[Reblog]New IOM report focuses on funding health improvement rather than financing health system reform

Posted on April 26, 2012 by sarabeazley at American Hospital Association Resource Center Blog

” . . . it is no longer sufficient to expect that reforms in the medical care delivery system (for example, changes in payment, access and quality) alone will improve the public’s health.”

The Institute of Medicine has issued the third and final report of a series on public health that focuses on how altering the fundamental physical and social environment will lead to improved health in the general population, an essential requirement of any effective reform of the system that delivers health care services.

For the Public’s Health: Investing in a Healthier Future addresses its thesis in four chapter:

• Introduction and Context
• Reforming Public Health and Its Financing
• Informing Investment in Health
• Funding Sources and Structures to Build Public Health

The committee responsible for the report also propose ten recommendations, among which are the following:

• Greater legislative/regulatory flexibility in the allocation of funds by state and local health agencies in pursuit of public health improvement initiatives;
• Reduction in the provision of clinical care services by public health agencies so that they can focus on the delivery of population-based services, such as nurse home visits and health promotion activities;
• Development of  a model chart of accounts for use by public health agencies to improve their tracking of funds and measuring program effectiveness;
• Doubling the current federal appropriation for public health, with periodic adjustments to ensure public health agencies’ ability to deliver a minimum package of services;
• Reallocation of state and local funds from paying for services currently reimbursed through Medicaid or state health insurance exchanges to financing population-based prevention and health promotion initiatives conducted by public health departments.

Source: Institute of Medicine.  For the Public’s Health: Investing in a Healthier Future. Washington, DC: National Academies Press, 2012.  Free online edition at:http://books.nap.edu/openbook.php?record_id=13268.

The two previous reports are also available online.

For the Public’s Health: Revitalizing Law and Policy to Meet New Challenges.  2011. http://www.nap.edu/catalog.php?record_id=13093

or the Public’s Health: The Role of Measurement in Action and Accountability. 2010. http://books.nap.edu/openbook.php?record_id=13005

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American Hospital Association Resource Center Blog

” . . . it is no longer sufficient to expect that reforms in the medical care delivery system (for example, changes in payment, access and quality) alone will improve the public’s health.”

The Institute of Medicine has issued the third and final report of a series on public health that focuses on how altering the fundamental physical and social environment will lead to improved health in the general population, an essential requirement of any effective reform of the system that delivers health care services.

For the Public’s Health: Investing in a Healthier Future addresses its thesis in four chapter:

• Introduction and Context
• Reforming Public Health and Its Financing
• Informing Investment in Health
• Funding Sources and Structures to Build Public Health

The committee responsible for the report also propose ten recommendations, among which are the following:

• Greater legislative/regulatory flexibility in the allocation of funds by state and local health agencies in pursuit of public health…

View original post 171 more words

Letting Doctors Make the Tough Decisions

Excerpt from the 11 August New York Times article

…..When it came to medical decisions, almost all the respondents wanted their doctors to offer choices and consider their opinions. But a majority of patients — two out of three — also preferred that their doctors make the final decisions regarding their medical care.

“The data says decisively that most patients don’t want to make these decisions on their own” said Dr. Farr A. Curlin, an associate professor of medicine at the University of Chicago and one of the authors of the study.

The challenges appear to arise not when the medical choices are obvious, but when the best option for a patient is uncertain. In these situations, when doctors pass the burden of decision-making to a patient or family, it can exacerbate an already stressful situation. “If a physician with all of his or her clinical experience is feeling that much uncertainty,” Dr. Curlin said, “imagine what kind of serious anxiety and confusion the patient and family may be feeling.”

Patients and their families also often don’t realize that their doctors may be grappling with their own set of worries. …

Read the entire New York Times article

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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.

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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

Connect: Patients and the Power of Data

Source: Young Foundation (UK)

Information is the lifeblood of high quality healthcare. There have been huge technological advances about how it can be used and by whom, which have been under utilised by the NHS. It is now possible to give people control over their own data. If this were done, it would have the potential to revolutionise healthcare delivery for patients, their families and carers.

This discussion paper sets out seven practical ways and examples, each of which the Young Foundation believes would transform health care delivery. These could improve patient experiences, reduced errors and omissions, improve communication and make healthcare more efficient and effective.

+ Direct link to document (PDF; 2.4 MB)

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Health Care Delivery Needs To Be A Science Too, Carolyn Clancy Tells University Of Maryland

From the 6 May 2011 Medical News Today article

Carolyn Clancy, MD, director of the federal Agency for Healthcare Research and Quality (AHRQ), says that although the U.S. “leads the way” in science to develop medical methods, the country still needs to treat health care delivery as a science.

Health care should emulate Starbucks in teamwork, Clancy told a standing-room audience at Pharmacy Hall at the University of Maryland School of Pharmacy. “They get it. You order a drink at the cashier, even one of those complicated ones. The cashier repeats it back to you and writes it on the cup. Then she repeats it to the person making it, who also repeats it. Most of medicine has not done that. They do a better job at Starbucks.” …

…Delivering the annual Andrew G. Dumez Memorial Lecture, “Research Meets Practice at the RX: Keeping Patients and Consumers at the Center of Care,” Clancy provided a high-level view of the current challenges to improve the quality of care, as well as the pharmacists’ roles in those challenges. As a producer of what Clancy called “benchmark” reports for health care industry and policymakers, AHRQ “supports research that helps people make more informed decisions and improves the quality of health care services,” according to its website.

Clancy praised the current collaborative trend in health care research, which is designed to inform health care decisions by providing evidence on the effectiveness, benefits, and harms of different treatment options. The evidence is generated from research studies that compare drugs, medical devices, tests, surgeries, or ways to deliver health care. Such “patient-centered research,” she said, greases the skids of scientific advances into actual clinical practice and usable information for clinicians and patients.

During the creation of the American Recovery and Reinvestment Act of 2009, “All parties agreed,” she said, that “patient-centered care needs to involve more than clinical intervention. It also needs to include such things as drug-to-drug interaction, care management, avoiding hospital stays” and more.

Clancy said a recent AHRQ report found that progress has been made in data collection in the health care system as more providers are collecting and storing patient data. The team concept in health care transcends the “my data” mentality of the past, she said. “We are getting to a point when data are ubiquitous, allowing for more success in using comparative effectiveness as a tool, with improved methods that can support learning and improvement at the front lines of care delivery.”

Addressing the pharmacy students in attendance, Clancy said, “If there was ever a time when we need you, it is now. It is becoming increasingly important to safety and quality is to do medicine as a team sport. And the pharmacist is a vital member of the team.” …..

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Create Your Mayo Clinic Health Experience At Mall Of America(R) To ‘Help People Live The Best Lives They Possibly Can’

Construction Under Way on New Prototype Mayo Clinic Facility to Open This Summer

People will interact, engage, relate, participate and share with Mayo Clinic experts to learn more about what they want and need from their health care experience.

From the 3 May 2011 Mayo Clinic Press Release

ROCHESTER, Minn. — Construction has begun on ‘Create Your Mayo Clinic Health Experience’ at Mall of America. The new space is a health care laboratory designed to integrate health and health care needs to help people stay well and get well. People will interact, engage, relate, participate and share with Mayo Clinic experts to learn more about what they want and need from their health care experience.

“The concepts for ‘Create Your Mayo Clinic Health Experience’ are based on extensive interaction with individuals. We know that health permeates virtually all aspects of our lives — how we eat, socialize, care for our children, exercise, work and so on,” says David Hayes, M.D., a cardiologist at Mayo Clinic who is leading the Mall of America project. “We know health care in the future will not be limited to hospitals and doctor’s offices. Mall of America provides an opportunity for Mayo Clinic to help transform health care delivery by enhancing convenience and enabling more people to access Mayo Clinic health resources on a day-to-day basis.”

At ‘Create Your Mayo Clinic Health Experience,’ you will be able to:

Interact with touch-screen health applications designed to entertain, inform and educate.
Engage with health care experience navigators who will help you assemble the tools you need to improve your health and well-being. These navigators will be experienced, Mayo-trained experts.
Relate individually with more in-depth information and programs tailored to your needs.
Participate in health education classes.
Share offerings from Mayo Clinic health professionals specific to women’s health, sports and performance health, preventive health and family and lifestyle health.
Learn more about the services Mayo Clinic provides at its Arizona, Florida, Minnesota and Mayo Health System campuses.
“This is really about Mayo’s commitment to helping people live the best lives they possibly can. The development of ‘Create Your Mayo Clinic Health Experience’ will be an exploration of health care, wellness and targeted prevention,” adds John La Forgia, senior administrator for the project. “Mayo is well known as a place for patients to find answers, but we would also like to gather more input about the future of preventive health services.”

“Our collaboration with Mayo Clinic throughout the past year has not only built momentum for this exciting venture, it has helped promote healthy living for thousands of mall visitors,” says Maureen Bausch, executive vice president of business development at Mall of America. “We look forward to the opportunities that our visitors will have to provide feedback and shape their own health experiences when this prototype space opens.”

‘Create Your Mayo Clinic Health Experience’ will be located on the first level near the East Market Rotunda. Construction began in April and Mayo Clinic plans to open the space in July. ‘Create Your Mayo Clinic Health Experience’ is a prototype space through which Mayo Clinic experts will gather input as part of the possible permanent facility Mayo Clinic plans for the Phase II expansion of Mall of America.

Mayo Clinic’s Arizona, Florida and Minnesota campuses, including Mayo Health System, will remain the patient-focused care centers that have been the hallmark of Mayo Clinic for more than 100 years. Both ‘Create Your Mayo Clinic Health Experience’ and the eventual permanent facility as part of the Phase II Mall of America expansion will complement these locations by providing convenient, day-to-day services to improve health and well-being, as well as offering direct connections to Mayo Clinic.

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HHS Announces Plan To Reduce Health Disparities

From the April 11 2011 Medical News Today article

The U.S. Department of Health and Human Services launched two strategic plans aimed at reducing health disparities.

The HHS Action Plan to Reduce Racial and Ethnic Health Disparities outlines goals and actions HHS will take to reduce health disparities among racial and ethnic minorities.

HHS also released the National Stakeholder Strategy for Achieving Health Equity, a common set of goals and objectives for public and private sector initiatives and partnerships to help racial and ethnic minorities and other underserved groups reach their full health potential. The strategy, a product of the National Partnership for Action (NPA), incorporates ideas, suggestions and comments from thousands of individuals and organizations across the country. The NPA was coordinated by the HHS Office of Minority Health.

 

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Disaster Medicine and Public Health Preparedness (Journal Article)

From the March 18 2011 DISASTR-OUTREACH-LIB **posting

Disaster Medicine and Public Health Preparedness
The March 2011 issue of this journal includes an article titled,
“Supporting Evidence-based Health Care in Crises: What Information Do Humanitarian Organizations Need?” ***as well as a selection of open access articles relevant to the Japan earthquake. [Submitted by Anna Gieschen]

Abstract

Supporting Evidence-based Health Care in Crises

What Information Do Humanitarian Organizations Need?

Tari Turner, PhD, Sally Green, PhD and Claire Harris, MBBSAuthor Affiliations: Dr Turner and Dr Green are with the Australasian Cochrane Centre, Monash University, Victoria, Australia; and Dr Harris is with the Centre for Clinical Effectiveness, Southern Health, Victoria, Australia.

In crisis situations, there is an enormous burden of disease and very limited resources. To achieve the best possible health outcomes in these situations and ensure that scarce resources are not wasted, knowledge from health research needs to be translated into practice. We investigated what information from health research was needed by humanitarian aid workers in crisis settings and how it could be best provided. Semistructured interviews were conducted by telephone with 19 humanitarian aid workers from a range of organizations around the world and the results analyzed thematically. Participants identified a clear and currently unmet need for access to high-quality health research to support evidence-based practice in crisis situations. They emphasized that research into delivery of health care was potentially morevaluable than research into the effectiveness of particular clinical interventions and highlighted the importance of includingcontextual information to enable the relevance of the research to be assessed. They suggested that providers of health research information and humanitarian aid organizations work together to develop these resources. [editor Flahiff’s emphasis]

**DISASTR-OUTREACH-LIB is a discussion group for librarians, information specialists and othersinterested in disaster information outreach to their communities and responding to information needs for all-hazards preparedness, response and recovery.
The DISASTR-OUTREACH-LIB archives are available at
https://list.nih.gov/archives/disastr-outreach-lib.html.

*** For information on how to get this article for free or at low cost, click here

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