The document discusses Heartland Health's patient portal experience. It provides details on Heartland's facilities and services, as well as statistics on portal usage. The portal allows both patients and physicians to access records. Early usage was heavily dependent on physicians, with one physician driving 75% of registrations. The portal has the potential to streamline communication and reduce barriers between patients and care providers. However, challenges remain in fully engaging patients and adapting policies and workflows to incorporate new technologies.
India Medical Tourism Industry Outlook to 2015AMMindpower
Executive Summary
The report titled “India Medical Tourism Industry Outlook to 2015” provides a comprehensive analysis of the India Medical tourism industry covering in detail various aspects such as market size on the basis of number of foreign patients and medical tourists, revenue from foreign patients and medical tourist receipts, market segmentation, competitive landscape and profiles of the major hospitals treating foreign patients in the country. The report also entails major drivers and growth barriers of medical tourism market. The future outlook along with projections and macro-economic factors has also been presented providing an insight on the prospects in the medical tourism industry.
For more information please refer to the below mentioned link:
http://www.ammindpower.com/report.php?A=235
India Medical Tourism Industry Outlook to 2015AMMindpower
Executive Summary
The report titled “India Medical Tourism Industry Outlook to 2015” provides a comprehensive analysis of the India Medical tourism industry covering in detail various aspects such as market size on the basis of number of foreign patients and medical tourists, revenue from foreign patients and medical tourist receipts, market segmentation, competitive landscape and profiles of the major hospitals treating foreign patients in the country. The report also entails major drivers and growth barriers of medical tourism market. The future outlook along with projections and macro-economic factors has also been presented providing an insight on the prospects in the medical tourism industry.
For more information please refer to the below mentioned link:
http://www.ammindpower.com/report.php?A=235
Portals, Mobile Devices, and Patient EngagementIatric Systems
Why aren't patients engaging in their own healthcare? Let's explore why they aren't, and changes that will encourage patients to engage in their healthcare. Frank Fortner, President at Iatric Systems, discusses these topics on an HISTalk Tweet chat.
As healthcare reform and transformation advances, providers will seek new ways to engage patients and influence behavior using connected health and will increasingly look for more advanced solutions that are proven to consistently motivate sustained behavioral change. These solutions are referred to as “Patient Portal 2.0.”
The Patient Portal 2.0 that the market requires relies on a host of functions that think outside the confines of Meaningful Use. In order to develop a portal that reaches into a population and makes a difference it is important to understand the purpose of the portal. Taking the necessary time to identify what motivates the intended audience and developing tools that deliver that experience is key to successfully engaging patients.
This paper looks at seven portal features that the market is currently pushing towards.
Portals, Mobile Devices, and Patient EngagementIatric Systems
Why aren't patients engaging in their own healthcare? Let's explore why they aren't, and changes that will encourage patients to engage in their healthcare. Frank Fortner, President at Iatric Systems, discusses these topics on an HISTalk Tweet chat.
As healthcare reform and transformation advances, providers will seek new ways to engage patients and influence behavior using connected health and will increasingly look for more advanced solutions that are proven to consistently motivate sustained behavioral change. These solutions are referred to as “Patient Portal 2.0.”
The Patient Portal 2.0 that the market requires relies on a host of functions that think outside the confines of Meaningful Use. In order to develop a portal that reaches into a population and makes a difference it is important to understand the purpose of the portal. Taking the necessary time to identify what motivates the intended audience and developing tools that deliver that experience is key to successfully engaging patients.
This paper looks at seven portal features that the market is currently pushing towards.
How to engage patients to use the patient portal to meet meaningful useFast Track Marketing
Getting patients to engage fully with your patient portal can be hard work but it is a must for meaningful use. If done properly, your portal can not only decrease the time your staff has to spend scheduling appointments, processing paperwork and calling in prescriptions but will give your patients the ability to have some control over their healthcare.
Fast Track Marketing works with practices across the U.S. helping them grow, meet goals and gain efficiency to name a few. One of the areas is this topic: helping them to engage more of their patients with their patient portal.
HPCC Systems Engineering Summit Presentation - Collaborative Research with FA...HPCC Systems
Presenters: Borko Furht, Department of Electrical & Computer Engineering and Computer Science, FAU
In 2009, Florida Atlantic University (FAU) received a grant from the National Science Foundation (NSF) to create the site of the Center for Advanced Knowledge Enablement (CAKE) as an Industry/University Cooperative Research Center (I/UCRC) that provides a framework for interaction between university faculty and industry in the areas of information technology, communication, and computing. LexisNexis is currently one of the CAKE industry members. In this session, we will talk about the significance of the membership, joint accomplishments, contributions back to the HPCC Systems community, as well as sharing experiences on including a Data Intensive Computing program in the FAU curriculum.
NOTE: This is one of 3 presentations for this session and is the 2nd one shown in the accompanying YouTube video.
Nicholas Mays | Evaluating current market reforms in the English NHSSax Institute
Professor Nicholas Mays, Professor of Health Policy at the London School of Hygiene and Tropical Medicine in the UK, presented to the HARC network in January 2008 on evaluating current market reforms in the UK National Health Service.
HARC stands for the Hospital Alliance for Research Collaboration. HARC is a collaborative network of researchers, health managers, clinicians and policy makers based in NSW, Australia managed by the Sax Institute.
HARC Forums bring members of the HARC network together to discuss the latest research and analysis about important issues facing our hospitals.
For more information visit saxinstitute.org.au.
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.
Title: Sense of Taste
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 structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
The Gram stain is a fundamental technique in microbiology used to classify bacteria based on their cell wall structure. It provides a quick and simple method to distinguish between Gram-positive and Gram-negative bacteria, which have different susceptibilities to antibiotics
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
Adv. biopharm. APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMSAkankshaAshtankar
MIP 201T & MPH 202T
ADVANCED BIOPHARMACEUTICS & PHARMACOKINETICS : UNIT 5
APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMS By - AKANKSHA ASHTANKAR
Pharynx and Clinical Correlations BY Dr.Rabia Inam Gandapore.pptx
Patient portal experience personal version
1. A Discussion on Patient Engagement
Heartland Health’s
Patient Portal Experience
1
10/15/2012
2. Heartland Health
• Non-profitMedical Center
Heartland Region
• 353 beds IDS • Annually:
• Tertiary care regional medical center
19,000 annual admissions
• Level 2 trauma center
Heartland Clinics (> 60 in region) 90,000 patient days
Community Health Improvement Solutions > 500,000 annual outpatient visits
• Aetna plans > 60,000 annual ED visits
• Care Management 160+ employed physicians
• Wellness
3400 Total FTEs
• Foundation
• Medicaid ASO
Hospice & home health
LTACH (41 beds)
Serving a 22 county service area
(~300,000 lives)
10/15/2012 2
3. Primary Service Area
Population: 109,425
Market Share: 83.7%
Discharges: 14,939
Secondary Service Area
Population: 182,674
Market Share: 16.5%
Discharges: 4,343
10/15/2012 3
4. The Process To Date
Go Live
First Pilot Innovation Most Clinics
Clinic
Fall 2007 Spring 2008 2012
Went through 3 iterations of the application
10/15/2012 4
5. Portal: Provides both PHR and EMR access
Patients via Physicians via
web EMR
PHR EMR
10/15/2012 5
6. Message Analysis
Monthly Messages
700
35.0%
600
30.0%
500
25.0%
System Provider
400 20.0%
Staff Nurse
Patient Patient
300 15.0%
Nurse Staff
Provider System
200 10.0%
100 5.0%
0 0.0%
In Out In Out
10/15/2012 6
11. Portal Usage Begins with Providers
1,800
Pts IQH Pts If the physician is not driving the
1,600
1,400 use of the portal, it won’t be used.
1,200 Early 2010 data
1,000
Single physician accounted for over
800
600
75% of the patient portal registrations
400 an usage in the pilot clinic.
200
-
Team based approach? May work
Phys1 Phys2 Phys3 Phys4
10/15/2012 11
12. Workflow Changes
Possible with Direct Patient
Involvement
Can use new tools to optimize and eliminate many physician/patient barriers
12
13. Portal streamlines processes Reducing steps and handoffs
Traditional messaging
involves mutliple steps
and puts insulating
barriers between
patients and physicians
Direct patient
participation streamlines
the communication and
has the potential to
eliminate barriers
10/15/2012 13
14. Forwarding Lab Results
• Labs to endorse drop into
physician’s Inbox
• Creates a message to the
patient
• Results and normals
automatically appear in
the body of the message
– Physician can add personal
interpretation
– Copy any others that need
to be informed
– Add new prescriptions or
orders
10/15/2012 14
15. How Much Change?
» Reduced patient phone » Reduced total messages in the
conversations around 75% Inbox by nearly 30%
» The more barriers between
» More time for nurses to do a physician and the patient
other work the more messages there
are in the physicians (and
» Have more time for prior the nurse’s) inbox
authorizations and other » Completely counter
logistical activities intuitive finding
10/15/2012 15
17. The Web Itself
We live in a mobile, app dominated world.
Most patients are essentially healthy. Forget
URL and Password when they need to
connect.
Are travelling and don’t have ready access to
a computer.
Patients want and need an App in addition to
the Web.
10/15/2012 17
18. Visual World
We live in a very vibrant and visual world.
Text is a poor substitute for pictures.
More and more a picture doesn’t convey the
story … but a short video does.
Many patients are used to posting multimedia
to social networks.
Potential to reduce or improve the
appropriateness of office visits … especially in
an ACO world.
10/15/2012 18
20. Providers, Policies, P
olitics
Providers (physicians) not on board yet.
There still exists a very strong reluctance to have
patient’s interacting in the same space as
providers.
Most of our policies and procedures are based
on paper work flows.
Current laws, policies and procedures lag behind
the technology curve and the distance between
them and the world is increasing, not
decreasing.
10/15/2012 20
Heartland Health quietly turned on Cerner's patient portal in 2007 and after several years of piloting it in one clinic has now expanded it throughout it's entire network. The primary benefit has been to provide patients a secure communication directly with their providers. Patients also have access to their labs, medications, problems, physician documents and upcoming visits. This talk will go over usage, enrollment decisions and issues as well as many other outcomes.This Scottsdale Institute presentation discusses that experience for the audience
The primary service area surrounds St. Joseph, MO with a population of a little over 100,000. Surrounding the primary service area is a secondary one scattered in a wide area in 4 states (Missouri, Kansas, Iowa and Nebraska and we are expanding southward into the greater Kansas City metropolitan area with a much larger population.
The pilot was started in with one physician in a single of around 30 Heartland Health clinic, primarily with one physician in a clinic located in the north suburbs of Kansas City. It was originally started as a stealth project, requiring very few resource to see if there would be any traction. After nearly a year over a thousand patients were registered and many of them were interacting with good feedback. Very few problems were encountered and significant work flow improvements were documented and in 2008 the pilot expanded to the entire clinic. All 4 physicians were encouraged to enroll their patients and each of their staff were taught how to enroll and educate their patients. Attempts were made to encourage other clinics to enroll their patients but this process did not become part of Heartland Health’s core strategy until early in 2012 when the need arose as part of the Meaningful Use Stage 1 attestation process.
Our patient portal is provided by Cerner and integrated with our Cerner Platform. Patients access the portal either through Cerner Health’s personal health record or directly via IQHealth.Patients can use the Healthe PHR to record home measurements and maintain their own medical record that is separate from Heartland’s Electronic Health Record. IQHealth is a web view of Heartland Health’s EMR and we current open most of the record to patients. They can see their problem lists, medications, appointments as well as physician derived notes including admission H&P’s, discharge summaries and clinic notes.Physicians interact with patients within Cerner’s PowerChart Messaging Center where patient originated messages show up as another item in the Message Center. They do not need to leave their critical work flow to participate electronically with patients.
Physicians express concerns that they will be overloaded with patient originated messages and change the nature of their interaction with the electronic message center or Inbox. Our own experience is that providers during a measurement period averaged a little over 600 messages a month of which a around 13% were patient originated. This compares favorably with a little over 12% of messages originated by the physician to the patients (close to a 1:1 ratio). In other words the communication stream was not dominated by “needy” and “unnecessary” patient originated messages.Most of the messages in-bound and outbound are with nursing and other staff (>30% of all messages). Interactions with other providers and the system (alerts) comprise the remainder of messages.
Patients can create and use 3 message types:General Messages that resemble traditional e-mail Medication Refills in which a list of their current medications are presented and they can select ones or request a new one by completing a form that captures all the elements a provider needs to respond to the patientSpecific messages focused on a particular visit … helps the provider pull up the right visit to review before answering
These messages show up in the Consumer Messages tab of the Message Center’s Inbox right next to other messages. Answering these messages is no different than answering messages from nurses and other providers. We’ve found that a large number of messages result in the physician needing to create a prescription or an order. To facilitate this interaction a button that brings up the Ordering tool is built into each of these messages and their replies. All selected prescription(s) or order(s) are textually rendered when the physician returns to the message and included in the body of the message.Many times the physician will also copy the nurse or another provider in the reply to the patient and having the textual rendition of the order dramatically speeds up any handoffs and eliminates any need for redundant processing or potential for errors since all those who need to be in the loop are part of the reply to the original message and the entire message thread is included.
In late 2011 Cerner, the provider of the patient portal, migrated their platform to a new system and enrollment process. Every user was sent several messages with an invitation to re-enroll. Initially very few responded to this enrollment request and the number of enrolled users plummeted from a little over 8,000 to well under 1,000. This illustrated that while it was very easy to enroll over nearly 90% of all patients during their visits, the overwhelming majority of them had no reason to actually log in and use the system as they were for the most part healthy. Those who did log in did so primarily to review lab results and maybe ask a follow-up questions. Apart from the chronically ill and those on controlled substances that needed frequent attention most patient’s next need of the system occurred many months if not over a year later. By that time most had completely forgotten the URL let alone their username and password to the system. In addition many patients change physicians annually and often jobs and they may have used work-related e-mails for their primary contact. This active migration requiring re-enrollment essentially dictated that we start all over again with our patients and we began re-enrolling them.The new platform required that every patient have a unique e-mail. This led to the discovery that many families shared a single e-mail account and had built communication strategies around a single e-mail not unlike most homes had only one telephone number. The requirement that every portal user have a unique e-mail was surprisingly uncomfortable for many families as usually a single user (most often the wife) logged in and managed the IQHealth accounts of each of the family members. On the positive side this re-enrollment process did illustrate that while it is easy to enroll a large majority of patients the overwhelming majority of enrollees have no need to use the patient portal. The re-enrollment process enabled us to winnow out those inactive accounts and have a system where a greater percentage of enrollees are active users. It must be said, however, we have no effective way of validating this explanation of why so few of the original enrollees re-enrolled.Only in the last month have we seen a change in the curve from the relatively stable 2,000 or so enrollees that logged in and claimed their accounts.We also removed all of the pediatric patients under the age of 18 from the list as Missouri laws requires a complicated set of age-related abilities to redact information from others that are very difficult to deliver. We are waiting for more clarification and or improvement in the ability of the system to meet these rules before re-enrolling children under 18. Other clients enroll children but un-enroll them between 12 and 13 until the age of 18 for compliant reasons.
The first lesson we learned was that the patient portal use is highly dependent on the willingness of the physician or provider to engage patients directly. Those providers where relied on their nurses to register and enroll patients, never promoted it during the face-to-face encounters and had their nurses be the primary responders to patient queries (in essence duplicating their phone messaging workflow) saw little use or value in the patient portal.On the other hand the physicians who actively promoted this and responded directly to patient questions, bypassing the nursing triage, saw immediate benefits.
These graphs illustrate the importance of physician involvement in the use of the portal. We are experimenting around with team based approach utilizing the call center but up to now it appears patients want one-to-one connections with their providers and respond accordingly.
Those physicians who leveraged the asynchronous communications with patients experienced changes in workflows that benefitted the working unit (physician-nurse-scheduler) as illustrated in the following slide.
Traditional phone messaging necessarily insulated the physician as direct patient-physician phone interactions are very time consuming. These phone conversations can easily average 5 minutes or more. Unlike synchronous mediums, asynchronous communications are much less time consuming and often a physician can read and respond to a patient message in a minute or less. This is one of the reasons e-mail has dominated business communication for over a decade.Those physicians who leveraged the patient portal were able to streamline their patient communications process by eliminated several handoffs and at least 2 processes. Quantitatively we were able to document up to 8 hours of patient-provider (nurse/physician) phone time per week per care delivery unit (patient-nurse-scheduler).
A very good example of simplified communication stream is illustrated in how patients are now notified of their results.The most common physician originated messages to patients are lab results. As labs are processed and resulted they are returned as a message to the physician to endorse. If the patient has been registered and activated their invitation to the portal the physician is able to generate a message to the patient and the results along with normals are automatically inserted into the body of the message to the patient. The physician is able to add a personal interpretation, instructions, alter existing or create new prescriptions and write any new orders that might be needed. Like the lab results, new prescriptions and orders are automatically rendered into text and included in the message.In the process of replying to the patient the physician can also CC nurses, physicians or other providers.This process has dramatically shortened the time between a specimen’s drawing and the patients notification of these results. Most patients have messages in their inboxes with interpretations before the end of the day or at most a day after they are drawn.
When physicians interact asynchronously with patients this interaction replaced phone conversations. As mentioned before phone conversations are much more time consuming than asynchronous communication. In care delivery pods that effectively leveraged the patient portal we witnessed around 75% fewer patient phone conversations.It is very counter intuitive but those physicians who chose to configure their portal so patient messages bypassed the nurse and went directly to them answered on average 30% fewer messages throughout the day. This surprised us but as we examined the messages requiring a typical response we found that a single patient message being intercepted by the nurse almost always required the physician to either answer the nurses question and/or to co-sign an order. In short, every patient originated message that went first to the nurse resulted in more than one message to requiring a physician response. It was not atypical to find the physician and the nurse exchanging up to 3 or 4 inbox messages before the nurse was able to compete the patient’s request. By contrast if the request went directly to the physician, bypassing the nurse, the message to response ratio was almost 1 instead of 1:2.3 over the period studied. The physician very often looked at the message, moving it to one side of the screen, opened up and reviewed parts of the chart on the other half of the screen and responded not only with a change in medication dosage, the addition of another medication or placing several downstream orders that all were textually rendered and then returned to the patient along with copying the nurse and other physicians … all in a single transaction.In short we discovered that unlike the phone world, the more barriers physicians created between themselves, the more work they had to do. The fewer barriers the less work.
There remain significant challenges.
The first is turning out to be the web itself; or more accurately put, the dependency of the portal on the need for computer accessing a URL in order to effectively use the portal. Over the last few years the world has moved away from computers to mobile phones. The current patient portal is not designed for mobile computing. Most patients still cannot remember a URL or their user name and password in the time between the need for logins. Only those who are chronically ill or have need for frequent interactions are not experiencing this problem. In short, the patient portal needs to be an app in which the average relatively health patient can configure once and then use infrequently without having to re-identify themselves.
Just looking around we see the importance of images in news print, web sites and social media. The same is true in the clinical world. A significant number of patient originated messages involve minor injuries or rashes and the primary question is whether they should be seen. Images are essential to many of these. While it’s relatively straightforward to transmit photos increasingly videos are being recorded.
This anecdoteiIlustrates the importance of photos and videos. This elderly patient has been having spells that were thought to be TIA’s or strokes that had resulted in several ED visits and subsequent short term hospital stays. One day the daughter took several pictures of this even in the home but had difficulty loading them into the patient portal (the portal did not have the ability for patients to upload photos at the time). Notice the Facebook solution for me to get the videos.A few days later she was able to capture another whole sequence with the her daughter’s camera. Once again she had difficulty getting the image to me. This time she used YouTube to view as well as brought me a CD to view.Patient portals do need to have the same multimedia sharing available in social media applications as the patients are used to them and expect this type of activity.
Finally there’s a widening gap between where patients are as a group and the providers. Neither appreciate how far the other has come. It get’s worse when it comes to our documented policies and procedures that, for the most part are based on paper work flows. Many organizations still prohibit their own employees from opening up their electronic charts, for example. And then the political world continues to lag even farther behind as the time to legislative action is very lengthy.