A Dartmouth Microsystem Assessment was conducted to examine a hospital unit\\’s functionality and to highlight opportunities for improvement. To enhance the gathering of data, a statistical tool was created to measure a wider sample population. The CNL student implemented a more reliable and valid data gathering system. The nurse educator asked to use the graduate student’s tool on the unit and throughout the hospital.
Four strategies to upgrade clinical trial quality in this computerized world ...Pubrica
• Biostatistics Services is important for collecting, reviewing, presenting, and interpreting data in clinical research.
• Applications of clinical biostatistics services are in different areas, such as epidemiology, clinical trials, population genetics, the biology of structures, and more.
Reference : https://pubrica.com/services/research-services/biostatistics-and-statistical-programming-services/
Continue Reading: http://bit.ly/36nwtcs
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When you order our services, Plagiarism free|onTime|outstanding customer support|Unlimited Revisions support|High-quality Subject Matter Experts.
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Web: https://pubrica.com/
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WhatsApp : +91 9884350006
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The Survivor community can learn more about the state of the art in new tests available in cancer centres, which pinpoint specific types of tumours that will respond best to treatments.
A Dartmouth Microsystem Assessment was conducted to examine a hospital unit\\’s functionality and to highlight opportunities for improvement. To enhance the gathering of data, a statistical tool was created to measure a wider sample population. The CNL student implemented a more reliable and valid data gathering system. The nurse educator asked to use the graduate student’s tool on the unit and throughout the hospital.
Four strategies to upgrade clinical trial quality in this computerized world ...Pubrica
• Biostatistics Services is important for collecting, reviewing, presenting, and interpreting data in clinical research.
• Applications of clinical biostatistics services are in different areas, such as epidemiology, clinical trials, population genetics, the biology of structures, and more.
Reference : https://pubrica.com/services/research-services/biostatistics-and-statistical-programming-services/
Continue Reading: http://bit.ly/36nwtcs
Why Pubrica?
When you order our services, Plagiarism free|onTime|outstanding customer support|Unlimited Revisions support|High-quality Subject Matter Experts.
Contact us :
Web: https://pubrica.com/
Blog: https://pubrica.com/academy/
Email: sales@pubrica.com
WhatsApp : +91 9884350006
United Kingdom: +44- 74248 10299
The Survivor community can learn more about the state of the art in new tests available in cancer centres, which pinpoint specific types of tumours that will respond best to treatments.
Breakout 4. 2 Benefits of implementing medicines optimisation in a COPD and a...NHS Improvement
Breakout 4. 2 Benefits of implementing medicines optimisation in a COPD and asthma clinic - Clare Watson
Medicines Management Pharmacist (NHS Hampshire)
Independent Prescriber (Victoria Practice, Aldershot)
Part of a set of presentations from NHS Improvement event: Better value, better outcomes held on Thursday 21 February 2013,
Guoman Tower Hotel, London
How to deliver quality and value in chronic care:sharing the learning from the respiratory programme
The Percepta Bronchial Genomic Classifier uses advanced genomic technology to improve lung cancer diagnosis for patients, reducing the need for invasive procedures that can follow when potentially cancerous lung nodules or lesions are found on CT scans. Lung cancer is the leading cause of cancer deaths in the United States, killing more than 154,000 Americans each year—more than the next three leading cancers combined.
Answering key questions on malaria drug delivery: 8 years of researchACT Consortium
Presentation by David Schellenberg
Director, ACT Consortium
Professor of Malaria & International Health at London School of Hygiene & Tropical Medicine
ECO 11: Medicines Optimisation Through Precision - Sir Munir PirmohamedInnovation Agency
Munir Pirmohamed discusses the potential impact of medicines optimisation in terms of ensuring the right patients get the right choice if medicine at the right time. He presents a case history of over prescription and introduces three examples of medicines optimisation through use of genetics, big data, and pharmacogenetics profiling.
Interventions to change providers' practice in cameroon h hopkinsACT Consortium
Presentation by Heidi Hopkins
Cross-cutting analysis Lead, ACT Consortium
Senior Lecturer in Malaria & Diagnostics at London School of Hygiene & Tropical Medicine
A brief presentation on medicines optimisation and the input a clinical pharmacist can make in improving treatment outcomes for patients and help make evidence led cost effective improvements for the wider NHS.
In this presentation, Bill Dempster and Johanne Chambers of 3Sixty Public Affairs walk through the different steps in bringing a new medicine through the regulatory review process, health technology assessment and funding, highlighting where patients can make a difference, and how their role is rapidly expanding.
Research the requirements to sit for the PMP Exam (both paper and .docxronak56
Research the requirements to sit for the PMP Exam (both paper and online methods).
Write a 2 page paper. In your paper include a discussion on the following:
· The amount of experience you must have to sit for the exam
· The amount of hours of project management training you must take before you sit for the exam
· The fees required to take the exam
· Download and fill out the "PMP Credential Application - submit it with your 2 page paper in the Appendix
Include a cover sheet and 2-3 references. References should be obtained through the Grantham University online library. You may use online resources for this assignment (not Wikipedia). Please adhere to the Publication Manual of the American Psychological Association (APA), 6th ed., 2nd printing when writing and submitting assignments and papers
S224 • CID 2010:51 (Suppl 2) • Eron
S U P P L E M E N T A R T I C L E
Telemedicine: The Future of Outpatient Therapy?
Lawrence Eron
John A. Burns School of Medicine, University of Hawaii, Kaiser Moanalua Medical Center, Honolulu
Early hospital discharge of acutely infected patients to received outpatient parenteral antimicrobial therapy
has been shown to be safe and effective. However, concerns over safety, potential litigation, and anxieties of
the patient and family about not receiving professional care have limited the use of this approach. Telemedicine
may overcome these barriers by allowing health care providers to monitor and communicate with acutely
infected patients from a remote medical center via a home computer station transmitting audio, video, and
vital signs data. Potential benefits of telemedicine include significant cost savings and faster convalescence,
because patients at home may feel more comfortable and actively involved in their treatment than patients
in the hospital. Clinical studies have shown that telemedicine is safe and cost-effective, compared with hospital
treatment, in chronically ill and acutely infected patients. More studies are needed to further establish the
widespread and increasing practice of telemedicine, which may represent the future of medicine.
Early hospital discharge to use of outpatient parenteral
antimicrobial therapy (OPAT) has been shown to be
both safe and effective for the treatment of acutely in-
fected patients [1–5]. Conditions frequently treated in
this manner include community-acquired pneumonia
(CAP), skin and soft-tissue infection, urinary tract in-
fection, and bacterial endocarditis. However, OPAT
alone is not recommended for some patients with severe
illness or complications, including those who must be
monitored several times per day because of comorbid-
ities and/or low performance scores [6]. Furthermore,
the decision to discharge a patient to OPAT or to dis-
charge a patient who has been switched to oral anti-
biotics may be delayed because of persistent fever or
simply for a day of observation [4, 7, 8]. Routine in-
hospital observation after the or ...
Measuring to Improve Medication Reconciliationin a Large Sub.docxalfredacavx97
Measuring to Improve Medication Reconciliation
in a Large Subspecialty Outpatient Practice
Elizabeth Kern, MD, MS; Meg B. Dingae, MHSA; Esther L. Langmack, MD; Candace Juarez, MT; Gary Cott, MD;
Sarah K. Meadows, MS
Background: To assess performance in medication reconciliation (med rec)—the process of comparing and reconciling
patients’ medication lists at clinical transition points—and demonstrate improvement in an outpatient setting, sustainable
and valid measures are needed.
Methods: An interdisciplinary team at National Jewish Health (Denver) attempted to improve med rec in an ambulatory
practice serving patients with respiratory and related diseases. Interventions, which were aimed at physicians, nurses (RNs),
and medical assistants, involved changes in practice and changes in documentation in the electronic health record (EHR).
New measures designed to assess med rec performance, and to validate the measures, were derived from EHR data.
Results: Across 18 months, electronic attestation that med rec was completed at clinic visits increased from 9.8% to 91.3%
(p < 0.0001). Consistent with this improvement, patients with medication lists missing dose/frequency for at least one prescription-
type medication decreased from 18.1% to 15.8% (p < 0.0001). Patients with duplicate albuterol inhalers on their list decreased
from 4.0% to 2.6% (p < 0.0001). Percentages of patients increased for printing of the medication list at the visit (18.7% to
94.0%; p < 0.0001) and receipt of the printed medication list at the visit (52.3% to 67.0%; p = 0.0074). Documentation
that patient education handouts were offered increased initially then declined to an overall poor performance of 32.4% of
clinic visits. Investigation of this result revealed poor buy-in and a highly redundant process.
Conclusion: Deriving measures reflecting performance and quality of med rec from EHR data is feasible and sustainable
over the time periods necessary to demonstrate change. Concurrent, complementary measures may be used to support the
validity of summary measures.
Medication reconciliation (med rec) is the process of sys-tematically and comprehensively reviewing the
medications a patient is taking, to ensure that medications
added, changed, or discontinued are evaluated for poten-
tial safety concerns. One of the three current Joint
Commission National Patient Safety Goals (NPSGs) on med-
ication safety (Goal 3), concerns medication reconciliation,
which ambulatory care organizations have been expected to
perform since 2005. The current version of the goal
(NPSG.03.06.01), effective July 1, 2011, stipulates that am-
bulatory care organizations maintain and communicate
accurate patient medication information.1 One require-
ment is that the organization obtain the patient’s medication
information at the beginning of an episode of care, with the
information to be updated when the patient’s medications
change. Ideally, med rec should occur at each transition of
care or han.
Breakout 4. 2 Benefits of implementing medicines optimisation in a COPD and a...NHS Improvement
Breakout 4. 2 Benefits of implementing medicines optimisation in a COPD and asthma clinic - Clare Watson
Medicines Management Pharmacist (NHS Hampshire)
Independent Prescriber (Victoria Practice, Aldershot)
Part of a set of presentations from NHS Improvement event: Better value, better outcomes held on Thursday 21 February 2013,
Guoman Tower Hotel, London
How to deliver quality and value in chronic care:sharing the learning from the respiratory programme
The Percepta Bronchial Genomic Classifier uses advanced genomic technology to improve lung cancer diagnosis for patients, reducing the need for invasive procedures that can follow when potentially cancerous lung nodules or lesions are found on CT scans. Lung cancer is the leading cause of cancer deaths in the United States, killing more than 154,000 Americans each year—more than the next three leading cancers combined.
Answering key questions on malaria drug delivery: 8 years of researchACT Consortium
Presentation by David Schellenberg
Director, ACT Consortium
Professor of Malaria & International Health at London School of Hygiene & Tropical Medicine
ECO 11: Medicines Optimisation Through Precision - Sir Munir PirmohamedInnovation Agency
Munir Pirmohamed discusses the potential impact of medicines optimisation in terms of ensuring the right patients get the right choice if medicine at the right time. He presents a case history of over prescription and introduces three examples of medicines optimisation through use of genetics, big data, and pharmacogenetics profiling.
Interventions to change providers' practice in cameroon h hopkinsACT Consortium
Presentation by Heidi Hopkins
Cross-cutting analysis Lead, ACT Consortium
Senior Lecturer in Malaria & Diagnostics at London School of Hygiene & Tropical Medicine
A brief presentation on medicines optimisation and the input a clinical pharmacist can make in improving treatment outcomes for patients and help make evidence led cost effective improvements for the wider NHS.
In this presentation, Bill Dempster and Johanne Chambers of 3Sixty Public Affairs walk through the different steps in bringing a new medicine through the regulatory review process, health technology assessment and funding, highlighting where patients can make a difference, and how their role is rapidly expanding.
Research the requirements to sit for the PMP Exam (both paper and .docxronak56
Research the requirements to sit for the PMP Exam (both paper and online methods).
Write a 2 page paper. In your paper include a discussion on the following:
· The amount of experience you must have to sit for the exam
· The amount of hours of project management training you must take before you sit for the exam
· The fees required to take the exam
· Download and fill out the "PMP Credential Application - submit it with your 2 page paper in the Appendix
Include a cover sheet and 2-3 references. References should be obtained through the Grantham University online library. You may use online resources for this assignment (not Wikipedia). Please adhere to the Publication Manual of the American Psychological Association (APA), 6th ed., 2nd printing when writing and submitting assignments and papers
S224 • CID 2010:51 (Suppl 2) • Eron
S U P P L E M E N T A R T I C L E
Telemedicine: The Future of Outpatient Therapy?
Lawrence Eron
John A. Burns School of Medicine, University of Hawaii, Kaiser Moanalua Medical Center, Honolulu
Early hospital discharge of acutely infected patients to received outpatient parenteral antimicrobial therapy
has been shown to be safe and effective. However, concerns over safety, potential litigation, and anxieties of
the patient and family about not receiving professional care have limited the use of this approach. Telemedicine
may overcome these barriers by allowing health care providers to monitor and communicate with acutely
infected patients from a remote medical center via a home computer station transmitting audio, video, and
vital signs data. Potential benefits of telemedicine include significant cost savings and faster convalescence,
because patients at home may feel more comfortable and actively involved in their treatment than patients
in the hospital. Clinical studies have shown that telemedicine is safe and cost-effective, compared with hospital
treatment, in chronically ill and acutely infected patients. More studies are needed to further establish the
widespread and increasing practice of telemedicine, which may represent the future of medicine.
Early hospital discharge to use of outpatient parenteral
antimicrobial therapy (OPAT) has been shown to be
both safe and effective for the treatment of acutely in-
fected patients [1–5]. Conditions frequently treated in
this manner include community-acquired pneumonia
(CAP), skin and soft-tissue infection, urinary tract in-
fection, and bacterial endocarditis. However, OPAT
alone is not recommended for some patients with severe
illness or complications, including those who must be
monitored several times per day because of comorbid-
ities and/or low performance scores [6]. Furthermore,
the decision to discharge a patient to OPAT or to dis-
charge a patient who has been switched to oral anti-
biotics may be delayed because of persistent fever or
simply for a day of observation [4, 7, 8]. Routine in-
hospital observation after the or ...
Measuring to Improve Medication Reconciliationin a Large Sub.docxalfredacavx97
Measuring to Improve Medication Reconciliation
in a Large Subspecialty Outpatient Practice
Elizabeth Kern, MD, MS; Meg B. Dingae, MHSA; Esther L. Langmack, MD; Candace Juarez, MT; Gary Cott, MD;
Sarah K. Meadows, MS
Background: To assess performance in medication reconciliation (med rec)—the process of comparing and reconciling
patients’ medication lists at clinical transition points—and demonstrate improvement in an outpatient setting, sustainable
and valid measures are needed.
Methods: An interdisciplinary team at National Jewish Health (Denver) attempted to improve med rec in an ambulatory
practice serving patients with respiratory and related diseases. Interventions, which were aimed at physicians, nurses (RNs),
and medical assistants, involved changes in practice and changes in documentation in the electronic health record (EHR).
New measures designed to assess med rec performance, and to validate the measures, were derived from EHR data.
Results: Across 18 months, electronic attestation that med rec was completed at clinic visits increased from 9.8% to 91.3%
(p < 0.0001). Consistent with this improvement, patients with medication lists missing dose/frequency for at least one prescription-
type medication decreased from 18.1% to 15.8% (p < 0.0001). Patients with duplicate albuterol inhalers on their list decreased
from 4.0% to 2.6% (p < 0.0001). Percentages of patients increased for printing of the medication list at the visit (18.7% to
94.0%; p < 0.0001) and receipt of the printed medication list at the visit (52.3% to 67.0%; p = 0.0074). Documentation
that patient education handouts were offered increased initially then declined to an overall poor performance of 32.4% of
clinic visits. Investigation of this result revealed poor buy-in and a highly redundant process.
Conclusion: Deriving measures reflecting performance and quality of med rec from EHR data is feasible and sustainable
over the time periods necessary to demonstrate change. Concurrent, complementary measures may be used to support the
validity of summary measures.
Medication reconciliation (med rec) is the process of sys-tematically and comprehensively reviewing the
medications a patient is taking, to ensure that medications
added, changed, or discontinued are evaluated for poten-
tial safety concerns. One of the three current Joint
Commission National Patient Safety Goals (NPSGs) on med-
ication safety (Goal 3), concerns medication reconciliation,
which ambulatory care organizations have been expected to
perform since 2005. The current version of the goal
(NPSG.03.06.01), effective July 1, 2011, stipulates that am-
bulatory care organizations maintain and communicate
accurate patient medication information.1 One require-
ment is that the organization obtain the patient’s medication
information at the beginning of an episode of care, with the
information to be updated when the patient’s medications
change. Ideally, med rec should occur at each transition of
care or han.
This presentation has the measures to be taken for the safety of patients. It covers the 6 goals
Goal 1: Identify patients correctly
Goal 2: Improve effective communication
Goal 3: Improve the safety of high-alert medications
Goal 4: Ensure safe surgery
Goal 5: Reduce the risk of health care-associated infections
Goal 6: Reduce the risk of patient harm resulting from falls
IV Congresso Internacional CBA 2017
17 a 19 de setembro de 2017.
Sheri Dodd, VP and General Manager, Medtronic Care Management Services
Otávio Berwanger – MD, Diretor do Instituto de Ensino e Pesquisa do HCor - Hospital do Coração de São Paulo -SP
Evandro Tinoco – MD, Diretor Clinico do Hospital Pró-Cardíaco - RJ
A Mobile-Phone Tele-Medicine System That Promotes Self-Management of Blood Pr...IJERA Editor
The current practice adopted by hypertensive patients in managing hypertension is making frequent visits to a health center as recommended by medical specialists. However, very few patients adhere to this practice as it is time consuming and tiresome especially if they have to travel for long distances to have their BP checked. This practice is also not practical for critically-ill patients. Consequently, most patients neglect BP check-ups and therefore focus on medication alone. This puts the patients’ at risk as uncontrolled BP can lead to fatal complications. The overall objective of this research was to design, develop and pilot-test a mobile telemedicine system that helps patients’ to self-manage their BP condition from the comfort of their homes. Participatory action research design was used in this study. Testing for performance, usability and utilityof the tele-medicine system was conducted.
10 benefits of Remote Patient Monitoring (RPM).pdfHealthmote
Healthmote is one of the best remote patient monitoring services provider in USA. Remote patient monitoring uses equipment and technology in your home to send information about your health to clinicians on our team. Our remote patient monitoring program helps you stay informed about your condition while at home, and increases your independence in managing it. For more information visit us at healthmote.com today!
Remote Patient Monitoring (RPM) is becoming an essential part of future healthcare. Read this guide, to learn more about remote patient monitoring. Click here :https://bluestartelehealth.com/
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...GL Anaacs
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We specializes in exporting high quality Research chemical, medical intermediate, Pharmaceutical chemicals and so on. Products are exported to USA, Canada, France, Korea, Japan,Russia, Southeast Asia and other countries.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
1. NewYork-Presbyterian Healthcare System
Post Reform Strategies: Pragmatic Approaches
Quality Symposium 2010
to Improving Care
Pilot Study on the Effects of Medication Telemonitoring on Medication Compliance and the Rates of Re-Hospitalization in
CHF and Pneumonia Patients
J. Pinto, RPH MS; A. Farkas, PharmD; N. Tsirkas; B. Rapchack; M. Rader, MD
Nyack Hospital
Nyack Hospital is collaborating with Leap of Faith Technologies in a pilot study of the effects of a cellphone-based
medication telemonitoring system on rates of re-hospitalization in CHF and pneumonia patients. The system integrates cell
phones, radio frequency identification (RFID), and health and behavioral informatics to optimize medication adherence,
track medication use, and extend patient care to the ambulatory setting. It provides real-time, automated feedback on the
patient's medication compliance and documents compliance on a dose-by-dose basis. It can also send automatic alerts to
enable early intervention in the case of missed medications or adverse events before they become a serious health risk.
Problem
Medication compliance has been called the Achilles heel of modern healthcare. The average rate of compliance is only 50%
and continues to decline. Noncompliance is associated with nearly 70% of all medication-related hospital admissions at an
estimated annual cost of $100 billion. More specifically, according to Medicare claims data from 2003-2004, 19.6% of
Medicare beneficiaries who had been discharged from a hospital were re-hospitalized within 30 days, and 34.0% were re-
hospitalized within 90 days. The Medicare Payment Advisory Commission (MedPac) - in a report to the Congress in June
2007 - estimated that approximately three-quarters of readmissions were preventable -- amounting to $12 billion in annual
Medicare spending.
Goals
To facilitate transitional care from the acute to post-acute setting using a drug telemonitoring system, resulting in:
1. Improved compliance with prescribed therapy
2. Reduced rates of re-hospitalization
Methods
In this current transition care study, efficacy will be evaluated in a sample of patients being discharged from the hospital
after being treated for CHF or pneumonia, and taking at times more than 20 prescription and over the counter medications
daily (n=20). Subjects in the Test group will use the telemonitoring system; subjects in the Control group will be historical
controls. At the time of discharge, all of the patient's medications are entered into the eMedonline system, and wirelessly
downloaded to the phone for the patient. The pharmacist counsels the patient about his/her medications, including the
name of medication, strength, dosage form, quantity, dose, frequency, time taken, indication, instructions on how to take the
medication, and additional instructions as required, and gives the patient the eMedonline phone to use for 30 days. The
patient also receives "smart labels" (a label with RFID inlay) for each medication, which are affixed to the medication vial or
packaging. Each patient in the Test group receives a follow-up phone call from the pharmacist at days 7, 14, 21 and 30 post-
discharge and is given instructions about the medication being taken. Data on compliance rate and average compliance
time are collected by the mobile device for the Test Group, and compared to historical data in the Control Group. Rates of re-
hospitalization between the two groups will also be compared.
Results
To date, eight patients have enrolled in the pilot study. The Test group has thus far demonstrated 98.3 % compliance over
the 30 day study period (n= 6) for 2,317 scheduled doses. One subject's participation was terminated early due to personal
reasons. Average compliance time was 6.24 minutes (the average time it takes a patient to report a doses that it was taken).
Rate of hospital readmission for patients who have completed the 30 days enrollment is 0% to date (n= 5).
Introduction
Nyack Hospital
Quality Symposium 2010
Post Reform Strategies: Pragmatic Approaches to Improving Care
Page 119
2. NewYork-Presbyterian Healthcare System
Post Reform Strategies: Pragmatic Approaches
Quality Symposium 2010
to Improving Care
Pilot Study on the Effects of Medication Telemonitoring on Medication Compliance and the Rates of Re-Hospitalization in
CHF and Pneumonia Patients
J. Pinto, RPH MS; A. Farkas, PharmD; N. Tsirkas; B. Rapchack; M. Rader, MD
Nyack Hospital
Conclusions
The main outcomes of the pilot study will serve as the basis for a larger study with sufficient statistical power to evaluate the
true effects of the telemonitoring system on the rates of hospital readmissions. In addition, there are many other
opportunities to explore the use of such technology in improving communication between healthcare professionals related to
medication management and medication reconciliation in the continuum of care. Cellphone-based medication
telemonitoring may overcome some of the limitations of current methods used to manage transition care. Current
transitional care models frequently use a disease management approach, assigning a case worker to track and coach the
patient upon discharge. Follow-up office visits are typically scheduled 14 days or more after release—the timeframe in which
most readmissions occur. Of Medicare beneficiaries readmitted within 30 days, 64% received no post acute care between
discharge and readmission. During this critical period, there is no system to consistently and efficiently monitor the status of
the patient and provide timely feedback. eMedonline integrates the patient, caregiver, and provider into the transition care
plan, providing an important touch point that is available 24/7.
Nyack Hospital
Quality Symposium 2010
Post Reform Strategies: Pragmatic Approaches to Improving Care
Page 120