This document discusses concerns around the use of financial incentives in wellness programs and health plans. It notes that while wellness programs can improve health and lower costs, regulations do not adequately define reasonable programs or alternatives for those unable to meet health metrics. There are also concerns that higher premiums may penalize those with pre-existing conditions and create barriers to preventive care. Overall the document examines debates around using financial incentives to influence health behaviors and control rising healthcare costs.
Invest in your workforce, their health, wellness, & safety...and realize ROI and productivity while reducing health care cost, absenteeism, lost-day, (due to WC), and turnover!
Dr John Wren
Principal Researcher Advisor
New Zealand Accident Compensation Corporation
PO Box 242, Wellington, New Zealand
john.wren@acc.co.nz
(P23, Thursday 27, Civic Room 3, 1.30)
Prioritisation in Public Health: Overview of Health Economics ApproachesOlena Nizalova
Overview of Health Economics Approaches Towards Prioritization based on the developments from the NIHR School of Public Health Research project led by Professor David Hunter.
Invest in your workforce, their health, wellness, & safety...and realize ROI and productivity while reducing health care cost, absenteeism, lost-day, (due to WC), and turnover!
Dr John Wren
Principal Researcher Advisor
New Zealand Accident Compensation Corporation
PO Box 242, Wellington, New Zealand
john.wren@acc.co.nz
(P23, Thursday 27, Civic Room 3, 1.30)
Prioritisation in Public Health: Overview of Health Economics ApproachesOlena Nizalova
Overview of Health Economics Approaches Towards Prioritization based on the developments from the NIHR School of Public Health Research project led by Professor David Hunter.
Looking for a healthier investment strategy? A new study by The Health Project (THP) finds that a portfolio of stock in companies that have won the prestigious C. Everett Koop National Health Award -- recognizing effective workplace health promotion programs -- has significantly outperformed the Standard & Poor's (S&P) 500 Index over the past 14 years. Since 2000, investing in Koop Award winners would have produced more than double the returns of the S&P 500, according to the new research led by THP President and CEO Dr. Ron Goetzel. Tune in to this webinar to hear more about this and related studies.
CDC will provide an overview of their WorkLife Wellness Office services and describe how they used the HealthLead accreditation process to provide a framework to assess the comprehensiveness of their new office and existing programs and processes. Also, how the scoring of framework identified strengths and weaknesses and how the assessment plan of action is used for future strategic planning to drive new connections, data sources, and programmatic gaps as they strive to achieve HealthLead Silver. CDC will share specific examples of what was required and shared as part of the HealthLead audit during the presentation.
Research co-authored by IBI and A. Mark Fendrick, MD, co-director of the University of Michigan Center for Value-Based Insurance Design, stresses that understanding the full value of improved health, including improvements in workforce productivity, lost time and medical costs, is essential in helping employers make better choices about how much to invest in health care and where to invest it. The report notes that a focus only on medical-cost-offset results is unlikely to generate the bottom-line impact and incentives for healthy human capital investments that would be generated by a full-cost view.
Synopsis: Impact of Health Systems Strengthening on HealthHFG Project
Leaders in low- and middle-income countries (LMICs) require timely and compelling evidence about how to strengthen their health systems to improve the health and well-being of their citizens. Yet, evidence on how to strengthen health system performance to achieve sustainable health improvements at scale, particularly toward Ending Preventable Child and Maternal Deaths (EPCMD), fostering an AIDS-Free Generation (AFG), and Protecting Communities against Infectious Diseases (PCID) is limited. The evidence that does exist is scattered, insufficiently analyzed, and not widely disseminated. Without evidence, decision-makers lack a sound basis for investing scarce health funds in health systems strengthening (HSS) in an environment of competing investment options.
USAID is committed to advancing the evidence base on HSS and this commissioned report clearly demonstrates that HSS can improve health in LMICs.
This report, based on a review of systematic reviews of the effects on health of HSS, presents a significant body of evidence linking HSS interventions to measureable impact on health for vulnerable people in LMICs. Making decisions on who delivers health services and where and how these services are organized is important to achieve priority health goals such as EPCMD, AFG, and PCID. The findings of this report document the value of investing in HSS.
Understanding the Dynamics of Successful Health System Strengthening Interven...HFG Project
Evidence is scarce, scattered, and not widely disseminated on how interventions to strengthen health system performance contribute to sustained improvements in health status, particularly toward ending preventable child and maternal deaths and fostering an AIDS-free generation. Without this evidence, decision-makers lack a sound basis for investing scarce health funds in health system strengthening (HSS) interventions in an environment of competing investment options. This evidence gap impedes support for HSS from numerous stakeholders, both within and outside of USAID. This study will help address this evidence gap by exploring the dynamics of successful HSS interventions in low-income countries. The study seeks to address four key questions:
How were a range of successful HSS interventions implemented in different countries?
What factors facilitated and constrained the successful implementation and documented outcomes of the interventions?
What were important factors about implementation that emerged across the different cases?
What are the implications of this study for implementing future HSS interventions?
The study will comprise three main activities:
Six qualitative, retrospective case studies of successful USAID-supported HSS interventions to explore what factors contributed to successful implementation
Qualitative cross-case analysis to identify patterns of policy processes, circumstances, relationships, and characteristics that may be associated with successful HSS reforms
Develop and propose a set of strategic recommendations for introducing and sustaining HSS reforms in low-income countries
Looking for a healthier investment strategy? A new study by The Health Project (THP) finds that a portfolio of stock in companies that have won the prestigious C. Everett Koop National Health Award -- recognizing effective workplace health promotion programs -- has significantly outperformed the Standard & Poor's (S&P) 500 Index over the past 14 years. Since 2000, investing in Koop Award winners would have produced more than double the returns of the S&P 500, according to the new research led by THP President and CEO Dr. Ron Goetzel. Tune in to this webinar to hear more about this and related studies.
CDC will provide an overview of their WorkLife Wellness Office services and describe how they used the HealthLead accreditation process to provide a framework to assess the comprehensiveness of their new office and existing programs and processes. Also, how the scoring of framework identified strengths and weaknesses and how the assessment plan of action is used for future strategic planning to drive new connections, data sources, and programmatic gaps as they strive to achieve HealthLead Silver. CDC will share specific examples of what was required and shared as part of the HealthLead audit during the presentation.
Research co-authored by IBI and A. Mark Fendrick, MD, co-director of the University of Michigan Center for Value-Based Insurance Design, stresses that understanding the full value of improved health, including improvements in workforce productivity, lost time and medical costs, is essential in helping employers make better choices about how much to invest in health care and where to invest it. The report notes that a focus only on medical-cost-offset results is unlikely to generate the bottom-line impact and incentives for healthy human capital investments that would be generated by a full-cost view.
Synopsis: Impact of Health Systems Strengthening on HealthHFG Project
Leaders in low- and middle-income countries (LMICs) require timely and compelling evidence about how to strengthen their health systems to improve the health and well-being of their citizens. Yet, evidence on how to strengthen health system performance to achieve sustainable health improvements at scale, particularly toward Ending Preventable Child and Maternal Deaths (EPCMD), fostering an AIDS-Free Generation (AFG), and Protecting Communities against Infectious Diseases (PCID) is limited. The evidence that does exist is scattered, insufficiently analyzed, and not widely disseminated. Without evidence, decision-makers lack a sound basis for investing scarce health funds in health systems strengthening (HSS) in an environment of competing investment options.
USAID is committed to advancing the evidence base on HSS and this commissioned report clearly demonstrates that HSS can improve health in LMICs.
This report, based on a review of systematic reviews of the effects on health of HSS, presents a significant body of evidence linking HSS interventions to measureable impact on health for vulnerable people in LMICs. Making decisions on who delivers health services and where and how these services are organized is important to achieve priority health goals such as EPCMD, AFG, and PCID. The findings of this report document the value of investing in HSS.
Understanding the Dynamics of Successful Health System Strengthening Interven...HFG Project
Evidence is scarce, scattered, and not widely disseminated on how interventions to strengthen health system performance contribute to sustained improvements in health status, particularly toward ending preventable child and maternal deaths and fostering an AIDS-free generation. Without this evidence, decision-makers lack a sound basis for investing scarce health funds in health system strengthening (HSS) interventions in an environment of competing investment options. This evidence gap impedes support for HSS from numerous stakeholders, both within and outside of USAID. This study will help address this evidence gap by exploring the dynamics of successful HSS interventions in low-income countries. The study seeks to address four key questions:
How were a range of successful HSS interventions implemented in different countries?
What factors facilitated and constrained the successful implementation and documented outcomes of the interventions?
What were important factors about implementation that emerged across the different cases?
What are the implications of this study for implementing future HSS interventions?
The study will comprise three main activities:
Six qualitative, retrospective case studies of successful USAID-supported HSS interventions to explore what factors contributed to successful implementation
Qualitative cross-case analysis to identify patterns of policy processes, circumstances, relationships, and characteristics that may be associated with successful HSS reforms
Develop and propose a set of strategic recommendations for introducing and sustaining HSS reforms in low-income countries
This document will explain how a comprehensive wellness program works and how much money you should budget in order to have one. If you are ready to kick start health in your organization this is the right place to start.
Bertus Van Niekerk: Unlocking the True Potential of Integrated Occupational H...SAMTRAC International
This presentation argues that the value of occupational health and safety, and corporate wellness programmes, can be increased exponentially through an integrated information system. This is accomplished by integrating data collected from a host of standalone safety technologies with an electronic health record, corporate wellness and ERP systems.
A very unique health and wellness movement which has developed a Corporate Wellness Program that can make a huge impact to your bottom line AND make your employees more productive through better health
Our Workplace Wellness PowerPoint addresses the concerns of today's businesses and how WillPowerUSA's Workplace Wellness Programs can reduce health care costs and disability claims, and increase productivity and workplace morale.
Our message is simple: RETHINK the way you view healthcare. Welcome to eHealth Companion, a Personal Healthcare Management System designed to help companies' of all sizes and their employees successfully transition to Consumer Directed Health Plans.
Similar to Building Consensus on the Appropriate Use of Health Outcomes Based Incentives in a Wellness Program with Jerry Noyce (20)
Place matters for health! A growing body of research over the last several decades has shown the connections between place and health. From obesity and chronic disease to depression, social isolation, or increased exposure to environmental toxins and pollutants, a person’s zip code can be a more reliable determinant of health than their genetic code.
In 2016, Project for Public Spaces compiled a report of peer-reviewed research that found key factors linking pubic spaces and peoples’ health. And public spaces are more than just parks and plazas – our streets represent the largest area of public space a community has!
This webinar will introduce participants to the placemaking process, the research behind the findings linking place and health, and how to envision streets as places – not just their function in transporting people and goods, but the vital role they play in animating the social and economic life of communities.
Using case problems, this webinar will give attendees real-world examples of workplace wellness situations and help attendees learn from those situations so that they can design and implement a compliant wellness program. Through case problems, attendees will review compliance mistakes concerning HIPAA, ACA, GINA, ADA, FLSA, data privacy and tax laws. Participants will learn how to use those laws to build a better workplace wellness program.
Learning Objectives:
* Understand how to apply laws to specific factual situations.
* Identify red flags in certain common workplace wellness practices.
* Learn the basics of HIPAA, ACA, GINA, ADA, FLSA, data privacy and tax laws as those laws relate to workplace wellness programs.
This webinar will discuss the prevalence of pre-diabetes and it’s contributing factors and the initial efforts to translate the National Diabetes Prevention Program to public health. We will also look at new approaches to providing interventions.
Learning objectives:
Scope and scale of pre-diabetes and what factors contribute to it.
Review initial efforts to translate the DPP to public health.
New approaches to providing interventions.
About The Presenter
Dr. Marrero received a B.A. (1974), M.A. (1978) and Ph.D. (1982) in Social Ecology from the University of California, Irvine. He joined the IU School of Medicine in 1984 and became the J.O. Ritchey Professor of Medicine in 2004. He was a member of the Diabetes Research & Training Center and served as Director of the Diabetes Prevention and Control Division. He is currently the Director of the Diabetes Translational Research Center. Dr. Marrero is an expert in the field of clinical trails in diabetes and translation research which moves scientific advances obtained in clinical trails into the public health sector. He helped design the Diabetes Prevention Program and the TRIAD study, which evaluated strategies to improve diabetes care delivery in managed care settings. His research interests include strategies for promoting diabetes prevention, care settings, improving diabetes care practices used by primary care providers, and the use of technology to facilitate care and education. Dr. Marrero was twice awarded the Allene Von Son Award for Diabetes Patient Education Tools by the American Association of Diabetes Educators, nominated to Who’s Who in Medicine and Health care in 2000, served as Associate Editor for Diabetes Care (1997-2002) and is currently the Associate Editor for Diabetes Forecast. He was selected as Alumni of the Year for University of California Irvine in 2006 and The Outstanding Educator in Diabetes in 2008 by the American Diabetes Association. He is the current President of the American Diabetes Association.
John Weaver, Psy.D. is a Licensed Psychologist who received his Doctor of Psychology degree from the Wisconsin School of Professional Psychology. He also has a Master of Science degree in Clinical Psychology from Marquette University and a Master of Divinity degree from St. Francis School of Pastoral Ministry.
The way you communicate, and what you communicate, shapes how your employees feel about working there. Yet organizations often fail to prioritize corporate communication, to the detriment of their entire workplace culture.
Regular communication with employees sends the message that you value them as whole people. And consistent, meaningful communication can strengthen the employee-employer relationship. And when that relationship is strong, everyone wins: the employees, the employer, and the customers, clients, or patients.
You’ll come away from this webinar with immediately-useful tips and insider tricks from our 30+ years of experience producing engaging employee communications and leave with a blueprint of how to produce your own communications, or evaluate a vendor’s options, plus creative options.
We are reminded of the risk of workplace violence every time we hear of a tragic shooting on the news. As wellness professionals, we often have a broad contact with individuals who are struggling and with the structures of organizations that can have an influence on whether those individuals get help or act out their anger and frustration. In this session we will look at risk factors that can be identified to indicate that an individual needs additional assessment and help and at the organizational structures that can be implemented to reduce the risk of violence in your workplace. It is important that, as wellness professionals, we look at how to address this extreme form of unhealthy behavior.
Wellness is who we are, not what we do. As Oklahoma State University’s Chief Wellness Officer, Dr. Suzy Harrington shares a comprehensive, evidence based, wellness strategy model, driving America’s Healthiest Campus®. This model is transferrable to any setting to strategize the collaboration and vision for students, employees, and in the communities in which we live, learn, work, play, and pray. In addition to the model, Dr. Harrington will share the foundational structures that must be in place to support a sustainable culture of wellness.
Have you ever wondered why it is that even people who desperately want to adopt healthier lifestyles don’t stick with them once their initial burst of motivation fades? This provocative webinar will discuss the surprising reasons this is true and also showcase a new science-based paradigm to motivate healthy behavior so it is maintained over time. Dr. Michelle Segar will explain why logic-based reasons for behavior change (e.g., better heath, disease prevention, etc.) keep people stuck in cycles of starting and stopping but not behavioral sustainability. Using story and science, she will describe an easy-to-adopt, novel approach to promoting health, wellness, and fitness behaviors that leading organizations are starting to adopt. Attendees will leave this webinar with a more strategic way to communicate about and promote the sustainable behavior necessary for achieving improved health and well-being.
This webinar will discuss the major federal laws that impact workplace wellness program design, including the Affordable Care Act/HIPAA Nondiscrimination rules on the use of financial incentives, the Americans with Disabilities Act (ADA), the Genetic Information Nondiscrimination Act (GINA), federal tax laws as well as recent EEOC action such as the proposed ADA rules and lawsuits against Honeywell, Flambeau and Orion Energy Systems. Through case examples, the speaker will explain how each of these laws interact with one another, who enforces these laws, what to expect in terms of future guidance, and how health promotion professionals can use these laws as tools in designing more effective and inclusive workplace wellness programs.
Are you looking to refresh your current workplace wellness program or have you thought about starting a workplace wellness program and don't know where to begin? Check out Workplace Wellness 2.0. In 60 minutes, you'll learn the 10 easy steps to create an inexpensive, community-based, volunteer-managed, thriving wellness initiative. Hope Health's managing editor, Jen Cronin, will walk you through the effective strategy based on the custom publisher's 30-plus years of working with hundreds of organizations and their workplace wellness efforts.
Learning Objectives:
How to begin a new program, or add new life to an existing wellness program, with the Workplace Wellness 2.0 concepts
How to take advantage of inexpensive, free and readily available resources to power your wellness program
How to create a program WITH employees vs. FOR employees.
About The Presenter
Jen Cronin
Managing Editor
Hope Health
An avid runner and foodie, Jen's goal is to help others embrace — and enjoy — a healthful lifestyle by creating inspiring, engaging, and fun content that focuses on simple ways people can take care of their mind, body, and spirit. Jen has more than 18 years of writing, editing, and communications project management experience. She has worked as a health reporter, a public relations specialist at a major medical school, and a marketing communications consultant for a Blue Cross Blue Shield affiliate before coming to HOPE Health in 2009.
Samantha Harden discuss provides an overview of the RE_AIM framework which evaluates the effectiveness of interventions based on the following five dimensions:
Reach into the target population
Effectiveness or efficacy
Adoption by target settings, institutions and staff
Implementation - consistency and cost of delivery of intervention
Maintenance of intervention effects in individuals and settings over time.
We will also practice using RE-AIM in planning, implementation, and evaluation and share resources available on RE-AIM.org.
Learning Objectives
1. Understand the five RE-AIM dimensions
2. Practice using RE-AIM for planning, implementation, and evaluation
3. Explore available resources found at RE-AIM.org
Simply applying knowledge we have reliably in hand, we could prevent fully 80% of all chronic disease and premature death in modernized and modernizing countries. Standing between us and that prize is an obstacle course of competing claims, false promises, and profit-driven, pop culture nonsense. The case will be made for True Health Coalition to rally diverse voices to the cause of using what we know, even as we pursue what we do not. The challenges, operations, and promise of the endeavor will be discussed.
Shannon Polly will lead a webinar on teaching tangible techniques and exercises that help people cultivate presence. The hour-long webinar will also include information on what science is telling us about presence. Shannon Polly brings both her expertise as a professional actor, playwright and Broadway producer and her background in positive psychology as a teacher, facilitator and coach to this somatic approach to well-being and thriving.
“It’s a common myth that you either have ‘executive presence’ – that essence that helps you to command a room – or you don’t”, says Polly, “but that is simply not true. As an actor, I know there are tricks and techniques, and as a Positive Psychology Expert, I also know that how you carry yourself physically has a big impact.”
A historical journey into the origin of Emotional Intelligence (EQ) as a concept developed by Mayer & Salovey and later Daniel Goleman. A futuristic trek revealing the application of Emotional Intelligence via 8 EQ Competencies developed by the International EQ Organization, Six Seconds.
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
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Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
Adv. biopharm. APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMSAkankshaAshtankar
MIP 201T & MPH 202T
ADVANCED BIOPHARMACEUTICS & PHARMACOKINETICS : UNIT 5
APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMS By - AKANKSHA ASHTANKAR
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
CDSCO and Phamacovigilance {Regulatory body in India}NEHA GUPTA
The Central Drugs Standard Control Organization (CDSCO) is India's national regulatory body for pharmaceuticals and medical devices. Operating under the Directorate General of Health Services, Ministry of Health & Family Welfare, Government of India, the CDSCO is responsible for approving new drugs, conducting clinical trials, setting standards for drugs, controlling the quality of imported drugs, and coordinating the activities of State Drug Control Organizations by providing expert advice.
Pharmacovigilance, on the other hand, is the science and activities related to the detection, assessment, understanding, and prevention of adverse effects or any other drug-related problems. The primary aim of pharmacovigilance is to ensure the safety and efficacy of medicines, thereby protecting public health.
In India, pharmacovigilance activities are monitored by the Pharmacovigilance Programme of India (PvPI), which works closely with CDSCO to collect, analyze, and act upon data regarding adverse drug reactions (ADRs). Together, they play a critical role in ensuring that the benefits of drugs outweigh their risks, maintaining high standards of patient safety, and promoting the rational use of medicines.
The Gram stain is a fundamental technique in microbiology used to classify bacteria based on their cell wall structure. It provides a quick and simple method to distinguish between Gram-positive and Gram-negative bacteria, which have different susceptibilities to antibiotics
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
2. About
HERO
• The
Health
Enhancement
Research
Organization
• Non-‐profit
501(c)3
founded
in
1996
• Vision:
To
promote
a
culture
of
health
and
performance
through
employer
leadership
• Major
Activities
• HERO
Think
Tank
• HERO
EHM
Best
Practice
Scorecard
in
collaboration
with
MERCER
• HERO
Forum
• HERO
Research
3. Properly
Designed
Wellness
Programs
• Improve
employee
health
and
wellness
• Show
return
on
investment
(>$3
return
for
every
dollar
invested)
• Can
lower
health
care
costs
and
other
costs
associated
with
chronic
disease
and
disability
• Can
reduce
absenteeism
and
presenteeism
and
improve
productivity
4. Escalating
Health
Care
Costs
• Health
care
costs
in
the
U.S.
are
rising
at
an
unsustainable
rate
• Rising
health
insurance
premiums
are
forcing
many
employers
and
especially
small
businesses
to
drop
health
insurance
for
their
employees
or
increase
their
out-‐of-‐
pocket
costs
• Since
1994,
average
nationwide
costs
paid
by
an
employee
for
an
individual
health
insurance
premium
have
risen
nearly
eight
times
faster
than
average
U.S.
incomes
• 36
percent
of
Americans
are
now
forced
to
limit
the
amount
of
money
they
put
toward
retirement
because
of
rising
health
care
costs
(Employee
Benefit
Research
Institute)
5. Health
Care
Costs
• U.S.
health
care
spending
rose
3.9
percent
between
2009
and
2010
• Total
health
expenditures
reached
$2.6
trillion,
which
translates
to
$8,402
per
person
or
17.9
percent
of
the
nation's
Gross
Domestic
Product
Centers
for
Medicare
and
Medicaid
Services.
2012.
National
Health
Expenditure
Data.
http://cms.hhs.gov/Research-‐
Statistics-‐Data-‐and-‐Systems/Statistics-‐Trends-‐and-‐Reports/NationalHealthExpendData/
NationalHealthAccountsHistorical.html
6. Prevention
• Four
modifiable
risk
factors
(tobacco
use,
poor
nutrition,
lack
of
physical
inactivity,
and
excessive
alcohol
consumption)
are
responsible
for
most
of
the
chronic
disease
burden
in
the
US
• CVD
can
start
early
in
life
and
is
influenced
by
modifiable
risk
factors
• People
who
reach
middle
age
(~age
50)
with
few
risk
factors,
have
lower
lifetime
risk
for
CVD
mortality,
increased
survival
and
improved
quality
of
life
Lloyd-‐Jones
DM,
Leip
EP,
Larson
MG,
et
al.
Prediction
of
lifetime
risk
for
cardiovascular
disease
by
risk
factor
burden
at
50
years
of
age.
Circulation.
Feb
14
2006;113(6):791-‐798
7. Health
Reform
• Codifies
existing
statute
that
allows
employers
in
conjunction
with
a
worksite
wellness
program
to
charge
employees
a
different
premium
based
on
meeting
certain
health
status
factors
(i.e.
body
mass
index,
tobacco
cessation,
cholesterol,
blood
pressure)
• The
maximum
differential
was
increased
from
20%
to
30%
(starting
in
2014)
and
allows
the
Secretaries
of
HHS
and
Treasury
to
increase
to
50%
over
time
if
they
deem
appropriate
8. Size
of
Potential
Increase
in
Health
Care
Plan
Cost
HIPAA Premium Variation Under 20%, 30%, and 50%
Total Cost of Percentages
ESI Plan 20% 30% 50%
Individual $5,470 $1094 $1,641 $2,735
Family $15,520 $3,104 $4,656 $7,760
Source: Average premiums for individual and family coverage in 2011 based on Kaiser/HRET annual survey of health plans
9.
Employers
are
Moving
in
the
Direction
of
Holding
Employees
Accountable
for
their
Health
Behaviors
• A
survey
by
Towers
Watson:
62%
of
employers
plan
on
switching
from
incentives
for
participation
to
incentives
for
improvements
in
health
metrics.
• Employers
see
this
approach
as
a
means
to
control
upwardly
spiraling
health
care
costs
10. Concerns
• There
is
no
clear
definition
of
what
constitutes
a
health
status
factor
• The
regulations
do
not
adequately
define
a
“reasonably
designed”
wellness
program
or
the
alternative
standard
for
those
who
cannot
meet
the
health
metric
for
health-‐related
reasons
• There
is
limited
evidence
that
the
use
of
financial
incentives
results
in
sustained
health
improvements
11. Other
concerns
• Premium
variation
based
on
health
status
may
penalize
people
with
pre-‐existing
conditions
or
those
who
have
a
genetic
predisposition
12.
Impact
of
Higher
Deductibles/
Premiums
• Evidence
does
show
that
individuals
delay
needed
health
care
because
of
cost
• High
deductible
benefit
designs
requiring
significant
cost-‐
sharing
may
create
real
barriers
to
preventive
care
and
disease
management
and
lead
to
higher
medical
costs
over
the
long-‐term
• Hall,
JP.
Carroll
SL.
Moore
JM.
Health
care
behaviors
and
decision-‐making
processes
among
enrollees
in
a
state
high-‐risk
insurance
pool:
focus
group
findings.
American
Journal
of
Health
Promotion.
May/June
2010.
24(I
13. Where
do
we
go
from
here?
• The
American
Heart
Association,
the
American
Cancer
Society,
and
the
American
Diabetes
Association
joined
with
the
Health
Enhancement
Research
Organization
(HERO)
and
the
American
College
of
Occupational
and
Environmental
Medicine
to
develop
consensus
guidance
to
employers
around
the
following
issues:
• What
constitutes
a
reasonably
designed
program?
• What
is
a
reasonable
alternative
standard?
• What
are
future
research
questions
that
can
improve
our
understanding
of
the
use
of
these
types
of
incentives
?
14. JOINT
CONSENSUS
STATEMENT
Guidance
for
a
Reasonably
Designed,
Employer-‐Sponsored
Wellness
Program
Using
Outcomes-‐Based
Incentives
Consensus Statement of The Health Enhancement Research Organization (HERO),
American College of Occupational & Environmental Medicine, American Cancer Society,
American Cancer Society Cancer Action Network, American Diabetes Association
and the American Heart Association
15. Fundamentals
• The
fundamental
goal
of
any
wellness
program
should
be
to
provide
opportunities
for
individuals
to
improve
their
health
and
wellness.
• A
wellness
program
should
not
be
used
in
a
way
that
threatens
an
employee’s
ability
to
maintain
health
insurance,
as
this
would
be
in
direct
conflict
with
improving
employee
health.
16. Beyond
Financial
Incentives
• Evidence
suggests
that
long-‐term
lifestyle
modification
or
risk
factor
management
requires
more
than
financial
motivation
• Success
is
based
on
intrinsic
and
extrinsic
motivation
• One
of
the
keys
to
a
successful
worksite
wellness
program
that
is
capable
of
sustaining
behavioral
change
is
a
workplace
culture
and
environment
that
supports
health
and
wellness.
• CEO/leadership
buy-‐in
and
role
modeling
• Healthy
environment
(e.g.
healthy
foods,
time
to
be
physically
active
during
the
day,
occupational
safety,
smoke-‐free)
17. Key
Elements
of
a
Reasonably
Designed
Program
• Strategic
Planning
• Cultural
Support
• Programs
for
Assessment
and
Screening
• Behavior
Change
Interventions
(Programs,
activities,
information)
• Engagement
(Communications,
Incentives)
• Measurement/Evaluation
18. Incentive
Design
• Should
be
related
to
health
promotion/disease
prevention
• Not
be
overly
burdensome
• Should
not
be
a
subterfuge
for
discrimination
• Most
common
health
metrics
used
–
tobacco,
weight,
blood
pressure,
cholesterol
• Only
health
status
factors
that
are
modifiable
for
many
individuals
through
changes
in
health
behaviors
should
be
considered
• Employers
should
factor
in
potential
time
and
financial
barriers
• Assure
that
the
incentive
design
does
not
place
a
greater
economic
burden
on
one
race
or
ethnic
group
than
another
• Reward
vs.
Penalty
19. Important
considerations
surrounding
incentive
design
• Does
the
incentive
amount
fit
within
your
culture?
• Will
the
amount
drive
behavior
change
in
the
population?
• If
penalties
are
used,
will
they
have
disproportionate
financial
impact
across
different
income
levels
or
racial/ethnic
groups?
• Is
the
incentive
so
large
that
it
results
in
cost-‐shifting
to
non-‐
participating
or
non-‐attaining
employees
and
jeopardizes
the
affordability
of
their
health
care
coverage?
• Any
design
that
eliminates
a
participant’s
access
to
group
coverage
would
run
counter
to
the
fundamental
goal
of
a
reasonably
designed
program
to
promote
health.
20. Reasonable
Alternative
Standard
• Offer
a
reasonable
alternative
standard
to
employees
for
whom
it
is
unreasonably
difficult
to
achieve
a
health
standard
due
to
a
medical
condition,
or
who
have
a
medical
reason
that
makes
it
inadvisable
for
them
to
do
so
within
the
allotted
time.
• For
employees
with
a
medical
condition
barrier
to
meeting
the
health
standard,
employers
should
defer
to
the
views
of
the
individual’s
health
care
provider
for
setting
and
achieving
a
reasonable
alternative
standard
or
providing
a
waiver.
21. Reasonable
Alternative
Standard
• Consider
incentive
designs
that
use
goals
that
are
more
flexible
than
“ideal”
targets
• Be
flexible
when
it
comes
to
the
use
of
alternative
standards
and
use
them
to
help
individuals
with
higher
health
risks
improve
their
health
habits
and
overall
health
• Consider
providing
all
employees
with
options
for
attaining
the
incentive
rather
than
only
offering
the
alternatives
to
those
with
a
medical
circumstance
• This
can
be
important
for
employees
who
have
legitimate
hardships,
outside
of
medical
circumstances,
that
make
it
difficult
for
them
to
meet
a
health
factor
standard
22. A
Reasonable
Alternative
Standard
• Avoid
using
a
reward
or
penalty
that
is
so
large
it
discourages
people
from
participating
because
the
goal
or
standard
is
out
of
their
reach
or
the
penalty
is
too
stiff
• Some
industry
experts
suggest,
based
on
extensive
real-‐world
experience
administering
such
programs,
that
amounts
in
the
range
of
$40
to
$60
per
month
are
capable
of
generating
behavior
changes
by
many
participants,
at
least
in
the
short
run
23. Reasonable
Alternative
Standard
• Consider
an
incentive
design
that
rewards
for
progress
toward
the
standard
targets,
instead
of
just
rewarding
employees
who
meet
the
goal
• Consider
strategies
that
will
help
employees
integrate
behavior-‐change
into
their
personal
value
framework
by
promoting
individual
choice
so
they
are
more
likely
to
sustain
healthy
behavior
changes
over
time.
(create
tailored.,
individualized
programs)
24. To
Learn
More
• Read
Guidance
for
a
Reasonably
Designed,
Employer-‐Sponsored
Wellness
Program
Using
Outcomes-‐Based
Incentives
in
the
July
2012
issue
of
the
Journal
of
Occupational
Medicine
(vol.
54,
no.
7,
p.
889-‐896)
• Free
full-‐text
access
at
http://journals.lww.com/joem/pages/default.aspx
(note,
direct
link
will
be
available
Friday
afternoon)
• Other
suggestions
here