Aligning Incentives for Patient Engagement: Enabling Widespread Implementation of Shared Decision Making
May 24, 2013
John E. Wennberg, The Dartmouth Institute
Aligning Incentives for Patient Engagement: Enabling Widespread Implementation of Shared Decision Making
May 24, 2013
Jeff Thompson, Washington State Health Care Authority
David Downs, Engaged Public
David Swieskowski, Mercy ACO Mercy Clinics, Inc.
Lisa Weiss, High Value Healthcare Collaborative
Kate Chenok, Pacific Business Group on Health
Aligning Incentives for Patient Engagement: Enabling Widespread Implementation of Shared Decision Making
May 23, 2013
Angela Coulter, Informed Medical Decisions Foundation
Dominick Frosch, Gordon and Betty Moore Foundation
Floyd J. Fowler, Informed Medical Decisions Foundation
Aligning Incentives for Patient Engagement: Enabling Widespread Implementation of Shared Decision Making
May 23, 2013
Neil Korsen, MaineHealth
Larry Morrisey, Stillwater Medical Group
Charlie Brackett, Dartmouth-Hitchcock Medical Center
Grace Lin, Palo Alto Medical Foundation
Carmen Lewis, University of North Carolina
Leigh Simmons, Massachusetts General Hospital
Aligning Incentives for Patient Engagement: Enabling Widespread Implementation of Shared Decision Making
May 23, 2013
Karen Sepucha, Massachusetts General Hospital
Dale Collins Vidal, The Dartmouth Institute for Health Policy & Clinical Practice
Do you know where the term “shared decision making” was first used…or when the first center dedicated to its research and implementation was opened? Our infographic “Shared Decision Making through the Decades” will take you on a historical journey through four decades of shared decision making to understand where it is today and what the future might hold.
Angela Coulter: Getting the best value for patientsThe King's Fund
Dr Angela Coulter, Director of Global Initiatives, Foundation for Informed Medical Decision Making, spoke at The King's Fund's 'Reducing unwarranted variations in health care' conference, giving her expert opinion on how to give the best value for patients: with the right intervention, in the right place, at the right time with the right level of involvement.
Aligning Incentives for Patient Engagement: Enabling Widespread Implementation of Shared Decision Making
May 24, 2013
Jeff Thompson, Washington State Health Care Authority
David Downs, Engaged Public
David Swieskowski, Mercy ACO Mercy Clinics, Inc.
Lisa Weiss, High Value Healthcare Collaborative
Kate Chenok, Pacific Business Group on Health
Aligning Incentives for Patient Engagement: Enabling Widespread Implementation of Shared Decision Making
May 23, 2013
Angela Coulter, Informed Medical Decisions Foundation
Dominick Frosch, Gordon and Betty Moore Foundation
Floyd J. Fowler, Informed Medical Decisions Foundation
Aligning Incentives for Patient Engagement: Enabling Widespread Implementation of Shared Decision Making
May 23, 2013
Neil Korsen, MaineHealth
Larry Morrisey, Stillwater Medical Group
Charlie Brackett, Dartmouth-Hitchcock Medical Center
Grace Lin, Palo Alto Medical Foundation
Carmen Lewis, University of North Carolina
Leigh Simmons, Massachusetts General Hospital
Aligning Incentives for Patient Engagement: Enabling Widespread Implementation of Shared Decision Making
May 23, 2013
Karen Sepucha, Massachusetts General Hospital
Dale Collins Vidal, The Dartmouth Institute for Health Policy & Clinical Practice
Do you know where the term “shared decision making” was first used…or when the first center dedicated to its research and implementation was opened? Our infographic “Shared Decision Making through the Decades” will take you on a historical journey through four decades of shared decision making to understand where it is today and what the future might hold.
Angela Coulter: Getting the best value for patientsThe King's Fund
Dr Angela Coulter, Director of Global Initiatives, Foundation for Informed Medical Decision Making, spoke at The King's Fund's 'Reducing unwarranted variations in health care' conference, giving her expert opinion on how to give the best value for patients: with the right intervention, in the right place, at the right time with the right level of involvement.
Dr. Edward Wagner, Director (Emeritus) MacColl Center, Senior Investigator, Group Health Research Institute addresses the 2014 Weitzman Symposium on The Future of Primary Care
David Arterburn, MD, MPH, describes the Group Health experience in implementing decision aids as part of the shared decision making pathway. David also notes his publication in Health Affairs detailing the results of decision aid implementation.
Presented in:
Pre-Conference Workshop on Communication Skills in Management of Cancer Patients,
World Cancer Day Conference & Expo 2015
by National Cancer Society of Malaysia
At the end of the session patient/family champions as well as health authorities will leave armed with best practices, resources and ideas on how to open the door for patient/family engagement with health authorities and how to make the most of the time together.
Dr. Judith Hibbard presents The Case for Patient Activation - Activate 2017 b...mPulse Mobile
Leading patient activation researcher, Dr. Judith HIbbard, delves deep into the research findings of countless studies to reveal the definition, value and outcomes of patient activation during Activate 2017.
How to Engage Physicians in Best Practices to Respond to Healthcare Transform...PYA, P.C.
PYA Principal Kent Bottles, MD, spoke about physician engagement when it comes to value payment models during “How to Engage Physicians in Best Practices to Respond to Healthcare Transformation” at the Georgia Society of Certified Public Accountants’ (GSCPA) 2016 Healthcare Conference, February 11, 2016. Dr. Bottles discussed the difficulty of weaning physicians from fee-for-service payment models and the often-unappreciated reasoning behind the shift to value-based payment models. He also highlighted MACRA, MIPS, patient satisfaction surveys, Physician Compare, and the ProPublica Surgeon Scorecard.
Dr. Edward Wagner, Director (Emeritus) MacColl Center, Senior Investigator, Group Health Research Institute addresses the 2014 Weitzman Symposium on The Future of Primary Care
David Arterburn, MD, MPH, describes the Group Health experience in implementing decision aids as part of the shared decision making pathway. David also notes his publication in Health Affairs detailing the results of decision aid implementation.
Presented in:
Pre-Conference Workshop on Communication Skills in Management of Cancer Patients,
World Cancer Day Conference & Expo 2015
by National Cancer Society of Malaysia
At the end of the session patient/family champions as well as health authorities will leave armed with best practices, resources and ideas on how to open the door for patient/family engagement with health authorities and how to make the most of the time together.
Dr. Judith Hibbard presents The Case for Patient Activation - Activate 2017 b...mPulse Mobile
Leading patient activation researcher, Dr. Judith HIbbard, delves deep into the research findings of countless studies to reveal the definition, value and outcomes of patient activation during Activate 2017.
How to Engage Physicians in Best Practices to Respond to Healthcare Transform...PYA, P.C.
PYA Principal Kent Bottles, MD, spoke about physician engagement when it comes to value payment models during “How to Engage Physicians in Best Practices to Respond to Healthcare Transformation” at the Georgia Society of Certified Public Accountants’ (GSCPA) 2016 Healthcare Conference, February 11, 2016. Dr. Bottles discussed the difficulty of weaning physicians from fee-for-service payment models and the often-unappreciated reasoning behind the shift to value-based payment models. He also highlighted MACRA, MIPS, patient satisfaction surveys, Physician Compare, and the ProPublica Surgeon Scorecard.
Unit 1Emergency Department Overcrowding Due to L.docxwillcoxjanay
Unit 1
Emergency Department Overcrowding Due to Lack of Access to Primary Care
Teresa Cochran
November 12, 2015
Emergency Department Overcrowding Due to Lack of Access to Primary Care
Emergency Department overcrowding related to patients seeking care for non-emergent conditions is an increasing concern for hospitals across the country. In rural areas, this issue is of concern not only for patient care but also has an impact economically on hospital financial viability.
Current Situation
Emergency Departments are designed to provide expedient care for individuals with emergent, life-threatening situations. However, in the current state, emergency departments are increasingly serving as a source of providing primary care. The resulting inappropriate use of the emergency department for non-emergent visits has been shown to increases cost, impact patient safety and quality.
Healthcare organizations must find and development innovative methods to provide quality patient care while maintaining low cost and maximum efficiencies. While demand for Emergency Services grows in part due to an aging population, the volume also has grown due to lack of primary care physicians and patient preference. The financial pressures faced by hospitals due to reductions in reimbursement necessitate a restructuring of the standard model of healthcare care delivery.
Problem Statement
As the population continues to grow emergency departments will continue to see not only acute illness but more chronic illness. It is essential for health care systems to continue in developing new and innovative means related to optimization of care delivery. Specifically this will identify factors that affect overutilization of the emergency department by individuals that are more appropriately treated in the primary care setting. Therefore, the increasing use of emergency departments will impact overall patient care due to lack of continuity that is provided in the primary care setting for chronic illness.
Research Objective
This research proposal will evaluate the feasibility of incorporating a medical home into the emergency department setting, therefore, reducing overcrowding in the Emergency Department. This increased access to primary care will ultimately increase access to quality care in the most appropriate cost-effective setting
Research Question
The intended purpose of this research proposal will examine the concept volume and acuity of patients seen in the Emergency Department. The following questions will be addressed. What measures can be implemented to reduce the overutilization of the ED yet offer the appropriate level of care for the patient? What barriers are associated with accessing sustained primary care?
Hypothesis
In order to improve outcomes, healthcare organizations must evaluate the feasibility of healthcare redesign related to the delivery of care. By restructuring how and where care is delivered will reduce the number of non-eme ...
The Healthcare Team as the Healthcare Provider: A Different View of the Patie...guesta14581
Presentation to the Ohio State Society of Medical Assistant's annual convention about the Patient Centered Medical Home and the role of the medical assistant
Rethinking, rebuilding psychosocial care for cancer patientsJames Coyne
Presented as the 8th Trevor Anderson Psycho-Oncology Lecture, September 8, 2014, Melbourne, Australia.
Discusses how psychosocial care for cancer patients needs to be reorganized so that a broader range of cancer patients are served. Routine screening for distress is unlikely to be an efficient means of countering tendencies of cancer care more generally becoming more organized around time efficiency and billable procedures. Psychosocial care for many cancer patients involves discussions, negotiations, and care coordination they cannot be well fit into the idea of a counseling session. The unsung heroes of providing such care are underappreciated social workers and oncology nurses.
Case Study "Using Real Time Clinical Data To Support Patient Risk Stratification in The Clinical Care Setting"
HealthInfoNet operates the statewide health information exchange in Maine. The exchange currently manages clinical and patient care encounter information on 97 percent of the residents of the State of Maine. The information is gathered in real time, standardized, and aggregated at a patient specific level to support treatment. For the past three years, HealthInfoNet has worked with HBI Solutions, Inc of Palo Alto, CA to utilize this real time clinical and encounter data to support the development of predictive analytic tools that risk stratify patient populations and individual patients for future incidence of disease, cost, and both inpatient and ambulatory care encounters. These real time predictive models have now been used in clinical care settings for a year. The presentation will cover both lessons learned to date from implementing and optimizing real time predictive analytic tools and the early finding of the impact that the use of these tools is having on patient care management, utilization and outcome.
Devore Culver
Executive Director & CEO
HealthInfoNet
The Future of the American Healthcare Delivery System in an Era of ChangePYA, P.C.
PYA Principal Dr. Kent Bottles, who is also PYA Analytics' Chief Medical Officer, gave the keynote address, "The Future of the American Healthcare Delivery System in an Era of Change at the Healthcare Business Intelligence Summit," September 19, 2013, in Minneapolis. Dr. Bottles discussed four key trends affecting the American healthcare delivery system: the Affordable Care Act (“ACA”), the digital revolution, big data, and social media. He examined how these trends together affect the way hospitals, providers, payers, employers, and government agencies adapt to the changing healthcare environment.
Empowering Healthcare Leaders: The Business Case for Language Access_10.3.14Douglas Green
Empowering Healthcare Leaders: The Business Case for Language Access provides a framework for calculating total potential encounters with limited English patients, the economic benefit and cost of not providing language access and a frame work to align the economic benefits with organizational goals under the Affordable Care Act.
Running head STRATEGIC PLAN FOR CHANGE1STRATEGIC PLAN FOR.docxtoltonkendal
Running head: STRATEGIC PLAN FOR CHANGE
1
STRATEGIC PLAN FOR CHANGE
2
Strategic Plan for Change
Jennifer Zimmerman
Walden University- NURS 6201
December 29, 2017
Improving Patient Experience who are Undergoing Chemotherapy from an Outpatient setting to an Inpatient Setting
1.
Introduction and Statement of the Problem
1.1.
What is the problem?
Outpatient chemotherapy sessions are sufficient in most organizations, especially for those receiving curative intent chemotherapy (Davidoff et al. 2013). The patients who meet the set criteria end up receiving supportive care post induction chemotherapy, as well as different cycles as other outpatients. Outpatient management can be made safe and the transition to inpatient more efficient, which is considered a challenge for most healthcare organizations. The problem at hand in this section has been adequately analyzed, which involves the transition of patients receiving chemotherapy from outpatient to inpatient in healthcare facilities.
1.2.
Why is it important enough to warrant a change?
Outpatient care especially for most patient has become a familiar concept that is driven by increased healthcare costs and more so, the increased demand for existing inpatient resources in different organizations (Joana et al. 1987). Improved supportive care in inpatient is also another reason for the need to embrace the transition, and patient wishes to spend the least amount of time, especially in waiting for service delivery in the outpatient setting. With these concepts in mind, it is important enough to warrant a change. Patient satisfaction ought not to be ignored in different healthcare organizations. There is a need to, therefore, be on the forefront in enhancing adequate care, and embracing inpatient plans for the chronically ill patients.
1.2.1.
Scholarly Reference #1
Joana, L., Mary, H., Alan, M., Andrew, B., & Steven, C., (1987). Case Mix and Changes in inpatient and outpatient chemotherapy. PubMed 8(4): 65-71.
In most healthcare settings, the therapy provided in outpatient has been associated with substantial tumors, chemotherapy involving high doses, and then followed by autologous stem cell transplantation. Outpatient administration of consolidation cycles has been reported, which emphasizes the major problem in this scholarly soured. According to the authors, the transition to inpatient to outpatient care should be considered and priority to solve the efficiency problems at hand.
1.2.2.
Scholarly Reference #2
Hayes, J. (2014). The theory and practice of change management. Palgrave Macmillan.
This source deals with theory and practice of change management. Change management is an adequate practice in the healthcare setting. There is a need for all healthcare organizations to be at the forefront to ensure that healthcare, both inpatient and outpatient are realized. The source provides and explains outpatient inefficiency for chronic patients as the worst problem in the medical profession. Th ...
Physician age and outcomes in elderly patients in hospial in the US: observat...Akshay Mehta
It is an observational study Physicians age and outcomes of their treatment on elderly patients.
Datas are really very shocking and it tells more about the experience and technology.
25 Champions of Shared Decision Making, selected by the staff of the Informed Medical Decisions Foundation. This is not a top 25 list, merely a list of 25 individuals the staff wanted to recognize.
Diana Stilwell, MPH, chief production officer at the Informed Medical Decisions Foundation, walks through the role of narratives in decision aids and how the available evidence relates to the Foundation approach.
This presentation was part of a Shared Decision Making Month webinar -- The Power of Narratives: How They Shape the Way Patients Make Medical Decisions.
Jack Fowler, PhD, senior scientific advisor at the Informed Medical Decisions Foundation provides an overview of the Foundation's path to developing decision aids that included patient narratives.
This presentation was part of a Shared Decision Making Month webinar -- The Power of Narratives: How They Shape the Way Patients Make Medical Decisions.
Victoria Shaffer, PhD, describes the the pros and cons of narratives and then explains her work to develop a system of classification for narratives as part of the solution. Victoria provides an overview of the narrative taxonomies she and her colleague have developed.
This presentation was part of a Shared Decision Making Month webinar -- The Power of Narratives: How They Shape the Way Patients Make Medical Decisions.
Karen Sepucha, PhD, describes what a good decision is, how we measure decision quality and how the decision quality instrument might be used.
This presentation was part of a Shared Decision Making Month webinar -- What Makes a Good Medical Decision? Defining and Implementing Decision Quality Measures.
Floyd J. Fowler Jr, PhD, provides an overview of decision quality measures and the importance of this measurement.
This presentation was part of a Shared Decision Making Month webinar -- What Makes a Good Medical Decision? Defining and Implementing Decision Quality Measures.
David Wennberg, MD, MPH, describes a recent randomized trial he was involved with that studied the potential of shared decision making to reduce costs among preference-sensitive conditions. David also explains the vision of the 20-member High Value Healthcare Collaborative.
This presentation was part of the Shared Decision Making Month webinar "Turning Shared Decision Making Policy into a Reality."
Ben Moulton, JD, MPH, provides an overview of the shared decision making policy landscape.
This presentation was part of a Shared Decision Making Month webinar -- Turning Shared Decision Making Policy into a Reality: Can We Really Improve the Quality of Care While Reducing the Costs.
Kristen Oganowski, CD(DONA) shares her experience as a parent/patient doula advocate.
This presentation was part of a Shared Decision Making Month webinar -- Maternity Care and Shared Decision Making: Improving Care for Mothers and Babies.
Kate Chenok, a director at Pacific Business Group on Health, provides the purchaser perspective on shared decision making and maternity care.
This presentation was part of a Shared Decision Making Month webinar -- Maternity Care and Shared Decision Making: Improving Care for Mothers and Babies.
Maureen Corry, executive director of Childbirth Connection, provides an overview of the state of shared decision making and maternity care.
This presentation was part of a Shared Decision Making Month webinar -- Maternity Care and Shared Decision Making: Improving Care for Mothers and Babies.
Jeff Belkora, associate professor at the University of California, San Franscisco, shares UCSF Breast Care Center's unique approach to support shared decision making: using student health coaches.
This presentation was part of a Shared Decision Making Month webinar -- Shared Decision Making in the Real World: Stories from the Frontline.
More from Informed Medical Decisions Foundation (20)
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
Title: Sense of Smell
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 primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
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.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
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.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
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
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
1. Ke y n o t e A d d r e s s
Aligning Incentives for Patient
Engagement
May 24, 2013
2. Unwarranted Variation in Health Care Delivery
and the Struggle for Reform
Aligning Incentives for Patient Engagement
Washington D.C.
May 24, 2013
John Wennberg
3. The Research in a nutshell
In Health Care, Geography is Destiny
Medical practice occurs within a local context: Per capita
expenditures, resource use and utilization vary extensively
among regions, communities and health care organizations.
4. The Research in a nutshell
In Health Care, Geography is Destiny
Medical practice occurs within a local context: Per capita
expenditures, resource use and utilization vary extensively
among regions, communities and health care organizations.
Much of this variation is unwarranted: It isn’t explained by
illness, evidence-based medicine or patient preferences.
The causes and remedies of unwarranted variation differ
according to the category of care.
5. Preference-Sensitive Care
• Involves tradeoffs -- more than one treatment exists and the
outcomes are different
• Decisions should be based on the patient’s own preferences – On
the ethic of informed patient choice
• But provider opinion often determines which treatment is used
8. The Dartmouth Atlas Project: 306 Hospital Referral Regions
Ongoing Study of Traditional Medicare Population USA
9. Knee replacement per 1,000 Medicare
enrollees
0.0
2.0
4.0
6.0
8.0
10.0
12.0
14.0
16.0
1992 2000 2007
Red dot = US average: 4.0 5.4 8.6
10. Relationship between rates of knee replacement per
1,000 Medicare enrollees in 1992 and 2007
0.0
4.0
8.0
12.0
16.0
0.0 4.0 8.0 12.0 16.0
Knee replacement (1992)
Kneereplacement(2007)
R2 = 0.62
11.
12. Determining the Need for Hip and Knee Arthroplasty:
The Role of Clinical Severity and Patients’ Preferences
• . . . Among those with severe arthritis, no more than 15%
were definitely willing to undergo (joint replacement), emphasizing
the importance of considering both patients’ preference and
surgical indications in evaluating need and appropriateness of
rates of surgery
13. Which Rate is Right?
Medical Necessity = clinically appropriate + informed patient choice
14. Which Rate is Right?
Medical Necessity = clinically appropriate + informed patient choice
Informed patient choice is an ethical imperative for uncovering “true”
demand for surgery & learning which rate is right.
15. Which Rate is Right?
Medical Necessity = clinically appropriate + informed patient choice
Informed patient choice is an ethical imperative for uncovering “true”
demand for surgery & learning which rate is right.
In the absence of informed patient choice, surgeons are at risk for
operating on the wrong patient: on patients who preferred another
treatment.
16. Which Rate is Right?
Medical Necessity = clinically appropriate + informed patient choice
Informed patient choice is an ethical imperative for uncovering “true”
demand for surgery & learning which rate is right.
In the absence of informed patient choice, surgeons are at risk for
operating on the wrong patient: on patients who preferred another
treatment.
Effective tools are available to improve decision quality and avoid
wrong patient surgery.
17.
18. Supply-Sensitive Care
Everyday services provided mainly to patients with medical
(non-surgical) conditions: physician visits, referrals to
specialists, MRIs, laboratory tests, screening exams and
hospitalizations, and stays in ICUs
19. Supply-Sensitive Care
Everyday services provided mainly to patients with medical
(non surgical) conditions: physician visits, referrals to
specialists, MRIs, laboratory tests, screening exams and
hospitalizations, and stays in ICUs
At issue is the frequency of use of such care, particularly in
managing chronic illness over time: “Which rate is Right?”
20. Supply-Sensitive Care
Everyday services provided mainly to patients with medical
(non surgical) conditions: physician visits, referrals to
specialists, MRIs, laboratory tests, screening exams and
hospitalizations, and stays in ICUs
At issue is the frequency of use of such care, particularly in
managing chronic illness over time: “Which rate is Right?”
Supply-sensitive care accounts for most of the more two-fold
variation in Medicare spending among regions.
22. Hospital resources invested in health care of Bostonians
compared to New Havenites
Resources Ratio: Boston
to New Haven
Beds per 1,000 1.55
Employees per 1,000 1.89
Per capita Spending 1.87
23. Standardized hospital discharge rates for medical
conditions: Boston and New Haven region (1994-95)
(Discharge ratio: Boston/New Haven in black)
Figure 8.2
1.64
1.14
1.66
1.58
1.72
2.17
1.52
1.89
3.06
1.50
0.0
0.5
1.0
1.5
2.0
2.5
AllMedical
Discharges
Uncomplicated
Pneumonia
Heart
Failure
Gastro-
enteritis
Cellulitis
COPD
Diabetes
Kidney&Urinary
TractInfections
Bronchitis
&Asthma
Angina
Pectoris
RatiotoU.S.average(1994-95)
Boston
New Haven
:
24. Hip Fracture
R2 = 0.06
All Medical
Conditions
R2 = 0.54
0
50
100
150
200
250
300
350
400
1.0 2.0 3.0 4.0 5.0 6.0
Acute Care Beds
DischargeRate
Association between hospital beds per 1,000 and discharges
per 1,000 among Medicare Enrollees: 306 Hospital Regions
26. A behavioral interpretation of variation in
frequency of use of supply-sensitive care
• The frequency of use is governed by the assumption that
resources should be fully utilized, i.e. that more is better.
• Specific medical theories and medical evidence play little role in
governing frequency of use.
27. Supply-Sensitive Care
Physician Visits per Decedent During Last Six Months of Life Among
Patients Assigned to Academic Medical Centers (2010 deaths)
10.0
20.0
30.0
40.0
50.0
60.0
70.0
80.0
Cedars-Sinai Medical Center 72.6
NY-Presbyterian Hospital 39.1
Mass. General Hospital 34.7
Brigham & Women's Hospital 31.5
Beth Israel Deaconess 30.3
Boston Medical Center 29.2
UCSF Medical Center 28.3
Mayo Clinic-St. Mary's 21.3
Scott & White Memorial Hosp 19.8
NYU Langone Medical Center 58.5
Ronald Reagan UCLA Med Ctr 49.7
Mount Sinai Hospital 49.1
28. A behavioral interpretation of variation in
frequency of use of supply-sensitive care
• The frequency of use is governed by the assumption that
resources should be fully utilized, i.e. that more is better.
• Specific medical theories and medical evidence play little role in
governing frequency of use.
• In the absence of evidence and under the assumption that more is
better, available supply governs frequency of use.
29. Which Rate is “Right”?
More frequent use of supply-sensitive care isn’t resulting in better
outcomes:
30. Which Rate is “Right”?
More frequent use of supply-sensitive care isn’t resulting in better
outcomes:
• More than two-fold variation in frequency of use is uncorrelated
with prevalence of severe chronic illness and with outcome
measured by mortality.
31. Which Rate is “Right”?
More frequent use of supply-sensitive care isn’t resulting in better
outcomes:
• More than two-fold variation in frequency of use is uncorrelated
with prevalence of severe chronic illness and with outcome
measured by mortality.
• Technical quality of care tends to be better in low use regions.
32. Which Rate is “Right”?
More frequent use of supply-sensitive care isn’t resulting in better
outcomes:
• More than two-fold variation in frequency of use is uncorrelated
with prevalence of severe chronic illness and with outcome
measured by mortality.
• Technical quality of care tends to be better in low use regions.
• Patients rank their hospital experiences higher in low use regions.
33. Which Rate is “Right”?
More frequent use of supply-sensitive care isn’t resulting in better
outcomes:
• More than two-fold variation in frequency of use is uncorrelated
with prevalence of severe chronic illness and with outcome
measured by mortality.
• Technical quality of care tends to be better in low use regions.
• Patients rank their hospital experiences higher in low use regions.
• Care coordination is better in low use regions.
34. Which Rate is “Right”?
More frequent use of supply-sensitive care isn’t resulting in better
outcomes:
• More than two-fold variation in frequency of use is uncorrelated
with prevalence of severe chronic illness and with outcome
measured by mortality.
• Technical quality of care tends to be better in low use regions.
• Patients rank their hospital experiences higher in low use regions.
• Care coordination is better in low use regions.
• End of life care is less aggressive in low use regions.
35. Supply-Sensitive Care
Percent of Deaths Associated with ICU Admission Among Patients
Assigned to Academic Medical Centers (2010 deaths)
10.0
15.0
20.0
25.0
30.0
35.0
40.0
45.0
Boston Medical Center 27.8
NYU Langone Medical Center 23.8
UCSF Medical Center 22.7
Beth Israel Deaconess 22.2
Brigham & Women's Hospital 19.4
Mass. General Hospital 17.9
Mount Sinai Hospital 17.0
Mayo Clinic-St. Mary's 16.8
NY-Presbyterian Hospital 16.2
Scott & White Memorial Hosp 15.7
Ronald Reagan UCLA Med Ctr 40.6
Cedars-Sinai Medical Center 38.2
36.
37. Conclusion: Song et al.
The use of clinical or claims-based diagnoses in risk adjustment may
introduce important biases in comparative effectiveness studies, public
reporting and payment reforms.
Conclusion: Welch et al.
There is an inverse relationship between regional frequency of diagnosis
and the case fatality rate for chronic conditions.
Conclusion: Wennberg et al.
Adjusting for illness using HCCs, Iezzoni chronic illness and Charlson co-
morbidity index make regions with high visit rates seem to have lower
mortality and lower costs and visa versa.
In the states, despite early efforts to conduct health planning, the population served by a given health care organization is not know or ignored, despite 40 years of small area analysis. In the UK, budgets and other aspects of resource allocation have more or less been made on a geographic, per capita basis. However, under the new commissioning strategy, the UK is moving away from population-based medicine.
In the states, despite early efforts to conduct health planning, the population served by a given health care organization is not know or ignored, despite 40 years of small area analysis. In the UK, budgets and other aspects of resource allocation have more or less been made on a geographic, per capita basis. However, under the new commissioning strategy, the UK is moving away from population-based medicine.
Communities served by the nation’s leading academic medical centers show just as much variation.
Add 115% increase to match format for previous slde
In the states, despite early efforts to conduct health planning, the population served by a given health care organization is not know or ignored, despite 40 years of small area analysis. In the UK, budgets and other aspects of resource allocation have more or less been made on a geographic, per capita basis. However, under the new commissioning strategy, the UK is moving away from population-based medicine.
In the states, despite early efforts to conduct health planning, the population served by a given health care organization is not know or ignored, despite 40 years of small area analysis. In the UK, budgets and other aspects of resource allocation have more or less been made on a geographic, per capita basis. However, under the new commissioning strategy, the UK is moving away from population-based medicine.
In the states, despite early efforts to conduct health planning, the population served by a given health care organization is not know or ignored, despite 40 years of small area analysis. In the UK, budgets and other aspects of resource allocation have more or less been made on a geographic, per capita basis. However, under the new commissioning strategy, the UK is moving away from population-based medicine.
Communities served by the nation’s leading academic medical centers show just as much variation.
The effect of hospital bed capacity is to exercise a subliminal effect on the clinical threshold for admitting patients to hospital; the effect is seen across most acute and chronic medical conditions; but not for elective surgery, which generally isn’t correlated with regional variation in bed capacity.