare delivery from reactive to proactive models through connected health across settings.
HxRefactored 2015: MediSafe "Cloud-Synced Medication Management for Patients ...HxRefactored
MediSafe introduces their medication
management solution cloud-synced mobile app designed to help people integrate healthier behaviour into their daily lives.
Deploying Telehealth to 1.2 M Users - LA County Case StudyVSee
Innovating Equitable Telehealth for LA County
The Los Angeles County Department of Mental Health (LACDMH) is the largest county-operated mental health department in the United States, directly operating 85+ programs and contracting with close to 1,000 organizations and individual practitioners. It’s goal is to reach 1.2M of its 10M residents who are in need of mental health services.
HXR 2016: Tracking the Body: Devices, Consumer Genomics, and Sensors- Aymen E...HxRefactored
The document discusses Massive Bio, Inc. (MBI), a platform that aims to overcome barriers to precision cancer care by providing a digital analytics platform, virtual tumor board, live support, and other services. It outlines challenges currently facing cancer patients, oncologists, insurance companies, and academic centers due to siloed information and lack of infrastructure and support. The MBI platform integrates patient data, guidelines, clinical trials, and partners to provide testing and treatment recommendations through a virtual tumor board, as well as primary oncologist support, reimbursement guidance, and outcomes comparisons. A demo of the GUI is shown and value propositions for stakeholders over phases 1 and 2 are outlined. The team behind MBI is also
Health 2.0 Boston 2015 Code-a-Thon - 1st Place Winner - HEALTHPartnerhealth2dev
We are building a chronic condition management platform that integrates with Allscripts EMRs. It identifies gaps in patient care, develops personalized care plans, and enables ongoing patient education and monitoring between visits. The platform aims to address the gap between great physician instruction and meaningful patient action. It utilizes CMS financial incentives for coordinated care and Allscripts APIs to integrate within clinical workflows and exchange data with patients. There is potential for significant impact given the large problem of heart disease and gaps in patient self-management, as well as meaningful provider incentives and patient readiness with smartphones.
Meaningful Use Stage 1 establishes the basic concepts and requirements for using electronic health records to qualify for incentive payments, including: establishing core measures of meaningful use; requiring the use of certified EHR systems; and outlining the stages of meaningful use that focus on data capture, clinical processes, and improved outcomes. It also describes the eligible providers, certified EHR criteria, Medicare and Medicaid program differences, and recommendations to familiarize oneself with the requirements to receive incentive payments.
Mark Frisse gave a keynote address covering four main topics: the turbulence in healthcare due to various forces driving change; the current confusion from uncertainties in the evolving healthcare system; some vital elements that could help forge solutions; and the need for an emergent, incremental approach to progress. He argued that meaningful change requires renewed focus on critical goals through a systematic, component-based approach with tangible early results.
HXR 2016: Human Focused Innovation in a Clinical Setting -Lesley Solomon, Bri...HxRefactored
The Brigham and Women's Hospital Innovation Hub (iHub) was created to foster innovation among clinicians and staff and help move ideas from concept to implementation. The iHub provides programs like innovation accelerators and advisory services to help innovators overcome common barriers to innovation such as lack of funding, time, and clarity on next steps. Notable innovations supported include reducing MRI analysis time from 3 days to 3 seconds. Innovators report that the iHub helped connect them to resources and partners to further develop their ideas.
HXR 2016: Free the Data Access & Integration -Aashima Gupta, ApigeeHxRefactored
Utilizing the power of data can empower patients and arm developers in the creation of new tools and platforms. Whether it’s authenticating data, downloading it via BlueButton, or connecting data with other applications using BlueButton on FHIR, increased data accessibility is a win for everyone. Presenters will give an overview of the opportunities and challenges that exist today and share the newest technologies and initiatives that are overcoming them.
The Internet of Things (IoT) is the latest buzzword out of the interface between information technology and business. As technologies like Bluetooth and sensors enable connections between devices and networks, innovation has brought connections between devices and a human interface. In healthcare, this has been termed the Internet of Medical Things or Healthy things. Medical devices and consumer health devices generate data which can be analyzed, synthesized and displayed for the consumer and healthcare provider to get a broader picture of one’s health. Everything from fitness devices to glucose monitors can give us information about our current health status as never before. How this will integrate into a clinician’s workflow is a new journey of discovery as medical practice catches up with these innovations.
Jennifer Horowitz EHR Adoption in Michigan & Nationwidemihinpr
This document discusses EHR adoption trends in Michigan and nationwide based on data from the HIMSS Analytics Database. It finds that Michigan hospitals have a higher average EMR adoption score than the national average, with 4.0458 compared to 3.6500. The top issues impacting healthcare according to the HIMSS Leadership Survey are healthcare reform and financial considerations. The primary clinical IT focus for most hospitals is improving quality outcomes and reducing medical errors. Radiology PACS installations are nearly universal in Michigan hospitals at 89.74%. Ambulatory EMR adoption in Michigan is lower than the national average at 61.97% versus 65.84% nationwide.
Accountable Care Workgroup: Draft RecommendationsBrian Ahier
The document outlines the recommendations from an Accountable Care Workgroup on advancing health IT capabilities to support accountable care models. It discusses the workgroup background and members, their charge to provide recommendations to ONC and HHS, and six draft recommendation areas: 1) HIT adoption and infrastructure, 2) access to administrative and encounter data, 3) exchanging data across healthcare organizations, 4) data portability, 5) clinician use of data to improve care, and 6) streamlining administration of value-based programs. Specific draft recommendations are provided under each area.
Virtual health is supporting continuing efforts to further humanize health care by extending and expanding the concept of a patient-centric care delivery model into one that is truly life-centric.
Virtual health uses telecommunication and networked technologies to connect clinicians with patients (and with other clinicians) to remotely deliver health care services and support well-being. For providers, committing to virtual health at a personal and organizational level affords ever-increasing opportunities to deliver the right care at the right time in the right place, in a connected and coordinated manner.
By strengthening and facilitating a therapeutic alliance between clinicians and patients, virtual health is an important step on our continuous journey to humanize health care. It works within and around a patient’s life, as opposed to their sickness, to deliver care when, where, and how they need and want it. Also, virtual health works its way into consumers’ daily routines by being embedded in electronic devices associated with living life (e.g., smartphones and personal computers) more so than caring for sickness.
The healthcare industry is primed for expanded adoption of virtual health; a 2016 report estimated that the US virtual health market will reach $3.5 billion in revenues by 2022. Several factors are elevating stakeholder interest, including expected physician shortages, continued growth in digital technologies, changing reimbursement models, increasing consumer demand, and the evolving regulatory landscape. One game-changer: Today, nine in 10 American adults use the internet, giving clinicians the capability and flexibility to communicate with and serve health care consumers via the web.
Millennials are driving trends in mobile health as digital natives who rely on technologies like social media, texting, and apps. Hospitals are using portals, telemedicine, and remote monitoring to engage patients. However, many patients do not use portals due to lack of awareness or complex interfaces. Texting shows promise for improving outcomes through appointment reminders and health messages. Apps and games also motivate patients, especially for conditions like diabetes. Overall, mobile technologies allow more convenient, engaged, and proactive healthcare management.
m-Health: Engaging Patients at Every TouchpointCognizant
Today, people want fast, easy and secure access to their health records, from wherever they may be and from whatever device they choose. Electronic health records (EHR) can alleviate this issue, and encourage proactive, preventive care, all within a robust, integrated, interoperable, and inclusive health system that serves the best interests of patients, physician practices, hospitals, public health, and the population at large.
HXR 2016: Data Insights: Mining, Modeling, and Visualizations- Jennifer GambleHxRefactored
Data is useless if it fails to inform, which is precisely what data experts are furiously working on: turning raw informatics into meaningful narratives that begin to shift our standards. From the individual to the population level, data is leading both policy and better decision making in the clinical sphere.
Mobile health (mHealth) applications have grown significantly in recent years due to developments like electronic health records, FDA guidance on medical apps, and new monitoring technologies. While over 97,000 health apps exist, barriers to adoption include regulatory uncertainty, reliability/privacy concerns, and a lack of proven return on investment. Remote patient monitoring shows promise by providing continuous patient surveillance with actionable data from sensors and wearables. Social media also plays a critical role in mHealth by facilitating support groups, clinical trials recruitment, and more convenient healthcare access and information for patients. Surveys find healthcare organizations increasingly prioritizing mobile technologies but more work is still needed in areas like standards, funding, and demonstrating clinical impact.
Connecting Patients, Providers and Payers John Halamka Keynotemihinpr
The document discusses goals and strategies for connecting patients, providers, and payers through healthcare IT and analytics. It outlines core objectives for physicians and hospitals that focus on clinical documentation, decision support, care coordination and exchange. It also describes various approaches to analytics using expert queries, self-service tools, repeatable reports and outsourced clinical repositories. The final sections discuss providing universal access to personal health records and required PHR functionality, as well as utilizing various decision support service providers.
The document discusses the need for next generation electronic medical records (EMRs) as current EMRs are not delivering hoped-for value and cannot be improved solely by vendors. It proposes a new solution architecture integrating EMRs, telehealth, clinical decision support systems, analytics, and research capabilities to create a learning health system. This system would provide team-based and population care, integrate multiple stakeholders, and accelerate EMR research and development to better address evolving healthcare demands.
What we can learn from Amazon for Clinical Decision SupportKarim Keshavjee
This document discusses how clinical decision support systems (CDSS) can learn from features of Amazon to improve the user experience for clinicians. It describes how CDSS could incorporate real-time user data and feedback to rapidly improve functionality, provide personalized treatment recommendations and medication reviews based on similar patient experiences, and standardize care through shared treatment protocols. However, barriers include the need for multi-institutional collaboration and data sharing between different health records systems. The document concludes by stating these barriers can be overcome.
Pitfalls and realities of working with Big DataKarim Keshavjee
This document summarizes Karim Keshavjee's presentation on designing a solution to enable standardized data collection across electronic medical records (EMRs) and the transmission of that data to a central repository. The presentation outlines the problem, lessons learned from previous related projects, stakeholder engagement activities, the proposed solution design, key barriers addressed by the design, and advantages of the approach. The proposed design features clinical data collection forms that are evidence-based, can be incorporated into any EMR instantly, and retrieve data via a standard server to facilitate research using big data.
Jump-Start Health Data Interoperability with Apigee Health APIxApigee | Google Cloud
New policies, technology advances, and evolving customer expectations are altering the healthcare landscape. At the heart of all this lies the interoperability of patient data.
The Apigee Health APIx solution accelerates interoperability, enabling healthcare providers to quickly begin using FHIR (Fast Healthcare Interoperability Resources) API-based digital services to bootstrap internal and external innovation.
Learn more about this innovative solution in a wide ranging interview with Aashima Gupta, Apigee’s healthcare industry leader.
Wordpress & Drupal: The way to enlightenmentAmye Scavarda
This document compares the content management systems WordPress and Drupal, providing pros for each, and discusses how to choose between them based on skills, needs, and users. It also touches on trends in open source software and collaboration, envisioning a future "Internet Operating System". The key factors to consider are your skills, technical requirements, user roles, and end goals for your site or content.
The document discusses the fiscal stress facing higher education worldwide due to demands on public funds. Despite the growth of the knowledge economy, education is in crisis. All major nations fund higher education through taxation, but taxation cannot keep pace with rising costs. The supply of higher education has increased but demand is even greater, putting pressure on limited public dollars. National and worldwide trends follow this pattern and solutions emphasize efficiency, cost sharing, and finding alternative sources of funding like philanthropy.
Sma case study - arab media influence report 2011Anochi.com.
1. Increased role of religion in politics. Groups like the Muslim Brotherhood and Salafi movements gained influence and supporters during the Arab Spring uprisings and will likely continue expanding their role in governments and shaping public policy.
2. Rise of populist, socialist economic policies. There is strong public support for larger government intervention in the economy through policies like subsidizing basic goods, increasing wages and jobs.
3. Growing pan-Arab nationalism. The uprisings sparked dreams of greater unity among Arab countries and people. While a full union may not be imminent, sentiments of Arab solidarity and opposition to foreign influence will remain powerful
This document discusses payment card industry frameworks and identity systems. It describes traditional payment flows involving consumers, merchants, acquirers, issuers and payment networks. It then discusses how identity flows could work similarly to authorize transactions based on personal account numbers (PANs) and identify cardholders. Finally, it outlines some benefits identity systems could provide like issuer fraud reduction, identity theft protection, and monetization opportunities for issuers as identity providers.
Degree of economic_freedom_and_relationship_to_economic_growthAnochi.com.
Freedom is an intrinsic element of the life of every person, yet is often noticed only
in the event that attempts are made at limiting it. It is possible today to select many
areas in which it is more or less consciously diminished. One of these is the field of
economic freedom, which may be reduced through bureaucracy for example, as well as
through various forms of concession. The means of preventing this particular
weakening of the development of an economy may be a gradual liberalization of it.
Individuals aspire to gain happiness through the fulfillment of their needs, assistance
in which may be provided by an increase in income. Economic growth triggers an
increase in the income of individuals, but is also equated with an increase in access to
such goods as better medical care or education. On account of this it becomes vital to
investigate the influence of the liberalization of an economy on economic growth
Israel is often falsely accused of apartheid during "Apartheid Week" events on college campuses. In response, posters were created promoting the Elder of Ziyon blog to counter false claims and highlight that Israel gives equal rights to all citizens, regardless of race or religion, in contrast to actual apartheid regimes in history. The posters encourage learning facts instead of believing biased rhetoric.
how to secure web applications with owasp - isaca sep 2009 - for distributionSantosh Satam
This document discusses how to secure web applications using OWASP (Open Web Application Security Project). It recommends taking a systemic approach and implementing application security practices throughout the entire software development lifecycle (SDLC), from requirements to deployment. OWASP provides free tools, guides, and projects to help with tasks like threat modeling, code reviews, and vulnerability testing at each stage of the SDLC. Following OWASP best practices can help prevent security issues and ensure applications are secure before they go into production.
Powerpoint Presentation detailing Chapter 6 of Henry Jenkins Work, Confronting the Challanges of Participartory Culture: Media Education for the 21st Century.
Empowering Healthcare: The Evolution of Healthcare App Development ServicesElina619459
In today's digital age, healthcare is no longer limited to traditional brick-and-mortar clinics and hospitals. The advent of healthcare app development services has ushered in a new era of accessible, efficient, and patient-centric healthcare solutions. These applications have transformed the way patients interact with healthcare providers, manage their health, and access vital medical information.
Mobile Apps for RDNs in Patient Care: What Does the Evidence Say?milfamln
This document summarizes a webinar presentation on using mobile apps to support nutrition education and diabetes management. The presentation discusses the evidence from studies on using apps for nutrition education and behavior change, provides guidance on how to evaluate app quality, and reviews some popular apps for weight management and diabetes self-management. Some key findings include evidence that apps can improve user engagement and retention in nutrition interventions compared to websites or paper tracking, and that app users often experience greater weight loss. However, many apps have low quality information and limited personalization. The presenters provide a tool to help dietitians systematically evaluate apps.
How Healthcare App Development Helps Doctors and Patients.Techugo
Sometimes, the patient needs to remember to make an appointment with their doctor. This can cause delays in the delivery of healthcare services by the doctor. A mobile healthcare applications by healthcare app development company allows patients to schedule appointments from their phones. For planning and forecasting tasks, hospitals can also use scheduling software to schedule staff.
Developing a healthcare app in 2022 what do patients wantAndroid Developer
An MVP is particularly useful with regards to fostering a healthcare services application. It can assist you with producing a lot of noteworthy bits of knowledge from early adopters. In any case, ensure that you seriously view client input and attempt to carry out them to make your Healthcare app development services more open and advantageous.
Among a huge number of healthcare applications, you will discover some applications undeniably more important to further develop how you deal with your healthcare. Hire Android App Developers that take care of arrangement planning to prescription updates and tracking down your clinical records, these applications permit you more command over your healthcare whenever it might suit you.
This document discusses consumer health apps and mHealth. It begins by defining mHealth as the practice of medicine supported by mobile devices like phones and PDAs. It then discusses various types of fitness, wellness and healthcare apps. The document predicts that the number of consumer health apps will explode and discusses popular categories like weight loss, diabetes and gluten free apps. It also discusses desirable app characteristics, challenges, and resources for mHealth professionals.
Mobile health apps have the potential to aid in patient recovery and promote healthy lifestyles. However, some apps are misguided in their development if they fail to address a specific problem or just collect data without translating it into useful information for users. Properly evaluating usability is also important to ensure efficiency and user satisfaction. When developing an app, developers must consider relevant technologies, stakeholders, and regulatory requirements. They should also involve clinicians to help ensure the app meets real needs and will be adopted.
Healthcare App Development- How to Create a Top-Notch App.pdfMobenture
Developing a top-notch healthcare app requires careful planning, attention to detail, and a deep understanding of the needs of the healthcare industry. From designing a user-friendly interface to ensuring compliance with regulatory standards, this article provides insights on how to create a healthcare app that stands out from the rest.
Mobile health technology is becoming increasingly important in healthcare. Clinicians now use mobile devices extensively to access patient information, clinical references, and communicate with colleagues. Integrating mobile effectively presents challenges around selecting appropriate apps, maintaining data security, and ensuring interoperability with electronic health records. To maximize benefits, healthcare organizations should focus on supporting clinical decisions with vetted apps, enhancing workflows, enabling care coordination through secure messaging, and engaging patients through their mobile devices. Done thoughtfully, integrating mobile can improve patient care, outcomes and practice efficiency.
How to measure conversations - evaluation and analytics for a healthcare chat...Ed Hammerton
Presentation from Measurecamp Manchester 2019 on chatbot analytics. It covered: a specific (scripted) chatbot service and how this was evaluated; a discussion on other techniques and tools. Enjoy!
Digital Marketing and Social Media Platforms Used By Pharma CompaniesMOHAMMED FAHEEM KHAN
Digital platforms can effectively connect healthcare professionals, patients, and sales teams during the pandemic. Several pharmaceutical companies have launched apps to enable teleconsultations between doctors and patients. Mankind Pharma's Drona app allows doctors to easily connect with patients for online consultations. Zydus Cadila partnered with Remedo to introduce a teleconsultation app for doctors and patients. Sun Pharma launched the Respitrack app to help doctors track asthma patients' treatment progress and medication adherence.
Top Healthcare Apps in the USA Market in 2024.pdfJPLoft Solutions
A user-friendly interface can be an interface that makes the users feel at ease. So, ensuring you have the best user experience is another essential goal required to create a healthcare app. With an understanding of what constitutes health apps, let's examine a few of the characteristics that they should possess.
The document outlines Dash Mobile's behavioral change program to help lower blood pressure using a mobile app. It discusses targeting the 70 million Americans with high blood pressure as customers. The main app features include daily monitoring, evidence-based practices, involvement of doctors, and live coaching. Next, it examines refining the value proposition through customer surveys and a pilot program. It also reviews competitive landscape and scale up options like partnerships. In conclusion, it recommends focusing on behavioral change as the core competency and forming strategic partnerships within the mobile health ecosystem.
Improving Healthcare App Development- Reasons Why You Should Invest in it.Techugo
Customers are looking for ways to find different specialists in their fields (including prescriptions and medicine), so the healthcare industry is searching for innovative approaches to make things more efficient.
It is common to combine healthcare services with cell phones and innovation. For example, 47.526 iOS Human service apps and 325,000 mHealth Android apps exist. This is why all healthcare specialists must shift towards the mobile economy.
The Mobile healthcare app development company allows the user to not only manage patients’ care better but also enable them to monitor operational efficacy in clinics and hospitals.
Improving Healthcare App Development Reasons Why You Should Invest in it.pdfTechugo
In today's digital age, healthcare app development is a rapidly growing industry that offers immense potential for healthcare providers and patients alike. By investing in healthcare app development, healthcare providers can improve patient engagement, streamline medical procedures, and enhance the overall quality of healthcare delivery. With the use of advanced technologies such as AI and blockchain, healthcare apps can also provide personalized treatment plans, secure medical data sharing, and real-time remote monitoring. Investing in healthcare app development can help healthcare providers stay ahead of the curve and meet the evolving needs of patients in the modern era.
Maheu & Luxton Evidenced Based Apps and Text Messaging Legal and Ethical Str...Marlene Maheu
American Psychological Association Annual Convention, August 7, 2014
To invite Dr. Maheu to speak to your group about these issues, please send an inquiry at www.telehealth.org/contact
At the TeleMental Health Institute, you can earn CEs while you learn. Benefit from our webinars, our individual courses or full certificate in telemental health and online therapy.
For the certificate program, go to: http://telehealth.org/courses/
This program is for “tele-practitioners” in these disciplines:
Psychiatrists, Psychologists, Counselors, Social Workers, Therapists, Marriage & Family Therapists, Internists, Pediatricians, Gerontologists, Nurses, Physician Assistants, Nurse Practitioners, Speech Pathologists, Dietitians, Occupational Therapists, Behavioral Analysts Substance Use Professionals,
CEOs, COOs, Administrators, and Billing & Coding Staff
Join the innovative community of thousands of mental health professionals from 39 countries at the TeleMental Health Institute: www.telehealth.org
How Much Does It Cost To Develop An On-demand Medical Healthcare App_.pdfMoonTechnolabsPvtLtd
Food delivery app development is growing and businesses are getting accustomed to it. This blog encapsulates everything you need to know about the business.
Are you tired of wasting time in never-ending lines at the doctor's office? Are you longing for a more convenient approach to managing your health and wellness? Look towards the advancements in healthcare software development In today's fast-paced world, technology has revolutionized every aspect of our lives, including healthcare.
Similar to Health Apps by Design: A reference architecture (20)
Principles of Cleaning
Nonsurgical root canal treatment is a predictable method of retaining a tooth that otherwise would require extraction. Success of root canal treatment in a tooth with a vital pulp is higher than that of a tooth that is necrotic with periradicular pathosis. The difference is the persistent irritation of necrotic tissue remnants, and the inability to remove the microorganisms and their by-products. The most significant factors affecting this process are tooth anatomy and morphology, and the instruments and irrigants available for treatment. Instruments must contact and plane the canal walls to debride the canal.
Morphologic factors such as lateral and accessory canals, canal curvatures, canal wall irregularities, fins, cul-de-sacs, and isthmuses make total debridement virtually impossible. Therefore the goal of cleaning not total elimination of the irritants but it is to reduce the irritants.
Currently there are no reliable methods to assess cleaning. The presence of clean dentinal shavings, the color of the irrigant, and canal enlargement three file sizes beyond the first instrument to bind have been used to assess the adequacy; however, these do not correlate well with debridement. Obtaining glassy smooth walls is a preferred indicator. The properly prepared canals should feel smooth in all dimensions when the tip of a small file is pushed against the canal walls. This indicates that files have had contact and planed all accessible canal walls thereby maximizing debridement (recognizing that total debridement usually does not occur).
Principles of Shaping
The purpose of shaping is to
1) facilitate cleaning and
2) provide space for placing the obturating materials.
The main objective of shaping is to maintain or develop a continuously tapering funnel from the canal orifice to the apex. This decreases procedural errors when cleaning and enlarging apically. The degree of enlargement is often dictated by the method of obturation. For lateral compaction of gutta percha the canal should be enlarged sufficiently to permit placement of the spreader to within 1-2 millimeters of the corrected working length. There is a correlation between the depth of spreader penetration and the apical seal.5 For warm vertical compaction techniques the coronal enlargement must permit the placement of the pluggers to within 3 to 5 mm of the corrected working length.6
As dentin is removed from the canal walls the root is weakened.7 The degree of shaping is determined by the preoperative root dimension, the obturation technique, and the restorative treatment plan. Narrow thin roots such as the mandibular incisors cannot be enlarged to the same degree as more bulky roots such as the maxillary central incisors. Post placement is also a determining factor in the amount of coronal dentin removal.
Osvaldo Bernardo Muchanga- MALE CIRCUMCISION, ITS Vs SOCIOCULTURAL BELIEFS (C...Osvaldo Bernardo Muchanga
MALE CIRCUMCISION consists of the surgical act of removing the foreskin (skin that covers the glans of the penis), leaving the glans more prominent and better cleanable.
MALE CIRCUMCISION itself has medical as well as sociocultural implications, as it has been proven to be an act that can minimize SEXUALLY TRANSMITTED INFECTIONS (STIs), especially HIV, but it also represents the SOCIOCULTURAL IDENTITY of some people, respectively.
Now, in a SERO-EPIDEMIOLOGICAL PROFILE like that of Mozambique where the prevalence of HIV is around 12.5% which corresponds to approximately 2 million people living with HIV, where the province of GAZA is the most seroprevalent with a positivity rate of 21% (INSIDA, 2021), it is extremely necessary to THOROUGHLY scrutinize all possibilities for preventing or minimizing the spread of HIV and other STIs.
STRATEGIES FOR RATIONALISING/REDUCING CAESAREAN SECTION RATE BY USE OF "SION ...Niranjan Chavan
The journey to reduce/rationalise the C-section rate started in June 2023 and it’s an ongoing study been carried out at #SionHospital #LTMMC Mumbai.
It’s going to revolutionise the journey of motherhood for safer, predictable maternal and fetal outcome.
The SION model is a structured and networked approach to promoting vaginal deliveries.
By integrating education, support, policy implementation, and continuous improvement, it aims to enhance maternity care and reduce unnecessary C-sections through collaborative efforts among healthcare providers and patients.
Encouraging trials of labor after previous C-sections (TOLAC) and fostering a multidisciplinary team approach in maternity care are crucial.
Regular training for healthcare providers and establishing supportive hospital policies further promote vaginal births.
CASE PRESENTATION ON ACUTE GASTROENTERITIS.Bhavana
This is a case presentation of a 72 year old female patient who was admitted in the hospital with the chief complaints of loose stools since 6 Days and generalised weakness and history of one episode of vomiting (one day back).
Introduction of mental health nursing, Perspective of mental health and mental health nursing, Evolution of mental health services, treatment and nursing practices Mental health team, Nature and scope of mental health nursing, Role & function of mental health nurse inn various settings and factors affecting the level of nursing practice, concept of normal and abnormal behavior
The Revolutionary Nature of Needleless Double Transfer Spikes in HealthcareNanchang Kindly Meditech
It's likely that you have witnessed medical personnel using needles to transmit fluids or medicines if you have ever visited a hospital or other healthcare facility. But as technology advances, needleless double transfer spikes are becoming more and more common and revolutionizing the delivery of healthcare.
Human blood has a hydrogen ion concentration [H+ ] of 35 to 45 nmol/L and it is essential that its concentration is maintained within this narrow range.
Hydrogen ions are nothing but protons which can bind to proteins and alter their characteristics.
All the enzymes present in the body are proteins and an alteration in these enzyme systems can change the homeostatic mechanisms of the body.
Hence, a disturbance in acid-base balance can result in malfunction of the various organ systems.
The normal pH of blood is 7.35-7.45.
Acidosis is defined as a pH Less than 7.35.
Conversely, when the pH is more than 7.45, alkalosis is said to exist.
Acidosis and alkalosis are of two types each: respiratory and metabolic.
An increase in carbon dioxide (CO2 ) levels increases the plasma [H+ ] and decreases the pH (respiratory acidosis).
Similarly, a decrease in plasma carbon dioxide levels reduces the [H+ ] and increases the pH (respiratory alkalosis).
A decrease in [HC03 -] reduces the pH and is called metabolic acidosis.
Similarly, an increase in [HC03 -] increases the pH and produces metabolic alkalosis.
The pH is regulated in the human body mainly by two organs: the respiratory system and the renal system.
The arterial carbon dioxide levels are regulated by the respiratory system.
Any increase in carbon dioxide levels stimulates the respiratory centre in the medulla thus augmenting respiration, alveolar ventilation and elimination of extra CO2 levels.
A decrease in CO2 levels may reduce the stimulus to breathe and cause hypoventilation.
This response is limited by hypoxia as the hypoxic drive stimulates the patient to maintain respiration.
Respiratory response to changes in CO2 level occurs very fast.
The plasma bicarbonate levels are regulated by the kidneys.
Any decrease in [HC03 -] stimulates the kidney to retain and synthesise bicarbonate.
High [HC03 -] results in elimination of more bicarbonate in urine.
In general, the pulmonary response to a change in acid-base status is faster and occurs immediately.
However, renal regulation takes time, a few hours to days.
Kidneys filter and reabsorb all the bicarbonate in the urine.
When necessary, kidneys can also produce extra bicarbonate through the glutamine pathway.
When an acid-base disorder occurs, the initial disturbance that occurs is termed the primary disorder.
The body attempts to normaliZe the pH by certain compensatory mechanisms resulting in a secondary disorder, e.g. primary metabolic acidosis results in an increase in hydrogen ions and a consequent decrease in bicarbonate ions.
To compensate for this, the patient hyperventilates and reduces the arterial carbon dioxide levels, thus moving the pH back to normal ( compensatory respiratory alkalosis )
These are the class of Drugs that are used to treat and prevent cardiac arrhythmias by blocking ion channels involved in cardiac impulse generation and conduction. Class I drugs like quinidine and procainamide block sodium channels to prolong the action potential duration, while Class IB drugs like lignocaine shorten repolarization. Class III drugs like amiodarone block potassium channels to prolong the action potential. Calcium channel blockers like verapamil inhibit calcium influx. Other drugs include adenosine for paroxysmal supraventricular tachycardia, beta blockers for supraventricular arrhythmias, and atropine for bradycardias. Adverse effects vary between drugs but include arrhythmias, heart block and QT prolong
General Endocrinology and mechanism of action of hormonesMedicoseAcademics
This presentation, given by Dr. Faiza, Assistant Professor of Physiology, delves into the foundational concepts of general endocrinology. It covers the various types of chemical messengers in the body, including neuroendocrine hormones, neurotransmitters, cytokines, and traditional hormones. Dr. Faiza explains how these messengers are secreted and their modes of action, distinguishing between autocrine, paracrine, and endocrine effects.
The presentation provides detailed examples of glands and specialized cells involved in hormone secretion, such as the pituitary gland, pancreas, parathyroid gland, adrenal medulla, thyroid gland, adrenal cortex, ovaries, and testis. It outlines the special features of hormones, differentiating between peptides and proteins based on their amino acid composition.
Key principles of endocrinology are discussed, including hormone secretion in response to stimuli, the duration of hormone action, hormone concentrations in the blood, and secretion rates. Dr. Faiza highlights the importance of feedback control in hormone secretion, the occurrence of hormonal surges due to positive feedback, and the role of the suprachiasmatic nucleus (SCN) of the hypothalamus as the master clock regulating rhythmic patterns in biological clocks of neuroendocrine cells and endocrine glands.
The presentation also addresses the metabolic clearance of hormones from the blood, explaining the mechanisms involved, such as metabolic destruction by tissues, binding with tissues, and excretion by the liver and kidneys. The differences in half-life between hydrophilic and hydrophobic hormones are explored.
The mechanism of hormone action is thoroughly covered, detailing hormone receptors located on the cell membrane, in the cell cytoplasm, and in the cell nucleus. The processes of upregulation and downregulation of receptors are explained, along with various types of hormone receptors, including ligand-gated ion channels, G protein–linked hormone receptors, and enzyme-linked hormone receptors. The presentation elaborates on second messenger systems such as adenylyl cyclase, cell membrane phospholipid systems, and calcium-calmodulin linked systems.
Finally, the methods for measuring hormone concentrations in the blood, such as radioimmunoassay and enzyme-linked immunosorbent assays (ELISA), are discussed, providing a comprehensive understanding of the tools used in endocrinology research and clinical practice.
Regenerative Medicine in Chronic Pain ManagementReza Aminnejad
Regenerative technologies are the future of medicine. The current clinical strategy focuses primarily on treating the symptoms but regenerative medicine seeks to replace tissue or organs that have been damaged by age, disease, trauma, or congenital issues.
A medical treatment that uses high doses of radiation to kill cancer cells or shrink tumors by damaging their DNA. When the DNA is damaged, cancer cells can no longer divide and grow, and they eventually die.
Periodontal disease is a disease, or more likely a number of diseases of the periodontal tissues that results in attachment loss and destruction of alveolar bone. The natural history of periodontal disease, in some but not all patients, results in tooth loss. Periodontal disease, however, encompasses a wider spectrum of diseases than just periodontitis and the recognition of these diseases requires a diagnosis be made.
Classification is the process of identifying and grouping objects or ideas into predetermined categories.
Lymphoma Made Easy , New Teaching LecturesMiadAlsulami
This lecture was presented today as part of our local Saudi Fellowship program. After three years of direct interaction with trainees and hematologists, I have started to develop an understanding of what needs to be covered. This lecture might serve as a roadmap for approaching and reporting lymphoma cases.
As a leading rheumatologist in Chandigarh, Dr. Aseem specializes in the diagnosis and management of a wide range of rheumatic conditions, including but not limited to:
Rheumatoid Arthritis: An autoimmune disorder that causes chronic inflammation of the joints.
Osteoarthritis: A degenerative joint disease characterized by the breakdown of cartilage.
Lupus: A systemic autoimmune disease that can affect the skin, joints, kidneys, and other organs.
Ankylosing Spondylitis: A type of arthritis that primarily affects the spine, causing pain and stiffness.
Gout: A form of arthritis characterized by sudden, severe attacks of pain, redness, and tenderness in the joints.
Psoriatic Arthritis: A type of arthritis that affects some people with psoriasis.
Vasculitis: An inflammation of the blood vessels that can cause a variety of symptoms.
Sjogren’s Syndrome: An autoimmune disorder characterized by dry eyes and mouth.
Accurate diagnosis is crucial for effective treatment. Dr. Aseem Goyal utilizes advanced diagnostic techniques to identify the underlying causes of rheumatic conditions. Our state-of-the-art facility is equipped with the latest technology to provide comprehensive diagnostic services, including:
Blood Tests: To check for markers of inflammation and autoimmune activity.
Imaging Studies: Such as X-rays, MRI, and ultrasound to assess joint and soft tissue damage.
Joint Fluid Analysis: To examine the fluid in the joints for signs of inflammation or infection.
Biopsy: In certain cases, a small tissue sample may be taken for further examination.
Treatment Approaches
Dr. Aseem Goyal adopts a holistic and patient-centered approach to treatment. Depending on the specific condition and its severity, treatment options may include:
Medications
Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): To reduce inflammation and relieve pain.
Disease-Modifying Antirheumatic Drugs (DMARDs): To slow the progression of rheumatic diseases.
Biologic Agents: Targeted therapies that block specific pathways in the immune system.
Corticosteroids: To control severe inflammation quickly.
8. TYPE 1 DIABETES APPS
• Patients have traditionally
always written down their
insulin dosages and their
blood sugar readings
• Apps are a natural
replacement of paper logs and
provide some additional
useful functionality
• But does not apply to Type 2
diabetes, who make up 90% of
patients with diabetes.
9. COMPLEXITIES, RABBIT HOLES AND
CONFUSION
What is preventing patients and health
practitioners from adopting mHealth
apps?
10. METHODS
• Searched: PubMed & Google Scholar
• Used gap analysis: that drew on philosophy, data science,
education, life science and business analyses methods to
develop a concept that would overcome the constraints and
meet the goals identified
• Through analysis, discussion and iteration: arrived at an
evidence-informed proposed architecture
• Works within the framework of clinical practice
• Values the patient-physician relationship
• Uses scientifically validated tools effectively
12. 9 BARRIERS TO MHEALTH USE
Conflicting Information: App provides information that conflicts
with that received from health care providers (Bierbrier, Lo & Wu,
2014);
Health Literacy: Language and terminology of the app may not be
compatible with the patient’s health literacy (Caburnay, 2015);
Data Entry: Patient has to enter the data themselves (Gruman, 2013);
Meaningful Use: Patient cannot use information in a meaningful
way;
e.g., he or she cannot order diagnostic testing or prescribe
medications to himself or herself;
Lack of incentives like cost saving or social approval;
13. BARRIERS TO MHEALTH USE
(CONT’D.)
Not Habit Forming: Daily use of the app is not required and
therefore the patient does not get into the habit of using it;
Unknown Provenance: Providers don’t value data collected by
patients in apps downloaded from an app store whose
provenance and pedigree is not known or established (Terry, 2015);
Lack of Tools: There is no way for providers to consume the large
amounts of data that are collected in apps (Terry, 2015);
i. i.e., visualize, analyze, derive meaning from;
Lack of Interoperability: Providers unable to integrate app data
into their own (EMR) for analysis or follow-up or share the data
in their EMR with their patient’s apps (Abebe, 2013).
18. GAMIFICATION IS NOT ENOUGH
• Patient engagement needs to be rooted in science, not games
• Need behavior change models with evidence behind them
• Prochaska’s Model
• Behavior Change Wheel
• Commitment needs to be cemented
• Accountability to health care team
• Follow-up by physician and their staff
• App is ‘prescribed’ from EMR which activates App
• Doctors are regulated by their colleges and are expected to
act according to professional rules
19. SOLUTION:
NEEDS LOTS OF INFORMATION (DATA)
A. Healthcare without data is meaningless
B. Must meet evidence-based content and
process requirements
C. Also need to track patient experience and
outcome measures
21. APPLICATION TO
DIABETES TYPE 2 APPS
• We developed screening criteria using our reference
architecture for design and development of mhealth apps,
• Apple iTunes and Google Play app stores were searched for
diabetes apps –found 201
• Following a calibration exercise, two individuals
independently reviewed and evaluated each app against the
screening criteria
• Data was collated and analyzed
22. RESULTS:
• 201 total apps were reviewed
• No app met all the criteria outlined
• Most apps were replacement of paper journals or diaries
• Many apps were recipe apps
• Majority of the apps provided education/recommendations
• Most of the apps failed at integrations with devices
(glucometer, BP machine) and patients medical records (EMR,
primary care provider)
25. WE INTERRUPT THIS
BROADCAST…..
• Bluestar is a new diabetes
app that must be prescribed!
• It recently obtained FDA
approval
• Got a score of 12 (out of 15)
on our rating scale
• Very promising development
26. REASONS FOR NOT MEETING
CRITERIA
• Many apps were conference apps or guideline apps for
professionals
• Of the highest scoring apps, major reasons for not getting a
higher score
• Lack of integrations with devices–relatively easy these days (but
requires FDA approval)
• Lack of integration with EMRs –many features are dependent on
this
27. DISCUSSION
• There is great need for high quality apps which can be
prescribed by a physician and whose use can be monitored by
the health care team
• Apps need to focus on managing the whole patient along with
their disease and not a small part of a patient’s care such as
self management
• Better embedding physician patient relationship into patient
app interactions for provider guided management
28. LIMITATIONS
• Due to budgetary constraints, we did not download apps from the
stores
• Some vendors had poorer descriptions of their product than
others
• A very small number of apps were in languages that are not
understood by the people conducting the review
• We were not able to quantitate which apps are used and which
ones are not
• We did not include any patients in defining the criteria nor in
reviewing the apps.
29. RECOMMENDATIONS
• Apps should be prescribed and monitored by health care
providers
• Requires participation of EMR vendors in developing APIs for apps
• mhealth app certification by a standards organization would go a
long way to ensuring higher quality apps and increasing the level
of trust for apps by health providers
• An Interoperability Kit for EMRs and Apps would help make it
easier to deploy an app
• Standard interoperability for apps with medical devices would
lower the investments required to create good apps
30. CONCLUSION
• mHealth Apps show lots of promise, but not being used
• Information asymmetry, data credibility and entering own
data are main causes
• Engagement framework requires a commitment to
communication and empowerment
• Need to use scientific, proven behavior change models
• Needs to be grounded in clinical practice and within the
patient-provider relationship –needs to support on-going
communication and interaction after the visit is over
31. CONCLUSION
• Health behavior changes are difficult to sustain
• Need external motivation and commitment –App needs to
be “prescribed”
• Needs consistent follow-up and reinforcement
• mHealth Apps need to have bi-directional integration with
EMRs
• Need to collect lots of experience, process and outcome data –
lab, questionnaire and system use data
• Use the data to constantly improve the user engagement and
user experience
• Use the data to improve patient disease outcomes
32. REFERENCES
Chindalo P, Karim A, Brahmbhatt R, Saha N, Keshavjee K. Health Apps by
Design: A Reference Architecture for Mobile Engagement. International
Journal of Handheld Computing Research (IJHCR). 2016 Apr 1;7(2):34-43.
Balouchi S, Keshavjee K, Zbib A, Vassanji K, Toor J. Creating a Supportive
Environment for Self-Management in Healthcare via Patient Electronic
Tools. Social Media and Mobile Technologies for Healthcare. 2014 Jun
30;109.
Brahmbhatt R, Niakan S, Saha N, Tewari A, Pirani A, Keshavjee N,
Mugambi D, Alavi N, Keshavjee K. Diabetes mHealth Apps: Designing for
Greater Uptake. Studies in health technology and informatics. 2017;234:49.