The document discusses Project ECHO and its mission to expand access to specialty healthcare for common and complex diseases in rural and underserved areas. Project ECHO uses teleconferencing and case-based learning to train primary care clinicians to treat and manage conditions like hepatitis C. An evaluation showed primary care clinicians trained through Project ECHO achieved similar treatment outcomes for hepatitis C as specialists at a university medical center, improving access to care for rural and minority populations.
In first of two-part series, Pamela Greenhouse explores the differences and similarities of the Patient and Family Centered Care Methodology and Practice (PFCC M/P) and leean process improvement approachs, such as Lean, Six Sigma and Toyota. She believes that the PFCC M/P can be the unifying theme for health care, incorporating both process improvement and performance improvement.
PFCC Methodology and Practice: Deliver Ideal Care Experiences and Outcomes…By...EngagingPatients
The document describes the Patient and Family Centered Care (PFCC) methodology used at UPMC, a large integrated health system. The six-step PFCC methodology involves: 1) defining the care experience, 2) forming a guiding council, 3) observing the current state through shadowing, 4) identifying touchpoints through a working group, 5) creating a shared vision for an ideal experience, and 6) implementing improvement projects. The methodology aims to improve outcomes and experiences by engaging patients and families in co-designing care and breaking down silos between care providers. Examples of successful PFCC projects that improved discharge processes and communication through bedside rounding are provided.
The document discusses various topics related to physical therapy (PT) practice. It notes that in 2014, PTs can avoid PQRS penalties by reporting 3 quality measures for 50% of patients, and the number of measures required to receive bonuses will increase from 3 to 9. It also eliminates reporting via measures groups through claims. The document discusses focusing on developing quality measures for PT, payment models that promote value, and public policy initiatives to advance the role of PT in areas like disease management. It also discusses improving access, eliminating self-referral profits, and ensuring an adequate PT workforce.
Partnering with Patients, Families and Communities for Health: A Global Imper...EngagingPatients
Engagement is an essential tool to improving global health. This report introduces a new framework for engagement to help countries assess current programs and think strategically about future engagement opportunities. It spotlights barriers to engagement and offers concrete examples of effective engagement from around the globe.
This resource summarizes the eight recommendations outlined in the Institute of Medicine's a new consensus study entitled, Improving Diagnosis in Health Care. The recommendations are aimed at making diagnoses more accurate, reliable, efficient, and safe. This work is a continuation of the IOM’s Quality Chasm series.
Over half of patients at a rehabilitation hospital reported wanting greater involvement in their care decisions. To address this, the hospital conducted patient and family shadowing where observers followed patients to experience care from their perspective. This identified themes like explanations during rounds and involvement in discharge plans. A post-intervention survey found a statistically significant improvement in patients feeling involved in care decisions and clinically relevant improvements in understanding doctor explanations and recommending the hospital. Engaging medical leaders and balancing data with reflection time led doctors to change practices without formal rules.
This document summarizes a session at the 2015 CADTH conference on engaging patients in defining value and drug development. It provides an overview of the session which included panels discussing defining value from the patient perspective and models of patient engagement. It also summarizes some of the key points discussed, such as the need to include patient perspectives throughout the drug development process to better measure what is meaningful to patients and alternative approaches to patient engagement like patient and community engagement researchers. The document advocates that embedding meaningful patient measures can help weight evidence from the patient perspective.
This document provides an overview of transitions of care, including definitions, models, and best practices. It describes transitions as the movement of patients between healthcare settings or providers. Poor transitions can lead to adverse outcomes for patients and increased costs. Several evidence-based models are described that aim to improve transitions through elements like medication reconciliation, discharge planning, and post-discharge follow up. These models have demonstrated reductions in readmissions and healthcare utilization. The document provides resources for additional information on improving the quality of patient transitions.
This infographic speaks to the challenges Emergency Departments face in caring and following up with the growing population of patients they see, and demonstrates how some EDs are seeing measurable improvements in care, patient satisfaction and efficiency.
Creating a standard of care for patient and family engagementChristine Winters
Nationally-recognized governance expert Beth Daley Ullem addresses the state of patient engagement in heathcare and provides a vision for establishing a minimum standard of care for patient engagement programs.
An integrated model of psychosocial cancer care: a work in progress…Cancer Institute NSW
Cancer patients are faced with a multitude of stressors, from diagnosis, through treatment, at recurrence, in the stages following treatment completion, and in the terminal phase. Psychosocial care has been highlighted as a critical aspect of providing comprehensive patient-focused care. Specifically, one of the goals of The NSW Cancer Plan 2011-2015 is to improve the quality of life of people with cancer and their carers. This project was initiated to improve the current psychosocial model of care at The Kinghorn Cancer Centre (TKCC), to better reflect an integrated, holistic and comprehensive model of patient-centred care.
Building the Case for Implementing Postgraduate Residency Training ProgramCHC Connecticut
Community Health Center, Inc. is proposing to implement postgraduate residency programs for nurse practitioners and clinical psychologists. Residencies would provide intensive clinical training over 12 months to address workforce shortages and reduce burnout. Core elements include precepted clinics, specialty rotations, didactics, and quality improvement training. Residencies aim to develop expert clinicians prepared to lead community health centers. While start-up costs are required, residencies may increase retention, productivity, and recruitment over time, providing a return on investment. Residencies can smooth new providers' transition to independent practice.
Patient-centered medical homes (PCMHs) are intended to actively provide effective care by physician-led teams, Where patients take a leading role and responsibility. Objective: To determine whether the Walter Reed PCMH has reduced costs while at least maintaining if not improving access to and quality of care, and to determine
whether access, quality, and cost impacts differ by chronic condition status. Design, setting, and patients: This study
conducted a retrospective analysis using a patient-level utilization database to determine the impact of the Walter Reed PCMH on utilization and cost metrics, and a survey of enrollees in the Walter Reed PCMH to address access to care and quality of care. Outcome measures: Inpatient and outpatient utilization, per member per quarter costs, Healthcare Effectiveness Data and Information Set metrics, and composite measures for access, patient satisfaction, provider communication, and customer service are included. Results: Costs were 11% lower for those with chronic conditions compared to 7% lower for those without. Since treating patients with chronic conditions is 4 times more costly than treating patients without such conditions, the vast majority of dollar savings are attributable to chronic care.
June 27/2017 - SPOR-PIHCI Network presentations from the pre-CAHSPR conference day in Toronto, Ontario
Sharing Practical Advances in Research Knowledge-
Translating Findings to Action from PIHCIN Research
Patient Engagement Presentation - MPN Network Forum April 18, 2017Alexandra Enns
April 18, 2017
In April we held a Network Forum on engaging policymakers and patients/public effectively and appropriately. We would like to give a warm thanks to both Carolyn Shimmin, Patient Engagement expert of CHI's Knowledge Translation team, and Marcia Thomson, Assistant Deputy Minister of Manitoba Health, Seniors and Active Living for their presentations. Below you can see Carolyn's presentation - to see more of her work on patient engagement and to learn more about knowledge translation at CHI, please check out the blog Knowledge Nudge here. If you would like more information, helpful tools or advice about patient/public engagement in research, please contact Carolyn Shimmin at cshimmin@exchange.hsc.mb.ca
PIHCI programmatic grants webinar (en) for circulationAlexandra Enns
These are the slides from CIHR’s webinar providing information for the upcoming PIHCI Network Programmatic Grant funding opportunity.
The complete instructions are on ResearchNet: https://www.researchnet-recherchenet.ca/rnr16/vwOpprtntyDtls.do?prog=2734&view=currentOpps&org=CIHR&type=EXACT&resultCount=25&sort=program&next=1&all=1&masterList=true
Safety is Personal: Partnering with Patients and Families for the Safest CareEngagingPatients
The work of NPSF"s Lucian Leape Institute's Roundtable on Consumer Engagement, "Safety Is Personal: Partnering with Patients and Families for the Safest Care" is a call to action for health leaders, clinicians, and policy makers to take the necessary steps to ensure patient and family engagement at all levels of health care.The report identifies specific action items for health leaders, clinicians, and policy makers to pursue in making patient and family engagement a core value in the provision of health. care.
Patients and their loved ones often hold critical knowledge that informs diagnosis. This toolkit from the Institute of Medicine offers patients, families and clinicians guidance on how they can collaborate to improve diagnosis.
The document summarizes a presentation by Paul Grundy on extracting value from the patient centered medical home model. It discusses:
1) How the patient centered medical home model creates partnerships across the healthcare system to drive primary care redesign, offer population health management, and move away from an episodic, fee-for-service model.
2) Studies that show improvements in costs, quality, access, and utilization from implementing the patient centered medical home model, including reduced hospital and ER use.
3) How payment models are shifting towards value-based purchasing tied to quality, utilization, and patient satisfaction outcomes rather than volume of services.
Project ECHO (Extension for Community Health Outcomes)icornpresentations
Sanjeev Arora MD, Distinguished Professor of Medicine (Gastroenterology/Hepatology); Director of Project ECHO®
Department of Medicine, University of New Mexico Health Sciences Center
Project ECHO aims to expand access to specialty healthcare for common and complex diseases in rural and underserved areas through its teleECHO model. It uses videoconferencing and case-based learning to train primary care providers to safely and effectively treat diseases like hepatitis C. Evaluations show providers gain clinical skills and patients achieve similar treatment outcomes to specialty clinics. The model has been successfully implemented for over a dozen disease areas.
MicroGuide app, pop up uni, 1pm, 3 september 2015NHS England
Expo is the most significant annual health and social care event in the calendar, uniting more NHS and care leaders, commissioners, clinicians, voluntary sector partners, innovators and media than any other health and care event.
Expo 15 returned to Manchester and was hosted once again by NHS England. Around 5000 people a day from health and care, the voluntary sector, local government, and industry joined together at Manchester Central Convention Centre for two packed days of speakers, workshops, exhibitions and professional development.
This year, Expo was more relevant and engaging than ever before, happening within the first 100 days of the new Government, and almost 12 months after the publication of the NHS Five Year Forward View. It was also a great opportunity to check on and learn from the progress of Greater Manchester as the area prepares to take over a £6 billion devolved health and social care budget, pledging to integrate hospital, community, primary and social care and vastly improve health and well-being.
More information is available online: www.expo.nhs.uk
Cadth symposium 2015 d3 pro presentation apr 2015 - for debCADTH Symposium
This document summarizes a presentation on implementing patient reported outcomes (PROs) to improve patient-centered care. It discusses collecting PRO data through distress screening tools and patient satisfaction surveys, analyzing the data, and using it to select and evaluate quality improvement initiatives. PROs are outcomes that patients report on issues like symptoms, experience of care, and quality of life. The presentation outlines the benefits of PROs, Saskatchewan Cancer Agency's implementation including two PRO tools and progress to date, and lessons learned around using a phased approach and technology to gather and apply PRO evidence to enhance care.
Aldo Rolfo, National Clinical Development Manager, Genesis Cancer Care, Austr...GenesisCareUK
A program that seeks to redefine best practice across the drivers of the GenesisCare business (Quality, Access and Efficiency) in order to deliver on their vision of “Innovating Healthcare. Transforming Lives.”
This document summarizes the implementation and results of a routine HIV testing program called ACTS (Advise, Consent, Test, Support) across 10 community health centers in the Bronx over 10 years. Key findings:
1) HIV testing rates increased nearly threefold during the 2003-2007 ACTS pilot, from 8% tested in 2003 to 20% in 2007.
2) Testing rates were sustained or continued to increase with little ongoing support - 23% tested in 2008, 28% in 2011, 29% in 2012, and 28% in 2013.
3) 433 new HIV-positive patients were identified between 2006-2013, with 96% linked to care within 90 days, demonstrating the program's success
Comparative Effectiveness of a Multifaceted Intervention to Improve Adherence to Annual Colorectal Cancer Screening in Community Health Centers (RCT)
Présentation de David W. Baker au colloque "Recherche interventionnelle contre le cancer : Réunir chercheurs, décideurs et acteurs de terrain » - 17 et 18 novembre 2014, BnF, Paris
Methods for Observational Comparative Effectiveness Research on Healthcare De...Marion Sills
Research Objective: The SAFTINet project was funded by the AHRQ to build a distributed network of existing clinical and claims data that would support comparative effectiveness research (CER), with a focus on underserved populations and healthcare delivery system (HDS) characteristics. Observational research methods are appropriate, but require detailed protocols with a priori hypotheses and analytic plans. SAFTINet research specifically concerns the effects of a discrete set of HDS features (those often included in Patient-Centered Medical Home (PCMH) models) on health outcomes for primary care patients with asthma, hypertension, and hypercholesterolemia. Our objective is to present a description of this study’s measurement challenges, and to specify a priori hypotheses, analytic strategies, and plans for addressing bias and confounding for our asthma cohorts.
Study Design: An observational, longitudinal cohort study of primary care patients with asthma, with both secondary use of existing clinical and claims data and primary data collection for HDS features and patient- reported outcomes.
Population Studied: Our sample consists of 59 primary care practices in 5 healthcare organizations in Colorado, Utah and Tennessee; all practices serve underserved populations. These practices care for about 275,000 patients per year, of whom an estimated 22,000 have a diagnosis of asthma.
Principal Findings: We will present the processes used to define and measure the HDS features, covariates and asthma outcomes, along with planned analysis. Challenges include valid measurement of a multi-faceted HDS “exposure” variable, the inability to identify exposure onset, and the non-dichotomous nature of HDS characteristics. To measure HDS characteristics, we created a practice-level survey assessing 9 PCMH domains, including care coordination, specialty care and mental health integration, and patient-centeredness, as well as asthma-specific HDS characteristics (e.g., the use of asthma registries). Asthma outcomes included (1) those available as a result of routine electronic documentation of clinical care and claims administration (utilization indicative of an exacerbation), and (2) patient reported outcomes tools (Asthma Control Test). We used directed acyclic graphs to identify potential confounders of the relationship between HDS characteristics and asthma control, as well as other potential biases. The analytic plan is based on linear mixed effects models. Perspectives of the CER team, the technology team and the community engagement group were considered in the operationalization of all variables.
Conclusions: The design of rigorous observational CER observational CER should recognize the need for an intense planning phase. In accordance with good practice guidance for observational studies, an important component of the planning phase is to disseminate and obtain feedback on the research design in advance of its conduct.
Heavily based on a presentation I gave for the CMS 2020 National Quality Forum. Emphasis is on dialysis (particularly home dialysis). Discusses regulatory framework, medical devices used to render the services and outcomes of studies performed to day
Hand hygiene knowledge & practices among healthcare providers in a tertiary h...MASUM BILLAH
This study assessed hand hygiene knowledge, attitudes, and practices among healthcare providers at a tertiary hospital in Nigeria. A cross-sectional survey was administered to 500 doctors and nurses to understand their handwashing behaviors and identify barriers. While most providers had good knowledge and positive attitudes, actual handwashing compliance before and after patient contact was only around 60-70%. Factors like heavy workloads, lack of water/soap access, and inadequate training were found to influence practices. The researchers concluded hand hygiene promotion programs addressing these barriers could help reduce hospital-acquired infections.
This document summarizes the partnership between the National Institute for Health Research (NIHR) and industry to support clinical research and innovation in the UK. Key points:
- NIHR invests over £1 billion annually in research infrastructure including clinical trials facilities to support industry partnerships and clinical research.
- In 2015/16 this infrastructure supported over 11,000 studies, recruited over 320,000 patients, and resulted in over 1,300 collaborations and 576 partnerships with industry worth £149.7 million.
- Examples are provided of NIHR funding programs that support translational research and adoption of novel technologies, helping to bridge the "valley of death" between research and commercialization.
The Flu-FIT Program : An Effective Colorectal Cancer Screening Intervention
Présentation de Michael B. Potter au colloque "Recherche interventionnelle contre le cancer : Réunir chercheurs, décideurs et acteurs de terrain » - 17 et 18 novembre 2014, BnF, Paris
The document summarizes a randomized trial comparing a public health approach to a standard clinical approach for delivering antiretroviral therapy in Cameroon. The trial aims to compare the increase in CD4 cell count and other outcomes between the two approaches. It describes the standard clinical approach as relying on biological exams and physicians, while the public health approach uses simplified criteria and involves other personnel like nurses. The trial design involves randomizing patients across 9 rural hospitals to receive antiretrovirals through either approach and following outcomes over 24 months. Baseline characteristics of the 459 enrolled patients are provided. Survival and treatment change outcomes over time are shown graphically. The discussion covers feasibility challenges and capacity building efforts, as well as relevance for
Trends & Issue Medical surgical nsg.pptxkanwark781
Trends in medical surgical nursing include the use of new technologies like robotics, mobile health apps, gene therapy and artificial intelligence. New areas of research include pandemic management, oncology, bariatric care and forensic nursing. Education is evolving through virtual simulation, skills training and new degree programs. Issues facing medical surgical nurses are staff shortages, meeting patient expectations, long work hours, workplace violence and hazards, scope of practice limitations, and maintaining personal health.
Trends & Issue Medical Surgical Nursing,GajeSingh9
Trends in medical surgical nursing include the use of new technologies like robotics, mobile health apps, gene therapy and artificial intelligence. New areas of research include oncology nursing, bariatric nursing and pandemic management. Education is evolving through virtual simulation, skills training and new specialty courses. Issues facing medical surgical nurses are staff shortages, meeting patient expectations, long work hours, and workplace hazards.
Innovations conference 2014 building a quality cancer system concurrent sessi...Cancer Institute NSW
The document summarizes findings from a survey of GPs in NSW, Australia that was part of an international cancer benchmarking study. Key findings included:
- GPs expressed strong support for timely cancer diagnosis but less so for lung cancer. Nearly half saw gatekeeping as important.
- There were differences in access to diagnostic tests and specialists between urban and rural GPs, and between public and private systems.
- Waiting times heavily influenced referral pathways.
- The findings can help improve coordination between primary and specialist cancer care and provide a baseline for monitoring changes over time.
The document summarizes key themes from a webinar on developing medical policies and coverage guidelines for next generation sequencing in oncology. It discusses the challenges of evaluating genomic tests and gaining insurance coverage. Recommendations include requiring laboratories to obtain accreditation for analytic validity, covering small gene panels when clinical utility is established, and facilitating data collection to support coverage of larger tests and off-label drug use. The webinar included perspectives from various stakeholders on addressing these issues.
The COVID-19 pandemic has created several challenges for our country’s health care infrastructure, and the community health center workforce is no exception. Join us as we describe strategies to get patients back into dental care. Along with these strategies, participants will learn how to recognize challenges in dental practices, as well as how to engage the interdisciplinary care team through role redesign and integration to increase access to comprehensive care.
NTTAP Webinar Series - June 7, 2023: Integrating HIV Care into Training and E...CHC Connecticut
In order for health centers to provide compassionate and respectful HIV prevention, care, and treatment in comprehensive primary care settings, the clinical workforce must be knowledgeable, confident, and competent in their ability to do so.
We’ll explore the need to integrate HIV care into training and education for the clinical care team, as well as educational models to train the next generation. Using Community Health Center Inc.’s Center for Key Populations Fellowship for Nurse Practitioners (NPs) as a framework for best practices, experts will discuss how to implement specialty care for key populations in your training programs. Additionally, participants will gain awareness of the importance of training the clinical workforce on key population competencies in HIV programs (e.g. HCV, MOUD, LGBTQI+ health, homelessness, and harm reduction).
Utilizing the Readiness to Train Assessment Tool (RTAT™) To Assess Your Capac...CHC Connecticut
Improve educational training experiences at your health center by assessing your capacity and infrastructure to host health professions students.
Join the upcoming hands-on interactive activity session to learn how to utilize the Readiness to Train Assessment Tool (RTAT™). This tool was developed by HRSA-funded National Training and Technical Assistance Partners (NTTAP) at Community Health Center, Inc. (CHC) to understand organizational readiness to host health professions student training programs.
NTTAP Webinar Series - May 18, 2023: The Changing Landscape of Behavioral Hea...CHC Connecticut
The COVID-19 pandemic has resulted in significant shifts in the mode of care from face-to-face to virtual interactions. Join us as we discuss the challenges currently facing behavioral health care and at least one strategy for each. Along with these strategies, panelists will go over what integrated behavioral health care was and is before and following COVID-19, as well as what actions should be taken going forward to increase access to comprehensive care.
Panelists:
• Dr. Tim Kearney, PhD, Chief Behavioral Health Officer, Community Health Center, Inc.
• Melinda Gladden, LCSW, PMHC, Behavioral Health Clinician, Community Health Center, Inc.
• Jodi Anderson, LMFT, Virtual Telehealth Group Coordinator, Community Health Center, Inc.
Newborn screening involves testing newborns for treatable genetic and metabolic disorders through methods like dried bloodspot testing, hearing screening, and pulse oximetry. The goals are to identify at-risk newborns early before symptoms present, when treatment is most effective. Abnormal screening results require follow up diagnostic testing, education of families, and treatment if a condition is confirmed. Future directions may include expanded screening panels and genomic newborn screening, though these raise additional complex issues to consider.
Health Professions Student Training Webinar: Assessing Organizational CapacityCHC Connecticut
This document provides information about a webinar on assessing organizational capacity for health professions student training. It includes details about continuing education credits, speakers, objectives, and an overview of key aspects of assessing capacity. These include identifying willing and available faculty members, maintaining a spreadsheet of available preceptors, conducting a secondary review of space, training, and onboarding needs, and negotiating placements with academic affiliations. It also discusses best practices for clinical observation and feedback forms, and introduces some preceptor panelists. Finally, it provides an overview of the Readiness to Train Assessment Tool (RTAT) and how it can be used to understand an organization's capacity based on survey results.
Training the Next Generation: Investing in Workforce TrainingCHC Connecticut
This document provides information about an upcoming webinar on workforce training. The webinar will discuss why health centers should invest in health professions education and training programs, how to assess organizational readiness to implement such programs, and best practices for developing replicable training models. Attendees will learn how workforce development planning makes business sense by reducing costs from employee turnover and increasing access to care. A tool called the Readiness to Train Assessment can help organizations evaluate their capacity and motivation to engage in training programs. Successful training requires identifying qualified preceptors and building a culture of learning in the organization.
NTTAP Webinar Series - April 13, 2023: Quality Improvement Strategies in a Te...CHC Connecticut
Join us for a webinar on quality improvement in team-based care!
Building a quality improvement (QI) infrastructure within team-based care is an organizational strategy that will establish a culture of continuous improvement across departments and improve quality in all domains of performance.
Participants will learn about:
• QI infrastructure
• Facilitating QI committees
• Coach training within health centers
Faculty will also provide an example of how trained coaches use QI tools to test and implement changes within an organization.
Addressing Genetics Workforce Shortage - April 11, 2023CHC Connecticut
The document discusses the shortage of geneticists and genetic counselors in the United States. It notes that there are currently only around 1,240 medical geneticists and 4,700 genetic counselors serving the population, below the recommended levels. Many states have fewer than the recommended number of geneticists per population. The document explores ways primary care physicians can help address gaps, such as playing a more active role in selected genetic situations like cancer risk assessment. It also identifies growing the educational opportunities in genetics as important for increasing the workforce.
Implementation of Timely and Effective Transitional Care Management ProcessesCHC Connecticut
Join us to discuss best practices for integrating daily follow-ups for patients recently hospitalized for health emergencies. Effectively following up with patients is a critical responsibility for integrated care teams.
Experts will share how their teams respond to patients to identify care gaps and support the transition of care. Workflow descriptions will provide participants with the tools to support their work to adapt specific steps into their model of team-based care.
Panelists:
• Mary Blankson, DNP, APRN, FNP-C, FAAN, Chief Nursing Officer, Community Health Center, Inc.
• Veena Channamsetty, MD, FAAFP, Chief Medical Officer, Community Health Center, Inc.
• Bibian Ladino-Davis, Behavioral Health Coordinator, Weitzman Institute
Direct to Consumer Test and Ancestry Testing - March 14, 2023CHC Connecticut
Direct to Consumer Genetic and Ancestry Testing
This document discusses direct-to-consumer (DTC) genetic and ancestry testing. It defines DTC testing as testing that can be ordered by consumers without a health care provider. The document outlines the types of information provided by DTC tests, including ancestry, traits, disease risks, and results for some Mendelian conditions. However, it notes limitations like low predictive value without family history and risks of false positives. It provides examples of patients impacted by DTC testing results and emphasizes the need for confirmation of pathogenic variants by clinical genetics. The document also discusses privacy and legal issues related to DTC testing.
Implement Behavioral Health Training Programs to Address a Crucial National S...CHC Connecticut
Health centers are uniquely positioned to address the unprecedented need for behavioral health services but are challenged by the workforce shortage. Participants will gain the knowledge needed to begin conceptualization of a training pathway.
Join us to discuss the considerations of sponsoring an in-house training program across all educational levels, including the benefits, program structure, design, curriculum, supervisors' role, and required resources.
Experts will provide participants with examples from practicum and postdoctoral level training programs to help them gain confidence in developing a behavioral health training pathway.
Genetic Connections to Breast Cancer - February 14, 2023CHC Connecticut
This document discusses genetic connections to breast cancer. It begins by outlining the learning objectives, which are to understand the importance of collaboration between genetics and non-genetics experts for hereditary breast cancer patients, emphasize obtaining accurate family histories, and discuss benefits and limitations of next generation sequencing panel tests. It then discusses genetic counselors' role in oncology, hereditary cancer risks and patterns, BRCA genes, obtaining family histories, genetic testing options like multi-gene panels, interpreting results, cancer screening recommendations, and prophylactic surgery options. Resources and established risk models are also referenced.
Connective Tissue Disorders Slides - January 17, 2023CHC Connecticut
This document discusses several genetic connective tissue disorders including Ehlers Danlos syndromes, Marfan syndrome, Loeys-Dietz syndrome, Stickler syndrome, Shprintzen Goldberg syndrome, Cutis Laxa, and Osteogenesis Imperfecta. It highlights the importance of identifying these disorders to allow for timely detection of serious complications and management by multiple medical specialists. Connective tissues are the most abundant tissues in the body and connect, support, bind or separate other tissues. Identification of a connective tissue disorder through genetic diagnosis guides appropriate care.
Implementation of Facial Recognition Software for Clinical Genetics Practice...CHC Connecticut
This document discusses the potential uses of facial recognition software in clinical genetics practice and education. It provides 3 examples of how facial recognition software could help in rare disease identification and interpreting genetic testing results. The document also outlines learning objectives about identifying medical uses of facial recognition, using facial grids to match patterns to syndromes, and the importance of diverse training data.
HIV Prevention: Combating PrEP Implementation ChallengesCHC Connecticut
Expert faculty present case-based scenarios illustrating common challenges to integrating HIV PrEP in primary care. As part of improving clinical workforce development, this session will delve into a variety of specific PrEP implementation challenges. Participants will leave with strategies to overcome these obstacles to establish or strengthen their PrEP program.
Panelists:
• Marwan Haddad, MD, MPH, AAHIVS, Medical Director, Center for Key Populations, Community Health Center, Inc.,
• Jeannie McIntosh, APRN, FNP-C, AAHIVS, Family Nurse Practitioner, Center for Key Populations, Community Health Center, Inc.
NTTAP Webinar Series - December 7, 2022: Advancing Team-Based Care: Enhancing...CHC Connecticut
Join us as expert faculty outline the differences between case management, care coordination and complex care management to frame up a discussion on strategies to leverage effective models for both in-person and remote services.
Expert faculty will discuss the role of the medical assistant and the nurse in care management, as well as how standing orders and delegated orders support this work. This session will discuss how telehealth and remote patient monitoring enhancements can support complex care management for patients with chronic conditions.
Participants will leave this session with the knowledge and tools to begin or enhance implementation of chronic care management by enhancing the role of the medical assistant, nurse and the technology that supports the clinical care.
Panelists:
• Mary Blankson, DNP, APRN, FNP-C, Chief Nursing Officer, Community Health Center, Inc.
• Tierney Giannotti, MPA, Senior Program Manager, Population Health, Community Health Center Inc.
Genetics Cases and Resources Webinar Slides - November 8, 2022CHC Connecticut
The document discusses various metabolic diseases, including those that cause muscle symptoms like long chain hydroxyacyl CoA dehydrogenase (LCHAD) deficiency and Pompe disease. It provides information on fatty acid oxidation defects, describing how the body metabolizes fatty acids and the consequences of defects in breaking down different chain length fatty acids. Symptoms of long chain fatty acid oxidation defects are discussed, including fasting intolerance, encephalopathy, liver dysfunction, and muscle involvement. The diagnosis and treatment of these conditions is also summarized.
NTTAP Webinar: Postgraduate NP/PA Residency: Discussing your Key Program Staf...CHC Connecticut
This document discusses a webinar presented by Community Health Center, Inc. on their postgraduate nurse practitioner and physician assistant residency and fellowship programs. It provides an agenda for the webinar which will discuss the key program staff and their responsibilities, including the program director, clinical director, preceptors, mentors and other faculty. The webinar objectives are to identify drivers for implementing such programs, describe the implementation process, discuss program structure and highlight the roles of program staff.
Training the Next Generation within Primary CareCHC Connecticut
This document summarizes a presentation about training the next generation within primary care. It discusses Community Health Center Inc.'s various workforce development programs, including clinical and non-clinical fellowships and student programs. Specifically, it focuses on administrative fellowships, outlining their purpose and key factors to consider when establishing one, such as the fellow's access and experiences. It also describes other opportunities at the Weitzman Institute for training students, such as research programs with Wesleyan University and health policy fellowships. The presentation emphasizes that community health centers are important training grounds and considers how to structure diverse programs to support succession planning.
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Gata să te bucuri de o vară vibrantă și plină de energie? Life Care îți vine în ajutor cu Jurnalul Fericirii din Iulie 2024, un ghid complet pentru o viață armonioasă și echilibrată.
Pe parcursul a cateva de pagini pline de informații utile și inspirație, vei descoperi:
Sfaturi practice pentru o alimentație sănătoasă:
Rețete delicioase și ușor de preparat: Bucură-te de preparate gustoase și nutritive, perfecte pentru zilele călduroase de vară.
Recomandări pentru o alimentație echilibrată: Asigură-ți aportul necesar de nutrienți esențiali pentru un organism sănătos și plin de vitalitate.
Sfaturi pentru alegeri alimentare inteligente: Învață cum să faci cumpărături sănătoase și să eviți tentațiile nesănătoase.
Trucuri pentru un stil de viață activ:
Rutine de exerciții fizice adaptate nevoilor tale: Găsește antrenamente potrivite pentru a te menține în formă și energic pe tot parcursul verii.
Idei de activități în aer liber: Descoperă modalități distractive de a te bucura de vremea frumoasă și de a petrece timp de calitate cu cei dragi.
Sfaturi pentru un somn odihnitor: Asigură-ți un somn profund și reparator pentru a te trezi revigorat și pregătit pentru o nouă zi.
Sfaturi pentru o stare de bine mentală:
Tehnici de relaxare și gestionare a stresului: Învață cum să te relaxezi și să faci față provocărilor zilnice cu mai multă ușurință.
Sfaturi pentru cultivarea optimismului și a gândirii pozitive: Descoperă cum să abordezi viața cu o perspectivă optimistă și să atragi mai multă bucurie în ea.
Recomandări pentru a te conecta cu natura: Bucură-te de beneficiile naturii asupra stării tale mentale și emoționale.
Bonus:
Oferte exclusive la produsele Life Care: Beneficiază de reduceri și promoții speciale la o gamă largă de produse pentru o viață sănătoasă.
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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
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Ventilation Perfusion Ratio, Physiological dead space and physiological shuntMedicoseAcademics
In this insightful lecture, Dr. Faiza, an esteemed Assistant Professor of Physiology, delves into the essential concept of the ventilation-perfusion ratio (V˙/Q˙), which is fundamental to understanding pulmonary physiology. Dr. Faiza brings a wealth of knowledge and experience to the table, with qualifications including MBBS, FCPS in Physiology, and multiple postgraduate degrees in public health and healthcare education.
The lecture begins by laying the groundwork with basic concepts, explaining the definitions of ventilation (V˙) and perfusion (Q˙), and highlighting the significance of the ventilation-perfusion ratio (V˙/Q˙). Dr. Faiza explains the normal value of this ratio and its critical role in ensuring efficient gas exchange in the lungs.
Next, the discussion moves to the impact of different V˙/Q˙ ratios on alveolar gas concentrations. Participants will learn how a normal, zero, or infinite V˙/Q˙ ratio affects the partial pressures of oxygen and carbon dioxide in the alveoli. Dr. Faiza provides a detailed comparison of alveolar gas concentrations in these varying scenarios, offering a clear understanding of the physiological changes that occur.
The lecture also covers the concepts of physiological shunt and dead space. Dr. Faiza defines physiological shunt and explains its causes and effects on gas exchange, distinguishing it from anatomical dead space. She also discusses physiological dead space in detail, including how it is calculated using the Bohr equation. The components and significance of the Bohr equation are thoroughly explained, and practical examples of its application are provided.
Further, the lecture examines the variations in V˙/Q˙ ratios in different regions of the lung and under different conditions, such as lying versus supine and resting versus exercise. Dr. Faiza analyzes how these variations affect pulmonary function and discusses the abnormal V˙/Q˙ ratios seen in chronic obstructive lung disease (COPD) and their clinical implications.
Finally, Dr. Faiza explores the clinical implications of abnormal V˙/Q˙ ratios. She identifies clinical conditions associated with these abnormalities, such as COPD and emphysema, and discusses the physiological and clinical consequences on respiratory function. The lecture emphasizes the importance of understanding these concepts for medical professionals and students, highlighting their relevance in diagnosing and managing respiratory conditions.
This comprehensive lecture provides valuable insights for medical students, healthcare professionals, and anyone interested in respiratory physiology. Participants will gain a deep understanding of how ventilation and perfusion work together to optimize gas exchange in the lungs and how deviations from the norm can lead to significant clinical issues.
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.
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.
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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.
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.
Larry Smarr’s Prostate Cancer Early Detection and Focal Therapy
Weitzman 2013: Project ECHO
1. WORKING TO BRING SPECIALTY HEALTHCARE TO ALL PEOPLE
Sanjeev Arora MD
Professor of Medicine (Gastroenterology/Hepatology)
Director of Project ECHO®
Department of Medicine
University of New Mexico Health Sciences Center
Tel: 505-272-2808
Fax: 505-272-6906
sarora@salud.unm.edu
2. The mission of Project ECHO® is to
expand the capacity to provide best
practice care for common and complex
diseases in rural and underserved areas
and to monitor outcomes.
Supported by N.M. Dept. of Health, Agency for Health Research and Quality HIT Grant 1
UC1 HS015135-04, New Mexico Legislature, and the Robert Wood Johnson Foundation.
3. U.S.A.
4 M
SOUTH
AMERICA
10 M
AFRICA
32 M
EAST
MEDITERRANEAN
20M
SOUTH EAST ASIA
30 M
AUSTRALIA
0.2 M
Source: WHO 1999
WEST
EUROPE
9 M
FAR EAST ASIA
60 M
Hepatitis C: A Global Health Problem
Over 170 Million Carriers Worldwide, 3-4 MM new
cases/year
4. • Estimated number is greater than 28,000
• In 2004 less than 5% had been treated
– 2,300 prisoners were HCV positive (~40% of those
entering the corrections system), none were
treated
• Highest rate of chronic liver disease/cirrhosis
deaths in the nation; 25% higher incidence
than the next highest state
• Ten times more prevalent than HIV
Hepatitis C in New Mexico
6. • Good News
• Curable in 45-81% of cases
• Bad News
• Severe side effects:
– anemia (100%)
– neutropenia >35%
– depression >25%
• No Primary Care Physicians treating HCV
Hepatitis C Treatment
7. • 121,356 sq miles
• 1.83 million people
• 42.1% Hispanic
• 9.5% Native American
• 17.7% poverty rate
compared to 11.7%
nationally
• >22% lack health
insurance
• 32 of 33 New Mexico
counties are listed as
Medically Underserved
Areas (MUAs)
• 14 counties designated as
Health Professional
Shortage Areas (HPSA’s)
Underserved Area for Healthcare Services
Rural New Mexico
8. practice in rural or
frontier areas
New Mexico Physician Survey 2001
Health Care in New Mexico
20%
9. • Develop capacity to safely and
effectively treat HCV in all areas of New
Mexico and to monitor outcomes
• Develop a model to treat complex
diseases in rural locations and
developing countries
Goals of Project ECHO®
10. • University of New Mexico School of Medicine
Dept of Medicine, Telemedicine and CME
• NM Department of Corrections
• NM Department of Health
• Indian Health Service
• FQHCs and Community Clinics
• Primary Care Association
Partners
11. • Use Technology (multipoint videoconferencing and
Internet) to leverage scarce healthcare resources
• Disease Management Model focused on improving
outcomes by reducing variation in processes of care
and sharing “best practices”
• Case based learning: Co-management of patients
with UNMHSC specialists (learning by doing)
• HIPAA compliant web-based database to monitor
outcomes
Arora S, Geppert CM, Kalishman S, et al: Acad Med. 2007 Feb;82(2): 154-60.
Methods
12. What is Best Practice in Medicine
• Algorithm
• Check Lists
• Process
• Wisdom Based on Experience
13. • Train physicians, mid-level
providers, nurses, pharmacists, educators in HCV
• Train to use web based software — “iHealth”
• Conduct telemedicine clinics — “Knowledge
Network”
• Initiate co-management — “Learning Loops”
• Collect data and monitor outcomes centrally
• Assess cost and effectiveness of programs
Steps
14. • No cost CMEs and Nursing CEUs
• Professional interaction with colleagues with similar
interest
‒ Less isolation with improved recruitment and retention
• A mix of work and learning
• Obtain HCV certification
• Access to specialty consultation with
GI, hepatology, psychiatry, infectious diseases, addiction
specialist, pharmacist, patient educator
Benefits to Rural Clinicians
15. NEJM : 364: 23, June 9-2011, Arora S, Thornton K, Murata G
18. How well has model worked for Hepatitis C?
• 500 HCV TeleECHO Clinics have been conducted
• >5,000 patients entered HCV disease management
program
CME’s/CE’s issued:
• >6,000 CME/CE hours issued to ECHO® Clinicians for
Hep C
‒ Total CME hours 27,000 at no cost
• 280 hours of HCV Training conducted at rural sites
• National Recognition as Model for Complex Disease
Care
19. scale: 1 = none or no skill at all 7= expert-can teach others
Community Clinicians
N=25
BEFORE
Participation
MEAN (SD)
TODAY
MEAN (SD)
Paired
Difference
(p-value)
MEAN (SD)
Effect
Size
for the
change
1. Ability to identify suitable
candidates for treatment
for HCV.
2.8 (1.2) 5.6 (0.8)
2.8 (1.2)
(<0.0001)
2.4
2. Ability to assess
severity of liver disease in
patients with HCV.
3.2 (1.2) 5.5 (0.9)
2.3 (1.1)
(< 0.0001)
2.1
3. Ability to treat HCV
patients and manage side
effects.
2.0 (1.1) 5.2 (0.8)
3.2 (1.2)
(<0.0001)
2.6
Project ECHO® Clinicians
HCV Knowledge Skills and Abilities (Self-Efficacy)
(continued)
20. Community Clinicians
N=25
BEFORE
Participation
MEAN (SD)
TODAY
MEAN (SD)
Paired
Difference
(p-value)
MEAN (SD)
Effect
Size
for the
chang
e
4. Ability to assess and manage
psychiatric co- morbidities in
patients with hepatitis C.
2.6 (1.2) 5.1 (1.0)
2.4 (1.3)
(<0.0001)
1.9
5. Serve as local consultant
within my clinic and in my
area for HCV questions and
issues.
2.4 (1.2) 5.6 (0.9)
3.3 (1.2)
(< 0.0001)
2.8
6. Ability to educate and
motivate HCV patients. 3.0 (1.1) 5.7 (0.6)
2.7 (1.1)
(<0.0001)
2.4
(continued)
Project ECHO® Clinicians
HCV Knowledge Skills and Abilities (Self-Efficacy)
21. Community Clinicians
N=25
BEFORE
Participation
MEAN (SD)
TODAY
MEAN (SD)
Paired
Difference
(p-value)
MEAN (SD)
Effect
Size
for the
change
Overall Competence
(average of 9 items)
2.8* (0.9)
5.5*
(0.6)
2.7 (0.9)
(<0.0001)
2.9
Cronbach’s alpha for the BEFORE ratings = 0.92 and Cronbach’s alpha for the TODAY ratings = 0.86 indicating a
high degree of consistency in the ratings on the 9 items
Arora S, Kalishman S, Thornton K, Dion D et al: Hepatology. 2010 Sept;52(3):1124-33
Project ECHO® Clinicians
HCV Knowledge Skills and Abilities (Self-Efficacy)
23. N=17 Mean Score
(Range 1-5)
Project ECHO® has diminished my professional isolation. 4.3
My participation in Project ECHO® has enhanced my professional
satisfaction.
4.8
Collaboration among agencies in Project ECHO® is a benefit to my
clinic.
4.9
Project ECHO® has expanded access to HCV treatment for patients in
our community. 4.9
Access, in general, to specialist expertise and consultation is a major
area of need for you and your clinic. 4.9
Access to HCV specialist expertise and consultation is a major area of
need for you and your clinic. 4.9
Project ECHO®
Annual Meeting Survey
25. • To train primary care clinicians in rural areas
and prisons to deliver Hepatitis C treatment
to rural populations of New Mexico
• To show that such care is as safe and
effective as that give in a university clinic
• To show that Project ECHO® improves
access to Hepatitis C care for minorities
OBJECTIVES
26. • Study sites
– Intervention (ECHO)
• Community-based clinics: 16
• New Mexico Department of Corrections: 5
– Control: University of New Mexico (UNM) Liver
Clinic
• Subjects meeting inclusion / exclusion criteria
– Community cases seen by primary care physicians
– Consecutive University patients
Participants
27. • Prospective cohort study
– Participation determined by available technology
– Randomization by patient, Clinician, or site not
feasible
• Advantages
– Uniform eligibility criteria
– Standardized treatment
– Prospective measurement of end-points
• Limitation: groups unbalanced with respect to
patient covariates
Study Design
28. • Sustained Viral Response (SVR): no
detectable virus 6 months after completion
of treatment
PRINCIPLE ENDPOINT
29. • 407 hepatitis C patients met inclusion and
exclusion criteria
– Age: 43.0 ± 10.0 years
– Men: 63.3%
– Minority: 65.2%
– Genotype 1: 57.0%
– Log10 viral load: 5.89 ± 0.95
– Treatment sites
• UNMH: 146
• ECHO site: 261
Developing New Standards of
Practice for Hepatitis C
31. • Rural primary care Clinicians deliver
hepatitis C care under the aegis of Project
ECHO® that is as safe and effective as that
given in a University clinic.
• Project ECHO® improves access to hepatitis
C care for New Mexico minorities.
Conclusions
32. Disease Selection
• Common diseases
• Management is complex
• Evolving treatments and medicines
• High societal impact (health and economic)
• Serious outcomes of untreated disease
• Improved outcomes with disease
management
34. Force Multiplier
Use Existing Community Clinicians
Specialists
Primary
Care
Physician
Assistants
Nurse
Practitioners
Chronic Pain
Rheumatoid Arthritis + Rheumatology Consultation
Substance Use and Mental Health Disorders
35. Successful Expansion into
Multiple Diseases
Mon Tue Wed Thurs Fri
8-10
a.m.
Hepatitis C
• Arora
• Thornton
Diabetes &
Cardiac Risk
Reduction
• Colleran
Geriatrics/
Dementia
• Herman
Palliative Care
• Neale
10-12
a.m.
Rheumatology
• Bankhurst
Chronic Pain
• Katzman
Integrated
Addictions &
Psychiatry
• Komaromy
Complex Care
• Neale &
Komaromy
2-4
p.m.
HIV
• Iandiorio &
Thornton
Prison Peer
Educator
Training
• Thornton
Women’s
Health &
Genomics
• Curet
37. Integrated Addictions and
Psychiatry Clinic
• Focus on treating opiate addiction (heroin, pain pills) with
psychosocial support + effective medication
• Only 32 physicians in New Mexico certified to prescribe
Buprenorphine in 2007
• Trained/certified 225 physicians statewide in use of
buprenorpine/Suboxone, 274 total clinicians trained
42. Community Based Care for
Cardiac Risk Factor Reduction was more
Effective than Enhanced Primary Care
Becker Circulation. 2005:111:1298-1304.
43. • Live in Community
• Understand culture
• Appreciate economic limitations of patient
and know community resources available to
patient
• Often know family and can engage other
social resources for patient
• Spend more time with patient
Why is a CHW Intervention Effective?
44. • CHW Specialist Training
– CREW: Diabetes, Obesity, Hypertension,
Cholesterol, Smoking Cessation, Exercise
Physiology
– CARS: Substance Use Disorders
– ECHO Care: Complex Multiple Diagnoses
• Prison Peer Educator Training
ECHO ® CHW Training — Multiple Tracks
45. • Use low-cost technology to take specialty training to
CHWs, Promotoras, CHRs, Medical Assistants where they live
• Narrow Focus — Deep Knowledge
• Standardized Curriculum
– 3 Day Onsite
– Webcam/Weekly Video Based Clinics
• Diet
• Exercise
• Smoking Cessation
• Motivational Interviewing
• Gentle Nudges
• Finger Stick
• Foot Exam
– Ongoing support via knowledge networks
– Part of Disease Management Team
– Warm Handoff
Specialty CHW Program
46. Community Health Workers in Prison
The New Mexico Peer Education Program
Pilot training cohort, CNMCF Level II, July 27-30, 2009
Photo consents on file with Project ECHO and CNMCF
First day of peer educator training
47. Graduation Ceremony of First Cohort
The New Mexico Peer Education Program
Pilot training cohort, CNMCF Level II, July 27-30, 2009
Photo consents on file with Project ECHO and CNMCF
Graduation as Peer Educators
48. • Quality and Safety
• Rapid Learning and best-practice dissemination
• Reduce variations in care
• Access for Rural and Underserved Patients, reduced disparities
• Workforce Training and Force Multiplier
• De-monopolize Knowledge
• Improving Professional Satisfaction/Retention
• Supporting the Medical Home Model
• Cost Effective Care- Avoid Excessive Testing and Travel
• Prevent Cost of Untreated Disease (e.g.: liver transplant or
dialysis)
• Integration of Public Health into treatment paradigm
Potential Benefits of ECHO® model to
Health System
49. • University of Washington (HCV, Chronic Pain, HIV, Addiction)
• University of Chicago (HTN, Cancer, ADHD)
• Veteran’s Administration Health System (Chronic Pain, DM,
Heart Failure, HCV, Women’s Health, Nephrology) – 11 regions
• US Department of Defense
• University of Nevada (DM)
• University of Utah (HCV)
• University of South Florida, ETAC (HCV/HIV Co-Infection)
• Florida and Caribbean, AETC (HIV/AIDS)
• Harvard, Beth Israel Deaconess Medical Center (HCV, Dementia)
• Community Health Center, Inc. (HIV, HCV, Chronic Pain)
• LA Net
ECHO® Replication in US:
50. • India: New Delhi (HIV and HCV), Lucknow
(Autism)
• Uruguay (Liver disease)
ECHO® Replication Sites worldwide:
52. • Excellence in Clinical Research Award, University of New Mexico Health Sciences
Center, 2012
• New England Journal of Medicine Article, “Outcomes of Treatment for Hepatitis C Virus
Infection by Primary Care Providers” named one of the Most Influential Research Articles
of 2011 by the Robert Wood Johnson Foundation, 2012
• 21st Century Awards for Best Practices in Distance Learning from the United States
Distance Learning Association (USDLA), 2010
• ASHOKA Fellowship for Social Entrepreneurship, 2009
• Lemelson Fellow for Using Technology to help Humanity, 2009
• Leadership in Distance Learning Program Administration Award from the United States
Distance Learning Association (USDLA), 2009
• eHealth Initiative Award: “Transforming Care Delivery at the Point of Care,” 2008
• Robert Wood Johnson Foundation/Ashoka Foundation Changemakers Competition
Winner: “Disruptive Innovations in Health and Healthcare--Solutions People Want,” 2007
Awards for ECHO® Team
53. Use of multipoint videoconferencing, best
practice protocols, co-management of
patients with case based learning (the ECHO
model) is a robust method to safely and
effectively treat common and complex
diseases in rural and underserved areas and
to monitor outcomes.
WORKING TO BRING SPECIALTY HEALTHCARE TO ALL PEOPLE
Editor's Notes
Project ECHO is the Brain child of SanjeevArora & started in 2003. Vision is the energy behind every effort and the force to push thru problems that we are encounteredFor ECHO Global Connections we hope to engage the health-care community by fostering communications and identifying common themes affecting health issues, in India. Health Care professionals work in vastly different environments, yet we all face many of the same challenges. With this presentation we offer various perspectives and expect to provoke thoughtful discussion.
WHO estimates that 170 million persons or 3 % of the world’s population are infected with hepatitis C and 3 to 4 million persons are newly infected each year. The prevalence of HCV in some countries in Africa, the Eastern Mediterranean, South East Asia and Western Pacific is high compared to some countries in Europe and North America.According to the National Health and Nutrition Examination Survey of 1988 to 1994, the NHANES survey, and other population-based surveys, nearly 2% of Americans test positive for the hepatitis C antibody. This prevalence corresponds to an estimated 4 million Americans infected with HCV.
NM 2 M people……………. is larelgy rural just like India, 32 of 33 New Mexico counties are listed as Medically Underserved Areas (MUAs)
Arora S, Geppert CM, Kalishman S, et al: Acad Med. 2007 Feb;82(2): 154-60.4 principles #2 is caring sharing and Improving by using Best practices and Reduce variation4 is tracking outcomes on InternetBecause lectures to Dr’s is not enough, but university students learn by guided practice. U prof becomes a mentor
Knowledge comes but wisdom lingers. Guide lines and process alone not enough expert modify criteria…roll w the punchesAlgorithm gene + ve 1 ,RX for 1 yr GuidelineCk list 16 wk do 16 cks all, instead of 12 Process…who does what, what can nurse does, because Dr does not have time, he delegatesKnowledge comes but wisdom lingers. Guide lines and process alone not enough expert modify criteria…roll w the punchesAlgorithm gene + ve 1 ,RX for 1 yr GuidelineCk list 16 wk do 16 cks all, instead of 12 Process…who does what, what can nurse does, because Dr does not have time, he delegates
Knowledge learning means they will learn from U prof, from each other and then learning by doing to become expert
Outcomes x Provider skills improvement, pt overall satisfaction, efficacy of RX1 is no skill and 7 is expert start from 2.4 before and in 1 yr 5.6