The document discusses health management services (HMS) programs for managing chronic diseases in Gulf Cooperation Council (GCC) countries. It notes that chronic diseases are a major cause of death in GCC nations and account for a large portion of healthcare costs. HMS programs help address gaps in chronic disease patient care by providing education, encouraging adherence to treatment plans, and coordinating care. Studies show HMS can improve health outcomes and lower healthcare costs. The document argues GCC countries should adopt HMS programs to help curb the growth of chronic diseases and related costs. It provides examples of services HMS programs provide to diabetes patients and research showing the benefits of HMS.
This document summarizes a study that analyzed predictors of traditional medicine utilization in Ashanti Region, Ghana. The study involved a survey of 324 participants across both rural and urban districts. Overall, 86.1% of participants reported using traditional medicine in the previous 12 months. The study found that traditional medicine use was predicted by having low income, being a trader, perceiving traditional medicine as effective and safe, having a good relationship with a traditional medical practitioner, and having a chronic illness. Demographic factors were not strong predictors of traditional medicine use. The study provides insight into why traditional medicine utilization is high in the region.
The document discusses improving patient safety in intensive care medicine. It describes launching a major initiative through the European Society of Intensive Care Medicine (ESICM) to bring together representatives from critical care societies around the world. The goal is to pledge efforts to improving patient care and outcomes. Key areas of focus include changing medical culture and priorities to better address patient safety issues, and evaluating patient safety at both the individual patient level and collective level to maximize benefits and minimize harms. The initiative aims to raise awareness of patient safety and help transform daily practice to improve quality of care for all patients.
Palliative care white paper for RegenceErin Codazzi
This document discusses the growing need for palliative care in the United States. It notes that 90 million Americans have a serious long-term illness, and the number is expected to more than double in the next 25 years. Additionally, four in ten Americans care for loved ones with serious illnesses. The document calls for a more holistic approach to palliative care that centers on patient needs, expands access to care for patients and families, engages stakeholders, and encourages industry solutions. It provides examples of organizations working to implement more comprehensive palliative care programs.
A briefing for Public Health teams on a public mental health approach resilience, trauma and coping beyond the pandemic, and addressing the needs of communities and workplaces
Presentation for "The annual medicine overseas conference: Research and response in the midst of chaos" at the UK Royal Society of Medicine. http://www.rsm.ac.uk/academ/ccd03.php
The document discusses population health management and achieving healthy communities. It outlines major issues with the US healthcare system like uneven access to care. Real reform requires a focus on prevention, continuous care relationships, and evidence-based decisions. Population health management programs aim to maintain and improve people's health across different risk levels. Barriers to population health include fragmented care and misaligned incentives. Patient-centered medical homes and accountable care organizations show promise by emphasizing coordinated, team-based care. Automation and health information technology can help strengthen these models and drive effective population health management.
Issue-specific fact sheets for transition age youth with chronic health needs. Provides overview information on legal and medical issues related to transition.
Suicide Care in Systems Framework (National Action Alliance for Suicide Preve...David Covington
Co-led with Dr. Mike Hogan, the Clinical Care & Intervention Task Force published this National Action Alliance for Suicide Prevention road map for the Zero Suicide in Healthcare initiative.
This document summarizes a study that analyzed predictors of traditional medicine utilization in Ashanti Region, Ghana. The study involved a survey of 324 participants across both rural and urban districts. Overall, 86.1% of participants reported using traditional medicine in the previous 12 months. The study found that traditional medicine use was predicted by having low income, being a trader, perceiving traditional medicine as effective and safe, having a good relationship with a traditional medical practitioner, and having a chronic illness. Demographic factors were not strong predictors of traditional medicine use. The study provides insight into why traditional medicine utilization is high in the region.
The document discusses improving patient safety in intensive care medicine. It describes launching a major initiative through the European Society of Intensive Care Medicine (ESICM) to bring together representatives from critical care societies around the world. The goal is to pledge efforts to improving patient care and outcomes. Key areas of focus include changing medical culture and priorities to better address patient safety issues, and evaluating patient safety at both the individual patient level and collective level to maximize benefits and minimize harms. The initiative aims to raise awareness of patient safety and help transform daily practice to improve quality of care for all patients.
Palliative care white paper for RegenceErin Codazzi
This document discusses the growing need for palliative care in the United States. It notes that 90 million Americans have a serious long-term illness, and the number is expected to more than double in the next 25 years. Additionally, four in ten Americans care for loved ones with serious illnesses. The document calls for a more holistic approach to palliative care that centers on patient needs, expands access to care for patients and families, engages stakeholders, and encourages industry solutions. It provides examples of organizations working to implement more comprehensive palliative care programs.
A briefing for Public Health teams on a public mental health approach resilience, trauma and coping beyond the pandemic, and addressing the needs of communities and workplaces
Presentation for "The annual medicine overseas conference: Research and response in the midst of chaos" at the UK Royal Society of Medicine. http://www.rsm.ac.uk/academ/ccd03.php
The document discusses population health management and achieving healthy communities. It outlines major issues with the US healthcare system like uneven access to care. Real reform requires a focus on prevention, continuous care relationships, and evidence-based decisions. Population health management programs aim to maintain and improve people's health across different risk levels. Barriers to population health include fragmented care and misaligned incentives. Patient-centered medical homes and accountable care organizations show promise by emphasizing coordinated, team-based care. Automation and health information technology can help strengthen these models and drive effective population health management.
Issue-specific fact sheets for transition age youth with chronic health needs. Provides overview information on legal and medical issues related to transition.
Suicide Care in Systems Framework (National Action Alliance for Suicide Preve...David Covington
Co-led with Dr. Mike Hogan, the Clinical Care & Intervention Task Force published this National Action Alliance for Suicide Prevention road map for the Zero Suicide in Healthcare initiative.
This document summarizes a meeting of the Hertfordshire and West Essex Sustainability and Transformation Partnership about population health management. The meeting included presentations on the national context of population health and PHM, developing PHM locally, and next steps. It discussed the role of elected members in improving health outcomes and wellbeing for residents. Attendees considered developing a population health strategy and wider determinants of health. The goal is to improve physical and mental health across the population through data-driven care that addresses health inequalities.
Overview and history of home health careSUNITA SINGH
The document provides an overview of home health care in the United States, including its history and the Medicare home health care program. It discusses how care shifted from the home to hospitals in the early 20th century due to advances in medicine and technology. It also summarizes how the Medicare home health care benefit expanded in the 1980s-1990s but was curtailed by the Balanced Budget Act of 1997 which focused the program on post-acute care and set limits on spending. The document outlines the eligibility requirements and covered services under Medicare home health care.
Recovery-Oriented Risk Assessment and Shared Decision Making. Mapping the Pro...CrimsonpublishersPPrs
Recovery-Oriented Risk Assessment and Shared Decision Making. Mapping the Process of Recovery in Mental Health Care by Jan Sitvast in Psychology and Psychotherapy Research Study
Association of an Educational Program in Mindful Communication With Burnout, ...DAVID MALAM
This document summarizes a study that evaluated the effectiveness of an educational program in mindful communication for primary care physicians. The program included mindfulness meditation, narrative exercises, and appreciative inquiry techniques. It was associated with short-term and sustained improvements in physician well-being, burnout, empathy, mood, and personality factors related to patient-centered care. However, the before-and-after study design limits conclusions about the causal effects of the intervention. Randomized trials with larger and more diverse groups of physicians are needed to validate these preliminary findings.
April 2005 Informational and Instructional Monograph from the Technical Assistance Collaborative. Uploaded for the National Action Alliance Crisis Services Task Force.
National Surveillence Systems 2011 Report Briefbiopharmaguru
Surveillance systems are meant to inform public health and clinical practitioners, policy makers, and the general public of the scope, magnitude, and cost of a health problem in order to influence priority setting, program development, and evalu- ation of services or policies. The ultimate aim is to catalyze actions to reduce morbidity and mor- tality and improve health, within a framework of finite resources used in an efficient and cost-effec- tive way.
The document discusses the need for healthcare reform in the United States. It notes that around 47 million Americans are uninsured, 50 million are underinsured, and 79 million struggle with medical debt. It argues that the current healthcare system lacks an organizing principle to effectively link resources into a high value system. Reform is necessary to address issues like a lack of coordinated care, high costs, inconsistent quality, and an inefficient use of resources. The document advocates for a patient-centered medical home model and insurance reforms influenced by state-level decisions around insurance exchanges.
An Evaluation of the Challenges of Doctor- Patient Communicationinventionjournals
1. Effective doctor-patient communication is important for building trust, facilitating information exchange, and involving patients in medical decisions. However, several challenges exist, including doctors' deteriorating communication skills over time, avoidance of discussing emotional issues, and discouraging patient collaboration.
2. Doctors can improve communication through training to develop skills like empathy and active listening. It is also important to understand patients' health beliefs as perceptions may impact treatment. With better communication, outcomes are improved through higher patient understanding, satisfaction, and adherence to care plans.
Engines of Success for U.S. Health Reform?
Eric B. Larson, MD, MPHVice President for Research, Group Health Executive Director, Group Health Research Institute
Trauma Informed Primary Care for Women Living with HIV ANAC Webinar May 2014Carol Dawson-Rose
This document presents a conceptual model for a trauma-informed primary care environment. The three core components of the model are:
1. A trauma-informed environment that is safe, calm, and empowering for patients and staff. Providers are educated about trauma's impacts and the clinical flow reduces triggers to promote trust and healing.
2. Universal screening for current and lifelong trauma, including abuse, as well as consequences like complex PTSD, depression, and substance abuse. Screening is patient-led but routine.
3. Screening is directly linked to on-site and community interventions. For recent trauma, safety and autonomy are prioritized. For lifelong abuse, longer-term evidence-based group interventions address
1) Family medicine involves providing comprehensive healthcare services to patients in their own homes to promote health, minimize illness effects, and restore function.
2) It serves patients with chronic conditions, acute episodic illnesses, or who need medical supervision after being discharged from the hospital or who are terminally ill.
3) Care includes medical treatment, nursing, rehabilitation, counseling, and coordinating community resources to support patients.
This document discusses mental health services and PTSD among veterans. It covers several topics:
1) Post-traumatic stress disorder (PTSD) rates and symptoms among veterans from different eras. Rates of PTSD are high and symptoms include flashbacks, nightmares, and suicidal ideation.
2) Legislation and policies aimed at improving access to mental healthcare for veterans, such as the Clay Hunt Act which requires annual evaluations of VA mental health programs and increased collaboration with outside organizations.
3) Questions around adequate funding for veteran mental healthcare, as funding amounts are unclear and appear insufficient to meet the high need for treatment.
This document provides background information and context for a case study about implementing lean principles at HomeCare, a large Canadian home health care organization. It summarizes that HomeCare was facing issues like poor service, long scheduling times, and low employee satisfaction due to siloed processes and lack of coordination. HomeCare leadership brought in consultants to redesign the entire service process from a lean perspective. The consultants conducted interviews and surveys, and recommended piloting redesigned processes in two districts before expanding organization-wide. The pilots were very successful, dramatically improving key metrics like scheduling times. This provided proof and momentum to redesign additional districts using the lean methodology.
Home health nursing services allow individuals to receive healthcare in their own homes, providing comfort and dignity. Services may include skilled nursing, physical therapy, occupational therapy, social services, and more. Care is provided through developing a treatment plan with the patient's physician, making regular visits to work towards goals, and documenting progress for quality assessment.
Social support among the Caregivers of Persons Living with Cancerinventionjournals
:The social support emphasize as the support given to any person in a troublesome or burdensome situation by family members, relatives as well as resources exerted by social connections, is effective in promoting physical health and feeling oneself good. The present study consisted of 300 caregivers of persons with cancer was selected based on simple random sampling, and with inclusion and exclusion criteria. Those patients satisfying the inclusion and exclusion criteria and attending both outpatient and inpatient services of cancer specialty hospital in KIDWAI Bangalore, Karnataka were selected randomly. The data was collected from the patients & caregivers of persons living with cancer who fulfill the inclusion/exclusion criteria were taken up for the study after their consent. Multidimensional Scale of Perceived Social Support (Zimet et al, 1998) was administered to understand Perceived Social Support. The interviews and the instruments were administered by research experts.The Results suggest that there were poor social support found in caregivers of married, female, belong to rural domicile, illiterate, and,caregivers who were not heard about the treatment of cancer.
There have always been substantial gaps in healthcare services for the higher-risk populations. Despite the best intentions of structure managed care programs introduced as early as the 1970’s, these gaps persist. This isn’t breaking news—over the past two decades, the term “vulnerable populations” has gained prominence in the healthcare industry. Messaging in the late 1990s to early 2000s was consistent: Certain populations are at greater risk because of who they are and where they live, regardless of their actual health condition.
Home health care involves providing medical care and services to individuals in their homes. It allows patients to receive skilled care while maintaining independence. The nursing process is used to assess patients' needs, develop care plans, implement care, and evaluate outcomes. Services typically include skilled nursing, therapy, and home health aide visits. Home health care allows patients to heal in a comfortable environment and reduces health care costs. It is a growing sector both in the US and India due to aging populations and increased chronic conditions.
David Levine: Environmentally conscience planningNuffield Trust
This document outlines the reform of Quebec's health and social services system. Key points include:
- The reform introduced a population-based managed care model with multidisciplinary teams responsible for rostered clients.
- Health and Social Services Centers were created by merging various institutions to provide integrated services through local networks.
- The reform aimed to improve access to services, care continuity, and population health while reducing costs through prevention and chronic disease management.
- Primary care teams play a central role in coordinating services and guiding clients to the appropriate level of care.
Asthma is a chronic lung disease that affects many residents of Ingham County, Michigan, and uncontrolled asthma can result in expensive hospitalizations. The rate of asthma-related hospitalizations is higher in Ingham County than statewide, with over 350 asthma hospitalizations occurring in the county in 2008. The document examines the costs of asthma hospitalizations and the county health department's plans to introduce a home-based asthma case management program to help reduce hospitalizations.
The document defines key public health terminology used by the Oregon Health Authority, including definitions of public health concepts like access, assessment, assurance, behavioral risk factors, benchmarks, best practices, boards of health, cultural competence, determinants of health, environmental health, epidemiology, and essential public health services. It also describes several federal agencies that support public health work, such as the CDC, HRSA, FDA, and EPA.
The document provides contact information for various Booz & Company experts located around the world who can assist with e-health initiatives. It then discusses the key elements needed for a successful e-health ecosystem, including governance policies, financing models, technology infrastructure, services, and stakeholders. The document emphasizes that e-health programs require a holistic, long-term approach considering all interconnected parts of the ecosystem, and that solutions must be customized to local conditions.
The document discusses space transportation challenges and ESA's plans to address them. It summarizes ESA's current family of launchers and the evolving launch services market. Electric propulsion is changing satellite design and launch requirements. ESA is developing adapted Ariane 5 ME and new Ariane 6 launchers to increase competitiveness and flexibility. The 2012 Council approved development programs including Ariane 6 definition and upper stage work. Ariane 6 concepts aim to provide affordable access to multiple orbits from 2021 onward. Synergies between Ariane 6 and Vega C are being assessed.
This document summarizes a meeting of the Hertfordshire and West Essex Sustainability and Transformation Partnership about population health management. The meeting included presentations on the national context of population health and PHM, developing PHM locally, and next steps. It discussed the role of elected members in improving health outcomes and wellbeing for residents. Attendees considered developing a population health strategy and wider determinants of health. The goal is to improve physical and mental health across the population through data-driven care that addresses health inequalities.
Overview and history of home health careSUNITA SINGH
The document provides an overview of home health care in the United States, including its history and the Medicare home health care program. It discusses how care shifted from the home to hospitals in the early 20th century due to advances in medicine and technology. It also summarizes how the Medicare home health care benefit expanded in the 1980s-1990s but was curtailed by the Balanced Budget Act of 1997 which focused the program on post-acute care and set limits on spending. The document outlines the eligibility requirements and covered services under Medicare home health care.
Recovery-Oriented Risk Assessment and Shared Decision Making. Mapping the Pro...CrimsonpublishersPPrs
Recovery-Oriented Risk Assessment and Shared Decision Making. Mapping the Process of Recovery in Mental Health Care by Jan Sitvast in Psychology and Psychotherapy Research Study
Association of an Educational Program in Mindful Communication With Burnout, ...DAVID MALAM
This document summarizes a study that evaluated the effectiveness of an educational program in mindful communication for primary care physicians. The program included mindfulness meditation, narrative exercises, and appreciative inquiry techniques. It was associated with short-term and sustained improvements in physician well-being, burnout, empathy, mood, and personality factors related to patient-centered care. However, the before-and-after study design limits conclusions about the causal effects of the intervention. Randomized trials with larger and more diverse groups of physicians are needed to validate these preliminary findings.
April 2005 Informational and Instructional Monograph from the Technical Assistance Collaborative. Uploaded for the National Action Alliance Crisis Services Task Force.
National Surveillence Systems 2011 Report Briefbiopharmaguru
Surveillance systems are meant to inform public health and clinical practitioners, policy makers, and the general public of the scope, magnitude, and cost of a health problem in order to influence priority setting, program development, and evalu- ation of services or policies. The ultimate aim is to catalyze actions to reduce morbidity and mor- tality and improve health, within a framework of finite resources used in an efficient and cost-effec- tive way.
The document discusses the need for healthcare reform in the United States. It notes that around 47 million Americans are uninsured, 50 million are underinsured, and 79 million struggle with medical debt. It argues that the current healthcare system lacks an organizing principle to effectively link resources into a high value system. Reform is necessary to address issues like a lack of coordinated care, high costs, inconsistent quality, and an inefficient use of resources. The document advocates for a patient-centered medical home model and insurance reforms influenced by state-level decisions around insurance exchanges.
An Evaluation of the Challenges of Doctor- Patient Communicationinventionjournals
1. Effective doctor-patient communication is important for building trust, facilitating information exchange, and involving patients in medical decisions. However, several challenges exist, including doctors' deteriorating communication skills over time, avoidance of discussing emotional issues, and discouraging patient collaboration.
2. Doctors can improve communication through training to develop skills like empathy and active listening. It is also important to understand patients' health beliefs as perceptions may impact treatment. With better communication, outcomes are improved through higher patient understanding, satisfaction, and adherence to care plans.
Engines of Success for U.S. Health Reform?
Eric B. Larson, MD, MPHVice President for Research, Group Health Executive Director, Group Health Research Institute
Trauma Informed Primary Care for Women Living with HIV ANAC Webinar May 2014Carol Dawson-Rose
This document presents a conceptual model for a trauma-informed primary care environment. The three core components of the model are:
1. A trauma-informed environment that is safe, calm, and empowering for patients and staff. Providers are educated about trauma's impacts and the clinical flow reduces triggers to promote trust and healing.
2. Universal screening for current and lifelong trauma, including abuse, as well as consequences like complex PTSD, depression, and substance abuse. Screening is patient-led but routine.
3. Screening is directly linked to on-site and community interventions. For recent trauma, safety and autonomy are prioritized. For lifelong abuse, longer-term evidence-based group interventions address
1) Family medicine involves providing comprehensive healthcare services to patients in their own homes to promote health, minimize illness effects, and restore function.
2) It serves patients with chronic conditions, acute episodic illnesses, or who need medical supervision after being discharged from the hospital or who are terminally ill.
3) Care includes medical treatment, nursing, rehabilitation, counseling, and coordinating community resources to support patients.
This document discusses mental health services and PTSD among veterans. It covers several topics:
1) Post-traumatic stress disorder (PTSD) rates and symptoms among veterans from different eras. Rates of PTSD are high and symptoms include flashbacks, nightmares, and suicidal ideation.
2) Legislation and policies aimed at improving access to mental healthcare for veterans, such as the Clay Hunt Act which requires annual evaluations of VA mental health programs and increased collaboration with outside organizations.
3) Questions around adequate funding for veteran mental healthcare, as funding amounts are unclear and appear insufficient to meet the high need for treatment.
This document provides background information and context for a case study about implementing lean principles at HomeCare, a large Canadian home health care organization. It summarizes that HomeCare was facing issues like poor service, long scheduling times, and low employee satisfaction due to siloed processes and lack of coordination. HomeCare leadership brought in consultants to redesign the entire service process from a lean perspective. The consultants conducted interviews and surveys, and recommended piloting redesigned processes in two districts before expanding organization-wide. The pilots were very successful, dramatically improving key metrics like scheduling times. This provided proof and momentum to redesign additional districts using the lean methodology.
Home health nursing services allow individuals to receive healthcare in their own homes, providing comfort and dignity. Services may include skilled nursing, physical therapy, occupational therapy, social services, and more. Care is provided through developing a treatment plan with the patient's physician, making regular visits to work towards goals, and documenting progress for quality assessment.
Social support among the Caregivers of Persons Living with Cancerinventionjournals
:The social support emphasize as the support given to any person in a troublesome or burdensome situation by family members, relatives as well as resources exerted by social connections, is effective in promoting physical health and feeling oneself good. The present study consisted of 300 caregivers of persons with cancer was selected based on simple random sampling, and with inclusion and exclusion criteria. Those patients satisfying the inclusion and exclusion criteria and attending both outpatient and inpatient services of cancer specialty hospital in KIDWAI Bangalore, Karnataka were selected randomly. The data was collected from the patients & caregivers of persons living with cancer who fulfill the inclusion/exclusion criteria were taken up for the study after their consent. Multidimensional Scale of Perceived Social Support (Zimet et al, 1998) was administered to understand Perceived Social Support. The interviews and the instruments were administered by research experts.The Results suggest that there were poor social support found in caregivers of married, female, belong to rural domicile, illiterate, and,caregivers who were not heard about the treatment of cancer.
There have always been substantial gaps in healthcare services for the higher-risk populations. Despite the best intentions of structure managed care programs introduced as early as the 1970’s, these gaps persist. This isn’t breaking news—over the past two decades, the term “vulnerable populations” has gained prominence in the healthcare industry. Messaging in the late 1990s to early 2000s was consistent: Certain populations are at greater risk because of who they are and where they live, regardless of their actual health condition.
Home health care involves providing medical care and services to individuals in their homes. It allows patients to receive skilled care while maintaining independence. The nursing process is used to assess patients' needs, develop care plans, implement care, and evaluate outcomes. Services typically include skilled nursing, therapy, and home health aide visits. Home health care allows patients to heal in a comfortable environment and reduces health care costs. It is a growing sector both in the US and India due to aging populations and increased chronic conditions.
David Levine: Environmentally conscience planningNuffield Trust
This document outlines the reform of Quebec's health and social services system. Key points include:
- The reform introduced a population-based managed care model with multidisciplinary teams responsible for rostered clients.
- Health and Social Services Centers were created by merging various institutions to provide integrated services through local networks.
- The reform aimed to improve access to services, care continuity, and population health while reducing costs through prevention and chronic disease management.
- Primary care teams play a central role in coordinating services and guiding clients to the appropriate level of care.
Asthma is a chronic lung disease that affects many residents of Ingham County, Michigan, and uncontrolled asthma can result in expensive hospitalizations. The rate of asthma-related hospitalizations is higher in Ingham County than statewide, with over 350 asthma hospitalizations occurring in the county in 2008. The document examines the costs of asthma hospitalizations and the county health department's plans to introduce a home-based asthma case management program to help reduce hospitalizations.
The document defines key public health terminology used by the Oregon Health Authority, including definitions of public health concepts like access, assessment, assurance, behavioral risk factors, benchmarks, best practices, boards of health, cultural competence, determinants of health, environmental health, epidemiology, and essential public health services. It also describes several federal agencies that support public health work, such as the CDC, HRSA, FDA, and EPA.
The document provides contact information for various Booz & Company experts located around the world who can assist with e-health initiatives. It then discusses the key elements needed for a successful e-health ecosystem, including governance policies, financing models, technology infrastructure, services, and stakeholders. The document emphasizes that e-health programs require a holistic, long-term approach considering all interconnected parts of the ecosystem, and that solutions must be customized to local conditions.
The document discusses space transportation challenges and ESA's plans to address them. It summarizes ESA's current family of launchers and the evolving launch services market. Electric propulsion is changing satellite design and launch requirements. ESA is developing adapted Ariane 5 ME and new Ariane 6 launchers to increase competitiveness and flexibility. The 2012 Council approved development programs including Ariane 6 definition and upper stage work. Ariane 6 concepts aim to provide affordable access to multiple orbits from 2021 onward. Synergies between Ariane 6 and Vega C are being assessed.
Maryland benefit corporations analysis full reportAmy Kincaid
The first study of the first Benefit Corporations and Benefit LLCs in the country in the first state to pass the laws (Maryland), and released by the first Benefit LLC, ChangeMatters. Research was conducted during the 2012 Fall semester by an MBA team at the Robert H. Smith School of Business's Center for Social Value Creation at University of Maryland as part of the Smith Experience.
This document summarizes innovation trends in 2015 and 2016 based on analysis of global patent data. Some key findings include:
- Global innovation activity experienced double-digit growth of 13.7% in 2015, driven by increased collaboration between organizations.
- Medical devices, home appliances, and aerospace & defense saw the largest year-over-year growth in innovation from 2014 to 2015.
- Looking from 2009 to 2015, food/beverage/tobacco and aerospace & defense saw the largest percentage increases in innovation output.
- Research activity related to the analyzed technology sectors has returned to pre-economic crisis levels, indicating recovery and continued collaboration.
La estratega de cuentas asociadas de Google Latam, Inés Peralta Agüero, compartió sus conocimientos sobre marketing digital.
La experta habló sobre los pasos para tener éxito en el marketing digital de servicios. Detalló cómo las aplicaciones móviles se han convertido en una parte integral de lo que denominó “nuestros micro momentos cotidianos”, situaciones que nos llevan a buscar ayuda en Internet, por ejemplo, y la importancia de que la marca de nuestros productos esté presente.
Peralta destacó la necesidad de que quienes estar interesados en el mercadeo digital adopten un nuevo modelo mental centrado en la audiencia y en las diferencias que hay entre quien aún no está decidido a adquirir un bien y quien ya está convencido de hacerlo. A cada una de estas audiencias, dijo, hay que darles el contenido correcto.
Booz co 2013-global-innovation-1000-study-navigating-the-digital-future_fact-...Dmitry Tseitlin
The document discusses Booz & Company's 2013 Global Innovation 1000 study which analyzes trends in R&D spending and the impact of digital technologies across industries. Key findings include:
- Global R&D spending grew 5.8% in 2013 to a record $638 billion, a slower rate than the prior two years.
- The top spending industries remained Computing & Electronics, Healthcare, and Automotive which combined accounted for 74% of spending growth.
- China increased R&D spending the most at 35.8% but growth is decelerating, while North America grew faster than average and Europe and Japan slower.
- Software/Internet saw the largest spending rise and most innovative companies again outperformed top
The document discusses creating an innovative culture in organizations. It argues that culture is important and difficult to change. An innovative culture is characterized by behaviors like collaboration, open feedback, informed decision making, and encouraging experimentation. The key imperatives for changing culture are to work with the existing culture, start by changing behaviors not mindsets, mobilize both rational and emotional forces, and spread behavior changes virally. Case studies of companies that successfully changed their culture are also presented.
The document is an investor presentation by SolarCity that provides forward-looking statements regarding the company's growth opportunities in the customer and market, operations, financing strategies, and future financial and operating results. It notes key risks and uncertainties that could impact actual performance, including demand for solar energy systems, supply and pricing of solar components, integration of acquisitions, cost reduction goals, access to capital, regulatory policies, and general market conditions.
Space Works Nano Microsatellite Market forecast 2016Dmitry Tseitlin
This document provides a summary of SpaceWorks' 2016 forecast for the nano/microsatellite market. Some key points:
- SpaceWorks predicts over 480 nano/microsatellites (1-50kg) will launch globally in 2016-2018, a 35% increase from their 2014 forecast, driven by growing commercial interest.
- The commercial sector is expected to contribute over 70% of future satellites compared to 37% in 2009-2015.
- More than 70% of future satellites will be used for Earth observation and remote sensing, compared to 37% in 2009-2015.
- While still popular for academia, 1-3kg CubeSats will decline to under 30% of the market
The Indian retail industry is at a crossroads facing many challenges. A study identified innovations in Indian retail and analyzed them to learn lessons that could help retailers. One key lesson is that a simple, well-executed idea can lead to successful innovation without large investments. An example is Tanishq's introduction of the "Karat Meter" which changed jewellery retail by increasing transparency and building trust with customers through accurate quality measurements.
Performance Driven Architecture V2 August 2010dfnewman
This document outlines Booz & Company's performance-driven architecture framework. The framework aims to focus and align an organization's architecture capabilities to create business value. It does this through a strategy-led approach that unlocks and delivers business value across the architecture lifecycle. The framework provides capabilities to integrate architectural efforts across enterprise, domain, and solution levels and manage performance through metrics. Booz & Company recommends a multi-phased approach to implement the framework for an organization.
The IoT Food Chain – Picking the Right Dining Partner is Important with Dean ...gogo6
Download our special report, IoT Tech for the Manager: http://bit.ly/report1-slideshare
The IoT Food Chain – Picking the Right Dining Partner is Important as presented at the IoT Inc Business' fourteenth Meetup. See: http://www.iot-inc.com/internet-of-things-value-chain-meetup/
In our fourteenth Meetup we have Dean Freeman, Research VP at Gartner presenting “The IoT Food Chain – Picking the Right Dining Partner is Important”.
Presentation Abstract
The Internet of Things means many different things to different people. What is key about the IoT is there is a distinct food chain that runs from the silicon devices to the services and then back. The level of success you will have in the IoT is heavily dependent upon where you fit in the food chain, and if you have the capability to move up the chain or across the chain into different verticals. In this presentation we will explore the food chain, what is important and what steps need to be taken to succeed in the world of the IoT.
Auto shoppers are open to influences. Today’s auto intenders are open-minded with 72% of search sessions involving cross-shopping. In-market shoppers are researching more than ever. While time in-market is roughly the same, these shoppers are turning to 24 research touch points on average. Connected devices are driving greater research activity. Mobile usage has increased 35% year over year, with a focus on research and comparison activities. Video influences auto brand discovery and consideration. Video research is on the rise and online video was the #1 format for encouraging brand consideration. Dealer interaction and post-purchase experiences matter. 62% of the vehicle owners said customer service could influence future purchases.
Social Media strategy - the rise of social apponomicsTamara Obradov
Booz & Company's social media breakfast meeting presentation from November 3rd 2010. We discuss why social media does matter, what the value is and how to capture the value. It also offers for the first time ever a sizing of the social commerce market (directly selling goods through social media) in this era of social apponomics.
Mercer Capital's Value Focus: FinTech Industry | Second Half 2016Mercer Capital
Mercer Capital’s newsletter, FinTech Watch, provides an overview of the FinTech industry, including public market performance, valuation multiples for public FinTech companies, and articles of interest from around the web. This newsletter focuses on FinTech segments, including payment processors, technology, and solutions companies, examining general economic and industry trends as well as a summary of M&A and venture capital activity.
Making health management services work in the GCCJad Bitar
This document discusses the need for health management services (HMS) programs in Gulf Cooperation Council countries to address rising rates of chronic diseases. It notes that HMS programs can help patients manage chronic conditions, lower healthcare costs, and improve relationships between patients and providers. However, for HMS programs to succeed in GCC countries, governments and organizations must address strategic questions about objectives, program design, incentives, and funding before implementation.
The document discusses the patient-centered medical home (PCMH) model, which aims to transform primary care delivery in the US healthcare system. It describes the principles of the PCMH model, including having a personal, long-term relationship with a primary care provider and their care team. The document also notes challenges with the current US system, such as rising costs, lack of care coordination, and physician shortages. It argues that the PCMH model could help address these issues if implemented according to best practices.
The document proposes that the Texas Department of Insurance adopt new rules allowing insurance payments for non-traditional public health services to help control chronic disease costs. It argues that chronic diseases account for the majority of healthcare spending and can be prevented or better managed through programs like self-management education, community health workers, and lifestyle interventions. New payment rules could help fund these services and reduce insurance premiums for individuals and employers that lower chronic disease rates in their communities. The goal is to bend the healthcare cost curve by preventing chronic diseases before medical treatment is needed through a comprehensive population health model.
This document discusses the promise of population health management (PHM) to improve healthcare in the United States. It outlines some of the key challenges with the current system, including a declining primary care workforce, fragmentation of care, and a lack of focus on prevention. The document then defines PHM and some of its core aspects, such as organized systems of care, care teams, and a focus on both medical and lifestyle factors that influence health. It also discusses some of the obstacles to implementing PHM, including the fee-for-service payment system and lack of health IT use. The document argues that new models like accountable care organizations and the patient-centered medical home show promise for enabling PHM and overcoming some of the current
Matthew selwyn bert, mha628, week 3 assignment.Berttrin
Johnson & Johnson supports disease management programs to promote health, decrease costs, and reduce preventable diseases. Their programs aim to improve the health of those with chronic conditions and reduce associated healthcare costs. This includes encouraging healthy behaviors, identifying those at risk, coordinating care, and using incentives and disincentives to encourage compliance. Evaluation of their programs shows improved quality of care, though evidence of cost savings is limited. Chronic diseases account for most US healthcare spending, so prevention and management can provide significant benefits.
Effective Disease Management (DM) can improve the health of many Americans suffering from chronic illness while reducing costs to patients, health care providers, employers and more. Discover how use of DM from McKesson is helping to improve patient safety and medication safety.
The Important Role of Population Health Management in Enhancing Healthcare | ...Enterprise Wired
Benefits of Population Health Management: 1. Improved Health Outcomes 2. Cost-Efficiency 3. Enhanced Patient Experience 4. Health Equity and Accessibility
Whsrma 2013 grundy singapore april 2013Paul Grundy
The document discusses the patient centered medical home (PCMH) model which aims to transform healthcare delivery from episodic care to population health management. It provides an overview of the key components of the PCMH model including acting as a system integrator across providers, driving primary care redesign, and offering utilities for population health and financial management. Studies show PCMHs can lead to reductions in hospital and ER use as well as lower overall costs. The PCMH framework focuses on features like patient-centeredness, comprehensive and coordinated care, improved access, and a commitment to quality and safety.
Tackling Post-Ebola Health Recovery: Strengthening health system capacity to ...JSI
The document describes a program to support Ebola virus disease (EVD) survivors in Sierra Leone. It found that 10% more survivors were able to lead healthy lives due to the program's interventions. Stigma against survivors from healthcare workers decreased by 12%. The program helped reduce stigma through peer support from Survivor Advocates. However, advocates were terminated without the planned transition to community health workers. The document recommends ensuring transitions between short and long-term support mechanisms are properly planned and communicated. It also discusses improving survivors' access to services and drugs long-term through strengthened health systems.
The document presents a strategic framework for the U.S. Department of Health and Human Services (HHS) to improve health outcomes for individuals with multiple chronic conditions. Approximately 75 million Americans have two or more chronic illnesses like arthritis, diabetes, and heart disease. These individuals face higher costs, worse health outcomes, and complex care needs. The framework aims to shift care from focusing on single diseases in isolation to a holistic approach that addresses all of a person's conditions. It establishes goals, objectives, and strategies for HHS agencies to better coordinate care, research, and policies related to multiple chronic conditions.
The document discusses challenges facing global healthcare systems including rising costs, lack of access, and variable quality of care. It argues that healthcare is increasingly turning to digital technologies like electronic medical records, telehealth, and analytics to simultaneously expand access, improve quality, and reduce costs. Specific examples are provided of initiatives leveraging these technologies to increase coordination between providers, empower patients in self-management, and generate insights from integrated data to personalize care and identify inefficiencies. The potential of these innovations to help build more sustainable healthcare systems is explored, along with barriers currently limiting their wider adoption.
1. Community Care Teams and the Patient-Centered Medical Home (PCMH) model can be enhanced by including mental health and substance use services and care coordination to create a Person-Centered Healthcare Home (PCHH).
2. Community Care of North Carolina uses Community Care Networks (CCNs) that are public-private partnerships providing coordinated care through medical homes. Preliminary results show improved care for patients with chronic conditions and cost savings.
3. CCNs employ care managers who work with medical homes to coordinate care for high-risk patients through activities like patient education and addressing barriers to care.
Population health management real time state-of-health analysispscisolutions
To lower health costs, physician networks and medical homes must employ a closed loop population management program that focus on patient SOH stratification, chronic disease management, care coordination and incentive management. This approach will enable them to consistently reduce ER and inpatient admissions, which are the greatest expenditures in health care today.
PSYCHIATRIC SERVICES ♦ March 2002 Vol. 53 No. 3 229933.docxamrit47
PSYCHIATRIC SERVICES ♦ March 2002 Vol. 53 No. 3 229933
Virtually every state in the Unit-ed States now uses managedcare techniques to control be-
havioral health costs for Medicaid re-
cipients. Implementation of these
strategies has proceeded in the ab-
sence of substantial information on
the resulting quality of care and ef-
fectiveness of services (1). Advocates
for persons who have severe mental
illness have raised concerns about the
application of cost-cutting techniques
developed in the private sector for
employed persons with acute illness-
es to persons in Medicaid and other
public-sector programs who have
persistent serious mental illness (2).
We wanted to compare the service
use patterns of Medicaid recipients
with serious mental illness in a full-
risk (capitated) and a no-risk (fee-for-
service) system of care and to deter-
mine whether the type of financial
risk arrangement affected patients’
health status.
Many state Medicaid agencies use
capitation—the prepayment of an es-
tablished fee per person for a defined
benefit over a set period—to keep
their costs predictable and limited. In
some instances a single capitated pay-
ment is made to a managed care or-
ganization (MCO). In these ostensi-
bly integrated plans, behavioral
health care can be provided directly
by MCO providers, by behavioral
health professionals who are paid on a
discounted fee-for-service basis, or
even by a behavioral health MCO or
another agency through a subcon-
tract. In other cases, the state Medic-
aid agency can carve out the behav-
ioral health benefit by making capi-
tated payments directly to a behav-
ioral health MCO.
Managed care programs that use
capitated payments to transfer finan-
cial risk to for-profit entities that are
responsible for the care of vulnerable
populations are of particular concern.
Specifically, the incentives of capita-
tion to lower costs and limit service
use may lead to worse outcomes for
persons with severe mental illness,
who often have multiple and inten-
sive service needs.
State Medicaid agencies that pay
for mental health care on a fee-for-
service basis also use cost-control
measures. Often an administrative
services organization that is not con-
Service Use and Health Status of Persons
With Severe Mental Illness in Full-Risk
and No-Risk Medicaid Programs
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Dr. Morrissey, Dr. Stroup, and Mr. Ellis are affiliated with the Cecil G. Sheps Center
for Health Services Research of the University of North Carolina at Chapel Hill, 275 Air-
port Road, Chapel Hill, North Carolina 27599-7590 (e-mail, [email protected]).
Dr. Merwin is with the Southeastern Rural Mental Health Research Center of the Uni-
versity of Virginia in Charlottesville.
Objective: The service use patterns and health status outcomes of Med-
icaid r ...
This e-book focuses on Health Management Solutions the value it adds alongside other systems that are already in place throughout the care lifecycle...
Running head DISEASE MANAGEMENT1DISEASE MANAGEMENT4.docxsusanschei
Running head: DISEASE MANAGEMENT 1
DISEASE MANAGEMENT 4
Disease Management
Weltee Wolo
Rasmussen College
Author Note
This paper is being submitted on April 17, 2017, Laura De La Cruz’s
Foundations of Managed Care H310/HSA3109 course
Disease Management
Disease management entails the reduction of costs plus improving the quality of life for the persons suffering from chronic diseases. This is achieved through prevention and minimization of the effects of the conditions through an integrated care. It can be defined as a system of organized medical involvements and communications within a distinct patient populaces with conditioned where implementation of self-care efforts can be applied (Nolte&Osborne, 2013). Disease management empowers persons together with other health care providers so as to manage their conditions and prevent avoidable complications. The chronic diseases and associated complications are identified quite earlier, and more efficiently, hence the development of the diseases is slowed.
Disease management has evolved as a hopeful approach for care improvement for the persons with chronic diseases. The common chronic conditions include; hypertension, diabetes mellitus, asthma, chronic obstructive pulmonary disease, congestive heart failure, and coronary heart disease. Often, persons with chronic diseases end up using more health care services that are not coordinated among the health providers; thus the patients are prone to be subjected to overuse and underuse of medical care as the providers take advantage of the situation (Ahn, et al, 2013). Disease management is a practical and an organized approach directed to a health care delivery that incorporates all persons with chronic illness, includes patient self-management, measures results, supports the provider-patient relationship and plan of care, and evaluates health status regularly. It also enhances the patient care through disease prevention and active meditations by evidence-based procedures and strives to improve the general health and quality of life while lowering the cost of care.
Disease management programs have been established, and they contain many components which make the programs effective. The components include; identification processes of the population, evidence-based practice guidelines, collaborative practice involvement which involve the physicians, psychologists, nurses. Also dieticians and pharmacists, identification of risks and corresponding of interventions to the need, educating patient of self-management, measurement, and evaluation of the processes and results, and trailing and observing the system. The aim of disease management is to encourage the patients to use medications correctly, to comprehend and see the symptoms more carefully and by all possible means change the behavior (Nolte & Osborne, 2013).
Managed care system is an intervention that is well integrated with the disease management. Managed care organizations are in ...
This document discusses the growing recognition of integrating patients and families into healthcare planning and delivery through a model of patient- and family-centered care. It provides examples from individual hospitals and healthcare systems that are partnering with patients at all levels from direct care to policy-making and education. The key aspects of patient- and family-centered care involve dignity and respect, information sharing, participation in decision-making, and collaboration between patients, families and healthcare providers.
1092 (16-17) Operational Framework Management of Common Cancers (1)Mayank Sharma
This document provides an operational framework for screening and management of common cancers in India. It aims to strengthen early detection and appropriate treatment of breast, cervical and oral cancers, which are common and amenable to early detection. The framework lays out guidelines for organizing referral networks and treatment services across primary, secondary and tertiary levels. It also addresses human resource requirements, training strategies, behavior change communication, program monitoring and financing to implement screening and management of these common cancers nationwide. The overall goal is to improve health outcomes and quality of life for cancer patients while reducing out-of-pocket costs through a public health approach.
The document discusses CMS's Chronic Care Management program, which pays providers to coordinate care for Medicare patients with multiple chronic conditions. Key points:
- The CCM program pays providers $42 per patient per month to perform 20 minutes of care management and coordination activities outside of office visits.
- To qualify for CCM, patients must have Medicare fee-for-service and two or more chronic conditions expected to last over a year.
- Eligible providers must obtain patient consent and provide 24/7 access, care management, care coordination, and electronic care plans shared with other providers.
- The program aims to improve outcomes and lower costs for patients with multiple chronic conditions by encouraging coordinated chronic care management between visits
Similar to Getting a handle on chronic disease (20)
10 Benefits an EPCR Software should Bring to EMS Organizations Traumasoft LLC
The benefits of an ePCR solution should extend to the whole EMS organization, not just certain groups of people or certain departments. It should provide more than just a form for entering and a database for storing information. It should also include a workflow of how information is communicated, used and stored across the entire organization.
Mercurius is named after the roman god mercurius, the god of trade and science. The planet mercurius is named after the same god. Mercurius is sometimes called hydrargyrum, means ‘watery silver’. Its shine and colour are very similar to silver, but mercury is a fluid at room temperatures. The name quick silver is a translation of hydrargyrum, where the word quick describes its tendency to scatter away in all directions.
The droplets have a tendency to conglomerate to one big mass, but on being shaken they fall apart into countless little droplets again. It is used to ignite explosives, like mercury fulminate, the explosive character is one of its general themes.
- Video recording of this lecture in English language: https://youtu.be/Pt1nA32sdHQ
- Video recording of this lecture in Arabic language: https://youtu.be/uFdc9F0rlP0
- 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
Travel vaccination in Manchester offers comprehensive immunization services for individuals planning international trips. Expert healthcare providers administer vaccines tailored to your destination, ensuring you stay protected against various diseases. Conveniently located clinics and flexible appointment options make it easy to get the necessary shots before your journey. Stay healthy and travel with confidence by getting vaccinated in Manchester. Visit us: www.nxhealthcare.co.uk
Does Over-Masturbation Contribute to Chronic Prostatitis.pptxwalterHu5
In some case, your chronic prostatitis may be related to over-masturbation. Generally, natural medicine Diuretic and Anti-inflammatory Pill can help mee get a cure.
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.
5-hydroxytryptamine or 5-HT or Serotonin is a neurotransmitter that serves a range of roles in the human body. It is sometimes referred to as the happy chemical since it promotes overall well-being and happiness.
It is mostly found in the brain, intestines, and blood platelets.
5-HT is utilised to transport messages between nerve cells, is known to be involved in smooth muscle contraction, and adds to overall well-being and pleasure, among other benefits. 5-HT regulates the body's sleep-wake cycles and internal clock by acting as a precursor to melatonin.
It is hypothesised to regulate hunger, emotions, motor, cognitive, and autonomic processes.
The skin is the largest organ and its health plays a vital role among the other sense organs. The skin concerns like acne breakout, psoriasis, or anything similar along the lines, finding a qualified and experienced dermatologist becomes paramount.
These lecture slides, by Dr Sidra Arshad, offer a simplified look into the mechanisms involved in the regulation of respiration:
Learning objectives:
1. Describe the organisation of respiratory center
2. Describe the nervous control of inspiration and respiratory rhythm
3. Describe the functions of the dorsal and respiratory groups of neurons
4. Describe the influences of the Pneumotaxic and Apneustic centers
5. Explain the role of Hering-Breur inflation reflex in regulation of inspiration
6. Explain the role of central chemoreceptors in regulation of respiration
7. Explain the role of peripheral chemoreceptors in regulation of respiration
8. Explain the regulation of respiration during exercise
9. Integrate the respiratory regulatory mechanisms
10. Describe the Cheyne-Stokes breathing
Study Resources:
1. Chapter 42, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 36, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 13, Human Physiology by Lauralee Sherwood, 9th edition
3. EXECUTIVE The growing prevalence of chronic diseases in Gulf
Cooperation Council (GCC)1 nations has socioeconomic
SUMMARY
implications that are quickly adding up. Chronic diseases
generate higher healthcare costs, which are borne by govern-
ments, insurers, and patients. They also lower productivity
among workers, clog healthcare service channels, and bring
about declines in a population’s health status. As GCC nations
continue to invest in their healthcare systems, the region’s
leaders should take their cue from certain developed nations in
adopting health management services (HMS) to help address
the specter of a chronic disease epidemic.
HMS programs address critical gaps practices—including effective use of
in the care of chronically ill patients incentives, physician involvement, and
by helping them understand the personalization—can help HMS pro-
implications of their disease and grams achieve their goals. But before
underlying lifestyle factors, amend GCC governments and healthcare
their harmful behavior, adhere to organizations can implement HMS
treatment regimens, and navigate the programs, they will need to answer
healthcare system. HMS programs strategic questions about the segments
have been proven to be successful at of society that should be targeted, the
improving individuals’ health and programs that will be most relevant,
generating significant savings for the incentives that would encourage
healthcare payors when all stakehold- involvement, the funding mechanism
ers—patients, physicians, hospitals, that will support HMS, the objec-
insurers, and government—buy into tives of the program, and the roles of
their development. A number of best public and private entities.
Booz & Company 1
4. KEY HIGHLIGHTS
• HMS programs are a key tool in
the effort to halt the rise of chronic
diseases in GCC countries and
keep healthcare costs in check.
• Numerous studies have
demonstrated the benefits of
HMS on individuals’ health
and on overall healthcare cost
management.
• HMS programs blend wellness
services that provide healthy
individuals with information and
encouragement to better manage
their health risks with disease
management that increases
chronically ill patients’ compliance
THE RUNAWAY hidden costs on society, such as lower
worker productivity. Recent research
with prescribed treatments. COSTS OF shows that on-the-job productivity
• Effective HMS programs are CHRONIC losses account for up to 60 percent2 of
the total healthcare costs associated
characterized by three common
themes: incentives to ensure
DISEASES with chronic diseases.
patient participation, strategies to
To counter these trends, care provid-
involve physicians as key program
ers in North America are increasingly
facilitators, and communications
turning to health management services
and incentives that are tailored to
(HMS). These services primarily work
individual preferences. Around the world, unhealthy lifestyles
in two ways: They help mitigate the
and aging populations are leading to a
spread of chronic diseases by estab-
higher prevalence of chronic disease,
lishing wellness programs and other
thus driving up healthcare costs and
preventive strategies, and they reduce
keeping economies from perform-
the costs of treating chronic diseases
ing at their true potential. Chronic
once they are diagnosed through
diseases strain healthcare providers
ongoing monitoring and frequent
and the overall healthcare system
interaction with patients.
with patients’ frequent and costly
trips to the emergency room (ER)
HMS will be a critical element of
and longer average stays. Long and
GCC countries’ overall healthcare
resource-intensive treatment periods
strategies in the future, as chronic
make patients with chronic disease
diseases exact a toll in terms of costs,
heavy users of healthcare services,
strain on providers, and healthcare
leading them to consume a dispropor-
status: In the coming years, chronic
tionate amount of the total available
diseases are expected to account for
services. This has a severe impact on
a significant portion of healthcare
the distribution of those services and
expenses. As governments, healthcare
clogs providers’ ER and other delivery
organizations, and private insurers in
channels.
the region look to develop a compre-
hensive health management strategy
Chronic diseases not only negatively
that addresses this mounting problem,
affect a population’s general health
HMS programs are a key tool.
status, but they also levy serious
2 Booz & Company
5. A PRESSING The rapid economic expansion of the
GCC region has brought its member
an increasing prevalence of chronic
diseases among their citizenry.
PROBLEM FOR nations the benefits of advanced
GCC NATIONS “developed” countries—higher stan-
dards of living, lower unemployment,
In the typical GCC country today,
chronic diseases are a leading cause
and increased purchasing power. of mortality; in 2007, the region was
But along with such advantages also home to four of the top five nations
come new and pressing challenges, in the world for diabetes cases among
particularly in the realm of health- adults (see Exhibit 1). Based on data
care. In recent years, GCC nations available from several GCC geog-
effectively combated typical “third raphies, chronic diseases currently
world” health challenges such as account for approximately 35 percent
tuberculosis and malaria. However, or more of the deaths in those
due to the rapid growth and develop- regions—fast approaching levels in
ment of the region and the resultant developed countries such as the U.S.,
change in lifestyles, GCC leaders where chronic diseases account for an
are now turning their attention to estimated 70 percent of mortalities.
Exhibit 1
Prevalence of Chronic Diseases in the GCC Region
LEADING CAUSES OF DEATH IN ABU DHABI
2007
23%
Accidents/Injury
32%
Cardiovascular
Cancer
Diabetes
18% Congenital
6% Other
7%
14%
PERCENTAGE OF ADULT POPULATION WITH DIABETES BY RANKING
2007
30.7%
19.5%
16.7%
15.2% 14.4%
13.1%
11.0%
7.8%
Nauru UAE Saudi Bahrain Kuwait Oman Egypt USA
Arabia
Source: HAAD statistics; World Health Organization
Booz & Company 3
6. Lifestyle factors in the GCC region Because many of these factors are not ditures than governments in other
have contributed mightily to this addressed before they mature into parts of the world. Public spending
scourge, setting the stage for the chronic diseases, GCC governments on healthcare averaged 74 percent
creation of a chronic disease epi- are being forced to dedicate more of in GCC countries in 2006, nearly 20
demic. Increasing affluence in GCC their budgets to treat a growing wave percentage points higher than the
countries has caused a once highly of patients. In the UAE, where one in global average of 57 percent4 (see
active population to become largely every five adults is afflicted with dia- Exhibit 2). But the issue also looms
sedentary, resulting in reduced levels betes, treatment of that illness alone large for the private insurance compa-
of physical activity, increased smoking takes up approximately 40 percent of nies that are entering GCC markets,
rates, and other unhealthy lifestyle the nation’s overall healthcare expen- which need to keep their costs down
changes. These changes are triggering ditures.3 The burden posed by chronic to remain competitive.
heightened obesity rates and inci- diseases weighs more heavily on GCC
dences of hypertension, key factors governments because they shoulder
that contribute to chronic disease. a greater share of healthcare expen-
Exhibit 2
GCC Governments Contribute Significantly More to Healthcare Costs Than the Global Average
SHARE OF PUBLIC EXPENDITURE IN HEALTHCARE
2006
90%
Public Expenditure as a % of Total Healthcare Expenditure
80%
GCC Average = 74%
70% Top 30 HDI* Average = 71%
60%
World Average* = 57%
50%
40%
30%
United Japan Sweden France Germany Canada Australia Switzerland Republic United China Oman Kuwait Saudi Qatar United Bahrain
Kingdom of Korea States of Arabia Arab
America Emirates
*HDI = Human Development Index; World Average is based on 177 countries; Top 30 excludes Hong Kong, for which figures were not available.
Source: WHO Statistical Information System, 2006 data
4 Booz & Company
7. ADDRESSING Needless to say, the rising socioeco-
nomic costs of chronic diseases have
Typically, chronically ill patients need
assistance in four major elements of
GAPS IN PATIENT caught the attention of GCC govern- their disease management: under-
CARE ments. Some have set up government
bodies and programs to develop
standing the implications of their dis-
ease, such as treatment options, risk
preventative healthcare strategies and factors, and potential complications;
address the low level of health aware- navigating the healthcare system
ness in the region. In many cases and communicating with the various
involving chronic diseases, consumers care providers, especially for patients
have little knowledge about preven- with multiple chronic diseases who
tion and management of their condi- must make multiple visits; gathering
tions. For instance, a study about information about the various actions
osteoporosis among educated women they need to undertake, including
in the UAE found that 44 percent self-care, dietary changes, and exer-
of women with at least a secondary cise; and complying with their care
school education had minimal or zero regimen, such as planning multiple
knowledge of the disease.5 provider visits and taking prescribed
medicines.6
To date, however, such government
programs have not been able to Currently, though, such needs are
fully address the escalating needs of filled only during formal physician
the GCC region’s large and grow- visits or informally by other sources
ing population of chronic disease such as family and friends. These
sufferers. Post-diagnosis, chronic interactions only partially address a
disease patients have a broad array of chronically ill patient’s continuous
clinical and non-clinical needs associ- need for care advice, monitoring, and
ated with managing their condition. compliance. As such, critical gaps in
Diabetics, for example, need to care provision exist before, between,
continually manage their disease, on and after provider visits, particularly
top of identifying and changing the when it comes to identifying high-risk
lifestyle factors that caused it. Their behavior, adhering to a treatment
responsibilities include measuring regimen, patient monitoring, and
blood glucose levels, taking insulin other elements of care coordination.
shots, and getting regular screenings
and tests.
Booz & Company 5
8. FACTS AND FIGURES
THE CASE FOR
• Obesity: GCC nations are home to some of the highest obesity rates in the
world. Thirty percent or more of the adult populations in Saudi Arabia, the
HMS
UAE, Kuwait, and Bahrain have a body mass index (BMI) of 30 or more,
the clinical definition of obese. In Abu Dhabi, the average BMI is 29 among
adults.i
• Smoking: GCC countries have a relatively moderate number of smokers—36 To close these gaps and improve
percent versus a global average of 33 percent. But on a per capita basis, the overall care of chronically
their annual intake of cigarettes is much higher, fueled by higher consumption ill patients, healthcare leaders in
among young males. For example, the average Kuwaiti smoker consumes some developed economies are
more than 2,500 cigarettes a year, compared with a worldwide average of employing HMS, which bundle a
900. prescribed set of healthcare services
into condition-specific programs
• Physical Inactivity: At least 40 percent of the GCC population fails to achieve
that are based on scientific evidence
the minimum daily recommendation of 30 minutes of moderate-intensity
and data analysis. The healthcare
physical activity. This rate is more than double the global estimate of 17
services address the patients’ needs
percent.ii
identified above: risk identification,
• Hypertension: Modernization has been directly linked to higher stress levels awareness and education, adherence
in GCC nations. Roughly 34 percentiii of the adult population in Abu Dhabi to treatment regimen, monitoring
has high blood pressure, compared with just 18 percent in the U.S. Statistics health indicators, and care
also reveal a high correlation between hypertension and the occurrence of coordination. The HMS program
diabetes. encourages individual members to
improve their health by creating
a support system that helps them
manage their condition, increasing
their awareness, providing critical
guidance, and employing incentives
to encourage healthy behavior. HMS
also strengthen relationships between
hospitals and their patients and
physicians, by creating a continuous,
longitudinal view of patient care that
competitors cannot match.
6 Booz & Company
9. As an example, diabetics enrolled in Coaching and intervention-related such savings are often difficult to
an HMS program designed to help services are at the core of HMS quantify, numerous studies have
manage their condition can expect the programs and they are typically demonstrated the benefits of HMS
following services: conducted by a call center staffed on individuals’ health, as well as on
by nurses. The call centers contact overall healthcare costs. For instance,
• Comprehensive diabetes plan patients to provide them with vari- a study published in Health Affairs
including diet, medication, exercise, ous services based on the program in 2004 showed an 8.1 percent drop
and screening in which the patient is enrolled in hospitalization costs of diabetes
(e.g., information on care regimen, patients after they were enrolled in
• Diabetes articles and the latest reminders for screening, coordinat- an HMS program to help manage
research on diabetes ing physician visits). Through these their treatment.7 A separate finding
coaching and intervention services, published in 2005 in the European
• Coordination with provider HMS provide consumers with the Journal of Public Health found that
information and guidance required HMS smoking cessation programs
• Remote consultation and setting of while coordinating care in order to resulted in a 15 percent to 35 percent
appointments help consumers manage their health quit rate, saving employers (here
and directly address the gaps in care collectively referred to as payors) an
• Diabetic community tools provision. average of US$11,880 per smoker
over their lifetimes.8
• Glycemic index counter and low By supporting individuals in main-
glycemic food guide taining their health and helping
chronic patients with their condi-
• Medication and screening test tions, HMS programs have a direct
alerts impact on healthcare costs. Although
By supporting individuals in
maintaining their health and helping
chronic patients with their conditions,
HMS programs have a direct impact
on healthcare costs.
Booz & Company 7
10. Such success stories have led health HEALTH MANAGEMENT GOES ONLINE
insurance companies and payors to
HMS providers are increasingly leveraging technology to conduct data analytics,
increasingly adopt these services as
integrate remote monitoring devices, and leverage alternative access channels.
a way of controlling their soaring
Still, it wasn’t until recently that HMS began migrating to Internet-based
healthcare costs. The HMS industry
platforms. Traditionally, health management programs were delivered solely
has been growing significantly in
through a nurse or a coach—an expensive medium for parlaying services. In the
early adopter markets such as the
interest of reducing costs, providers have begun effectively incorporating Web-
U.S., where it has enjoyed a com-
based programs in conjunction with coaches and nurse-staffed call centers.
pound annual growth rate of more
Another advantage to online HMS is it provides more leeway to personalize
than 25 percent over the past decade
program elements, which evidence shows increases patients’ participation in
and now enjoys a penetration rate
and compliance with HMS programs.
of 5 percent to 10 percent of total
insured lives.9 In recent years, pilot Citing these advantages, leading HMS providers are making acquisitions
HMS programs have begun to crop and other key investments to incorporate Internet-based models as a key
up in Latin America, Europe, and vehicle for delivering HMS programs. In fact, certain leading-edge providers
Asia. Payors especially have found have introduced programs that are delivered exclusively over the Internet.
these programs to be beneficial, due Leading HMS companies, including Healthways Inc. and Matria Healthcare,
to their positive impact on employee have made notable forays into online program delivery. Healthways has made
productivity and satisfaction. significant, targeted investments in this area, mainly focused on building an
Additionally, HMS programs are one internal technology team that could help it deliver an online platform for its
of the few options available to payors programs, while Matria, now part of Alere Medical, acquired online HMS provider
that believe that prevention needs to WinningHabits.com. Conversely, leading healthcare portals such as WebMD and
be a key element of their healthcare Revolution Health have purchased companies to add HMS programs to their
cost containment strategy. A recent already popular Web services.
evolution in the HMS delivery model
has been the integration of Internet-
based platforms, while face-to-face
coaching continues to be used to
deliver interventions (see “Health
Management Goes Online”).
HMS programs are one of the few
options available to payors that
believe that prevention needs to be a
key element of their cost-containment
strategy.
8 Booz & Company
11. KEY screenings and immunizations (e.g.,
flu shots), and share information to
Both types of HMS program are
typically designed around four major
COMPONENTS OF foster self-care practices. Follow-up components:
HMS PROGRAMS support is provided by on-site,
telephone-based, or online coaching • Adoption focuses on understand-
assistance through condition-specific ing members’ or employees’ needs,
programs such as weight manage- evaluating patients’ risk profiles
ment, smoking cessation, and stress through health-risk appraisals,
management. selecting the appropriate program
HMS programs are broadly classified and pricing strategy, and encourag-
as either wellness programs or disease Disease-management programs offer a ing adoption through marketing
management programs. Whereas prospective, disease-specific approach efforts and enrollment incentives.
the latter deals with patients already to coordinating the care of high-
afflicted with chronic diseases, the cost and high-risk populations with • Program delivery centers on core
former aims to reduce risk fac- chronic conditions, including dia- intervention elements that are
tors that cause the onset of chronic betes, asthma, and congestive heart designed to help the consumer
diseases in the first place through the failure. They typically involve a coor- manage his or her condition and
pursuit of mental and physical well- dinated set of healthcare interven- reduce risk factors through a per-
being. tions and communications designed sonalized delivery strategy.
to support the patient–physician
Typical wellness programs provide relationship by ensuring the patient’s • Monitoring sets clear performance
healthy individuals with information, compliance with the prescribed metrics, measures against them,
support, guidance, and encourage- care plan. These programs focus and verifies desired outcomes.
ment to better manage their lifestyle- on keeping conditions from being
related health risks. First, health-risk exacerbated, through co-morbidities • Improvement involves modifying
assessments help assign consumers to or other complications, by using the program elements to enhance
various risk groups. Then providers evidence-based practice guidelines the effectiveness of the program.
institute preventive measures such as and strategies to empower patients.
Booz & Company 9
12. PUTTING HMS To be sure, health management is
not an exact science, given that the
awareness of health issues in GCC
countries, there is greater reliance
INTO PRACTICE success of these programs depends on physicians by patients, making
to a large extent on their ability to physician involvement all the more
change behavior. The HMS industry critical. HMS programs in the region
is constantly innovating to develop will need to engage relevant physi-
new techniques to improve programs’ cian groups to obtain their buy-in
ability to ensure compliance, reduce and ensure their participation and
risk factors, and carry out preventive involvement.
screenings and thus deliver on their
promised benefits. There are three key Personalization: Tailoring com-
ingredients in successfully deployed munications and incentives to the
HMS programs, all of which can be individual’s tastes and preferences is
leveraged in GCC markets: a new and evolving trend credited
with increasing patient compliance
Incentives: Well-designed HMS with HMS programs. Participants
programs provide consumers with a receive personalized letters, educa-
variety of incentives to ensure partici- tional brochures, and booklets to
pation, such as reduced premiums, increase awareness. Incentives and
cash incentives, and redeemable other aspects of the plan’s design are
reward points akin to points given customized to adjust to the individual
by various reward programs. HMS participant’s ability to change. HMS
programs are also using negative providers are building large databases
incentives such as higher premiums of consumer information to document
or co-pays for non-participants. the success of interventions, incen-
Increasingly, programs are adopt- tives, and communications, and to
ing a combination of both—negative leverage these large data warehouses
incentives to ensure enrollment and to personalize their interactions with
positive incentives to effect behavioral other members.
change.
The ways in which these building
Physician Involvement: Coordinating blocks are used will be determined
program interventions and other by healthcare payors’ overall HMS
elements with the patient’s physi- strategy, which will require analysis,
cian is another critical facilitator in judgment, detailed design, and pilot-
assuring program efficacy. In a case ing of alternative concepts, as well
where drug adherence is identified as allocation of significant resources
as a problem, for instance, involving for implementation. Payors will also
the physician isn’t just about relat- likely require the involvement of lead-
ing critical information; it creates an ing disease management and wellness
opportunity for the physician to inter- companies from mature HMS mar-
vene and reinforce the importance of kets—primarily the U.S.—to ensure
sticking to the drug regimen. Given that the plan imperatives highlighted
the low level of health literacy and above are incorporated.
10 Booz & Company
13. CONCLUSION To help jump-start the process and
lay a sound foundation for successful
• What would be the financial and
health status objectives of HMS
implementation, GCC governments programs? Should GCC govern-
and healthcare organizations must ments support these programs if
assess their current overall healthcare the financial return on investment
strategy to address a number of stra- is not clear but there is a positive
tegic questions: impact on the health status of the
population? What will be the role
• How should HMS programs be of healthcare providers and health
integrated into their current health- insurance companies?
care strategic framework?
• Through which entity will the
• Which segments of the population programs be offered? Will it be a
will be targeted? How will the pro- public–private partnership between
gram design be modified to address a GCC government and an interna-
the cultural characteristics of the tional disease management/wellness
population? company, or will it be an entirely
private undertaking?
• Which HMS programs would
be most relevant for GCC • What policy initiatives will be
populations? required to support HMS rollout?
• What incentives will be required to • How will GCC governments ensure
ensure significant program adop- that other healthcare stakeholders,
tion among targeted segments? primarily providers, support the
rollout of the HMS programs?
• How will health management ser-
vices be funded? How will the costs • What will be the role of e-health in
(and risks) be distributed among delivering HMS to the population?
the various stakeholders?
Booz & Company 11
14. • How will the execution of HMS productivity, and immense strain on ing significant investments in their
programs be managed across the healthcare system. healthcare systems. Indeed, rapid
various governmental authorities? implementation of such programs is
What are the critical factors for the Well-crafted HMS programs are a within grasp for smaller markets in
successful execution and rollout of valuable tool that can help GCC the region.
HMS programs? nations stem the rising tide of chronic
diseases by helping to identify As GCC nations prime for a robust
Chronic disease management is unhealthy and risky behaviors, raise economic recovery, their leaders will
an issue that GCC nations can ill awareness of underlying lifestyle fac- need to put a premium on “smart
afford to ignore. Countries that fail tors, improve adherence to treatment growth” strategies. When it comes
to address this pressing concern run regimens, and strengthen the bonds to managing the population’s most
a real risk of being engulfed in a between patients and physicians. serious and costly illnesses, there is
chronic disease epidemic, resulting Now is an opportune time for GCC no smarter healthcare strategy than
in reduced health status, crippling nations to adopt HMS programs as HMS.
healthcare costs, lower workforce most GCC nations are undertak-
12 Booz & Company
15. Endnotes
1
The Gulf Cooperation Council consists of Bahrain, Kuwait, 7
Victor G. Villagra and Tamim Ahmed, “Effectiveness of a Disease
Oman, Qatar, Saudi Arabia, and the United Arab Emirates. Management Program for Patients with Diabetes,” Health Affairs,
vol. 23, no. 4, 2004, 255–266.
2
WHO Mortality Fact Sheet for Saudi Arabia (2006) and Qatar
Ministry of Health statistics. 8
Susanne R. Rasmussen, Eva Prescott, Thorkild I. A. Sørensen,
and Jes Søgaard, “The Total Lifetime Health Cost Savings of
3
“Treatment of Diabetes a Big Drain on National Healthcare Bud-
Smoking Cessation to Society,” European Journal of Public
get,” Gulf News, November 11, 2007.
Health, vol. 15, no. 6, December 2005.
4
WHO Statistical Information System, 2006 data. 9
Booz & Company estimates.
5
Haider M. Al Attia, Amal A. Abu Merhi, and Maha M. Al Farhan, i
Health Authority–Abu Dhabi (HAAD) statistics.
“How Much Do the Arab Females Know about Osteoporosis? The
Scope and the Sources of Knowledge,” Clinical Rheumatology, World Health Organization and Oxford Health Alliance; the rates
ii
vol. 27, no. 9, September 2008, 1167–1170. for physical inactivity in UAE were for the top and bottom quintiles
of income class.
6
A presumably simple element of the compliance regimen,
adherence to prescribed drug regimen, suffers from a large iii
HAAD statistics.
noncompliance rate.
About the Authors
Ramez Shehadi is a partner Walid Tohme is a principal with
with Booz & Company in Booz & Company in Beirut and
Beirut. He leads the informa- a leader in the information tech-
tion technology practice in the nology practice with a focus on
Middle East. He specializes in healthcare. He specializes in
e-government, e-business, and the management and strategic
technology-enabled transfor- use of technology to enable the
mation, helping both private transformation of healthcare
corporations and govern- organizations, services, and
ment organizations leverage infrastructure.
technology, achieve operational
efficiencies, and improve Jad Bitar is a senior associate
governance. with Booz & Company in Beirut
and a leader in the informa-
Ali Hashemi is a principal with tion technology practice with
Booz & Company in Dubai a focus on healthcare. He
and a leader in the healthcare specializes in healthcare and
practice in the Middle East. business technology, par-
He specializes in business ticularly strategy, organization,
strategy for players throughout operations, and innovation.
the healthcare value chain, as
well as advising government
entities on defining their overall
healthcare agendas.
Booz & Company 13