What does implementation and process evaluation means ? valéry ridde
Presentation done to share some concepts about implementation and process evaluation, an exploratory discussion for bHIP, a new Brac intervention in Bangladesh
What does implementation and process evaluation means ? valéry ridde
Presentation done to share some concepts about implementation and process evaluation, an exploratory discussion for bHIP, a new Brac intervention in Bangladesh
Value Based Purchasing: From Rule to Reality - One Hospital’s Journey - Susan...marcus evans Network
Susan Griffin, St. David's Medical Center - Speaker at the marcus evans National Healthcare CNO Summit Spring 2012, held in Hollywood, FL, April 26-28, 2012, delivered her presentation on Value Based Purchasing: From Rule to Reality - One Hospital’s Journey
This briefing from the Air Force Medical Service is directly applicable to civilian and military communities who need to be prepared for managing medical trauma scenarios. This presentation focuses on integrated trauma management systems.
mission model, mission model canvas, customer development, Hacking for Defense, lean startup, stanford, startup, steve blank, Pete Newell, Joe Felter, minimum viable product
Towards best practice in interventional radiologyNHS Improvement
Towards best practice in interventional radiology draws together the findings from visits to interventional radiology (IR) services at proposed major trauma centres in England during 2011/12. This record of their major findings provides a definitive read for trust chief executives and commissioners to help better inform IR service reviews. (June 2012)
A presentation given by international keynote speaker Dr. Stephen Muething from Cincinnati Children's Hospital, USA at the CHA conference The Journey, in October 2012.
Value Based Purchasing: From Rule to Reality - One Hospital’s Journey - Susan...marcus evans Network
Susan Griffin, St. David's Medical Center - Speaker at the marcus evans National Healthcare CNO Summit Spring 2012, held in Hollywood, FL, April 26-28, 2012, delivered her presentation on Value Based Purchasing: From Rule to Reality - One Hospital’s Journey
This briefing from the Air Force Medical Service is directly applicable to civilian and military communities who need to be prepared for managing medical trauma scenarios. This presentation focuses on integrated trauma management systems.
mission model, mission model canvas, customer development, Hacking for Defense, lean startup, stanford, startup, steve blank, Pete Newell, Joe Felter, minimum viable product
Towards best practice in interventional radiologyNHS Improvement
Towards best practice in interventional radiology draws together the findings from visits to interventional radiology (IR) services at proposed major trauma centres in England during 2011/12. This record of their major findings provides a definitive read for trust chief executives and commissioners to help better inform IR service reviews. (June 2012)
A presentation given by international keynote speaker Dr. Stephen Muething from Cincinnati Children's Hospital, USA at the CHA conference The Journey, in October 2012.
This is a presentation regarding how to think about and organize your hospital\'s disaster response planning using a matrixed based approach that can lead to significant detailed planing in one comprehensive manner.
Davin Lundquist, MD
CMIO
Dignity Health Medical Foundation
Case Study: "Leveraging technology to build an organizational strategy fostering staff competency & physician satisfaction"
Health IT systems will never please all users however providers are employing strategies that can significantly improve user satisfaction. Staff re-education and continually measuring the effectiveness of initiatives can make a positive impact on an organization’s ability to realize gains with IT. This presentation will explore Dignity Health’s lessons learned and organizational strategy to ensure staff competency levels and physician satisfaction.
Dignity Health is a family of more than 60,000 caregivers and staff delivering excellent care to diverse communities across 17 states. Founded in 1986 and headquartered in San Francisco Dignity Health is the fifth largest hospital provider in the nation and the largest hospital system in California.
Health System of 1: 305 Medical Group InitiativesDouglas Anderson
Summarizes 305 Medical Group's Initiatives to recapture care/services and integrate joint base health services. Overview:Situation Assessment, Joint Base and BRAC, Campaign Plan and Results
Way Ahead
Lessons: Issues and Information
Profiting From Hospital Disaster Preparedness: A Process Enhancement ModelDisabled/Retired
Hospital Disaster Preparedness is an expensive process that traditionally yields little or no return on investment. This innovative approach utilizes Process Enhancement rather than Event Response models to meet Disaster Preparedness benchmarks while improving daily operations thus yielding a net profit from the investment.
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
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
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.
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
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Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
1. AAMA (17 Nov 2011)
Lt Gen Green (1-Hour including Q&A)
Meeting: AAMA, Air Force Breakout, 17 October 2011, 1330
Theme: “The Future of Healthcare”
Audience: ~ 150 MSC Officers to include many previous MSC Corp Chiefs
Purpose: Future of the AFMS
Design: AFMS hot-topic issues: JUMC, mission and strategy, advances, and
current situations and how the AFMS mission/strategy tie into Joint healthcare
Format: Unclassified
Sources: SLW Brief, iEHR brief, MHS Capstone
Integrity - Service - Excellence 1
2. Headquarters U.S. Air Force
Integrity - Service - Excellence
Air Force Strategies for
Future Healthcare
Lt Gen C. Bruce Green
Surgeon General
17 November 2011
2
3. Moving Forward
2009: STRATEGIC IMPERATIVES
The Future & Communicating the Vision
2010 : EXECUTING THE STRATEGY
Focus on Alignment
2011: BREAKTHROUGH PERFORMANCE
Tools, Incentives, and Rewards
2012: CULTURE OF ACCESS, INNOVATION & SERVICE
Patient-Centered Care
Integrity - Service - Excellence 3
4. AFMS Framework Provides
Focus and Alignment(
Strategies
Overlapping
Mission Areas Transform Deployable Capability
Rapid Response to Any Worldwide Contingency
Fit
Force Build Patient-Centered Care
Continuity & Prevention to Optimize Health
Invest in Education, Training & Research
Sustain Our Future Capabilities
Strategy Common Practice Culture
Integrity - Service - Excellence
5. Global Operations:
~ 1,400 Total Force Medics Deployed
Distribution of Current
Total Force Deployments by Corps
MC
14%
Building Partnerships DC Major Conflicts
& Partner Capacity Irregular Warfare
0.51%
NC
Enlisted
16%
60%
MSC
4%
Humanitarian
Natural Disasters & BSC Response
Homeland Response 5.8%
a/o 2010 a/o 2011
0 41% 29%
MSC 1 38% 52%
Deployment 2 15% 15%
Frequency 3 4% 3%
(AD Only) 4 1% 0.75%
I n t e 5+ i t y - S e r v i c e - E x c0.29% n c e
gr 1% elle
6. CAF/MAF Improvement
Immediate
< 20 min
ER
< 2 hrs
T+0 hrs T+3 hrs
OR & ICU
< 3 hrs
EMEDS Health Response Team (HRT) a Reality!
Self-Aid Combat Medics Forward In Theater Care Definitive Care
Buddy Care Navy Corpsmen Resuscitative Rehab/Recovery Home w/Family
Care AF Theater Hosp SAMMC
Evolving Expeditionary Operations( SavingcLives Globally!
Integrity - Service - Excellen e
7. In Pursuit of Lighter &
Leaner Medical Response
Humanitarian Assistance Health Response Team (HRT)
Rapid Response Team (HARRT)
Airlift Deployment Requirements:
Earthquakes
Indonesia < 24 HRS +
C-17’s
Rapid Response Medical Capabilities:
Emergency, Resuscitative, & Surgical Care
Earthquakes
Chile Transition from Alaska Shelters to Utilis
AK Shelter Compatible; Decreased Build Time
Joint Program Testing w/ Collective Protection
Developing “Portable” Functional Supply
Earthquakes System (ER/OR/ICU/Peds/GYN/etc)
Improved Storage/Shipping
Haiti Secure/Weather Proof Versus Triwalls/Ropak
Standardized Packing Portable Drawer Modules
MSC/Technician Role: Plans, Logistics, & Development
Integrity - Service - Excellence
8. Recapturing Care Together
Where It Makes Sense
Delivering Patient Centered Care To Our Beneficiaries
Creating Currency Opportunities To Support Readiness
Allowing Medics To Practice Full Scope Of Care
Tackling Per Capita Cost Through Targeted Investments
Travis AFB, CA Wright –Patterson
AFB, OH Langley AFB, VA
Nellis AFB, NV
Keesler AFB, MS
Systems-Based Approach
Required To Optimize Our
Integrated Delivery System Eglin AFB, FL
Elmendorf AFB, AK
Building Capability...Expanding Services(Improving Currency
Integrity - Service - Excellence 8
9. Innovation & Insight to
Recapture Care
Specialty Hospitals Focused on Currency and Recapture
9
10. AF Medical Home
MSC and 4A Team’s Role Critical
Goal:
>1M Enrolled
Process Balance Decision Support Medical Health
Practice RSV Knowledge Mgmt Supply & Plan
Variation Training Tools Equipment Mgmt
(GPM) (Readiness) (IM/IT) (Logistics) (TOPA)
Healthcare Foundation – Every Team Must Improve Their Care
Integrity - Service - Excellence
11. Create The Setting
For “Right” Behaviors
Percent of Patients Satisfied* Continuity of Care
Other Provider
$
Family Health Providers at PCMH Sites MTF Primary Care Visit Distribution*
100% Family Health / PCMH Patients
100%
21471
95% 90% PCMH Team
64954
% Satisfied
80% 42400
90% UP is 70%
Good 60%
85% PCMH PCM
50%
PCMH TEAM
40%
80% 30% 123681 121580 Continuity
20% Other Provider
75% 10% (Family Health
Jan-11 Mar-11 May-11 Jan-11 Mar-11 May-11 0% Clinic)
Non-PCMH Sites (41/322163) PCMH Sites (34/351952) PCM
PCMH Aggregate Non-PCMH Aggregate (Non-PCMH
Dec 2010 - May 2011 Sites)
Satisfaction: Goal > 95% Continuity: Goal > 90%
$ $
Monthly Emergency Department and Urgent Care Utilization* HEDIS Measures - Patients Enrolled to PCMH Clinics
Per 100 PCMH Patients
10 40
Average Monthly Visit Rate (per 100)
8 30
6
Score
20
4
DOWN 10 UP is
2 is Good
$
Good
0 0
Dec-10 Feb-11 Apr-11 Dec-10 Feb-11 Apr-11 Dec-10 Feb-11 Apr-11 Dec-10 Feb-11 Apr-11
PCMH Aggregate Non PCMH Aggregate PCMH Aggregate Non-PCMH Aggregate
ED/Urgent Care Rate: Goal < 3/100 HEDIS Aggregate: Goal > 40
Inspiring Trust & Confidence by Measuring and Rewarding Outcomes
Integrity - Service - Excellence 11
12. Activating Patients & Care Teams
Health
Team Patient
Decision Patient Decision
Support Support
Centered
PCMH Is The LynchpineTorBetter Decision Support ForlPatients & Health Teams
Int g ity - Service - Excel ence
14. Transforming Data Into
Knowledge
Ready Better Health Better Care
Patients receiving Diabetic patient
massive infusions of > educated on
10 pints experienced “remote
mortality of 33% monitoring”
glucometer
Clinical Study
Readings
Practice registry MTF calls
automatically
Guideline to identify patient to
sent to
developed trends discuss
healthcare
management
team
Conclude infusing
whole blood
Uncontrolled sugar
reduced mortality
levels Identified
to less than 20%
Using Informatics to Accelerate Change in Practice Patterns & Behavior
Integrity - Service - Excellence 14
15. Leveraging Medical Informatics
DATA INFORMATION KNOWLEDGE WISDOM CHANGE
Better Care
TMDS Clinical
Through
Practice
Evidence Based
Guidelines
DEERS Practice
CarePoint Medication Better Health
PDTS Health
Alerts Enhanced Patient
Services Registries
Data Safety
$ / M2 Warehouse
User Home Best Value
(HSDW)
Interfaces Sensors Healthy Behavior
DMHRS
i Better Care
Expedited
EHR Test Results Improved Patient
Experience
Accelerating Information Exchange with Patient Activation
Integrity - Service - Excellence
16. Investing In Education,
Training, & Research
Open for Business
Joint Capabilities are Greater Than Any Single Service Capability
Integrity - Service - Excellence 16
17. Enduring
Academic Partnerships
Physician/Dentist Education (GME/DME)
Stand alone programs
Masters with civilian universities
Integrated/affiliated with Federal partners
84 Advanced Education General Dentistry-1 slots/yr
Dental Specialty certificate/Masters program opportunities
Nurse Education (Transition Program)
Increasing to 241 enrolled students in FY10
New sites include: Cincinnati, OH & Scottsdale Healthcare, AZ
Nurse Enlisted Commissioning Program (NECP)
50 per year with school of their choice
Research USAF Dental Hygiene Program
Diabetes 10 scholarships per year
Telepathology Trident Technical College (SC)
Teleradiology St. Petersburg College (FL)
Education & Research – Critical Step Toward
Building & Sustaining Medical Services
Integrity - Service - Excellence
18. Generating Knowledge(
PRIMARY CARE 2025: A Scenario Exploration of Forces,
Challenges, and Opportunities Shaping Primary Care in the U.S.
GENOMIC MEDICINE: An Active Consortium of Government,
Academic, and Industry Leaders in the Field of Genomic
Medicine Providing Expert Direction for PC2Z Program
DOD/VA iEHR and GOVERNMENT HIE SUMMIT:
Establishing a Common Roadmap for Today,
Tomorrow, and the Future
OPEN SOURCE SOFTWARE of the MILITARY HEALTH SYSTEM:
A Product Lifecycle Management Workshop
VETERANS AFFAIRS ROUNDTABLE: Future Performance Metrics to
Assess Population Health, Patient Experience, and Healthcare Value
USU-HJF Military Medicine Symposium:
The TBI Spectrum, Challenges, Initiatives, & Prevention
Innovative Collaboration to Shape the Future of Healthcare
Integrity - Service - Excellence 18
19. AHLTA on the(
Information Highway
Peak of Inflated
Opportunity!
Expectations
Plateau of Swamp of
Productivity Diminishing
Vehicle of Returns
Opportunity!
Innovation
Trigger Slope of
Enlightenment
Cliff of
Obsolescence
Trough of
Disillusionment
Time
* Gartner Inc., chart from Mastering the HYPE CYCLE by Jackie Fenn and Mark Raskino
Integrity - Service - Excellence
20. Sec Def/Sec VA Decision
Combined Efforts Provide the Best Future EHR
Integrity - Service - Excellence
21. DoD-VA “To-Be” iEHR Architecture
Common DoD-VA Requirements: HL7 EHR-S Functional Model with DoD and VA vetted Extensions (SV-4)
Common DoD-VA Integrated Health Business Reference Model (OV-5)
Common DoD-VA “To Be” Process Flow Model (OV-6C)
Presentation
Presentation (Common GUI)
Layer Team
Applications and Services
DoD Unique (16) Common (Joint) Applications & Services (30) VA Unique (6)
Systems Battlefield
Pediatrics Pharmacy
Personal
Laboratory Blood Mgmt
Nursing Long Term
Mission Capabilities Care Health Record Home Care
Requirements Disability Inpatient Emergency Document
Team Military
Obstetrics Evaluation Orders Mgmt Dept Care Mgmt
Rehabilitative Transient
& Performance Readiness Care Outreach
Consult & Operating
Outcomes Enroute
Veterinary Dental Care
Referral Mgmt
Immunization
Room Mgmt
Pharmacy Occupational
Care Mail Order Health (VA)
Team
Common Interface Standards
Business Enterprise Common Services Broker
Process Architecture (includes Enterprise Service Bus (ESB) and Infrastructure Services)
Team Team Common Interface Standards
Common Data Centers
Data Inter- Common Information Interoperability Framework (CIIF)
operability Common Information Model, Common Terminology Model,
Team Information Exchange Specifications, Translation Service
Common Data Standards: SNOMED CT and Extensions, LOINC and RxNorm
Common DoD-VA Measures of Effectiveness, Measures of Performance and key Performance Parameters
Joint DoD/VA DoD Only VA Only
Integrity - Service - Excellence 21
22. Leading the Way
with Open Source
HOSPITAL
PHARMACY
VISIT
Electronic
Electronic PROVIDER
RADIOLOGY Health Record
Health Record OFFICE
VISIT
PUBLIC
LAB SYSTEM HEALTH
SERVICE
Open-Source Provides Integration Without Barriers
Integrity - Service - Excellence 22
23. CLOUD COMPUTING
Data Center Akamai Network End Users End Users
Web 100,000+ Servers
Servers
1900+ Locations
Fire 1000+ Networks
700+ Cities Edge
Database Wall Servers
80+ Countries WAF
Load Edge EDNS
Balancer Servers EDNS
Edge
Transaction
Servers
Server Akamai EDNS
Network Site Shield
Storage
Edge
Servers
Directory/
Policy Server Edge
Servers
Edge
Servers Edge
Servers
Legacy App DNS End Users
Systems Servers Server
WAF
4,000+ customers
15+ million hits per second
Back-Up Site or Load End Users
4+ Tbps normal traffic
Balanced Multi-Data Center Peaks of 7+ Tbps Akamai Architecture
Operational View – OV-1
Better Access, iInnovation, eand xCare e n c ePatients
I n t e g r t y - S e r v i c - E c e l l For
24. Integrating New Technology
Hand-held,
Battery-powered,
Laser Cautery &
Ablation Tool
From Force Health Protection To Logistics To Portable Surgical Tools
Automated
Directed Information
Energy & Data
Sensors Collection
(AIDC) Future CCATT Mission -
Current CCATT Mission
Wireless
Reaching Beyond with Evolutionary Advances and Concepts
Integrity - Service - Excellence 24
25. Shaping the Future of Federal Healthcare
Synergy- Patient-Centered
Joint and Coalition Care
Organizational Precision
Agility Healthcare
Technology
Integration
Working Together, Achieving Success Through A Common Vision
Integrity - Service - Excellence
26. Patient-Centered Care
Ready: Reassure patient that you “know them”
Accessible: Be there when the patient needs you
Prepared: Respect patient and their time
Precise: Clarify all treatment and follow-up
Organized: Don’t ask patient what you should know or have
available in their medical record
Respectful: Always answer phones/resolve patient concerns
Thorough: Tell patient what to do if they feel worse
Patient-Centered Care Begins with Access to Earn Trust!
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