OpenNotes began as a research project that studied the effects of allowing patients access to their primary care doctors' visit notes. The study found that patients who read their notes felt more engaged in their care, better understood their conditions, and were better prepared for visits. Doctors had initial concerns about increased workload, but found little real impact. After one year, 99% of patients and the majority of doctors wanted to continue open notes access. The research demonstrated that open notes can help patients manage their health more effectively with little negative impact. The open notes movement has now expanded beyond primary care and many organizations are adopting the practice.
With patient responsibility becoming an increasing part of clinics AR, you need to make sure you have an effective strategy in place. Learn how to maximize your collections without negatively impacting your relationships with your patients.
Building A Chronic Care Management Program That Can ScaleVSee
Achieving 100% COVID Readiness with Chronic Care Telehealth
Chronically ill patients in the US account for 76% of all physician visits. They are also the most susceptible to COVID and COVID-related illnesses. With COVID variants on the rise, telehealth and remote patient monitoring (RPM) are essential to keeping these patients safe, while providing quality care and improving outcomes.
In addition, studies have shown that remote patient monitoring improves patient self-management and leads to earlier interventions. It can also reduce emergency hospital visits 30%. In 2015 Medicare began reimbursing clinicians for using remote patient monitoring technology to manage chronically ill patients with 2+ chronic conditions with Chronic Care Management (CCM) codes. In more recent years, it also began reimbursing remote patient monitoring (RPM) services for a wider range of patients.
Find out how you can become COVID ready by laying the foundations for a successful telehealth Chronic Care Management program on the next Telehealth Secrets webinar. Join us live with CEO Ajay Gehlot, MD, MBA of CareConnect Health–one of the largest primary care providers in the state of Georgia
Top 5 Telemedicine Regulatory Hurdles To OvercomeVSee
For more information please visit: https://vsee.com/blog/top-5-telemedicine-regulatory-hurdles-to-overcome/
For other webinars:
https://vsee.com/webinars/
Or join our Linkedin Group: https://www.linkedin.com/groups/Telehealth-Failures-Secrets-Success-13500037/about
Or Join our Facebook Group:
https://www.facebook.com/groups/tfssgroup/?ref=group_cover
Revenue at Risk: Understanding Financial Impacts of Quality ReportingBill Presley
Jodi Frei, Northwestern Medical Center Vermont, and I co-presented at the MUSE Executive Institute on Revenue at Risk: Understanding Financial Impacts of Quality Reporting. The Executive Institute featured many amazing CXO's discussing the changing landscape of revenue cycle management and how finance, quality, and IT departments are converging on revenue cycle.
Though pay for performance is the common theme, the logistics of programs including Value Based Purchasing (VBP), Inpatient Quality Reporting (IQR), Hospital Acquired Condition (HAC) Reduction Program, Readmission Reduction, MACRA, MIPS and APMs, are very different. In this session, the specifics of each Quality Program including reporting requirements, scoring methodologies, and associated incentives and penalties will be covered. In addition, tools to track performance and quantify financial risk will be shared.
Reimbursement in this era of health care reform is challenging. We all seek success under this new normal in health care. Optimizing revenue capture in a quality reimbursement model requires acquisition of new knowledge and the use of new tools and strategies. Join us in the conversation; share your strategies; learn from others.
Healthcare Industry Taxonomy for the Population Health EraDave Chase
See https://www.linkedin.com/pulse/population-health-investments-catastrophically-misaligned-dave-chase for background on taxonomy
Created for The Future Health Ecosystem Today by Cascadia Capital and Dave Chase
Riding the Rapids of Payment Reform: Downstream Effects of Quality Reporting ...Bill Presley
In this presentation, we highlighted how quality measurement programs impact reimbursement affecting your revenue. The revenue at risk in your organization. We focused on quality programs like Value-Based Purchasing (VBP), Merit-Based Incentive Program (MIPS) and Alternative Payment Models (APM) and their impact on Part A and Part B reimbursements.
It’s no surprise that reimbursement tied to quality performance is quickly becoming a reality for hospitals and physicians. CMS’ aggressive goals aimed at increasing the percentage of Medicare payments associated with quality versus quantity can be achieved through such programs as Value-based Purchasing and MACRA. This session will cover scoring methodologies, reporting requirements, reimbursement impact, infrastructure (and other resource needs), EMR tools and tactics, and workflow modifications.
The Alphabet Soup of Clinical Quality Measures ReportingBill Presley
CMS is transitioning to what the they call "a new and more responsive regulatory framework" for quality reporting and reimbursement. CMS goals are "…electronic health records helping physicians, clinicians, and hospitals to deliver better care, smarter spending, and healthier people". Over the next couple years, we will see a transformation of fee for service into value-based care models driven by the VBP, Quality Payment Program, MACRA, Merit-based Incentive Payment System (MIPS) and Alternative Payment Models (APM). Healthcare organizations will no longer be motivated by implementing and meeting Meaningful Use, but instead will be driven by value-based care and risk-based payment models that focus on quality outcomes for reimbursements.
In this Education Session we will review:
• How CMS is aligning clinical quality measures (CQMs) to reduce the reporting burden for healthcare organizations and providers. We will cover the vision and goals for achieving quality alignment for CMS.
• We will dive into the following CMS reporting programs and how they interact with each other: Value-Based Purchasing (VBP), Medicare Access and CHIP Reauthorization Act (MACRA), Merit-based Incentive Payments (MIPS), Hospital Inpatient Quality Reporting (IQR), The Joint Commission (ORYX), Outpatient Quality Reporting (OQR), and Alternative Payment Models (APM).
Transforming Clinical Practice InitiativeCitiusTech
The Transforming Clinical Practice Initiative (TCPI) is designed to help small practices and clinicians achieve large-scale health transformation. The initiative is designed to support more than 140,000 clinician practices over four years duration in sharing, adapting and further developing their comprehensive quality improvement strategies. The TCPI is one part of a unique strategy advanced by the Affordable Care Act to strengthen the quality of patient care and manage health care expenditures, ultimately saving the taxpayer from substantial costs. This document describes the initiative in detail with the type of participants, eligibility and reporting requirements of the participants. Understanding the implementation of this initiative not only helps clinicians, but opens up a huge market for Healthcare IT companies offering the products and services like EHR implementation, Integration, EHR/ Data Migration, Implementation of HIE etc.
Big Data and VistA Evolution, Theresa A. Cullen, MD, MSBrian Ahier
Presentation to Open Source Electronic Health Record Alliance (OSEHRA) Architecture Work Group by Theresa A. Cullen, MD, MS
Chief Medical Information Officer
Director, Health Informatics
Office of Informatics and Analytics
Veterans Health Administration
Department of Veterans Affairs
The slideshare is the first lecture in a series on Managing Information in Health by the Author at Kingston University London on the MSc Course. The topic of the first lecture was the management of information and the way data is presented.
With patient responsibility becoming an increasing part of clinics AR, you need to make sure you have an effective strategy in place. Learn how to maximize your collections without negatively impacting your relationships with your patients.
Building A Chronic Care Management Program That Can ScaleVSee
Achieving 100% COVID Readiness with Chronic Care Telehealth
Chronically ill patients in the US account for 76% of all physician visits. They are also the most susceptible to COVID and COVID-related illnesses. With COVID variants on the rise, telehealth and remote patient monitoring (RPM) are essential to keeping these patients safe, while providing quality care and improving outcomes.
In addition, studies have shown that remote patient monitoring improves patient self-management and leads to earlier interventions. It can also reduce emergency hospital visits 30%. In 2015 Medicare began reimbursing clinicians for using remote patient monitoring technology to manage chronically ill patients with 2+ chronic conditions with Chronic Care Management (CCM) codes. In more recent years, it also began reimbursing remote patient monitoring (RPM) services for a wider range of patients.
Find out how you can become COVID ready by laying the foundations for a successful telehealth Chronic Care Management program on the next Telehealth Secrets webinar. Join us live with CEO Ajay Gehlot, MD, MBA of CareConnect Health–one of the largest primary care providers in the state of Georgia
Top 5 Telemedicine Regulatory Hurdles To OvercomeVSee
For more information please visit: https://vsee.com/blog/top-5-telemedicine-regulatory-hurdles-to-overcome/
For other webinars:
https://vsee.com/webinars/
Or join our Linkedin Group: https://www.linkedin.com/groups/Telehealth-Failures-Secrets-Success-13500037/about
Or Join our Facebook Group:
https://www.facebook.com/groups/tfssgroup/?ref=group_cover
Revenue at Risk: Understanding Financial Impacts of Quality ReportingBill Presley
Jodi Frei, Northwestern Medical Center Vermont, and I co-presented at the MUSE Executive Institute on Revenue at Risk: Understanding Financial Impacts of Quality Reporting. The Executive Institute featured many amazing CXO's discussing the changing landscape of revenue cycle management and how finance, quality, and IT departments are converging on revenue cycle.
Though pay for performance is the common theme, the logistics of programs including Value Based Purchasing (VBP), Inpatient Quality Reporting (IQR), Hospital Acquired Condition (HAC) Reduction Program, Readmission Reduction, MACRA, MIPS and APMs, are very different. In this session, the specifics of each Quality Program including reporting requirements, scoring methodologies, and associated incentives and penalties will be covered. In addition, tools to track performance and quantify financial risk will be shared.
Reimbursement in this era of health care reform is challenging. We all seek success under this new normal in health care. Optimizing revenue capture in a quality reimbursement model requires acquisition of new knowledge and the use of new tools and strategies. Join us in the conversation; share your strategies; learn from others.
Healthcare Industry Taxonomy for the Population Health EraDave Chase
See https://www.linkedin.com/pulse/population-health-investments-catastrophically-misaligned-dave-chase for background on taxonomy
Created for The Future Health Ecosystem Today by Cascadia Capital and Dave Chase
Riding the Rapids of Payment Reform: Downstream Effects of Quality Reporting ...Bill Presley
In this presentation, we highlighted how quality measurement programs impact reimbursement affecting your revenue. The revenue at risk in your organization. We focused on quality programs like Value-Based Purchasing (VBP), Merit-Based Incentive Program (MIPS) and Alternative Payment Models (APM) and their impact on Part A and Part B reimbursements.
It’s no surprise that reimbursement tied to quality performance is quickly becoming a reality for hospitals and physicians. CMS’ aggressive goals aimed at increasing the percentage of Medicare payments associated with quality versus quantity can be achieved through such programs as Value-based Purchasing and MACRA. This session will cover scoring methodologies, reporting requirements, reimbursement impact, infrastructure (and other resource needs), EMR tools and tactics, and workflow modifications.
The Alphabet Soup of Clinical Quality Measures ReportingBill Presley
CMS is transitioning to what the they call "a new and more responsive regulatory framework" for quality reporting and reimbursement. CMS goals are "…electronic health records helping physicians, clinicians, and hospitals to deliver better care, smarter spending, and healthier people". Over the next couple years, we will see a transformation of fee for service into value-based care models driven by the VBP, Quality Payment Program, MACRA, Merit-based Incentive Payment System (MIPS) and Alternative Payment Models (APM). Healthcare organizations will no longer be motivated by implementing and meeting Meaningful Use, but instead will be driven by value-based care and risk-based payment models that focus on quality outcomes for reimbursements.
In this Education Session we will review:
• How CMS is aligning clinical quality measures (CQMs) to reduce the reporting burden for healthcare organizations and providers. We will cover the vision and goals for achieving quality alignment for CMS.
• We will dive into the following CMS reporting programs and how they interact with each other: Value-Based Purchasing (VBP), Medicare Access and CHIP Reauthorization Act (MACRA), Merit-based Incentive Payments (MIPS), Hospital Inpatient Quality Reporting (IQR), The Joint Commission (ORYX), Outpatient Quality Reporting (OQR), and Alternative Payment Models (APM).
Transforming Clinical Practice InitiativeCitiusTech
The Transforming Clinical Practice Initiative (TCPI) is designed to help small practices and clinicians achieve large-scale health transformation. The initiative is designed to support more than 140,000 clinician practices over four years duration in sharing, adapting and further developing their comprehensive quality improvement strategies. The TCPI is one part of a unique strategy advanced by the Affordable Care Act to strengthen the quality of patient care and manage health care expenditures, ultimately saving the taxpayer from substantial costs. This document describes the initiative in detail with the type of participants, eligibility and reporting requirements of the participants. Understanding the implementation of this initiative not only helps clinicians, but opens up a huge market for Healthcare IT companies offering the products and services like EHR implementation, Integration, EHR/ Data Migration, Implementation of HIE etc.
Big Data and VistA Evolution, Theresa A. Cullen, MD, MSBrian Ahier
Presentation to Open Source Electronic Health Record Alliance (OSEHRA) Architecture Work Group by Theresa A. Cullen, MD, MS
Chief Medical Information Officer
Director, Health Informatics
Office of Informatics and Analytics
Veterans Health Administration
Department of Veterans Affairs
The slideshare is the first lecture in a series on Managing Information in Health by the Author at Kingston University London on the MSc Course. The topic of the first lecture was the management of information and the way data is presented.
Tom Deblanco: maximising patient engagementNuffield Trust
Tom Delbanco, MD, MACP and Koplow–Tullis, Professor of Medicine, Harvard Medical School present on maximising patient engagement through health information technology.
iHT² Health IT Summit Denver 2013 - C.T. Lin, CMIO, University of Colorado Health "Patient Centered Information Technology"
Be able to define and describe:
∙ Patient centered information technology
∙ Risks and benefits of communication between patients and providers online
∙ Risks and benefits of online release of test results and disease management
∙ Impact of social media on patient online behavior
Improving Healthcare Outcomes with Active Patient Engagementmosmedicalreview
EHRs enable more effective medical records review for legal as well as medical purposes. They also allow patients to participate in their own healthcare
Shared Decision Making in health (Decisions Compartides) is a project of the Catalan Health Ministry of the Generalitat de Catalunya. Physicians and patients are involved in shared medical decisions. Both parties share information (evidence based information about treatment options, cons and pros, patient preferences and values) and an agreement is reached on the treatment to implement.
Insights into the e-Patient: An Analysis of the Inspire Annual SurveyInspire
"Insights into the e-Patient: An Analysis of the Inspire Annual Survey" was a presentation that Inspire's Dave Taylor made in May 2015 to the iPharma conference
My talk at the Scientific Research Day of Medical colleges, UQU
5 March 2019
where I presented my publication (Patient-Centered Pharmacovigilance: A review)
SLC CME- Evidence based medicine 07/27/2007cddirks
Saint Luke's Care, a quality improvement organization within Saint Luke's Health System, presents a CME presentation by Dr. Brent Beasley on Evidence Based Medical Care.
What does a 21st century technologically savvy pharmacistCody Midlam
This program will identify emerging technologies affecting the practice of pharmacy in a transitional healthcare delivery system, with a focus on those technologies that improve pharmacist-patient communication, and tools that aide in drug therapy monitoring
Objectives:
Identify what a technological savvy pharmacist looks like in 2014
Identify mobile health devices and applications (apps) to monitor blood pressure, blood glucose, and other patient-based labs
Differentiate between historical, current, and future programs to aide in medication adherence and compliance
Distinguish which technologies enable pharmacists to become more involved with their local healthcare communities
Please share this slideshow with anyone who may be interested!
Watch all our webinars: https://www.youtube.com/playlist?list=PL4dDQscmFYu_ezxuxnAE61hx4JlqAKXpR
In this webinar:
● Discussion of the CADTH Symposium
● Recommendations for HTA improvements in Canada
● Audience Q&A
View the video: https://youtu.be/AJCOemf2r6Y
Follow our social media accounts:
Twitter - https://twitter.com/survivornetca
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A Promulgation Of Incredulity In The Pharmaceutical IndustryStuart Silverman
It is simply no longer possible to believe much of the clinical research that is published, or to rely on the judgment of trusted physicians or authoritative medical guidelines.
For more informationGift of Life Donation Initiative www.oShainaBoling829
For more information
Gift of Life Donation Initiative
www.organdonor.gov
United Network For Organ Sharing
www.unos.org
Association of Organ Procurement Organizations
www.aopo.org
Arbor Research Collaborative for Health
www.arborresearch.org
National Kidney Foundation
www.livingdonors.org
Help Avoid Mistakes in Your Surgery
https://www.jointcommission.org/topics/
speak_up_preventing_surgical_errors.aspx
Health Care at the Crossroads:
Strategies for Narrowing the Organ Donation
Gap and Protecting Patients
www.jointcommission.org/organ_ donation/
The Joint Commission is the largest health care
accrediting body in the United States that
promotes quality and safety.
Helping health care organizations help patients
Information
For Living
Organ Donors
9/16
https://www.jointcommission.org/topics/speak_up_preventing_surgical_errors.aspx
www.organdonor.gov
www.unos.org
www.aopo.org
www.arborresearch.org
www.livingdonors.org
https://www.jointcommission.org/topics/speak_up_preventing_surgical_errors.aspx
https://www.jointcommission.org/organ_donation/
The goal of the Speak Up™ program is to help patients become more informed and involved in their health care.
Every year nearly 6,000 Americans become
living organ donors. Usually, they donate a kidney.
But donors can also give a part of their liver, lung
or pancreas. If you are thinking about becoming
a living organ donor, this brochure gives you
important questions to ask your health care team.
Can anyone be a donor?
No. Living organ donors must be healthy. They
cannot have diseases like diabetes, cancer, and
kidney, heart and blood disease. Also, the donor’s
blood type must match the recipient’s. And, donors
must be able to handle the stress of surgery
and recovery.
Will you have medical tests?
Yes. Your health care team will do tests to see if you
are healthy enough to be a donor. Tell them about
your health history and any concerns you have.
Are there risks?
All surgeries have risks, including the risk of death.
You could get an infection or another complication.
Ask about the risks of your surgery.
Will you get the same kind of health care
as the organ recipient?
Both you and the organ recipient should expect safe,
quality care.
Is living organ donation always successful?
No. Sometimes, the recipient’s body rejects the new
organ. Or, the recipient may have complications.
You can ask about the expected result of the
surgery for the recipient, and the risks to him or her.
Can you change your mind?
Yes. You can change your mind at any time for any
reason. Organ donation is a personal decision. No
one can make the decision for you. You should not
feel pressured to donate.
How do you get ready for the surgery?
• Ask your health insurance company if it will cover
your care and any complications from the surgery.
• Ask if your premium or coverage will change as a
result of your donation.
• Ask your life insurance company if you ...
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.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of 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 leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
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. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
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.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
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
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.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...GL Anaacs
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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
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
2. Background
Background information for using these slides:
•
OpenNotes began as a research and demonstration project that ran from 2010 to 2011 in primary
care in three sites, led by Beth Israel Deaconess Medical Center in Boston.
•
The study was funded by the Robert Wood Johnson Foundation (RWJF) and published in the
Annals of Internal Medicine in October 2012: “Inviting Patients to Read Their Doctors' Notes: A
Quasi-experimental Study and a Look Ahead.” The following slides report on these results.
•
Today, the study investigators and others are expanding OpenNotes beyond primary care and
studying further implications for patients, caregivers, and clinicians in specialty care, psychiatry,
and more. RWJF continues to fund OpenNotes projects, including an advocacy campaign to make
sharing visit notes a routine part of care.
•
The team has published several papers and maintains the OpenNotes website
(www.myopennotes.org) where you can find published papers, news, and other materials.
www.myopennotes.org
3. About the OpenNotes Study
Demonstration project summer 2010 – summer 2011 (and still ongoing)
Patients invited to view their PCPs’ signed notes via secure portals
(only notes signed during the project – not retroactive)
Each patient notified automatically via secure e-mail message when a
note was signed, and reminded to review note(s) before next visit
Patients and doctors completed surveys before and after, and we
collected administrative data (portal clicks, e-mail volume)
Primarily funded by the Robert Wood Johnson Foundation
www.myopennotes.org
4. The Study’s
Three Principal Questions
Would OpenNotes help patients become more engaged
in their care?
Would OpenNotes affect doctors’workflow negatively?
After one year, would patients and doctors choose to
continue?
www.myopennotes.org
5. Participants
108 volunteer PCPs and more than 19,000 of their patients
who use portals
•
BIDMC (urban and suburban Boston)
• 39 PCPs
•
Geisinger Health System (rural Pennsylvania)
• 24 PCPs
•
10,300 patients
8,700 patients
Harborview Medical Center (inner city Seattle)
• 45 PCPs
www.myopennotes.org
270 patients (new portal)
6. PCPs’ Concerns and Experiences
(surveys after 12 months experience with open notes)
www.myopennotes.org
7. PCPs’ Main Concerns
changes in workflow
Pre-intervention (%)
BIDMC/GHS/HMC
Post-intervention (%)
BIDMC/GHS/HMC
Visits significantly
longer
23/32/21
3/5/0
More time addressing
patient questions
outside of visits
49/45/34
8/0/0
More time
writing/editing/
dictating notes
46/36/34
21/14/0
And, compared to the year preceding the intervention, the volume of e-mails
from patients did not change
www.myopennotes.org
(Delbanco et al, Ann Int Med, 2012)
8. PCPs’ Main Concerns
changes in documentation
Changed the way they
addressed:
Pre-intervention (%)
BIDMC/GHS/HMC
Post-intervention (%)
BIDMC/GHS/HMC
Cancer/possibility of
cancer
33/18/26
26/18/3
Mental health issues
44/27/53
36/27/11
Substance abuse
38/32/42
28/23/8
Obesity
18/18/21
33/5/5
www.myopennotes.org
10. Among Patients
with Notes (Visits):
• 82% opened at least one of their notes
• Few patients said reading notes made them
• Worried (5-8%)
• Confused (2-8%)
• Offended (1-2%)
• 20-42% shared notes with others
www.myopennotes.org
11. Among Patients
with Notes:
• 70-72% of patients across the three sites reported taking
better care of themselves
• 77-85% reported better understanding of their health and
medical conditions
• 76-83% reported remembering the plan for their care
better
www.myopennotes.org
12. Among Patients
with Notes:
• 69-80% felt better prepared for visits
• 77-87% felt more in control of their care
• 60-78% among those taking medications reported
“doing better with taking my medications as prescribed”
www.myopennotes.org
14. Comments from Patients
Weeks after my visit, I thought, "Wasn't I supposed to look into something?" I
went online immediately. Good thing! It was a precancerous skin lesion my
doctor wanted removed (I did).
In his notes, the doctor called me "mildly obese." This prompted immediate
enrollment in Weight Watchers and daily exercise. I’m determined to reverse
that comment by my next check-up.
If this had been available years ago I would have had my breast cancer
diagnosed earlier. A previous doctor wrote in my chart and marked the exact
area but never informed me. This potentially could save lives.
It really is much easier to show my family who are also my caregivers the
information in the notes than to try and explain myself. I find the notes more
accurate than my recollections, and they allow my family to understand what is
actually going on with my health, not just what my memory decides to store.
www.myopennotes.org
15. Comments from Doctors
I had to have better documentation, which is a good thing.
My fears: Longer notes, more questions, and messages from
patients. In reality, it was not a big deal.
For me the most difficult thing was having to be careful about
tone and phrasing of the notes knowing the patient would be
reading them.
I felt like my care was safer, as I knew that patients would be
able to update me if I didn't get it right. I also felt great about
partnering with my patients, and the increased openness.
www.myopennotes.org
16. The Bottom Line for PCPs
After a year, PCPs were asked: Taking all considerations
into account, I would like my patients to continue to be able to
see my visit notes online.
Some said no:
26% of BIDMC PCPs
17% of GHS PCPs
19% of HMC PCPs
But, when offered the option of turning off open notes at the
end of the year-long intervention, not one doctor asked to do
so.
www.myopennotes.org
17. The Bottom Line for Patients
After one year, 99% of patients
wanted to continue to be able
to see their visit notes online.
When given a choice of doctors or health plans in the future:
4 out of 5 patients said the availability of open notes would
impact their choice of provider
www.myopennotes.org
18. The Bottom Line for
the Three Institutions
All 3 sites decided to expand OpenNotes
• Geisinger and Harborview: MDs/ NPs/PAs in ambulatory
practices
• BIDMC: All clinicians’notes (ambulatory opened in 2013 and
inpatient notes planned for 2014)
www.myopennotes.org
19. The Inexorable Rise of Online
Access and Transparency
Health care becoming more transparent: Open
disclosure, lab results, pricing, patient portals, Blue
Button…
Consumers:
• “I don’t know if I want to read my entire medical record, but I
want to have it.” (focus group participant)
• Government’s direct-to-consumer promotion of HIT
• Give Me My DaM Data (Data about Me)
www.myopennotes.org
20. Transparency Makes Headlines
The Road Toward Fully Transparent Medical Records
Letting Patients Read Doctors’ Notes
Consumers Gaining Ground in Healthcare
Ten Ways Patients Get Treated Better
Inviting Patients to Read Their Doctors' Notes:
A Quasi-Experimental Study and a Look Ahead
Will Reading Your Doctor’s Notes Lead to Better Health?
www.myopennotes.org
Should Patients See Their Doctors’ Notes?
21. OpenNotes: Standard of Care
Guest and Quincy. Consumers Gaining Ground in
Health Care, JAMA, 2013
Walker, Darer, Elmore, and Delbanco. The Road
toward Fully Transparent Medical Records, N Engl J
Med, 2013
www.myopennotes.org
22. Patients Pointing
toward the Future
In the study:
49-56% of patients wanted patient proxies to have access
86-88% of patients wanted access to inpatient notes
59-62% of patients wanted to add comments to their notes
30-40% of patients wanted to be able to approve what is
written in a note
www.myopennotes.org
23. OpenNotes is like a New
Medicine
• Its goal is to help people manage health and illness more
effectively
• It can have side effects and may hurt some patients
• Clinicians and patients will need to learn how to use it
well
www.myopennotes.org
24. Future Directions
Most organizations adopting OpenNotes begin by sharing clinicians’ notes in
ambulatory care.
Organizations have or will soon begin sharing notes with:
•
Caregivers
•
Psychiatry patients
•
Inpatients
And research continues:
•
Open notes and patient safety
•
Open notes and medication adherence
•
Open notes and end of life care
•
Patients and clinicians co-generating notes
www.myopennotes.org
25. Join the OpenNotes Movement!
Visit the OpenNotes website www.myopennotes.org and sign up
for the mailing list
Resources for organizations implementing open notes
• Toolkit for implementers
• Roadmap and advice about key decisions
• Sample FAQs for patients and clinicians
• Sample communications materials
• Resources for evaluators
• All open notes surveys are available free of charge
• Links to all open notes papers are on the website
Need something else? Contact the OpenNotes team:
• myopennotes@bidmc.harvard.edu
www.myopennotes.org
Background Information for those who plan to use these following slides:OpenNotes was a research and demonstration project that ran from 2010 to 2011 in primary care in three sites, led by Beth Israel Deaconess Medical Center in Boston. The study was funded by the Robert Wood Johnson Foundation (RWJF) and published in the Annals of Internal Medicine in October 2012: “Inviting Patients to Read Their Doctors' Notes: A Quasi-experimental Study and a Look Ahead.”The following slides report on these results. Today, the study investigators and others are expanding OpenNotes beyond primary care and continue to study OpenNotes implications for patients, caregivers, and clinicians. RWJF continues to fund OpenNotes projects, including an advocacy campaign to make sharing visit notes a routine part of care. The team has published more papers and maintains the OpenNotes website (www.myopennotes.org) where you can find published papers, news, and more.
Beth Israel Deaconess Medical CenterTeaching hospital of Harvard Medical School in BostonGeisinger Health SystemIntegrated health center serving 2.6 million people in rural PennsylvaniaHarborview Medical Center Safety-net hospital in inner city hospital
First question: did they look?From portal use dataSharing usually family members or relativesHMc recruited, not committed portal usersReasons for not reading: forgot couldn’t find no reason
new
HHS has proposed all labs released directly to ptsVA Blue Button – downloads entire recordMD Anderson – 30,000 pts/yrONC – starting DTC promotion with video about online access to care and records (does not mention notes though)Give Me My DaM Data (spin off from e-Pt Dave TED talk) DaM = Data that’s Mine Danny Sands sings!
First question: did they look?From portal use dataSharing usually family members or relativesHMc recruited, not committed portal usersReasons for not reading: forgot couldn’t find no reason