The HSE is owed over €266 million in outstanding patient fees. The majority is owed by health insurance companies for private patient treatment. The HSE has tried to speed up collection, including increasing prices charged to insurers, but most insurers refuse to agree to pay within 30 days. Much of the debt has been outstanding for over a year, so a large portion will likely have to be written off. The new Health Minister will need to address how to improve collection of these vital funds for the health system.
The document summarizes the results of a survey on healthcare systems in several European countries and the US. Key findings include:
- Respondents rated their country's healthcare system quality, though Germany, Sweden, and the UK received higher ratings than Italy, Poland and the US.
- Perceptions of doctors' skills and training quality were generally positive, though sharing of information between providers needed improvement.
- Ensuring access for all citizens and managing costs for an aging population will be ongoing challenges for healthcare systems.
- Most respondents felt their country's healthcare industry contributes significantly to economic growth.
Arkansas meets two of eight benchmarks for improving children's dental health. The state allows hygienists to place sealants without a dentist's prior exam and over half of Medicaid-enrolled children received dental care in 2009. However, the state's sealant programs reach less than 25% of high-risk schools and reimbursement rates for dentists who treat Medicaid patients have declined in recent years. Overall access to dental care remains a significant problem, as more than half of children on Medicaid received no dental services in 2009.
Do native speakers say "I am sorry to rush you, but.."? Does this expression sound natural?
For example;
I am sorry to rush you, but please respond to my email as soon as possible.
Primary Care Research - A Survey of Healthcare ProfessionalsCogora
We polled 1,122 primary healthcare professionals on their views on the state of the NHS, as well as their own morale.
The findings included a low level of support for the reform programme, with 64% of respondents believing that it was a step towards privatisation of healthcare. There also appeared to be a call for greater respect of NHS resources. 63% of those polled said that patients should pay for Accident and Emergency visits that were the result of alcohol while 83% said patients should be forced to pay a fee for not attending appointments.
The robust sample size and geographically representative sample provides a good insight into the attitudinal trends of a varying range of healthcare professionals. Furthermore, the report includes commentary from leading healthcare professionals, political figures, NHS England as well members of representative bodies such as the Royal College of General Practitioners to further shed insight on the statistical findings.
The document discusses patient experience from a global perspective. It summarizes findings from a survey of 2,000 individuals across 5 countries that show that over 60% believe having a good patient experience is extremely important. The top reasons for its importance are that their health and well-being are important, they want to be treated with respect, and it will influence future healthcare decisions. The survey also found that positive experiences lead to loyalty while negative ones lead to changing doctors or providers. Recommendations from friends and referrals are highly influential in healthcare decision making.
Blazing New Trails: Shifting the Focus on Alcohol and Drugsnashp
Presented at the National Academy for State Health Policy's 20th Annual State Health Policy Conference in Denver, Colorado. Authors: Barbara Cimaglio, Sally Fogerty, BSN, M.Ed., John C. Higgins-Biddle, Ph.D.
The document summarizes the results of an online survey conducted in China on health management. It finds that while people are increasingly aware of health, acceptance of health management costs remains low. Most respondents said physical exams were necessary but could only afford $200-500 per year. The survey covered residents aged 24-60 in Beijing, Shanghai, and Guangzhou with an income over $7,500 and at least a high school education.
The document summarizes the results of a survey on healthcare systems in several European countries and the US. Key findings include:
- Respondents rated their country's healthcare system quality, though Germany, Sweden, and the UK received higher ratings than Italy, Poland and the US.
- Perceptions of doctors' skills and training quality were generally positive, though sharing of information between providers needed improvement.
- Ensuring access for all citizens and managing costs for an aging population will be ongoing challenges for healthcare systems.
- Most respondents felt their country's healthcare industry contributes significantly to economic growth.
Arkansas meets two of eight benchmarks for improving children's dental health. The state allows hygienists to place sealants without a dentist's prior exam and over half of Medicaid-enrolled children received dental care in 2009. However, the state's sealant programs reach less than 25% of high-risk schools and reimbursement rates for dentists who treat Medicaid patients have declined in recent years. Overall access to dental care remains a significant problem, as more than half of children on Medicaid received no dental services in 2009.
Do native speakers say "I am sorry to rush you, but.."? Does this expression sound natural?
For example;
I am sorry to rush you, but please respond to my email as soon as possible.
Primary Care Research - A Survey of Healthcare ProfessionalsCogora
We polled 1,122 primary healthcare professionals on their views on the state of the NHS, as well as their own morale.
The findings included a low level of support for the reform programme, with 64% of respondents believing that it was a step towards privatisation of healthcare. There also appeared to be a call for greater respect of NHS resources. 63% of those polled said that patients should pay for Accident and Emergency visits that were the result of alcohol while 83% said patients should be forced to pay a fee for not attending appointments.
The robust sample size and geographically representative sample provides a good insight into the attitudinal trends of a varying range of healthcare professionals. Furthermore, the report includes commentary from leading healthcare professionals, political figures, NHS England as well members of representative bodies such as the Royal College of General Practitioners to further shed insight on the statistical findings.
The document discusses patient experience from a global perspective. It summarizes findings from a survey of 2,000 individuals across 5 countries that show that over 60% believe having a good patient experience is extremely important. The top reasons for its importance are that their health and well-being are important, they want to be treated with respect, and it will influence future healthcare decisions. The survey also found that positive experiences lead to loyalty while negative ones lead to changing doctors or providers. Recommendations from friends and referrals are highly influential in healthcare decision making.
Blazing New Trails: Shifting the Focus on Alcohol and Drugsnashp
Presented at the National Academy for State Health Policy's 20th Annual State Health Policy Conference in Denver, Colorado. Authors: Barbara Cimaglio, Sally Fogerty, BSN, M.Ed., John C. Higgins-Biddle, Ph.D.
The document summarizes the results of an online survey conducted in China on health management. It finds that while people are increasingly aware of health, acceptance of health management costs remains low. Most respondents said physical exams were necessary but could only afford $200-500 per year. The survey covered residents aged 24-60 in Beijing, Shanghai, and Guangzhou with an income over $7,500 and at least a high school education.
Health information infrastructure in supported accommodation: Reducing risks,...Bronwyn Hemsley
AIHI Seminar, 16 August 2018, Macquarie University
Prof Bronwyn Hemsley, Head of Speech Pathology, University of Technology Sydney
Dr Mary Dahm, Centre for Health Systems and Safety Research,
Australian Institute of Health Innovation, Macquarie University
The survey found several significant trends among US physicians in 2014:
- Physician income decreases were associated with being younger, more satisfied, and encouraging to the field, while increases were associated with being older, less satisfied, and discouraging.
- Satisfied physicians tended to be younger, work fewer hours, and have more privately insured patients, while dissatisfied physicians were older, worked longer hours, owned solo practices, and said patients delayed treatment more.
- Use of physician assistants increased from 25% to 30% from 2012 to 2014, and physician preference between PAs and nurse practitioners was split equally.
- High overhead, reimbursement cuts, and administrative hassles were the top reasons cited for
go to www.medicaldump.com to download this file and check out other medical powerpoints, medical powerpoint templates, medical pdfs and all other medical documents.
The document discusses ways to reform private health insurance (PHI) in Australia to better balance affordability and value for consumers. It provides background on the PHI industry and findings from consumer surveys. Key points include: consumers value predictability and treatment for urgent conditions but affordability is a major issue; online sources and health funds are preferred for information but have limitations; and changes are needed to simplify complex products and address rising costs while maintaining coverage levels important to consumers like protection from high costs.
The document discusses how consumers are taking more control over their health insurance choices. It notes that 200,000 consumers were referred to health funds in 2016 through comparison sites, 40% of one fund's sales came from comparisons sites, and another 30% of consumers do their own research. It argues that competition from new entrants, the ability to easily compare options, more informed consumers who want control, and transparency requirements will continue to empower consumers and drive health funds to provide better support for consumer decision making.
This document summarizes a presentation on workers' compensation policy issues and solutions related to opioids. It includes discussions from three presenters on topics like the Ohio Bureau of Workers' Compensation pharmacy program, physician dispensing of opioids, and policy reforms. The Ohio BWC program presentation describes the program's formulary changes from 2011-2014 to curb opioid utilization and other drug spending. It also evaluates the program's impact on reducing opioid prescriptions and medical costs. The physician dispensing presentation examines the financial incentives for dispensing and higher claim costs when physicians dispense opioids. It advocates for legislative reforms to curb dispensing to improve outcomes.
Icgp gp trainees conference 2017.william behan.finalDrWilliamBehan
The Solution to Bending the Irish Healthcare Value Curve
Is General Practice - The evidence supporting continuity of care from a personal GP team as opposed to a corporate primary care organisation
This document discusses various considerations related to physician employment contracts and practice mergers and acquisitions. It begins with an overview of general issues and then discusses specific topics like employment agreements between physicians and group practices or hospitals, compensation models, practice buy-ins, and mergers. Key parties in these arrangements are identified, as well as the typical professionals that comprise a consulting team. Factors around different alignment models and trends driving consolidation are also summarized.
Delivering value based_care_with_e_health_services.5Greg Bauer
The document discusses how value-based care requires new approaches to engage patients and improve outcomes while lowering costs. It argues that e-health tools can help by enabling better care coordination, remote patient monitoring, social support for patients, and customized care programs. These e-health disciplines are important for engaging patients in their care in new ways to support value-based models.
1) The study surveyed 187 dentists in Pelotas, Brazil to assess their attitudes and perceptions regarding child abuse and their ability to identify suspected cases.
2) While most dentists believed they could detect child abuse, only 14.3% reported ever suspecting a case and the majority of those who did suspect did not report it to authorities.
3) Dentists working at a university were more likely to have suspected child abuse compared to those in private practice, possibly because they see more patients and receive more training on the issue.
The document provides an overview of a typical day for a primary care physician at the Heartland Clinic of Platte City. It discusses the physician's schedule, use of electronic medical records, remote access capabilities, messaging with patients, clinical decision making, interruptions, and use of ePrescribing. It also outlines opportunities for innovative technologies, such as improving drug selection, pharmacy selection, and enabling real-time connections between prescribing systems and additional resources for physicians and patients.
How do we see the healthcare's digital future and its impact on our lives?Jane Vita
"Healthcare is undergoing major changes spurred on by, but not limited to, technology.
Digitalisation is changing the way we think about health, what taking care of it really entails, our personal role in healthcare systems and the way we interact with technology in the context of health.
In many ways, we are entering a post-institutional age of increased personal responsibility, which presents healthcare service providers and other players in the field with major opportunities and great risks. Technology has the potential to empower people and help them become more active in the management of their and their families’ health. This will change the relationship of the patient and the caregiver in profound ways." Mirkka Länsisalo
A co-creation with Mirkka Läansisalo and Sala Heinänen, at Futurice.
The document discusses the importance of including African American ophthalmologists in clinical trials. It notes that while efforts are being made to recruit more minority patients, African American doctors are often left out. Barriers include perceptions of lack of time/resources, distrust of industry, and regulatory hurdles. Breaking down these barriers could help faster drug approval through more diverse enrollment and compliance. Measurable outcomes include increased minority exposure to research and education of both patients and doctors.
Physician retention and recruitment presents organizational challenges as the healthcare industry faces physician shortages. The top reasons physicians leave organizations are for better pay, a more desirable location, and greater prestige. Few organizations provide leadership development opportunities for physicians like leadership academies or succession planning. On average, physicians stay at an organization for 7 years, with integrated health systems retaining physicians the longest. To attract physicians, organizations commonly offer benefits like paid leave, malpractice insurance, and retirement plans. Developing a positive culture and minimizing politics can also help with retention.
This document discusses outcomes-based contracts between pharmaceutical companies and payers. It provides background on rising healthcare costs, describes the benefits of outcomes-based contracts for stakeholders, and gives examples of existing contracts linked to outcomes like reduced hospitalizations or reaching clinical targets. The document also outlines challenges, keys to success, and potential future applications in areas like specialty medications.
HealthPanel is a platform that connects users to health experts for personalized consultations and shares health data to provide actionable advice. It aims to make healthcare more convenient, accessible, and results-oriented through a feedback loop model. By leveraging diagnostic testing, lifestyle data, and continuous accountability, HealthPanel believes it can help users take control of their health and avoid disease. It sees an opportunity in disrupting traditional healthcare models through personalized, software-based solutions that are simple for everyday people to use.
New Study Identifies High-Risk Variants Associated with Autism Spectrum Disor...Golden Helix Inc
A study identified 24 new genetic variants associated with autism spectrum disorders (ASDs), each conferring over a 2-fold increased risk of developing ASDs. The study analyzed data from over 9,000 subjects to validate these novel genetic variants, in addition to validating 31 previously reported variants. This represents a significant increase in understanding the genetic risk factors involved in ASDs.
This study compared rates of concussions and hiding concussions among Waukee High School athletes to national averages. A survey of Waukee athletes found higher rates of reported concussions (47.1% vs the national average of 20%) and similar rates of hiding concussions compared to national data. While the hypothesis was that rates would be lower in Waukee, the results showed statistically higher concussion rates. Possible reasons discussed included over-reporting in the survey or higher medical awareness in Waukee. The study aimed to raise awareness of concussion issues and advance research skills.
Did you know that among high-developed countries,
the U.S. ranks last in health system performance while spending the most per capita on healthcare?! Here are some key metrics and analysis that were made to reveal the reasons why patients are unhappy with the provided service!
In 3 sentences:
More than 5 million prescriptions for drugs to treat mental health issues like depression, anxiety, and insomnia are written in Ireland each year, costing over €110 million according to official figures. However, the true extent is likely much higher as the data only covers medical card holders, who are less than half the population. Popular drugs prescribed include the anti-anxiety drugs Xanax and Valium, the anti-psychotic Zyprexa, and the sleeping pill Zimovane.
The document discusses the high salaries earned by senior officials in local authorities across Ireland. It notes that householders who must pay the €100 local charge will be upset to see the large salaries at the top levels of each council. The document then provides a detailed breakdown of the salaries of the top earners in each local authority, including county and city managers, directors of services, engineers and other senior roles. It shows that most local authorities have multiple people earning over €90,000 and €100,000, with some individuals earning over €150,000.
Health information infrastructure in supported accommodation: Reducing risks,...Bronwyn Hemsley
AIHI Seminar, 16 August 2018, Macquarie University
Prof Bronwyn Hemsley, Head of Speech Pathology, University of Technology Sydney
Dr Mary Dahm, Centre for Health Systems and Safety Research,
Australian Institute of Health Innovation, Macquarie University
The survey found several significant trends among US physicians in 2014:
- Physician income decreases were associated with being younger, more satisfied, and encouraging to the field, while increases were associated with being older, less satisfied, and discouraging.
- Satisfied physicians tended to be younger, work fewer hours, and have more privately insured patients, while dissatisfied physicians were older, worked longer hours, owned solo practices, and said patients delayed treatment more.
- Use of physician assistants increased from 25% to 30% from 2012 to 2014, and physician preference between PAs and nurse practitioners was split equally.
- High overhead, reimbursement cuts, and administrative hassles were the top reasons cited for
go to www.medicaldump.com to download this file and check out other medical powerpoints, medical powerpoint templates, medical pdfs and all other medical documents.
The document discusses ways to reform private health insurance (PHI) in Australia to better balance affordability and value for consumers. It provides background on the PHI industry and findings from consumer surveys. Key points include: consumers value predictability and treatment for urgent conditions but affordability is a major issue; online sources and health funds are preferred for information but have limitations; and changes are needed to simplify complex products and address rising costs while maintaining coverage levels important to consumers like protection from high costs.
The document discusses how consumers are taking more control over their health insurance choices. It notes that 200,000 consumers were referred to health funds in 2016 through comparison sites, 40% of one fund's sales came from comparisons sites, and another 30% of consumers do their own research. It argues that competition from new entrants, the ability to easily compare options, more informed consumers who want control, and transparency requirements will continue to empower consumers and drive health funds to provide better support for consumer decision making.
This document summarizes a presentation on workers' compensation policy issues and solutions related to opioids. It includes discussions from three presenters on topics like the Ohio Bureau of Workers' Compensation pharmacy program, physician dispensing of opioids, and policy reforms. The Ohio BWC program presentation describes the program's formulary changes from 2011-2014 to curb opioid utilization and other drug spending. It also evaluates the program's impact on reducing opioid prescriptions and medical costs. The physician dispensing presentation examines the financial incentives for dispensing and higher claim costs when physicians dispense opioids. It advocates for legislative reforms to curb dispensing to improve outcomes.
Icgp gp trainees conference 2017.william behan.finalDrWilliamBehan
The Solution to Bending the Irish Healthcare Value Curve
Is General Practice - The evidence supporting continuity of care from a personal GP team as opposed to a corporate primary care organisation
This document discusses various considerations related to physician employment contracts and practice mergers and acquisitions. It begins with an overview of general issues and then discusses specific topics like employment agreements between physicians and group practices or hospitals, compensation models, practice buy-ins, and mergers. Key parties in these arrangements are identified, as well as the typical professionals that comprise a consulting team. Factors around different alignment models and trends driving consolidation are also summarized.
Delivering value based_care_with_e_health_services.5Greg Bauer
The document discusses how value-based care requires new approaches to engage patients and improve outcomes while lowering costs. It argues that e-health tools can help by enabling better care coordination, remote patient monitoring, social support for patients, and customized care programs. These e-health disciplines are important for engaging patients in their care in new ways to support value-based models.
1) The study surveyed 187 dentists in Pelotas, Brazil to assess their attitudes and perceptions regarding child abuse and their ability to identify suspected cases.
2) While most dentists believed they could detect child abuse, only 14.3% reported ever suspecting a case and the majority of those who did suspect did not report it to authorities.
3) Dentists working at a university were more likely to have suspected child abuse compared to those in private practice, possibly because they see more patients and receive more training on the issue.
The document provides an overview of a typical day for a primary care physician at the Heartland Clinic of Platte City. It discusses the physician's schedule, use of electronic medical records, remote access capabilities, messaging with patients, clinical decision making, interruptions, and use of ePrescribing. It also outlines opportunities for innovative technologies, such as improving drug selection, pharmacy selection, and enabling real-time connections between prescribing systems and additional resources for physicians and patients.
How do we see the healthcare's digital future and its impact on our lives?Jane Vita
"Healthcare is undergoing major changes spurred on by, but not limited to, technology.
Digitalisation is changing the way we think about health, what taking care of it really entails, our personal role in healthcare systems and the way we interact with technology in the context of health.
In many ways, we are entering a post-institutional age of increased personal responsibility, which presents healthcare service providers and other players in the field with major opportunities and great risks. Technology has the potential to empower people and help them become more active in the management of their and their families’ health. This will change the relationship of the patient and the caregiver in profound ways." Mirkka Länsisalo
A co-creation with Mirkka Läansisalo and Sala Heinänen, at Futurice.
The document discusses the importance of including African American ophthalmologists in clinical trials. It notes that while efforts are being made to recruit more minority patients, African American doctors are often left out. Barriers include perceptions of lack of time/resources, distrust of industry, and regulatory hurdles. Breaking down these barriers could help faster drug approval through more diverse enrollment and compliance. Measurable outcomes include increased minority exposure to research and education of both patients and doctors.
Physician retention and recruitment presents organizational challenges as the healthcare industry faces physician shortages. The top reasons physicians leave organizations are for better pay, a more desirable location, and greater prestige. Few organizations provide leadership development opportunities for physicians like leadership academies or succession planning. On average, physicians stay at an organization for 7 years, with integrated health systems retaining physicians the longest. To attract physicians, organizations commonly offer benefits like paid leave, malpractice insurance, and retirement plans. Developing a positive culture and minimizing politics can also help with retention.
This document discusses outcomes-based contracts between pharmaceutical companies and payers. It provides background on rising healthcare costs, describes the benefits of outcomes-based contracts for stakeholders, and gives examples of existing contracts linked to outcomes like reduced hospitalizations or reaching clinical targets. The document also outlines challenges, keys to success, and potential future applications in areas like specialty medications.
HealthPanel is a platform that connects users to health experts for personalized consultations and shares health data to provide actionable advice. It aims to make healthcare more convenient, accessible, and results-oriented through a feedback loop model. By leveraging diagnostic testing, lifestyle data, and continuous accountability, HealthPanel believes it can help users take control of their health and avoid disease. It sees an opportunity in disrupting traditional healthcare models through personalized, software-based solutions that are simple for everyday people to use.
New Study Identifies High-Risk Variants Associated with Autism Spectrum Disor...Golden Helix Inc
A study identified 24 new genetic variants associated with autism spectrum disorders (ASDs), each conferring over a 2-fold increased risk of developing ASDs. The study analyzed data from over 9,000 subjects to validate these novel genetic variants, in addition to validating 31 previously reported variants. This represents a significant increase in understanding the genetic risk factors involved in ASDs.
This study compared rates of concussions and hiding concussions among Waukee High School athletes to national averages. A survey of Waukee athletes found higher rates of reported concussions (47.1% vs the national average of 20%) and similar rates of hiding concussions compared to national data. While the hypothesis was that rates would be lower in Waukee, the results showed statistically higher concussion rates. Possible reasons discussed included over-reporting in the survey or higher medical awareness in Waukee. The study aimed to raise awareness of concussion issues and advance research skills.
Did you know that among high-developed countries,
the U.S. ranks last in health system performance while spending the most per capita on healthcare?! Here are some key metrics and analysis that were made to reveal the reasons why patients are unhappy with the provided service!
In 3 sentences:
More than 5 million prescriptions for drugs to treat mental health issues like depression, anxiety, and insomnia are written in Ireland each year, costing over €110 million according to official figures. However, the true extent is likely much higher as the data only covers medical card holders, who are less than half the population. Popular drugs prescribed include the anti-anxiety drugs Xanax and Valium, the anti-psychotic Zyprexa, and the sleeping pill Zimovane.
The document discusses the high salaries earned by senior officials in local authorities across Ireland. It notes that householders who must pay the €100 local charge will be upset to see the large salaries at the top levels of each council. The document then provides a detailed breakdown of the salaries of the top earners in each local authority, including county and city managers, directors of services, engineers and other senior roles. It shows that most local authorities have multiple people earning over €90,000 and €100,000, with some individuals earning over €150,000.
1) Over 2.3 million euro was spent last year placing 15 troubled Irish youths in special care facilities and foster care in other countries, with one placement in Scotland costing over 500,000 euro annually.
2) A study identified a "suicide cluster" involving 18 deaths, mainly adolescent and young men, over an 18-month period in a small area in Cork. However, funding for the research into suicide clusters has been cut.
3) Christine Lagarde, the French finance minister, praised the late Brian Lenihan saying that history will view him kindly for his "heroic" work during the financial crisis, though she refused to pass judgment on his bank guarantee decision.
- Sierra Leone's only psychiatric hospital is in a dilapidated state, with patients chained to mattresses on dirty floors and no access to therapy, electricity, running water or adequate food. Conditions are described as "deplorable" and "inhumane".
- Mental healthcare in Sierra Leone is severely underfunded and under-resourced. Only 2% of the mentally ill population receives treatment from doctors, while the other 98% are treated by traditional healers.
- A nurse is working to establish a mental health association to advocate for patients and set up youth programs, but faces significant challenges due to lack of funding, resources, and stigma around mental illness. Without improvements, patients will continue
CAMH researchers, led by Dr. Romina Mizrahi, are conducting innovative research using brain imaging and a specialized dye to map brain activity related to cannabis use and schizophrenia. They are the world leaders in this area. The dye allows them to see in real time how cannabis affects the endocannabinoid system in the brain. This research could lead to new treatments that reduce the risk of schizophrenia for those who use cannabis. Tamara overcame drug and alcohol addiction through CAMH's Aboriginal services program, which combines clinical treatment with cultural practices. The program helped her address trauma from losing family members and stay sober.
The document summarizes the evolution of the YMCA in the Greater Toronto Area over the past 160 years. It discusses the YMCA's plans to invest $250 million over the next 10 years to build 10 new community centers in underserved neighborhoods. The goal is to provide facilities and programs that promote health, employment, social inclusion and education for youth. The YMCA has expanded its services beyond fitness and recreation to help at-risk youth, newcomers, the homeless and those living in poverty.
This document discusses Nemours' efforts to implement a pediatric patient-centered medical home model in Delaware to improve health outcomes for children. It describes (1) the challenges facing children's health today, including rising rates of chronic disease, (2) the need to address social determinants of health in addition to medical care, which are currently the "blind side" of healthcare, and (3) Nemours' plan to pilot a "medical home plus" model integrating primary care and public health in three communities to achieve the triple aim of better health, better care, and lower costs.
Alliance Community Hospital on a mission towards Clinical TransformationVitreosHealth
Innovative initiatives that made Alliance Community Hospital a step ahead towards clinical transformation by providing better care delivery to its community. For more details visit: http://vitreoshealth.com/index.php/success-stories
The document discusses providing concise yet informative summaries of healthcare related news and legislation to clients. It aims to help clients understand challenges from the Affordable Care Act and determine solutions. The author will start a blog called "From the Desk of Mike Wojcik" to share healthcare market trends, legislative updates, and topics relevant to human resources challenges. The overall goal is to help the current healthcare model survive as more efficient, affordable and accessible to all.
ITS 835 enterprise risk managementChapter 15Embedding ERM in.docxjesssueann
ITS 835 enterprise risk management
Chapter 15
Embedding ERM into Strategic Planning at the City of Edmonton
University of Cumberlands
1
introduction
Edmonton –Past and present ERM
Links to strategic plan and to other strategic tools
Selecting and testing tools and framework
Recommended strategic ERM approach
Lessons learned
2
University of Cumberlands
Edmonton past and present erm
Edmonton –Capital of Alberta, Canada
Over 800,00 population
ERM piloted in 2005
CORPORATE Business Risk Planning (CBRP) model
Not fully implemented
Based on COSO
Adopted strategic plan
The Way Ahead
Strategic ERM
3
University of Cumberlands
Links to strategic plan
University of Cumberlands
4
Selecting and testing tools and framework
5
University of Cumberlands
Selecting and testing tools and frameworks
University of Cumberlands
6
Strategic goals and objectives
University of Cumberlands
7
Risks and strategic objectives
University of Cumberlands
8
Iso 31000 risk management
University of Cumberlands
9
Pm2 versus iso 31000
University of Cumberlands
10
Proposed erm framework
University of Cumberlands
11
Lessons learned
Key success factors
Senior management buy-in
Culture of innovation
Consistency of model across goals
Resource requirements for department SMEs
Department accountability for key risks
Process of selecting and implementing framework
Takes linger than expected
No system is perfect
Do not roll out all at once
Clearly define all milestones and deliverables
University of Cumberlands
12
CHAPTER NINE
Medicating Children
This chapter is divided into seven sections. Section One is an overview that discusses current trends in medicating children, problems the trends cause, and directions for the future. It also discusses developmental issues. Section Two focuses on stimulant medication and the diagnosis of attention deficit hyperactivity disorder (ADHD). Section Three focuses on research on combined interventions and particularly the Multimodal Treatment Study (MTA study) of Children with ADHD. Section Four focuses on children taking mood stabilizers. Section Five focuses on antipsychotics and children. Sections Six and Seven focus on anxiolytics and antidepressants in children, respectively.
SECTION ONE: PERSPECTIVES, DILEMMAS, AND FUTURE PARADIGMS
Learning Objectives
• Understand the problematic increase in psychotropic medications for children despite a dearth of evidence of the effectiveness of these drugs.
• Have a general understanding of the impact of the FDA Modernization Act and the Best Pharmaceuticals Act for Children.
• Be able to state the “developmental unknowns” associated with giving kids psychotropic medications.
Thus far, we have explored the medical model and psychological, cultural, and social perspectives as they relate to psychopharmacology. In this chapter, we demonstrate that using psychotropic medications with children and adolescents raises particular problems and concerns fro ...
A Matter Of Professional Status The Impact Of Medical Hierarchies On Child M...Alicia Edwards
The study explored differences between physicians, nurses, nurse assistants, and hospital social workers in their work addressing child maltreatment at children's hospitals in Sweden.
The results showed that nurses and nurse assistants had less experience and training than physicians and social workers. Nurses and nurse assistants were also less familiar with reporting guidelines and organizational support. It was rare for nurses and nurse assistants to have reported child maltreatment cases, compared to physicians and social workers. The analysis found that differences between professional groups were influenced by medical hierarchies within hospitals. The study concluded that all staff would benefit from additional training to improve assessments and feel more supported in the reporting process. Strengthening multidisciplinary collaboration at clinical levels could also help protect children
The convenience offered by retail pediatric clinics is making parents chose over a pediatrician’s office to treat their children. There are many concerns about how this will affect the quality of care.
This document discusses the growing use and benefits of telemedicine. It notes that telemedicine reduces costs, improves access to healthcare especially in rural areas, and can help reduce employee absenteeism for businesses. The document also outlines the projected rapid growth of telemedicine and increasing acceptance by both younger and older groups as well as how advisors can help consumers and businesses take advantage of telemedicine options.
This document discusses the high costs of child abuse and neglect on physical and psychological well-being. Children who experience abuse have greater health needs and costs, with estimated lifetime costs per victim of over $200,000. The document outlines opportunities for states to partner across agencies to address the health needs of at-risk children, including Section 1115 waivers, health homes, care coordination, and data sharing initiatives. These partnerships aim to provide early intervention and reduce long-term health costs and risks while improving outcomes.
The document discusses emerging home health monitoring technologies that promise to enhance care for aging patients and reduce healthcare costs through remote patient monitoring. However, reimbursement from Medicare and other payers has not kept pace, posing financial challenges for healthcare providers looking to adopt these technologies. Some states have begun reimbursing for telehealth services, but widespread reimbursement will be necessary for these technologies to truly transform home healthcare. The future of home health monitoring depends on resolving the conflict between providers wanting to invest in new technologies and payers refusing to pay until technologies are proven effective.
1) The document discusses how health information technology (HIT), such as electronic health records (EHRs) and health information exchanges (HIEs), has the potential to influence health reform efforts in the United States by reducing costs, increasing access to care, and improving quality of care.
2) The Affordable Care Act includes provisions and financial incentives to encourage widespread adoption of EHRs and use of HIT. Meaningful use criteria aim to ensure EHRs improve safety, quality, and coordination of care.
3) HIT such as EHRs and HIEs could transform healthcare by giving providers access to complete patient information, reducing medical errors, duplicative tests, and costs
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1. TERAPROOF:User:eoinosullivanDate:27/03/2011Time:21:05:50Edition:28/03/2011ExaminerLiveXX2803Page:15 Zone:XX1
15ANALYSISIrish Examiner
Monday 28.03.2011
XX1 - V1
Jennifer
Hough
explores the
issue of whether
to put a child
on medication if
they have
been diagnosed
with ADHD
‘‘
MATTER
OF LIFE
AND DEBT
The HSE is owed more than a quarter of a billion euro in patient fees. A share of these
much-needed funds will have to be written off, writes Priscilla Lynch
The majority of the outstanding debt is owed by the health
insurance companies... While the prices the HSE charges
the insurers has steadily increased... attempts to speed up
the collection... haven’t been that successful
IT has been revealed that the
HSE is owed a massive
266 million for patient
hospital charges, including
fees for services and accom-
modation for privately-insured
patients, inpatient and long-stay
charges, and emergency department
(ED) and road traffic accident fees.
That’s a lot of money in any terms.
It’s even more than what the
expensive and long-running Moriarty
Tribunal will cost us and the cash-
strapped HSE could certainly do
with this money.
While it managed to stay within
budget last year despite a significant
cut from 2009, this was partly
achieved with bed and ward closures
and cancelled operations, particularly
in the west. This year’s budget was
again reduced and the HSE is facing
another incredibly tough year as
evidenced by the fact that more than
400 ED patients have been forced to
wait on trolleys every day on average,
over the past fortnight and there are
now more than 1.6 million people
with a medical card — a figure that
is continuing to rise.
So why has this essential uncollected
income for our health services been
allowed to increase to such whopping
proportions and what’s been done
about trying to claw back some of this
cash?
Despite the increase in its overall
patient charges debt, the HSE has in-
sisted that it has made increased efforts
over the past few years to ensure that
patients and insurance companies pay
the money they owe.
Speeding up and improving the
rates of collection of patient fees is
one of the key HSE value-for-money
initiatives set for 2011 and debt
collection is also a standing item on
the agenda for the HSE audit com-
mittee, the HSE told the Irish Exam-
iner.
The responsibility for the collection
of charges generally lies with hospital
managers and procedures for collec-
tion can vary from hospital to hospi-
tal. So the HSE’s focus continues to
be on the performance of individual
hospitals in the management of their
patient debt, though it wouldn’t yet
release a breakdown of what hospitals
are the worst at collecting patient
charges, as this information is still
being audited by the Comptroller
and Auditor General.
The majority of the outstanding
debt is owed by the health insurance
companies for private patient treat-
ment fees. While the prices the
HSE charges the insurers has steadily
increased in recent years, its attempts
to speed up the collection of these
charges haven’t been that successful,
while collection by the private hospi-
tals of these fees is much faster.
The HSE says it is actively engaging
with the health insurance companies
about delays in certain hospitals and
wants to reach an agreement with
them that will allow the payment to
hospitals within 30 days, but it has
admitted that none of the three main
health insurers want to sign up to this
proposal and that it continues to have
to wait for up to six months for settle-
ment of these fees.
Part of this problem is that it often
takes quite some time for hospital
consultants to sign off on the needed
claim forms before the HSE can bill
the insurers, though consultants have
claimed this is not their fault and an
easier more streamlined system has
been sought with work now ongoing
on rolling out an electronic system for
submitting and processing these forms.
The HSE has also insisted the
collection of some patient charges
has improved despite the growth of
the overall debt figure.
ED — fees which were introduced
during the tenure of previous health
minister Mary Harney and are now
100 per visit (unless you have a
medical card or referral form from
your GP) — used to be difficult to
collect at first though hospitals now
generally try to collect the cash up-
front. Most offer laser machines to
take cash or credit straight from a pa-
tient’s card while many including
Cork University Hospital have even
installed ATM machines in the foyer
of the ED so there can be no excuses
for not having any cash to hand.
Unfortunately, as a large chunk of
the debt has been outstanding for be-
tween one to three years and beyond
— 54 million has been outstanding
for between 12-36 months while
39m has been outstanding for over
36 months — it is unlikely the HSE
will recoup much of this and it will
have to be written off.
While the HSE does use debt-col-
lection agencies as a last resort, this is
a delicate issue given that they could
be chasing payment from people who
have suffered serious ill health or a
bereavement or simply cannot afford
to pay and the HSE itself acknowl-
edges this, saying it seeks to maximise
the recovery of income “in a socially
responsible, ethical, efficient and cost
effective way”.
However, given the figures revealed
today it is likely the new Health Min-
ister James Reilly will be asking the
HSE for more information on how
the collection of vital patient charges
can be improved and put back into
helping run our stretched health
services.
A study in the US found ‘medication use was a significant marker not of
beneficial outcome, but of deterioration’, for children with ADHD.
A bitter pill for young ADHD sufferers?
THE question has long
dogged the debate on how
to treat attention deficit
hyperactivity disorder (ADHD) in
young people.
Should children be medicated
because of what might just be
hyperactivity or challenging
behaviour? Or are prescription
drugs needed to the treat them?
Characterised by inattentiveness,
over-activity, impulsivity and other
challenging behaviours, ADHD is a
disruptive behaviour condition the
specific causes of which are not
known.
It is estimated 60,000 children in
this country have the disorder, and
even that is said to be an
under-estimation.
However, although most child
psychiatrists insist drugs such as the
stimulant Ritalin are essential in
treating the condition, parents have
huge concern about medicating
their young children and some
professionals also question it.
British child psychiatrist Dr Sami
Timimi maintains the medication is
“highly addictive” and has chemical
properties which are “virtually
indistinguishable” from
amphetamines such as cocaine and
speed.
In a academic paper published in
the British Journal of Psychiatry Dr
Timimi, who works for the NHS,
wrote that ADHD is a “cultural
construct” and the result of
speculative “biobabble”.
In a book The Making and
Breaking of Children’s Lives he
wrote that ADHD is a “dumping
ground allowing all of us to avoid
the messy business of understanding
human relationships and institutions
and their difficulties, and our
common responsibility for nurturing
and raising well-behaved children”.
Dr Timimi prefers to examine
what lies behind a child’s
problematic behaviour which could
be learning difficulties, a high sugar
diet, domestic violence, extreme
lack of exercise or poor discipline.
There is a growing school of
thought that diet could have a big
role to play in treating ADHD.
A study published in the Lancet
journal last month found that
almost 80% of the children who
stayed on a strict diet for five weeks
had fewer symptoms. Some were
even able to stop taking medication.
Researchers from the Netherlands
put 50 children with ADHD on a
“restricted elimination diet”
consisting of foods with the least
possible risk of allergic reaction — a
combination of rice, meat,
vegetables, pears and water — and
which was tailored to the
preferences of each child.
The conclusion was that different
foods trigger different behavioural
problems and should be monitored,
In this country, however, the
medical model of treatment is
prevalent with dedicated facilities
for children with ADHD
mushrooming. There are now 37
such clinics to treat children who
have been diagnosed with the
disorder and there are plans for
more.
Indeed such is the concern, that in
its annual audit of services, the HSE
specifically asked community teams
what initiatives are being set up for
children with ADHD, causing one
consultant to ask: “Why is this
group of children singled out, why
not ask about initiatives for
attachment disorder or eating
disorders?”
This raises the question as to
whether there is undue pressure on
parents to comply with what is
called “pharmacotherapy” or
medicating children.
In a letter seen by the Irish
Examiner, a senior HSE registrar
writes that the parent of a
six-year-old boy “remains resistant”
about the consideration of drugs as
a option for her son. This
phraseology certainly seems to
suggest so.
Leading consultant child and
adolescent psychiatrist Dr Keith
Holmes maintains more than half of
children with ADHD will need
medication.
“For children who respond well it
is one of [the] more clearly treatable
and clearly recognisable illnesses.
There are strict criteria for diagnosis
and children undergo a clinical
interview which is often adequate
but sometimes there will be input
from another source such as school
or a speech and language therapist
to be sure.”
According to Dr Holmes, children
present at two main ages. First
about six or seven and again just as
they transfer to secondary school
and problems begin to surface.
“If symptoms are significant
children will be put on medication
at either of those times. At the
younger age it is mainly boys, and
then later the girls, who tend to
come to our attention. ADHD has
an impact on the whole family. It
can be hereditary and there can be
more than one child in a family and
even a parent.”
The most commonly prescribed
drug is still the stimulant drug
Ritalin, followed now by another
non-stimulant medication Strattera.
Dr Holmes says the reason why
ADHD was not diagnosed in the
past and seems to be a new
phenomenon is that it simply wasn’t
recognised before.
“What happened in years gone
past is that these children did not
survive in the school system and
many would not progress beyond
primary school.”
However, Dr Holmes believes
there are questions over who are the
best people to treat the condition.
“In other countries like New
Zealand and Australia, community
paediatricians treat the disorder and
certainly I think kids would rather
that than to be treated by mental
health practitioners.
“Untreated ADHD can be a
devastating problem not only for
families but for population at large.
“There can be implications to
being on medications long term
such as appetite, height, sleep loss,
but not to treat is not risk free.”
“A lot of things happen in school
setting and there are significant
behavioural problems. ADHD
causes significant impairment and
disrupts family life. It interferes with
the child’s ability to sustain
friendships with other children and
places the child at risk of longer
term problems.”
Conversely, US medical author
Robert Whitaker, who visited
Ireland recently for a series of
public talks on mental health says it
is imperative to look carefully at all
the research before continuing with
this model of care.
“The National Institute of Mental
Health in the US ran a long-term
study beginning in the 1990s, and
by the end of three years, and I am
quoting the study here, ‘medication
use was a significant marker not of
beneficial outcome, but of
deterioration’. That is, participants
using medication in the 24-to
36-month period actually showed
increased symptoms during that
interval relative to those not taking
medication”.
According to the study, at the end
of six years, it was much the same.
And as one of the lead investigators,
William Pelham, said: “We had
thought that children medicated
longer would have better outcomes.
That didn’t happen to be the case.
There were no beneficial effects,
none. In the short term, medication
will help the child behave better, in
the long run it won’t. And that
information should be made very
clear to parents.”
Given that long-term stimulant
does carry considerable risk,
according to Whitaker, it is
imperative that Irish doctors look at
that long-term study and carefully
assess whether it is a good idea to
diagnosis children with ADHD and
then put them on medications.
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