The Future of Healthcare Presentation on Video

<p><a href=”http://vimeo.com/27159668″>What is the Future of Healthcare?</a> from <a href=”http://vimeo.com/jonmrich”>Jonathan Richman</a> on <a href=”http://vimeo.com”>Vimeo</a&gt;.</p>

From the 12 August 2011 Science Roll

 

Jonathan Richman at Dose of Digital published his presentation that focused on the future of healthcare. He included the personalized, direct-to-consumer genetic companies, e-health, e-patients and many more emerging topics.

Wireless devices will dramatically change how medicine is practiced

From the 8 August 2011 KevinMD.com article by STEPHEN C. SCHIMPFF, MD

I interviewed about 150 medical leaders just a few years ago for my book The Future of Medicine – Megatrends in Healthcare. Not one mentioned wireless devices as a coming megatrend. How fast the world changes! Nowadays everyone has a cell phone and we rarely stop to think that just two decades ago almost no one had them. We have a laptop or tablet computer that can access information from the web at very high rates of speed; again it is hard to remember when this wasn’t so. And those with smart phones have numerous “apps” – to check traffic conditions, find the nearest Starbucks, or play games. But these and other devices that use wireless technology will lead to major changes in the delivery of health care in the coming years. This is another of those coming medical megatrends.
Read the rest of Wireless devices will dramatically change how medicine is practiced on KevinMD.com.

Related articles

• Unintended consequences of patient portals (kevinmd.com)
• Invasion of the Body Hackers? Wireless Medical Devices Susceptible to Attacks (tjantunen.com)
• Mobile Security Requires More Than Secure Wireless Devices (aviatnetworks.com)

Surgery as a public health intervention: common misconceptions versus the truth

From the Bulletin of the World Health Organization (WHO)

The world’s attention has recently been focused on the escalation of violence in north and west Africa. Daily reports of deaths and injuries from the region have raised concerns. What is missing from the picture, however, is the fact that many of these countries lack surgical capacity to treat the injured, and this inability to provide surgical care is contributing to a significant rise in the death toll. A recent World Health Organization (WHO) study found that more than 90% of deaths from injuries occur in low- and middle-income countries.1 This is not surprising, considering that the poorest third of the world’s population receives only 3.5% of the surgical operations undertaken worldwide.2 Many hospitals in these countries do not have a reliable supply of clean water, oxygen, electricity and anaesthetics, making it extremely challenging to perform even the most basic surgical operations.3 Despite such a surgical imbalance around the world, surgery is still “the neglected stepchild of global health”.4 No global funding organization focuses specifically on the provision of surgical care, and none of the major donors are willing to support and acknowledge surgery as an imperative part of global public health. This is largely due to the following common misperceptions about surgery that are not grounded in truth. First, many people think that surgical care can only address a very limited part of the global burden of diseases and thus is of low priority. In reality, injuries kill more than five million people worldwide each year, accounting for nearly one out of every ten deaths globally….. …Second, there is a common notion that surgical care is too expensive to be implemented as part of public health interventions. However, surgery can be remarkably cost-effective, even in comparison to non-surgical interventions that are commonly implemented as public health measures. …. ….Lastly, the focus of the global health community on the issue of surgical imbalance has been largely confined to providing short-term relief through medical missions. …

Read the entire article

Surgery as a public health intervention: common misconceptions versus the truth

 

From the Bulletin of the World Health Organization (WHO)

The world’s attention has recently been focused on the escalation of violence in north and west Africa. Daily reports of deaths and injuries from the region have raised concerns. What is missing from the picture, however, is the fact that many of these countries lack surgical capacity to treat the injured, and this inability to provide surgical care is contributing to a significant rise in the death toll. A recent World Health Organization (WHO) study found that more than 90% of deaths from injuries occur in low- and middle-income countries.1 This is not surprising, considering that the poorest third of the world’s population receives only 3.5% of the surgical operations undertaken worldwide.2 Many hospitals in these countries do not have a reliable supply of clean water, oxygen, electricity and anaesthetics, making it extremely challenging to perform even the most basic surgical operations.3

Despite such a surgical imbalance around the world, surgery is still “the neglected stepchild of global health”.4 No global funding organization focuses specifically on the provision of surgical care, and none of the major donors are willing to support and acknowledge surgery as an imperative part of global public health. This is largely due to the following common misperceptions about surgery that are not grounded in truth.

First, many people think that surgical care can only address a very limited part of the global burden of diseases and thus is of low priority. In reality, injuries kill more than five million people worldwide each year, accounting for nearly one out of every ten deaths globally…..

…Second, there is a common notion that surgical care is too expensive to be implemented as part of public health interventions. However, surgery can be remarkably cost-effective, even in comparison to non-surgical interventions that are commonly implemented as public health measures. ….

….Lastly, the focus of the global health community on the issue of surgical imbalance has been largely confined to providing short-term relief through medical missions. …

Read the entire article

Clinical Preventive Services for Women: Closing the Gaps

 

From the Institute of Medicine press release

 

As a centerpiece of the Patient Protection and Affordable Care Act (ACA) of 2010, the focus on preventive services is a profound shift from a reactive system that primarily responds to acute problems and urgent needs to one that helps foster optimal health and well-being. The ACA addresses preventive services for both men and women of all ages, and women in particular stand to benefit from additional preventive health services. The inclusion of evidence-based screenings, counseling and procedures that address women’s greater need for services over the course of a lifetime may have a profound impact for individuals and the nation as a whole.
Given the magnitude of change, the U.S. Department of Health and Human Services charged the IOM with reviewing what preventive services are important to women’s health and well-being and then recommending which of these should be considered in the development of comprehensive guidelines. The IOM defined preventive health services as measures—including medications, procedures, devices, tests, education and counseling—shown to improve well-being, and/or decrease the likelihood or delay the onset of a targeted disease or condition.

The IOM recommends that women’s preventive services include:

 

• improved screening for cervical cancer, counseling for sexually transmitted infections, and counseling and screening for HIV;
• a fuller range of contraceptive education, counseling, methods, and services so that women can better avoid unwanted pregnancies and space their pregnancies to promote optimal birth outcomes;
• services for pregnant women including screening for gestational diabetes and lactation counseling and equipment to help women who choose to breastfeed do so successfully;
• at least one well-woman preventive care visit annually for women to receive comprehensive services; and
• screening and counseling for all women and adolescent girls for interpersonal and domestic violence in a culturally sensitive and supportive manner.

What can we do about death? Reinventing the American medical system

From the 31 May 2011 Eureka News Alert

(Garrison, NY) In a feature article in The New Republic,(subscription only, check your local public library for availability)  Daniel Callahan and Sherwin Nuland propose a radical reinvention of the American medical system requiring new ways of thinking about living, aging, and dying. They argue that a sustainable—and more humane— medical system in the U.S. will have to reprioritize to emphasize public health and prevention for the young, and care not cure for the elderly.

An interesting twist on their argument, which would aim to bring everyone’s life expectancy up to an average age of 80 years but give highest priority for medical treatment to those under 80, is that Callahan and Nuland are themselves 80 years old. Daniel Callahan, Ph.D., is cofounder and president emeritus of The Hastings Center and author most recently of Taming the Beloved Beast: How Medical Technology Costs Are Destroying Our Health Care System. Sherwin Nuland, M.D., is a retired Clinical Professor of Surgery at the Yale School of Medicine and author of How We Die and the Art of Aging. He is also a Hastings Center Fellow and Board member.

“The real problem is that we have medicine excessively driven by progress, which aims to rid us of death and disease and treats them as the targets of unlimited medical warfare,” said Callahan and Nuland. “That warfare, however, has come to look like the trench warfare of World War I: great human and economic cost for little progress. Neither infectious disease nor the chronic diseases of an aging society will soon be cured. Cancer, heart disease, stroke, and Alzheimer’s disease are our fate for the foreseeable future. Medicine and the public must adapt it to that reality, one that has mainly brought us lives that end poorly and expensively in old age.”

The article notes that the Affordable Care Act might ease the financial burden of this system, but not eliminate it. It reports, for example, that the cost of Alzheimer’s disease is projected to rise from $91 billion in 2005 to $189 billion in 2015, and to $1 trillion in 2025 – twice the cost of Medicare expenditures for all diseases now.

“We need to change our priorities for the elderly. Death is not the only bad thing that can happen to an elderly person,” the authors write. “An old age marked by disability, economic insecurity, and social isolation are also great evils.” They endorse a culture of care, not cure, for the elderly, with a stronger Social Security program and a Medicare program weighted toward primary care that supports preventative measures and independent living.

Callahan and Nuland point the way to a more sustainable path that reprioritizes the entire system. Among their recommendations:

• improve medicine at the level of public health and primary care, while reducing its use for expensive high-tech end-of-life care;
• shift resources for the elderly to greater economic and social security and away from more medical care;
• subsidize the education of physicians, particularly those who go into primary care, and decrease medical subspecialization;
• train physicians better to tell the truth to patients about the way excessively aggressive medicine can increase the likelihood of a poor death;
• shift the emphasis in chronic disease to care rather than cure;
• conduct a top-down, bottom-up, long-range study of the entire American system of health care, including the training of physicians, with a view toward reconstituting it along systematic lines that take science, humanistic concerns, economics, and social issues into account.

Related articles

• Andrew Reinbach: Health Care Could Kill Us: We Don’t Have to Let It (huffingtonpost.com)
• New at Reason: Ronald Bailey on Health Care Reform (reason.com)

Contrary To Common Beliefs, Studies Find Aggressive Care May Yield Better Patient Outcomes

From the 24 June 2011 Medical News Today article

Health services researchers who studied controversial aspects of Medicare spending and quality of patient care received a prestigious award yesterday from the nation’s largest health services research professional association….

…The Article of the Year Award recognized two companion studies by Silber and Kaestner: “Aggressive Treatment Style and Surgical Outcomes,”*** published in the December 2010 issue of the journal Health Services Research, and “Evidence on the Efficacy of Inpatient Spending on Medicare Patients,” ***published the same month in The Milbank Quarterly.

As an indicator of aggressive care, Silber and Kaestner used the Dartmouth Index, a prominent set of measures of inpatient spending on elderly patients. In studying over 5 million Medicare admissions for various surgeries between 2000 and 2005, they found that surgical patients in hospitals with a more aggressive treatment style were less likely to die within 30 days of admission compared to patients in less aggressive hospitals. They also found that this benefit was stable, persisting after the 30-day mark. …

***For suggestions on how to get these articles for free or at low cost, click here

Related articles

• A promising way to control health costs (money.cnn.com)
• Fewer Medicare Patients Being Hospitalized for Heart Problems (insurance.zocdoc.com)
• Medicare premiums, saving Medicare and more; keep on eye on the real concerns (quinnscommentary.com)

Health Educators, Foundations Announce Competencies And Action Strategies For Interprofessional Education

From the 12 May 2011 Medical News Today article

Two new reports released today by six national health professions associations and three private foundations recommend new competencies for interprofessional education in the health professions, and action strategies to implement them in institutions across the country. By establishing these competencies, the proponents believe our nation’s health care system can be transformed to provide collaborative, high-quality, and cost-effective care to better serve every patient.

Click here to read the rest of the article

Related articles

• Future of Nursing Campaign Upends Old Ideas on Health Care (rwjfblogs.typepad.com)
• Interprofessionalism (digitalcollaboration.wordpress.com)

New Tutorials from HCUP (US Healthcare Cost and Utilization Project)

             
HCUP On-line Tutorial Series

HCUP Online Tutorial Series provides HCUP data users with information about HCUP data and tools, and training on technical methods for conducting research with HCUP data.

From the AHRQ (Agency for Healthcare Research and Quality) press release

HCUP Offers New Online Tutorial Series’ Modules

AHRQ is pleased to announce the release of a new module and an updated re-release of a favorite in the HCUP Online Tutorial Series.  These online trainings are designed to provide data users with information about HCUP data and tools, as well as training on technical methods for conducting research using HCUP datasets.

• The all-new Calculating Standard Error tutorial is designed to help users determine the precision of the estimates they produce from the HCUP nationwide databases.  Users will learn two methods for calculating standard errors for estimates produced from the HCUP nationwide databases.
• The newly revised HCUP Overview Course is a helpful introduction to HCUP for new users.  The original course has been updated to include the latest additions to the HCUP family of databases and tools, including the Nationwide emergency Department Sample.

 The HCUP Online Tutorial Series is available on the HCUP-US Web site.  For more information, contact HCUP User Support at hcup@ahrq.gov.

Related Articles

• HCUP Facts and Figures: Statistics on Hospital-based Care in the United States (jflahiff.wordpress.com)
• New Analysis Illustrates the Hidden Burden of Atrial Fibrillation on Healthcare Spending and Resources in Each State (prnewswire.com)
• AHRQ News And Numbers: Medication Side Effects, Injuries, Up Dramatically (jflahiff.wordpress.com)
• New Tab: Tutorials (tinysewingempire.wordpress.com)

School-based health centers improving access for youth: School settings a boon to student health

From the Nation’s Health ( April 2011, vol. 41 no. 3 , pp 1-20)

During a recent office visit, Robert Wolverton, MD, provided a young woman with emergency contraceptives, helped her restart regular birth control, evaluated a rash she was concerned about and investigated the cause of her ear pain.

Some doctors discourage patients from discussing multiple problems during one appointment, Wolverton said, but that recent patient was like many he sees at the Teen Wellness Center at T.C. Williams High School in Alexandria, Va. She had health concerns and she wanted to handle them quickly and confidentially….

…Nationwide, the number of school-based health centers is climbing, according to Linda Juszczak, DNSc, MPH, MS, CPNP, executive director of the National Assembly on School-Based Health Care. The City of Alexandria has had a wellness center for adolescents for more than a decade, but the previous center was located in a trailer off school property that students had a hard time accessing, Wolverton said….

…

The new center is one of more than 1,900 school-based health centers nationally operating in 48 states and territories. Such centers provide access to primary health care, mental health services, immunizations, sexually transmitted disease testing and a host of other services to about 2 million children and youth, regardless of ability to pay.

The centers are an attractive option for young patients seeking health care, as no patient will be turned away because she or he is not able to pay, said Terri Wright, MPH, director of APHA’s Center for School, Health and Education. In some places, school-based health centers open their doors to adults during non-school hours and bill third-party payers for their care as a way to make ends meet, Wright said.

The growth of school-based health centers such as the one in Alexandria may speed up in the near future, thanks to the health reform law passed last year.

 

Related Articles

• Columbus schools a center for students’ health care (dispatch.com)
• Oakland, L.A. schools to add health centers (sfgate.com)
• Health care part of Columbus schools’ services (dispatch.com)