The patient-completed medical history facilitates the physician's interview by providing a comprehensive preliminary survey of the patient's medical history and problems in a systematic arrangement. This allows the physician to easily review the information and ensures they do not overlook important symptoms or past medical history due to time constraints, as the form draws their attention to significant details.
This document is an introduction to the Michigan State Oral Health Plan. It acknowledges contributions from government officials, health organizations, and advocates. The plan highlights the current status of oral health issues in Michigan, outlines a collaborative partnership to improve conditions, and recognizes more work is needed. It invites readers to provide feedback on a survey about how to use the information in the plan.
STEAM: Set Goals, Take Control, Eat Healthy, Accountability, MoveMPCA
The document describes a childhood obesity program called STEAM. It provides criteria for participation, goals of promoting healthy behaviors and lifestyle changes, and an overview of the program structure and components. The program is evidence-based and aims to collaborate with other organizations to help address the issue of childhood obesity.
This document celebrates 30 years of an organization that promotes, supports, and develops comprehensive and quality primary care for all residents of Michigan.
The document celebrates 30 years of promoting, supporting and developing comprehensive and quality primary care for all residents of Michigan. It focuses on primary healthcare for Michigan residents over three decades by promoting, supporting and developing services.
Celebrating 30 years of promoting, supporting and developing comprehensive, quality primary care for all Michigan residents. The document appears to be about an organization that has been working for 30 years to ensure access to primary health care for all residents of Michigan through promotion, support and development of services.
Michigan is expanding access to health centers to improve healthcare for residents. With funding from foundations, 11 community development grants were awarded to build or renovate health center sites. This will generate $3.6 million annually in federal funding for expanded services. The expansion aims to serve more of the 600,000 residents who rely on health centers for care, and reduce health costs by increasing access to primary care.
Media planning is generally the task of a media agency and entails finding media platforms for a client's brand or product.
The job of media planning involves determining the best combination of media to achieve the marketing campaign objectives.
This one sentence document celebrates 30 years of promoting, supporting and developing comprehensive and quality primary care for all residents of Michigan.
This document is an introduction to the Michigan State Oral Health Plan. It acknowledges contributions from government officials, health organizations, and advocates. The plan highlights the current status of oral health issues in Michigan, outlines a collaborative partnership to improve conditions, and recognizes more work is needed. It invites readers to provide feedback on a survey about how to use the information in the plan.
STEAM: Set Goals, Take Control, Eat Healthy, Accountability, MoveMPCA
The document describes a childhood obesity program called STEAM. It provides criteria for participation, goals of promoting healthy behaviors and lifestyle changes, and an overview of the program structure and components. The program is evidence-based and aims to collaborate with other organizations to help address the issue of childhood obesity.
This document celebrates 30 years of an organization that promotes, supports, and develops comprehensive and quality primary care for all residents of Michigan.
The document celebrates 30 years of promoting, supporting and developing comprehensive and quality primary care for all residents of Michigan. It focuses on primary healthcare for Michigan residents over three decades by promoting, supporting and developing services.
Celebrating 30 years of promoting, supporting and developing comprehensive, quality primary care for all Michigan residents. The document appears to be about an organization that has been working for 30 years to ensure access to primary health care for all residents of Michigan through promotion, support and development of services.
Michigan is expanding access to health centers to improve healthcare for residents. With funding from foundations, 11 community development grants were awarded to build or renovate health center sites. This will generate $3.6 million annually in federal funding for expanded services. The expansion aims to serve more of the 600,000 residents who rely on health centers for care, and reduce health costs by increasing access to primary care.
Media planning is generally the task of a media agency and entails finding media platforms for a client's brand or product.
The job of media planning involves determining the best combination of media to achieve the marketing campaign objectives.
This one sentence document celebrates 30 years of promoting, supporting and developing comprehensive and quality primary care for all residents of Michigan.
The document discusses the basic workflow of medical practice, which involves a patient having a complaint or illness, a doctor gathering information and determining a diagnosis or approach, communicating with the patient, and prescribing treatment. It then examines how medicine has changed since the days of Charles Dickens, with patients now able to call their general practitioner and have information entered into a computer by the doctor. The document also discusses alternatives to traditional doctor-patient dialogues, such as involving patients more directly through computerized medical histories.
This document summarizes a Six Sigma project conducted by Abu Dhabi Police Medical Services from January to June 2012 to improve defects in pre-analytical and post-analytical processes in their medical laboratory. The project aimed to reduce delay in laboratory results, improve patient safety, and increase customer satisfaction by defining, measuring, analyzing, improving, and controlling critical-to-quality factors affecting the significance and delay of laboratory test results. Data was collected over 10 days to analyze factors such as inappropriate test requests, errors in specimen labeling, registration and verification of results, staff training, IT issues, and specimen transport times.
The document summarizes a student project to study a photovoltaic solar panel. The project was completed on time and on budget. Students designed and built a testing frame, then collected data on the panel's performance across varying light intensities. Testing showed the panel did not deliver its stated power output. Lessons included allowing more time for unexpected delays and fabrication issues, and triple checking budgets.
This document describes a system created using Internet of Things (IoT) technology to automatically record equipment breakdowns and maintenance at testing stations. Raspberry Pi boards were installed at each station and connected to sensors, buttons and displays. When issues arise, they are wirelessly reported to a central server and interface, removing the need for manual logging. This provides real-time visibility of equipment status, helps ensure all issues are addressed, and was designed to reduce non-compliance risks during audits. Lessons learned included programming various components and integrating them into a cohesive wireless network to remotely monitor and improve equipment uptime.
Prof Devlin discusses the rationale for the PROMs programme and provides an overview of the various uses of the EQ-5D in England—for example by NICE in health technology assessment, in population surveys and in the English NHS PROMS program. The presentation also reviews how EQ-5D data are collected, analysed and used in the UK to inform decisions by health care providers, payers and patients.
This document provides an overview of troubleshooting skills for process operations. It discusses the key elements of troubleshooting including defining the problem, investigating causes, planning solutions, implementing plans, evaluating results, and concluding. Common troubleshooting techniques are explained such as fishbone diagrams, fault tree analysis, 5 whys, and mind mapping. A case study example applies these techniques to troubleshoot a pump failure where the root cause was determined to be reverse motor rotation due to an operator error in verification. The presentation aims to improve troubleshooting skills for both experienced and new process engineers.
ADAPT: Analysis of Dynamic Adaptations in Parameter Trajectories Natal van Riel
Part of the Training Course: Data Integration in the Life Sciences.
from 2 Feb 2015 through 6 Feb 2015, Lorentz Center, Leiden
Organized by ERA-Net program for Systems Biology Applications (ERASysApp, https://www.erasysapp.eu/) and the Dutch systems biology and bioinformatics community (BioSB, http://biosb.nl).
http://www.lorentzcenter.nl/lc/web/2015/684/description.php3?wsid=684&venue=Snellius
IonExpress is developing an ion channel screening platform using injection molded plates and integrated instrumentation. Their business model involves selling instruments and consumables directly to pharmaceutical and academic customers. They estimate initial low adoption but growing to over 100 customers and $17M in annual revenue within 5 years. Customer lifetime value is estimated at over $2M per customer from both instrument sales and recurring consumable purchases.
This eight-discipline report summarizes an issue of misaligned metal layers causing failures in certain bins. The root cause was determined to be an incorrect overlay recipe setting on one product that caused the alignment of metal 5 to gradually shift over time due to feedback from the APC system. Corrective actions included fixing the recipe setting, improving monitoring of recipe modifications, and standardizing software change processes. The preventive actions aimed to review lithography software for other potential issues and implement run-time control monitoring of alignment recipes.
The document summarizes a Kaizen event held at an Indiana production facility to address the issue of dents in reflectors. The event aimed to reduce scrap costs from dents by $64,000 per year by identifying root causes, solutions, and implementing process improvements. Key areas of focus included standardizing work instructions, improving training, and ensuring accurate defect reporting. The event resulted in new processes for tracking defects and reviewing scrap to allow for more accurate diagnosis and countermeasures.
Laserfiche - User Presentation- Texas Higher Education Co-ordinating Laserfiche
The document discusses how the Texas Higher Education Coordinating Board Loan Program Operations division began automating their complex loan processing projects using Laserfiche Workflow. They started by setting goals to streamline processes, improve times, and track steps. They identified areas for Workflow like payment processing. They created process maps and tested Workflows without being afraid. Workflows reduced staff needs by 17%, temp services by 75%, and downtimes by 98%, while also reducing backlogs, processing times, and daily import times. Future projects include automating litigation documents and loan applications using Quick Fields and Workflow.
- The document outlines the initial idea, team, target market size, and interviews conducted for a startup aiming to help oncologists select personalized breast cancer therapies using PET/X technology.
- Over 10 weeks of interviews with 106 participants, the team validated the product-market fit, identified customer segments, and developed initial marketing and financial models.
- Next steps include completing an MVP, partnering with clinical sites, collecting quality data, and submitting a Phase II proposal to further validate the technology and business models.
Laserfiche - User Presentation- Texas Higher Education Co-ordinatingLaserfiche
Debbie Whitis, Manager of Continuous Improvement for the Texas Higher Education Coordinating Board, as she discusses how to translate complex projects involving many individuals, departments and decisions into one cohesive process in Laserfiche Workflow.
Whitis will demonstrate how to use advanced features of Workflow to automate a multi-step project from start to finish, from basic indexing of faxes to multi-department document review.
You'll learn how to create a process that reduces document processing time from days to seconds and generates detailed reporting on staff performance.
Asia Pesticide Residue Mitigation through the Promotion of Biopesticides and ...apaari
Asia Pesticide Residue Mitigation through the Promotion of Biopesticides and Enhancement of Trade Opportunities (APRMP), Virtual lab meeting
14 August 2020
7 QC Tools are simple statistical tools used for problem solving. Nilesh Arora presented basics of 7 QC Tool training and details about Pareto Diagram.
The document discusses improving the quality of Process Failure Mode and Effects Analyses (PFMEAs). It begins by providing context on the importance of PFMEAs in ensuring robust products and processes. It then outlines common errors seen in PFMEAs, such as not starting them until production equipment is operational, only considering Risk Priority Numbers when prioritizing actions, and inconsistencies in severity or detection rankings. The document also discusses the supplier PFMEA audit developed to evaluate PFMEA quality in a standardized, objective manner. It aims to accelerate PFMEA improvement by sharing best practices and ensuring cross-functional input.
The document summarizes the efforts of a team to improve the rigid laminate scheduling system at a manufacturing plant. Key changes included decoupling scheduling from sales orders, scheduling the press based on the top 5 master sheet parts to better manage variation, and batching odd rigid orders to be processed twice per month. These changes reduced unnecessary changeovers, late shipments, and inventory levels. Metrics showed improvements like a 14% increase in plant capacity and a 13% reduction in master sheet work-in-process inventory.
Performance tuning becomes essential when the system indicates sluggish or becomes absolutely unresponsive. Usually, this happens due to increased load with some degree of decreasing performance. Thus, Corporations can save a lot of money using Performance tuning just by modifying a system to handle higher loads and thereby enhance the server performance without spending on new informationrastructure or applications.
Why 85% of Decisions Made in Your Organization are Wrong and How to Fix It!MPCA
1. The document discusses why 85% of decisions may be wrong and how to improve decision making. It explores Deming's view that over 90% of decisions aimed at improvement are misguided.
2. Key strategies discussed for better decision making include understanding systems thinking, using data to detect real trends rather than reacting to normal variation, and applying profound knowledge of processes to design improvements.
3. The alternative to traditional management approaches is discussed as profound knowledge - understanding systems, variation, psychology, and knowledge to guide decision making. Plotting data over time to detect real changes is emphasized.
The document provides information for people with disabilities on the importance of quitting smoking, as smoking can worsen health conditions and reduce life expectancy, and outlines strategies clinicians can use to help patients with disabilities quit tobacco using the 5 A's approach of asking about tobacco use, advising patients to quit, assessing willingness to quit, assisting with a plan and support, and arranging follow-up. The 5 A's approach emphasizes establishing a quit plan and date, discussing triggers and challenges, prescribing cessation medications if appropriate, and following up in the first week and month to address any issues that come up and reinforce commitment to abstaining from tobacco.
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Similar to How to Stop Losing Money Using Your EMR
The document discusses the basic workflow of medical practice, which involves a patient having a complaint or illness, a doctor gathering information and determining a diagnosis or approach, communicating with the patient, and prescribing treatment. It then examines how medicine has changed since the days of Charles Dickens, with patients now able to call their general practitioner and have information entered into a computer by the doctor. The document also discusses alternatives to traditional doctor-patient dialogues, such as involving patients more directly through computerized medical histories.
This document summarizes a Six Sigma project conducted by Abu Dhabi Police Medical Services from January to June 2012 to improve defects in pre-analytical and post-analytical processes in their medical laboratory. The project aimed to reduce delay in laboratory results, improve patient safety, and increase customer satisfaction by defining, measuring, analyzing, improving, and controlling critical-to-quality factors affecting the significance and delay of laboratory test results. Data was collected over 10 days to analyze factors such as inappropriate test requests, errors in specimen labeling, registration and verification of results, staff training, IT issues, and specimen transport times.
The document summarizes a student project to study a photovoltaic solar panel. The project was completed on time and on budget. Students designed and built a testing frame, then collected data on the panel's performance across varying light intensities. Testing showed the panel did not deliver its stated power output. Lessons included allowing more time for unexpected delays and fabrication issues, and triple checking budgets.
This document describes a system created using Internet of Things (IoT) technology to automatically record equipment breakdowns and maintenance at testing stations. Raspberry Pi boards were installed at each station and connected to sensors, buttons and displays. When issues arise, they are wirelessly reported to a central server and interface, removing the need for manual logging. This provides real-time visibility of equipment status, helps ensure all issues are addressed, and was designed to reduce non-compliance risks during audits. Lessons learned included programming various components and integrating them into a cohesive wireless network to remotely monitor and improve equipment uptime.
Prof Devlin discusses the rationale for the PROMs programme and provides an overview of the various uses of the EQ-5D in England—for example by NICE in health technology assessment, in population surveys and in the English NHS PROMS program. The presentation also reviews how EQ-5D data are collected, analysed and used in the UK to inform decisions by health care providers, payers and patients.
This document provides an overview of troubleshooting skills for process operations. It discusses the key elements of troubleshooting including defining the problem, investigating causes, planning solutions, implementing plans, evaluating results, and concluding. Common troubleshooting techniques are explained such as fishbone diagrams, fault tree analysis, 5 whys, and mind mapping. A case study example applies these techniques to troubleshoot a pump failure where the root cause was determined to be reverse motor rotation due to an operator error in verification. The presentation aims to improve troubleshooting skills for both experienced and new process engineers.
ADAPT: Analysis of Dynamic Adaptations in Parameter Trajectories Natal van Riel
Part of the Training Course: Data Integration in the Life Sciences.
from 2 Feb 2015 through 6 Feb 2015, Lorentz Center, Leiden
Organized by ERA-Net program for Systems Biology Applications (ERASysApp, https://www.erasysapp.eu/) and the Dutch systems biology and bioinformatics community (BioSB, http://biosb.nl).
http://www.lorentzcenter.nl/lc/web/2015/684/description.php3?wsid=684&venue=Snellius
IonExpress is developing an ion channel screening platform using injection molded plates and integrated instrumentation. Their business model involves selling instruments and consumables directly to pharmaceutical and academic customers. They estimate initial low adoption but growing to over 100 customers and $17M in annual revenue within 5 years. Customer lifetime value is estimated at over $2M per customer from both instrument sales and recurring consumable purchases.
This eight-discipline report summarizes an issue of misaligned metal layers causing failures in certain bins. The root cause was determined to be an incorrect overlay recipe setting on one product that caused the alignment of metal 5 to gradually shift over time due to feedback from the APC system. Corrective actions included fixing the recipe setting, improving monitoring of recipe modifications, and standardizing software change processes. The preventive actions aimed to review lithography software for other potential issues and implement run-time control monitoring of alignment recipes.
The document summarizes a Kaizen event held at an Indiana production facility to address the issue of dents in reflectors. The event aimed to reduce scrap costs from dents by $64,000 per year by identifying root causes, solutions, and implementing process improvements. Key areas of focus included standardizing work instructions, improving training, and ensuring accurate defect reporting. The event resulted in new processes for tracking defects and reviewing scrap to allow for more accurate diagnosis and countermeasures.
Laserfiche - User Presentation- Texas Higher Education Co-ordinating Laserfiche
The document discusses how the Texas Higher Education Coordinating Board Loan Program Operations division began automating their complex loan processing projects using Laserfiche Workflow. They started by setting goals to streamline processes, improve times, and track steps. They identified areas for Workflow like payment processing. They created process maps and tested Workflows without being afraid. Workflows reduced staff needs by 17%, temp services by 75%, and downtimes by 98%, while also reducing backlogs, processing times, and daily import times. Future projects include automating litigation documents and loan applications using Quick Fields and Workflow.
- The document outlines the initial idea, team, target market size, and interviews conducted for a startup aiming to help oncologists select personalized breast cancer therapies using PET/X technology.
- Over 10 weeks of interviews with 106 participants, the team validated the product-market fit, identified customer segments, and developed initial marketing and financial models.
- Next steps include completing an MVP, partnering with clinical sites, collecting quality data, and submitting a Phase II proposal to further validate the technology and business models.
Laserfiche - User Presentation- Texas Higher Education Co-ordinatingLaserfiche
Debbie Whitis, Manager of Continuous Improvement for the Texas Higher Education Coordinating Board, as she discusses how to translate complex projects involving many individuals, departments and decisions into one cohesive process in Laserfiche Workflow.
Whitis will demonstrate how to use advanced features of Workflow to automate a multi-step project from start to finish, from basic indexing of faxes to multi-department document review.
You'll learn how to create a process that reduces document processing time from days to seconds and generates detailed reporting on staff performance.
Asia Pesticide Residue Mitigation through the Promotion of Biopesticides and ...apaari
Asia Pesticide Residue Mitigation through the Promotion of Biopesticides and Enhancement of Trade Opportunities (APRMP), Virtual lab meeting
14 August 2020
7 QC Tools are simple statistical tools used for problem solving. Nilesh Arora presented basics of 7 QC Tool training and details about Pareto Diagram.
The document discusses improving the quality of Process Failure Mode and Effects Analyses (PFMEAs). It begins by providing context on the importance of PFMEAs in ensuring robust products and processes. It then outlines common errors seen in PFMEAs, such as not starting them until production equipment is operational, only considering Risk Priority Numbers when prioritizing actions, and inconsistencies in severity or detection rankings. The document also discusses the supplier PFMEA audit developed to evaluate PFMEA quality in a standardized, objective manner. It aims to accelerate PFMEA improvement by sharing best practices and ensuring cross-functional input.
The document summarizes the efforts of a team to improve the rigid laminate scheduling system at a manufacturing plant. Key changes included decoupling scheduling from sales orders, scheduling the press based on the top 5 master sheet parts to better manage variation, and batching odd rigid orders to be processed twice per month. These changes reduced unnecessary changeovers, late shipments, and inventory levels. Metrics showed improvements like a 14% increase in plant capacity and a 13% reduction in master sheet work-in-process inventory.
Performance tuning becomes essential when the system indicates sluggish or becomes absolutely unresponsive. Usually, this happens due to increased load with some degree of decreasing performance. Thus, Corporations can save a lot of money using Performance tuning just by modifying a system to handle higher loads and thereby enhance the server performance without spending on new informationrastructure or applications.
Similar to How to Stop Losing Money Using Your EMR (20)
Why 85% of Decisions Made in Your Organization are Wrong and How to Fix It!MPCA
1. The document discusses why 85% of decisions may be wrong and how to improve decision making. It explores Deming's view that over 90% of decisions aimed at improvement are misguided.
2. Key strategies discussed for better decision making include understanding systems thinking, using data to detect real trends rather than reacting to normal variation, and applying profound knowledge of processes to design improvements.
3. The alternative to traditional management approaches is discussed as profound knowledge - understanding systems, variation, psychology, and knowledge to guide decision making. Plotting data over time to detect real changes is emphasized.
The document provides information for people with disabilities on the importance of quitting smoking, as smoking can worsen health conditions and reduce life expectancy, and outlines strategies clinicians can use to help patients with disabilities quit tobacco using the 5 A's approach of asking about tobacco use, advising patients to quit, assessing willingness to quit, assisting with a plan and support, and arranging follow-up. The 5 A's approach emphasizes establishing a quit plan and date, discussing triggers and challenges, prescribing cessation medications if appropriate, and following up in the first week and month to address any issues that come up and reinforce commitment to abstaining from tobacco.
This document recommends expanding federally qualified health center (FQHC) services in greater Detroit to improve access to quality healthcare. It identifies several high need areas that currently lack FQHC sites based on factors like poverty rates, uninsured populations, and health status indicators. New FQHC sites are recommended in specific zip codes to help address gaps. Expansion strategies include opening new access points, expanding medical services, and pursuing practice acquisitions or partnerships to better serve communities in greatest need. Cooperative efforts are suggested to help overcome challenges to development like capital needs.
This document discusses diabetes, kidney disease, and prevention programs in Michigan. It states that around 1 million Michigan adults have diabetes but 1/3 don't know it, and over 900,000 have chronic kidney disease but most don't know. It provides statistics on costs of treatment and discusses several state-funded prevention programs that help people manage diseases through education, lifestyle changes, and care coordination between patients and providers. The programs have shown benefits like reduced hospitalizations, improved health outcomes, and returns on investment.
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The document discusses the history and current state of integrating behavioral health and primary care services. It outlines the benefits of integration, including improved outcomes and cost savings. Barriers to integration include separate funding streams, lack of provider training, and cultural divides between specialties. Successful integration requires addressing financial, structural, clinical and programmatic integration through models like co-location, shared treatment plans, population health management and quality improvement efforts.
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Improving Oral Health Access Migrant and Seasonal WorkersMPCA
Migrant farmworkers face significant barriers to accessing oral healthcare. Dental disease is one of the top 5 health problems for farmworkers aged 5-29. The main barriers include lack of insurance, inability to afford care, and lack of providers accepting Medicaid. Several organizations in Michigan provide dental services to migrant farmworkers, but they can only serve about 15-20% of this population due to limited resources. Expanding access will require innovative models of care delivery and increasing funding for preventive oral health programs.
The document appears to be a graph showing adoption rates of a new product or innovation over time among different groups. It shows a bell curve distribution with Innovators and Early Adopters on the left side adopting early, the Early and Late Majority in the middle adopting later, and Laggards on the right adopting last or not at all.
The document summarizes a leadership workshop that provides a framework to drive organizational improvement. It discusses challenges facing a community health center called Chapel Road and presents best practices of transformational leadership, including setting direction with a clear vision and metrics, empowering staff, and using improvement methods to continuously enhance processes. The workshop emphasizes building leadership as a system through principles like communication, recognition, and continuous learning.
Service Excellence - Do You Have the Right Team?MPCA
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Routine HIV Testing in the Community Health CenterMPCA
Routine HIV screening in primary care settings can help identify undiagnosed cases of HIV infection earlier. Late HIV testing leads to poorer health outcomes compared to earlier diagnosis. The CDC now recommends opt-out routine HIV screening for patients ages 13-64 in primary care. A model developed by health centers successfully integrated routine HIV screening and achieved high testing rates, identifying new HIV cases and linking patients to care.
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Behavioral Health Integration in Primary Care 1MPCA
Hackley Community Care Center (HCCC) provides integrated behavioral health services at their primary care center located in Muskegon Heights, Michigan. They serve over 15,000 clients, many of whom have Medicaid or are uninsured. HCCC uses the 5 levels of behavioral health integration model, currently implementing level 4 where behavioral health providers are on-site and share some systems with primary care providers. They provide services like therapy, psychiatric consultations, and care management for depression. Barriers to further integration include reimbursement issues and lack of coordination with community mental health services.
The document summarizes hot topics in human resources, including provisions of the American Recovery and Reinvestment Act of 2009 related to unemployment benefits, health care technology funding, and COBRA subsidies. It also discusses recent changes to HIPAA regulations regarding privacy breaches and penalties as well as updates to FMLA rules. Additional legislative issues at the federal and state level are outlined.
Overhauling Health Center Operations: Project RevUp 101MPCA
Project RevUP aims to redesign the entire patient experience within clinics by bringing together staff from all areas, including providers, clinical support, operations, financial support, and administration. It examines workflows and promotes collaboration between finance and operations. Six health centers participated in the 2008-2009 program, which included an initial training session, site visits for coaching, regular calls and conferences for support, and a final meeting for sharing results. The goal was to measure progress in redesigning patient experiences.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
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.
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Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
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In this document , a brief outline of osteoporosis is given , including the risk factors of osteoporosis fractures , the indications for testing bone mineral density and the management of osteoporosis
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
1. How to Stop Losing Money
Using Your EMR
John Bachman MD
Saunders Professor of Primary Care
Mayo Foundation
2.
3. You are at the office
• A partner’s patient who has
hypertension comes to see you
because in the last ten days she has
noted that her blood pressure is
elevated from its baseline.
• Meds Lisinopril 20 mg daily
• BP 152/93
4.
5.
6.
7. It collects for appraisal a large
and comprehensive body of information
about the patient’s medical history
at no expenditure of the physician’s time;
it facilitates interview by making available
to the physician a preliminary survey
of the patient’s total medical problems;
its data being systematically arranged,
are easier to review than those
of conventional medical histories,
and, by calling attention
to the patient’s symptoms
and significant items of past history,
it assures that their investigation
will not be overlooked because
the physician lacked time to elicit them
8. 1949-1980 “An era of
Questionnaires”
• Answer questions in form of paper and
physician got paper back
• Lahey Clinic Duke Medical Center
Kaiser
• Clinicians would write on output
9. Advantages
• Patients complete at their own pace
• Patients can do things at home
• Patients are prompts to remember
things
• The forms are inexpensive
• More data is retrieved
• Provides an outline
10. Disadvantages
• Patients do not complete forms
• Forms are hard to change
• Forms do not clarify symptoms
• Prime MD-3 minutes too long
• Mayo 1971 study
• Forms not personalized
• Too many forms that you need
11. General
• Mayo Clinic-PPI 13 page form 216
questions, 25 spaces
• ACOG on line 90 questions
• How many are enough?
12. Review of AFP in just one year
• 44 questionnaires (2 an issue)
• 4-37 questions
• CAGE-alcoholism
• Check list to Assessment areas for
Maintaining Healthy Geriatric Patients
• Depression scales
• Smoking Scales
• Lead
13. Patient Computer Dialogue
• Mayo Proceedings
in January 2003
• Solves input
problem into
computers
• Powerful Tool for
Quality
• Pilot: You want
passengers to use
electronic tickets
20. 8 Time of a Routine Office Visit
S
O
7 A
6 8 P
E
5
4
3 Plan
2
1 Subj. 2
Obj. 2 Pat Ed
0
0.1
Traditional
21. 8 S
Future Time of a Routine Office Visit
O
7 A
6 P
E
5
4
Subj. Plan
3 Obj.
Pt. Ed
2
3
1 3 2 0.1 2
0
Software
22. Complete Physical Exam
35 S
35
O
30 A
P
25 E
20 17
Subj
nutes 15
15
Extra Time
10 7 8 7 Plan
Obj 5 Subj
5 Plan
Obj
0.1 0.1
0
OLD NEW
23. Going to the Web 2005-2012
• Primetime “Instant Medical History”
went to the web beside computers
• Published study of over 2500 online
visits at Mayo in 2010 at Mayo
Proceedings
• Integration of patient to the EMR
(Sage)
24.
25.
26.
27.
28. How many of you have a computer
do a history before seeing the
patient?
32. Companies
• Primetime Practice “Instant Medical
History”
• Engine for almost all EMRs
• Competitors just do not last
• EMRs
• Incentives are to sell product
• Not necessarily add ons
45. Patient collects information
that the clinician misses
• 40% of time
provided useful
information not
typically elicited
• Essential
Questions missed
• Pilot’s Checklist
46. How dangerous is health care?
Note: both dimensions are logarithmic scales
DANGEROUS REGULATED ULTRA-SAFE
(>1/1000) (<1/100K)
Health
Care Driving
10,000
Deaths per year
1,000
Scheduled
100 Chartered Airlines
Flights
Mountain European
Climbing Railroads
10
Bungee Manufacturing Nuclear
Jumping Power
10 10,000 100,000 1,000,000 10,000,000
Number of encounters per death
64. You can use a machine to
Do the hard time consuming
Work
65. You are in control
You will trust the work done
Check out a few things
66.
67.
68. Benefits of Patient-Delivered Medical
History Data
• See more patients each day
• Reduce dictation and data entry time
• Cut transcription costs in half
• Populate EHR data fields automatically
• Support appropriate billing levels
• Enhance patient communication and satisfaction
• If over Web, option to enable triage: assess urgency,
lab/X-ray in advance of encounter, schedule for
appropriate amount of time, recommend self-care, etc.
• Patients are most incented and cheapest resource
69. Several Studies
• Acceptance has been documented in
ethnic18 diverse groups, rural
practices19, in prenatal visits20,
patients seeking a urologist help21,
adolescents22, sports examinations23,
and well child visits24. Reliability has
been assessed between personal
interviews for gynecologic patients25,
preoperative patients26, and general
practice27-29.
70. E mail consultation
I had surgery on June 11th, things went pretty well as far as the surgery went. I did feel pretty awfull for the first 2 weeks and the day I left the hospital my
incision broke open---I had to pack it for 3 weeks then it was restitched and healed well.
I have to admit, the first couple of weeks I was really beginning to wonder if I had done the right thing but my mind is slowly changing. It is interesting to
feel myself slowly turn my priorities away from eating. It is consistently amazing to realize how much focus there is on food, in society and in my life
specifically. Jim and I always have a ton of company, from friends to family and you know, company centers around food!!
It is an amazing feeling to be full so quickly---I am still not used to that feeling. I do have my fears about not getting enough protein in, I seem to be having a
problem eating meats but I am not to regular foods yet and I am still trying to tell myself to slow down, that is such a hard habit to break! I can't really
eat sweets, so far anything too sweet just makes me sick. The adjustment of not drinking while eating is difficult too, but getting easier. The milk
drinking is getting easier too.
I am so grateful for the year prior to the surgery---I know it was a long time and it was making me spitting mad at the time but................the group sessions
were such and asset to me ---I learned so much, I developed actual habits and restrictions in that year. I had pretty much given up sweets and over
eating and I think that has been a springboard for me with my diet now. I went to group every week with few exceptions. I learned so much about
myself, others, and eating disorders. I gained an insight that so diet could have ever brought to light. I learned to quit beating myself up, to recognize
weaknesses and avoid them. I learned and practiced the importance of activity. The importance of "self-talk" was emphasized and I used it as a tool
every day---especially on the bad days. I learned that it was never too late and that being over weight was not a sentence, that it was overcomable but
that the road to overcoming was a difficult one and that I needed help in changing from the well trodden path to a new one. I am now acutely aware of
emotional eating, but I have no choice in the matter, I simply can not indulge---it is so wonderful. I ended up losing 50 pounds in year that I went to
group and I am very glad for that little boost. I had a fantastic group leader, I really lucked out! Not for sure how much more I have lost but I know the
total is well over 100 pounds. and yes..............I feel so much better. I can walk up the back of St. Marys Hill without even getting out of breath. I am
still riding bike and of course riding horse. In fact, Jim and I are going to Wyoming in September for our 20th anniversary---we are taking our horses
out to the Big Horns riding for a week---I am so excited--this has been a lifelong dream for me and now my horse has 100+ less pounds to lug. Let me
tell you, riding is so much more of a joy for me, it is like starting all over.
Karie is doing well, still in PA with Jason, they were home for 2 weeks this month and we really like him, he is very sweet and seems totally devoted to
Karie---while I don't care for his tatoos,(its a mom thing)he really is great. He had a great time in Minnesota---so maybe the might move back here.
Justin graduated and Jim and I are really empty nesting it---Justin is working in the cities and staying with my niece--he plans to attend RCTC winter
quarter.
I am still going to school, I completed my Associates Degree last spring and I only have 22 credits left for my Bachelors.
I do so hope all is well with you, I think of you and your family often.
I want to thank you again Michelle for all of your years of care and concern, but most of all for directing me to this surgery and the journey that brought me
to it.
90. Which would you want?
• Call • Go Online
• Nursing time for • Clinician uses set
protocol protocol
• Clinician time to say • Clinician checks
ok prevention
• Appointment desk • Instructions that are
written
• Nurse faxes
prescription • Prescription faxed
automatically
• Verbal instructions
• Time in minutes
• Time in hours
• MMSI $35 charge - margin
• Clinic loses money better then an exam
96. Billing
• Accountants high margin 35 dollars
• (Credit Cards) We went through
billing
• Went very smoothly
97. Totals 2 years
Largest Study Reported
• Total Registrations- 4282
• 7% primary family member
• Linked to 12%
• Online Consultations- 2531
• Total Consults Billed- 1159
104. Prevent Visits to Office
• 40% of the time saved a visit
• 12.8% Come in
• 16% Protocols
• 11% of the time handled by “on call”
105. Pictures
• 49 pictures were sent in
• 2% of our practice
• Diaper rash
• Bites
• Contact dermatitis
• Prescription refills
106. What are the steps
• Vendor
• How will you get input?
• In lobby? In office room?
• From the web
• With EMR
• Portal??
• How to get into your system?
107. It collects for appraisal a large
and comprehensive body of information
about the patient’s medical history
at no expenditure of the physician’s time;
it facilitates interview by making available
to the physician a preliminary survey
of the patient’s total medical problems;
its data being systematically arranged,
are easier to review than those
of conventional medical histories,
and, by calling attention
to the patient’s symptoms
and significant items of past history,
it assures that their investigation
will not be overlooked because
the physician lacked time to elicit them