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 ...
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.
1 Final Report Assignment - HCI499 INTRODUCTION .docxtarifarmarie
1
Final Report Assignment - HCI499
INTRODUCTION
The health information systems adoption is one of the most effective methods used to
alleviate the widening health care demand and supply gap. The purpose of this report
assignment is to identify and evaluate the current health care delivery system in your
training hospital. This evaluation should lead you to propose a healthcare system or
application and explain why this health system or application should be implemented
in your selected hospital.
Your Description of the Proposed System or (Health Application) should include:
1. The organization overview
2. Proposed System or Application, Its Features and Benefits
3. Its Challenges and Successful Factors
4. Tangible Values in Terms of Money
5. Tangible Values in Terms of Clinical Improvement
6. Patient Values
Submission:
You should submit as a .pdf document to the blackboard on the deadline. late submissions will
not be accepted after the deadline.
Instructions:
• This report should indicate that you’ve fulfilled the internship objectives
• Plagiarism is strictly not accepted in any form
• Overall Word limit = 300 to 600 words
• Well Referenced
• Font size = 12
• Font style = Times New Roman
• Double- Space
Overview about training report:
Training Report for health informatics specialist at Hospital, which has health information system and electronic health. Check the other the attached files for topic. Pick one topic from dawn write about challenge and success topic.
no plagiarism. Write by your own words not copy /paste
300 to 600 words.
(Glossary of Telemedicine and eHealth)
· Teleconsultation: Consultation between a provider and specialist at distance using either store and forward telemedicine or real time videoconferencing.
· Telehealth and Telemedicine: Telemedicine is the use of medical information exchanged from one site to another via electronic communications to improve patients' health status. Closely associated with telemedicine is the term "telehealth," which is often used to encompass a broader definition of remote healthcare that does not always involve clinical services. Videoconferencing, transmission of still images, e-health including patient portals, remote monitoring of vital signs, continuing medical education and nursing call centers are all considered part of telemedicine and telehealth. Telemedicine is not a separate medical specialty. Products and services related to telemedicine are often part of a larger investment by health care institutions in either information technology or the delivery of clinical care. Even in the reimbursement fee structure, there is usually no distinction made between services provided on site and those provided through telemedicine and often no separate coding required for billing of remote services. Telemedicine encompasses different types of programs and services provided for the patient. Each component involves differe.
ASTUTE: Acute Stroke Telemedicine: Utility Training and Evaluation
Implementing Telemedicine in Acute Stroke and the development of a Standardised Telemedicine Tookit
Lancashire Teaching Hsopitals NHS Foundation Trust
Poster from the 'Delivering NHS services, seven days a week' event held in Birmingham on 16 November 2013
More information about this event can be found at
http://www.nhsiq.nhs.uk/news-events/events/nhs-services-seven-days-a-week.aspx
PausraCeMaAna Deb Dec Insd DeInternati.docxssuser562afc1
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a De
b De
c Ins
d De
International Journal of Nursing Studies 50 (2013) 1537–1549
A R
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tient preference and satisfaction in hospital-at-home and
ual hospital care for COPD exacerbations: Results of a
ndomised controlled trial§,§§
cile M.A. Utens a,b,*, Lucas M.A. Goossens c, Onno C.P. van Schayck b,
ureen P.M.H. Rutten-van Mölken c, Walter van Litsenburg a, Annet Janssen a,
ouschka van der Pouw d, Frank W.J.M. Smeenk a
partment of Respiratory Medicine, Catharina Hospital, Eindhoven, The Netherlands
partment of General Practice, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands
titute for Medical Technology Assessment, Erasmus University, Rotterdam, The Netherlands
partment of Respiratory Medicine, Rijnstate Hospital, Arnhem, The Netherlands
What is already known about the topic?
� Patient satisfaction with hospital-at-home schemes is
high, but most schemes admit patients with various
conditions.
� Effectiveness and cost-effectiveness of hospital-at-home
and usual hospital care for COPD patients are not
T I C L E I N F O
le history:
ived 27 September 2012
ived in revised form 15 March 2013
pted 15 March 2013
ords:
pital-at-home
y assisted discharge
nic Obstructive Pulmonary Disease
ent preference
ent satisfaction
A B S T R A C T
Background: In the absence of clear differences in effectiveness and cost-effectiveness
between hospital-at-home schemes and usual hospital care, patient preference plays an
important role. This study investigates patient preference for treatment place, associated
factors and patient satisfaction with a community-based hospital-at-home scheme for
COPD exacerbations.
Methods: The study is part of a larger randomised controlled trial. Patients were
randomised to usual hospital care or early assisted discharge which incorporated
discharge at day 4 and visits by a home care nurse until day 7 of treatment (T + 4 days). The
hospital care group received care as usual and was discharged from hospital at day 7.
Patients were followed for 90 days (T + 90 days). Patient preference for treatment place
and patient satisfaction (overall and per item) were assessed quantitatively and
qualitatively using questionnaires at T + 4 days and T + 90 days. Factors associated with
patient preference were analysed in the early assisted discharge group.
Results: 139 patients were randomised. No difference was found in overall satisfaction. At
T + 4 days, patients in the early assisted discharge group were less satisfied with care at
night and were less able to resume normal daily activities. At T + 90 days there were no
differences for the separate items. Patient preference for home treatment at T + 4 days was
42% in the hospital care group and 86% in the early assisted discharge group and 35% and
59% at T + 90 days. Patients’ mental state was.
PausraCeMaAna Deb Dec Insd DeInternati.docxkarlhennesey
Pa
us
ra
Ce
Ma
An
a De
b De
c Ins
d De
International Journal of Nursing Studies 50 (2013) 1537–1549
A R
Artic
Rece
Rece
Acce
Keyw
Hos
Earl
Chro
Pati
Pati
§
dist
§§
*
Cath
002
http
tient preference and satisfaction in hospital-at-home and
ual hospital care for COPD exacerbations: Results of a
ndomised controlled trial§,§§
cile M.A. Utens a,b,*, Lucas M.A. Goossens c, Onno C.P. van Schayck b,
ureen P.M.H. Rutten-van Mölken c, Walter van Litsenburg a, Annet Janssen a,
ouschka van der Pouw d, Frank W.J.M. Smeenk a
partment of Respiratory Medicine, Catharina Hospital, Eindhoven, The Netherlands
partment of General Practice, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands
titute for Medical Technology Assessment, Erasmus University, Rotterdam, The Netherlands
partment of Respiratory Medicine, Rijnstate Hospital, Arnhem, The Netherlands
What is already known about the topic?
� Patient satisfaction with hospital-at-home schemes is
high, but most schemes admit patients with various
conditions.
� Effectiveness and cost-effectiveness of hospital-at-home
and usual hospital care for COPD patients are not
T I C L E I N F O
le history:
ived 27 September 2012
ived in revised form 15 March 2013
pted 15 March 2013
ords:
pital-at-home
y assisted discharge
nic Obstructive Pulmonary Disease
ent preference
ent satisfaction
A B S T R A C T
Background: In the absence of clear differences in effectiveness and cost-effectiveness
between hospital-at-home schemes and usual hospital care, patient preference plays an
important role. This study investigates patient preference for treatment place, associated
factors and patient satisfaction with a community-based hospital-at-home scheme for
COPD exacerbations.
Methods: The study is part of a larger randomised controlled trial. Patients were
randomised to usual hospital care or early assisted discharge which incorporated
discharge at day 4 and visits by a home care nurse until day 7 of treatment (T + 4 days). The
hospital care group received care as usual and was discharged from hospital at day 7.
Patients were followed for 90 days (T + 90 days). Patient preference for treatment place
and patient satisfaction (overall and per item) were assessed quantitatively and
qualitatively using questionnaires at T + 4 days and T + 90 days. Factors associated with
patient preference were analysed in the early assisted discharge group.
Results: 139 patients were randomised. No difference was found in overall satisfaction. At
T + 4 days, patients in the early assisted discharge group were less satisfied with care at
night and were less able to resume normal daily activities. At T + 90 days there were no
differences for the separate items. Patient preference for home treatment at T + 4 days was
42% in the hospital care group and 86% in the early assisted discharge group and 35% and
59% at T + 90 days. Patients’ mental state was ...
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.
1 Final Report Assignment - HCI499 INTRODUCTION .docxtarifarmarie
1
Final Report Assignment - HCI499
INTRODUCTION
The health information systems adoption is one of the most effective methods used to
alleviate the widening health care demand and supply gap. The purpose of this report
assignment is to identify and evaluate the current health care delivery system in your
training hospital. This evaluation should lead you to propose a healthcare system or
application and explain why this health system or application should be implemented
in your selected hospital.
Your Description of the Proposed System or (Health Application) should include:
1. The organization overview
2. Proposed System or Application, Its Features and Benefits
3. Its Challenges and Successful Factors
4. Tangible Values in Terms of Money
5. Tangible Values in Terms of Clinical Improvement
6. Patient Values
Submission:
You should submit as a .pdf document to the blackboard on the deadline. late submissions will
not be accepted after the deadline.
Instructions:
• This report should indicate that you’ve fulfilled the internship objectives
• Plagiarism is strictly not accepted in any form
• Overall Word limit = 300 to 600 words
• Well Referenced
• Font size = 12
• Font style = Times New Roman
• Double- Space
Overview about training report:
Training Report for health informatics specialist at Hospital, which has health information system and electronic health. Check the other the attached files for topic. Pick one topic from dawn write about challenge and success topic.
no plagiarism. Write by your own words not copy /paste
300 to 600 words.
(Glossary of Telemedicine and eHealth)
· Teleconsultation: Consultation between a provider and specialist at distance using either store and forward telemedicine or real time videoconferencing.
· Telehealth and Telemedicine: Telemedicine is the use of medical information exchanged from one site to another via electronic communications to improve patients' health status. Closely associated with telemedicine is the term "telehealth," which is often used to encompass a broader definition of remote healthcare that does not always involve clinical services. Videoconferencing, transmission of still images, e-health including patient portals, remote monitoring of vital signs, continuing medical education and nursing call centers are all considered part of telemedicine and telehealth. Telemedicine is not a separate medical specialty. Products and services related to telemedicine are often part of a larger investment by health care institutions in either information technology or the delivery of clinical care. Even in the reimbursement fee structure, there is usually no distinction made between services provided on site and those provided through telemedicine and often no separate coding required for billing of remote services. Telemedicine encompasses different types of programs and services provided for the patient. Each component involves differe.
ASTUTE: Acute Stroke Telemedicine: Utility Training and Evaluation
Implementing Telemedicine in Acute Stroke and the development of a Standardised Telemedicine Tookit
Lancashire Teaching Hsopitals NHS Foundation Trust
Poster from the 'Delivering NHS services, seven days a week' event held in Birmingham on 16 November 2013
More information about this event can be found at
http://www.nhsiq.nhs.uk/news-events/events/nhs-services-seven-days-a-week.aspx
PausraCeMaAna Deb Dec Insd DeInternati.docxssuser562afc1
Pa
us
ra
Ce
Ma
An
a De
b De
c Ins
d De
International Journal of Nursing Studies 50 (2013) 1537–1549
A R
Artic
Rece
Rece
Acce
Keyw
Hos
Earl
Chro
Pati
Pati
§
dist
§§
*
Cath
002
http
tient preference and satisfaction in hospital-at-home and
ual hospital care for COPD exacerbations: Results of a
ndomised controlled trial§,§§
cile M.A. Utens a,b,*, Lucas M.A. Goossens c, Onno C.P. van Schayck b,
ureen P.M.H. Rutten-van Mölken c, Walter van Litsenburg a, Annet Janssen a,
ouschka van der Pouw d, Frank W.J.M. Smeenk a
partment of Respiratory Medicine, Catharina Hospital, Eindhoven, The Netherlands
partment of General Practice, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands
titute for Medical Technology Assessment, Erasmus University, Rotterdam, The Netherlands
partment of Respiratory Medicine, Rijnstate Hospital, Arnhem, The Netherlands
What is already known about the topic?
� Patient satisfaction with hospital-at-home schemes is
high, but most schemes admit patients with various
conditions.
� Effectiveness and cost-effectiveness of hospital-at-home
and usual hospital care for COPD patients are not
T I C L E I N F O
le history:
ived 27 September 2012
ived in revised form 15 March 2013
pted 15 March 2013
ords:
pital-at-home
y assisted discharge
nic Obstructive Pulmonary Disease
ent preference
ent satisfaction
A B S T R A C T
Background: In the absence of clear differences in effectiveness and cost-effectiveness
between hospital-at-home schemes and usual hospital care, patient preference plays an
important role. This study investigates patient preference for treatment place, associated
factors and patient satisfaction with a community-based hospital-at-home scheme for
COPD exacerbations.
Methods: The study is part of a larger randomised controlled trial. Patients were
randomised to usual hospital care or early assisted discharge which incorporated
discharge at day 4 and visits by a home care nurse until day 7 of treatment (T + 4 days). The
hospital care group received care as usual and was discharged from hospital at day 7.
Patients were followed for 90 days (T + 90 days). Patient preference for treatment place
and patient satisfaction (overall and per item) were assessed quantitatively and
qualitatively using questionnaires at T + 4 days and T + 90 days. Factors associated with
patient preference were analysed in the early assisted discharge group.
Results: 139 patients were randomised. No difference was found in overall satisfaction. At
T + 4 days, patients in the early assisted discharge group were less satisfied with care at
night and were less able to resume normal daily activities. At T + 90 days there were no
differences for the separate items. Patient preference for home treatment at T + 4 days was
42% in the hospital care group and 86% in the early assisted discharge group and 35% and
59% at T + 90 days. Patients’ mental state was.
PausraCeMaAna Deb Dec Insd DeInternati.docxkarlhennesey
Pa
us
ra
Ce
Ma
An
a De
b De
c Ins
d De
International Journal of Nursing Studies 50 (2013) 1537–1549
A R
Artic
Rece
Rece
Acce
Keyw
Hos
Earl
Chro
Pati
Pati
§
dist
§§
*
Cath
002
http
tient preference and satisfaction in hospital-at-home and
ual hospital care for COPD exacerbations: Results of a
ndomised controlled trial§,§§
cile M.A. Utens a,b,*, Lucas M.A. Goossens c, Onno C.P. van Schayck b,
ureen P.M.H. Rutten-van Mölken c, Walter van Litsenburg a, Annet Janssen a,
ouschka van der Pouw d, Frank W.J.M. Smeenk a
partment of Respiratory Medicine, Catharina Hospital, Eindhoven, The Netherlands
partment of General Practice, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands
titute for Medical Technology Assessment, Erasmus University, Rotterdam, The Netherlands
partment of Respiratory Medicine, Rijnstate Hospital, Arnhem, The Netherlands
What is already known about the topic?
� Patient satisfaction with hospital-at-home schemes is
high, but most schemes admit patients with various
conditions.
� Effectiveness and cost-effectiveness of hospital-at-home
and usual hospital care for COPD patients are not
T I C L E I N F O
le history:
ived 27 September 2012
ived in revised form 15 March 2013
pted 15 March 2013
ords:
pital-at-home
y assisted discharge
nic Obstructive Pulmonary Disease
ent preference
ent satisfaction
A B S T R A C T
Background: In the absence of clear differences in effectiveness and cost-effectiveness
between hospital-at-home schemes and usual hospital care, patient preference plays an
important role. This study investigates patient preference for treatment place, associated
factors and patient satisfaction with a community-based hospital-at-home scheme for
COPD exacerbations.
Methods: The study is part of a larger randomised controlled trial. Patients were
randomised to usual hospital care or early assisted discharge which incorporated
discharge at day 4 and visits by a home care nurse until day 7 of treatment (T + 4 days). The
hospital care group received care as usual and was discharged from hospital at day 7.
Patients were followed for 90 days (T + 90 days). Patient preference for treatment place
and patient satisfaction (overall and per item) were assessed quantitatively and
qualitatively using questionnaires at T + 4 days and T + 90 days. Factors associated with
patient preference were analysed in the early assisted discharge group.
Results: 139 patients were randomised. No difference was found in overall satisfaction. At
T + 4 days, patients in the early assisted discharge group were less satisfied with care at
night and were less able to resume normal daily activities. At T + 90 days there were no
differences for the separate items. Patient preference for home treatment at T + 4 days was
42% in the hospital care group and 86% in the early assisted discharge group and 35% and
59% at T + 90 days. Patients’ mental state was ...
Mobile and Telehealth Programs Evidence and Emerging TechnologiesP. Kenyon Crowley
Review of current evidence on telehealth and mobile health interventions effectiveness, and emerging innovations in this space, presented at executive education session.
Tackling Post-Ebola Health Recovery: Strengthening health system capacity to ...JSI
In late 2015, the government-mandated Comprehensive Program for Ebola Survivors (CPES) was established as part of the key interventions within the Post-Ebola
Recovery Strategy. The CPES program, sought to improve the well-being of Ebola virus disease (EVD) survivors by providing basic and specialized health care and support to recover their livelihood. Survivors were also included in the existing Free Health Care Initiative (FHCI) program, already offered to children under 5 and pregnant and lactating women. This decision aimed at allowing survivors to access the public-sector health
services without cost.
As the program developed, the MoHS recognized that many of the health issues facing EVD survivors, such as mental health, eye complications, etc. were also common for general population, as well as other FHCI vulnerable population groups. Changes were made to promote self-reliance and were needed to enable the integration of the CPES supported health services and human resources within the MoHS system and the EVD survivors within the FHCI.
The CPES program worked to respond to survivor needs and restore EVD survivors’confidence in a country health system that was heavily disrupted by the Ebola outbreak; and ensure their special needs were addressed in a timely and efficient manner. 10% more survivors were able to lead a healthy functional life because of the project intervention. Moreover, there has been a 6.1% reduction in the proportion of survivors reporting some sort of stigma and a 12% drop in the proportion of those reporting stigma during their last interaction with a healthcare provider. Community support: The peer-to-peer approach implemented with the Survivor Advocates has helped reduce stigma associated with EVD and supported the rebuilding of trust between survivors, the communities, and local health facilities. However, when SAs were terminated, the transition to CHWs had not taken place.
This poster was presented at the Fifth Global Symposium on Health Systems Research in Liverpool in October by Soumya Alva.
Evaluation of patient and clinician experience in the Lothian Telehealth trial. Alex Tarling
Evaluation of patient and clinician experience in the Lothian Telehealth trial. Presentation delivered at the World Congress for IT conference, Amsterdam, June 2010.
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/
Telemedicine: Maintaining The Control and Clinical Outcomes During COVID-19 P...semualkaira
COVID-19 is a global challenge for health systems. The pandemic impacted traditional practice of our hospital's IBD program, favoring the implementation of telemedicine
appointments (TM).
1.2. Objectives: To describe and evaluate TM appointment effectiveness in a public IBD center in Chile during the pandemic.
Telemedicine: Maintaining The Control and Clinical Outcomes During COVID-19 P...semualkaira
COVID-19 is a global challenge for health systems. The pandemic impacted traditional practice of our hospital's IBD program, favoring the implementation of telemedicine
appointments (TM).
1.2. Objectives: To describe and evaluate TM appointment effectiveness in a public IBD center in Chile during the pandemic.
According to the textbook, the Federal Disaster Assistance Act of 19.docxronak56
According to the textbook, the Federal Disaster Assistance Act of 1950 (P.L. 81-875) defined the roles and responsibilities during natural disasters. Once the president issued a disaster declaration, federal relief resources could flow to the affected areas for response and recovery. The president would then delegate administrative control of relief efforts to the Housing and Home Finance Administration. This law also instituted the federal role in natural disasters as a supportive role, while instituting primary responsibility for disaster response and recovery with local and state governments. How had this changed by 1978? Why did it change? Do you agree with the change? Why, or why not?
300 WORDS
APA FORMAT
.
According to the Council on Social Work Education, Competency 5 Eng.docxronak56
According to the Council on Social Work Education, Competency 5: Engage in Policy Practice:
Social workers understand that human rights and social justice, as well as social welfare and services, are mediated by policy and its implementation at the federal, state, and local levels. Social workers understand the history and current structures of social policies and services, the role of policy in service delivery, and the role of practice in policy development. Social workers understand their role in policy development and implementation within their practice settings at the micro, mezzo, and macro levels and they actively engage in policy practice to effect change within those settings. Social workers recognize and understand the historical, social, cultural, economic, organizational, environmental, and global influences that affect social policy. They are also knowledgeable about policy formulation, analysis, implementation, and evaluation. Social workers:
Identify social policy at the local, state, and federal level that impacts well-being, service delivery, and access to social services;
Assess how social welfare and economic policies impact the delivery of and access to social services;
Apply critical thinking to analyze, formulate, and advocate for policies that advance human rights and social, economic, and environmental justice.
This assignment is intended to help students demonstrate the behavioral components of this competency in their field education.
To prepare: Working with your field instructor, identify, evaluate, and discuss policies established by the local, state, and federal government (within the last five years) that affect the day to day operations of the field placement agency.
The Assignment (1-2 pages):
Describe the policies and their impact on the field agency.
Propose specific recommendations regarding how you, as a social work intern, and the agency can advocate for policies pertaining to advancing social justice for the agency and the clients it serves.
.
More Related Content
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Mobile and Telehealth Programs Evidence and Emerging TechnologiesP. Kenyon Crowley
Review of current evidence on telehealth and mobile health interventions effectiveness, and emerging innovations in this space, presented at executive education session.
Tackling Post-Ebola Health Recovery: Strengthening health system capacity to ...JSI
In late 2015, the government-mandated Comprehensive Program for Ebola Survivors (CPES) was established as part of the key interventions within the Post-Ebola
Recovery Strategy. The CPES program, sought to improve the well-being of Ebola virus disease (EVD) survivors by providing basic and specialized health care and support to recover their livelihood. Survivors were also included in the existing Free Health Care Initiative (FHCI) program, already offered to children under 5 and pregnant and lactating women. This decision aimed at allowing survivors to access the public-sector health
services without cost.
As the program developed, the MoHS recognized that many of the health issues facing EVD survivors, such as mental health, eye complications, etc. were also common for general population, as well as other FHCI vulnerable population groups. Changes were made to promote self-reliance and were needed to enable the integration of the CPES supported health services and human resources within the MoHS system and the EVD survivors within the FHCI.
The CPES program worked to respond to survivor needs and restore EVD survivors’confidence in a country health system that was heavily disrupted by the Ebola outbreak; and ensure their special needs were addressed in a timely and efficient manner. 10% more survivors were able to lead a healthy functional life because of the project intervention. Moreover, there has been a 6.1% reduction in the proportion of survivors reporting some sort of stigma and a 12% drop in the proportion of those reporting stigma during their last interaction with a healthcare provider. Community support: The peer-to-peer approach implemented with the Survivor Advocates has helped reduce stigma associated with EVD and supported the rebuilding of trust between survivors, the communities, and local health facilities. However, when SAs were terminated, the transition to CHWs had not taken place.
This poster was presented at the Fifth Global Symposium on Health Systems Research in Liverpool in October by Soumya Alva.
Evaluation of patient and clinician experience in the Lothian Telehealth trial. Alex Tarling
Evaluation of patient and clinician experience in the Lothian Telehealth trial. Presentation delivered at the World Congress for IT conference, Amsterdam, June 2010.
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/
Telemedicine: Maintaining The Control and Clinical Outcomes During COVID-19 P...semualkaira
COVID-19 is a global challenge for health systems. The pandemic impacted traditional practice of our hospital's IBD program, favoring the implementation of telemedicine
appointments (TM).
1.2. Objectives: To describe and evaluate TM appointment effectiveness in a public IBD center in Chile during the pandemic.
Telemedicine: Maintaining The Control and Clinical Outcomes During COVID-19 P...semualkaira
COVID-19 is a global challenge for health systems. The pandemic impacted traditional practice of our hospital's IBD program, favoring the implementation of telemedicine
appointments (TM).
1.2. Objectives: To describe and evaluate TM appointment effectiveness in a public IBD center in Chile during the pandemic.
According to the textbook, the Federal Disaster Assistance Act of 19.docxronak56
According to the textbook, the Federal Disaster Assistance Act of 1950 (P.L. 81-875) defined the roles and responsibilities during natural disasters. Once the president issued a disaster declaration, federal relief resources could flow to the affected areas for response and recovery. The president would then delegate administrative control of relief efforts to the Housing and Home Finance Administration. This law also instituted the federal role in natural disasters as a supportive role, while instituting primary responsibility for disaster response and recovery with local and state governments. How had this changed by 1978? Why did it change? Do you agree with the change? Why, or why not?
300 WORDS
APA FORMAT
.
According to the Council on Social Work Education, Competency 5 Eng.docxronak56
According to the Council on Social Work Education, Competency 5: Engage in Policy Practice:
Social workers understand that human rights and social justice, as well as social welfare and services, are mediated by policy and its implementation at the federal, state, and local levels. Social workers understand the history and current structures of social policies and services, the role of policy in service delivery, and the role of practice in policy development. Social workers understand their role in policy development and implementation within their practice settings at the micro, mezzo, and macro levels and they actively engage in policy practice to effect change within those settings. Social workers recognize and understand the historical, social, cultural, economic, organizational, environmental, and global influences that affect social policy. They are also knowledgeable about policy formulation, analysis, implementation, and evaluation. Social workers:
Identify social policy at the local, state, and federal level that impacts well-being, service delivery, and access to social services;
Assess how social welfare and economic policies impact the delivery of and access to social services;
Apply critical thinking to analyze, formulate, and advocate for policies that advance human rights and social, economic, and environmental justice.
This assignment is intended to help students demonstrate the behavioral components of this competency in their field education.
To prepare: Working with your field instructor, identify, evaluate, and discuss policies established by the local, state, and federal government (within the last five years) that affect the day to day operations of the field placement agency.
The Assignment (1-2 pages):
Describe the policies and their impact on the field agency.
Propose specific recommendations regarding how you, as a social work intern, and the agency can advocate for policies pertaining to advancing social justice for the agency and the clients it serves.
.
According to the text, economic outcomes measured by economic gr.docxronak56
According to the text, economic outcomes measured by economic growth is affected by a number of factors. Also, hundreds of empirical studies on economic growth across countries have highlighted the correlation between economic growth and a variety of variables.
Claims regarding the determinants of economic growth are conditional, and the findings depend on the variables used. However, the availability of physical capital or infrastructure, government consumption, terms of trade, macroeconomic stability, the rule of law, regulatory quality, government effectiveness, foreign direct investments, population size, and natural resource availability are the most consistent findings of empirical studies on economic growth.
Review the literature on economic growth and provide a summary of how:
Population affects economic growth
Natural Resource Abundance affects economic growth
Note: The answers you provide to each of these sub-questions should not be more than 15 sentences.
Also note that because this is a literature review you must cite credible sources; avoid using news articles.
The examples below should serve as a guide
Example 1: The example below shows how inflation affects investment in a study of the effect of inflation on investment.
The destabilizing effect of inflation on investment has been a major source of debate in economic and business literature. Generally, inflation is often considered a sign of macroeconomic instability and the inability of government to control macroeconomic policy, both of which contribute to an adverse investment climate (Fischer, 2013; Greene & Villanueva, 1991). However, the empirical evidence is still far from convincing. While some authors claim positive effects of inflation on investment, others hold that inflation poses a “stealth” threat to investments. For example, Greene and Villanueva (1991) argue that high rate of inflation adversely affects private investment activity by increasing the riskiness of long-term investment projects. Also, Fischer (2013) observed that inflation uncertainty is associated with substantial reduction in total investment. On the contrary, McClain and Nicholes (1993) found that investment and inflation are positively related to each other.
Example 2: The example below shows how natural resource endowments affects income inequality in a study of the determinants of income inequality.
The nexus between natural resource endowments and income inequality has also been widely debated and has inspired a long history of research in both economics and political science (see, for example, Fum and Hodler, 2010; Goderis and Malone, 2011; Leamer, Maul, Rodriguez, and Schott, 1999; Carmignani, 2013; Parcero and Papyrakis, 2016; Bourguignon and Morrisson, 1998). For example, Anderson et al., (2004) argue that natural resources endowment provide a plausible explanation as to why the observed levels of inequality are significantly higher in both sub-Saharan Africa and Latin America.
According to the Council on Social Work Education, Competency 5.docxronak56
According to the Council on Social Work Education, Competency 5: Engage in Policy Practice:
Social workers understand that human rights and social justice, as well as social welfare and services, are mediated by policy and its implementation at the federal, state, and local levels. Social workers understand the history and current structures of social policies and services, the role of policy in service delivery, and the role of practice in policy development. Social workers understand their role in policy development and implementation within their practice settings at the micro, mezzo, and macro levels and they actively engage in policy practice to effect change within those settings. Social workers recognize and understand the historical, social, cultural, economic, organizational, environmental, and global influences that affect social policy. They are also knowledgeable about policy formulation, analysis, implementation, and evaluation. Social workers:
Identify social policy at the local, state, and federal level that impacts well-being, service delivery, and access to social services;
Assess how social welfare and economic policies impact the delivery of and access to social services;
Apply critical thinking to analyze, formulate, and advocate for policies that advance human rights and social, economic, and environmental justice.
This assignment is intended to help students demonstrate the behavioral components of this competency in their field education.
To prepare: Working with your field instructor, identify, evaluate, and discuss policies established by the local, state, and federal government (within the last five years) that affect the day to day operations of the field placement agency (
Georgia Department of Family and Children Services
).
The Assignment (1-2 pages):
Describe the policies and their impact on the field agency.
Propose specific recommendations regarding how you, as a social work intern, and the agency can advocate for policies pertaining to advancing social justice for the agency and the clients it serves.
.
According to the Council for Exceptional Children (CEC), part of.docxronak56
According to the Council for Exceptional Children (CEC), part of being a well-prepared special educator includes “developing relationships with families based on mutual respect and actively involving families and individuals with exceptionalities in educational decision making” (Council for Exceptional Children, 2015, Special Education Professional Ethical Principles, E). This includes advocating for parental involvement by providing information on educational rights and safeguards in a way that creates accessibility and transparent IEP meeting procedures (Council for Exceptional Children, 2015).
Hammond, Ingalls and Trussell (2008) investigated the experiences of those family members who attended an initial IEP meeting and then subsequent meetings over the next four years. Their findings indicated that the overwhelming majority of the 212 family participants agreed that the child needed special education services but had negative emotional responses to the initial team meeting. Some of the most beneficial information collected included acknowledging the emotions tied to having a child initial diagnosed with a disability; stronger communication skills by education professionals during the team meeting; and additional measures to better prepare parents for the team meetings (Hammond, Ingalls, & Trussell, 2008). Similarly, the article,
Building Parent Trust in the Special Education Setting (Links to an external site.)
(Wellner, 2012) was written to emphasize the importance of trust building strategies to avoid costly due process hearings and to maximize relationships with all involved in making decisions on behalf of the student with special needs.
Initial Post:
After reading the article, After reading the article,
The 5-Point Plan
, reviewing the Council for Exceptional Children’s (CEC) , reviewing the Council for Exceptional Children’s (CEC)
Special Education and Professional Ethical Principles and Practice Standards (Links to an external site.)
, and reading
Building Parent Trust in the Special Education Setting (Links to an external site.)
you will create an initial response depending on the first letter of your last name.
If your last name begins with the letters A – M:
You will respond as one of the parent participants in this the Hammond, Ingalls and Trussell study. Begin by explaining how you felt attending your child’s first IEP meeting, using the article and the Instructor Guidance as a foundation for your narrative. Then, describe how future IEP meeting experiences changed (improved or declined) and why. Finally, using the
CEC Professional Practice Standards for Parents and Families (Links to an external site.)
and
Building Parent Trust in the Special Education Setting (Links to an external site.)
, provide at least three suggestions to the special education team leader for how to improve this experience for parents of newly diagnosed children with disabilities.
.
According to the article, Answer these two questions. Why did Ma.docxronak56
According to the article, Answer these two questions.
Why did Marx believe that capitalism would fall on its own? Why did his predictions not come true? (hint: how has the economy changed since Marx’s time?
Describe Robert Owen’s “New Lanark” community? What were his innovations? Did he suspend either private property or market economics? Are there people today who follow a similar business model?
.
According to Neuman’s theory, a human being is a total person as a c.docxronak56
According to Neuman’s theory, a human being is a total person as a client system and the person is a layered, multidimensional being. Each layer consists of a five-person variable or subsystem: (1) physiological, (2) psychological, (3) sociocultural, (4) developmental, and (5) spiritual.
Considering the 'spiritual' variable- Do you feel this variable exists at all? Does it have as wide-ranging results as Neuman claims? Is it appropriate for an APRN to participate in or work with the patient’s spiritual dimension?
.
According to Rolando et al. (2012), alcohol socialization is the pr.docxronak56
According to Rolando et al. (2012), “alcohol socialization is the process by which a person approaches and familiarizes with alcohol learns about the values connected to its use and about how, when and where s/he can or cannot drink.”
Based on the focus group findings, describe what the first drink means in both Italy and Finland, and what types of attitudes are connected with different types of socialization processes.
.
According to your readings, cloud computing represents one of th.docxronak56
According to your readings, cloud computing represents one of the most significant paradigms shifts in information technology (IT) history, due to an extension of sharing an application-hosting provider that has been around for many years, and was common in highly regulated vertical industries like banks and health care institutions. The author’s knowledge from their research continue to assert that, the impetus behind cloud computing lies on the idea that it provides economies of scale by spreading costs across many client organizations and pooling computing resources while matching client computing needs to consumption in a flexible, real-time version.
Identify the issues and risks that pose concern to organizations storing data in the cloud - briefly support your discussion.
.
According to this idea that gender is socially constructed, answer.docxronak56
According to this idea that gender is socially constructed, answer the following questions:
1. What does it mean to be a man in the U.S.? What does it mean to be a woman?
2. From what institutions do we learn these gender roles?
3. How do these clips demonstrate the ways in which gender is socially constructed in the U.S.? Do the concepts discussed in the clips resonate with you? Why or why not?
In Persepolis, the main character Marji struggles to define her identity as an Iranian woman in a changing society.
· What roles are depicted for women in Iranian society in the film? How do they change over time?
· How does Persepolis demonstrate the ways in which gender and identity are influenced in many ways, by different processes across cultures? How are gender roles in Iran similar, or different to gender in the U.S.?
· What are some of the stereotypes that exist about Muslim women and how does Abu-Lughod in “Do Muslim Women Need Saving” and Persepolis complicate these stereotypes?
Answer the following questions 2 full pages
Running head: MAJOR HEALTH CARE PROBLEMS IN THE U.S. 1
Major Health Care Problems in the U.S.
Jane Doe
ID: 1212121
MAJOR HEALTH CARE PROBLEMS IN THE U.S. 2
Major Health Care Problems in the US
Problem statement: High and continuously rising cost of health care has been and still is one of
the biggest challenges affecting the Health Care system in United States.
Methods of Examining the Problem
Both qualitative and quantitative research methods should be used to fully understand the
issue of high cost of care in the US. Quantitative methods like surveys and experimentations will
aid in estimating the prevalence, magnitude and frequency of the problem in different regions.
On the other hand, qualitative methods like case studies and observation will help describe the
extent and complexity of the issue. The two approaches need to work in complementation to
obtain a clear understanding of this menace.
Surveys, as a quantitative research method, is one of the most effective in the social
research and present a more viable method of examining the cost of health in the country. They
involve asking of questions in the form of questionnaires and interviews. Questionnaires are
written questions to which the response can be open ended or multiple-choice format. This
would be used to gain information about cost within determinants that are of
disagree/neutral/agree nature. An example is if patients are contented with the cost of services
they get or they deem the cost of cover worthy. Interviews, the researcher discussing issues with
the respondents, are to be used to gain more details on already known aspects of the system. This
may include gathering information to inform policies, administration and use of technology to
minimize the cost of care.
Since health cost in the US is not a new challenge and there have been studies about it,
qualitative methods like .
According to Thiel (2015, p. 40), CSR literature lacks consensus fo.docxronak56
According to Thiel (2015, p. 40), “CSR literature lacks consensus for a standard definition. Typically, many people who are familiar with the concept will initially define CSR within the three domains of the social, economic and natural environments.”
Come up with your own definition of what you believe is a good definition of CSR that you would like your company to follow.
Afterward, explain each part of your definition and why you believe it is best.
.
According to recent surveys, China, India, and the Philippines are t.docxronak56
According to recent surveys, China, India, and the Philippines are the three most popular countries for IT outsourcing. Write a short paper (2-4 paragraphs) explaining what the appeal would be for US companies to outsource IT functions to these countries. You may discuss cost, labor pool, language, or possibly government support as your reasons. There are many other reasons you may choose to highlight in your paper.
.
According to Rolando et al. (2012), alcohol socialization is th.docxronak56
According to Rolando et al. (2012), “alcohol socialization is the process by which a person approaches and familiarizes with alcohol learns about the values connected to its use and about how, when and where s/he can or cannot drink.”
Based on the focus group findings, describe what the first drink means in both Italy and Finland, and what types of attitudes are connected with different types of socialization processes. Respond to two posts identifying how positive values can be connected to first memories of drinking.
.
According to the author, Social Security is an essential program, .docxronak56
According to the author, Social Security is an essential program, but its future is looking unpromising unless we start by eliminating the payroll tax cap.
In the author’s proposal to keep the funding open, the author proposes the acceptance of Bernie Sanders’ “Keeping Our Social Security Promises Act,” which the author suggests would removes the payroll tax cap. To elaborate further, the author stated that the reason for the cap on the social security is because of the uneven amount of participation during elections which makes the rich influential in governance. The author stated that, research have found that the rich who made over $125,000 contributed 35% in campaigns. According to the author, this act causes a major problem regarding the shaping of the social security because people with lower income would not be able to contribute that amount of money towards campaigns. The author also states that it causes greater income equality, since those who contribute are rich and as a matter of fact get more benefits from political power in the form of payroll tax cap. This in the authors words, compromises the state of social welfare in the United States because those active in politics don’t have the same views as the poor who are focused on housing, poverty, and health. Congressional Research Service was used to predicts that, if tax cap is not removed, there will be a permanent increase of tax rate from 12.4% to 15.1% which would hurt people making less than the current tax cap currently at $132,900 or, cutting benefits by 20% in 2035 and continuously rising every year.
In as much as the author makes a good point on the percentage of rich people that donated to campaign, the author failed to state how much the rich get in payroll tax cap since that is a major part of the authors argument. The authors failed to indicate how an increase in tax rate would affect people making less than the current tax cap which is $132,900. To sum it up, the author failed to expand and give more numeric evidence to support the argument.
In addition, to provide a guideline in eliminating payroll tax cap, the author suggested a bill introduced by Bernie Sanders called, Keeping Our Social Security Promises Act. The bill according to the author seeks to remove the cap placed on payroll taxes. The author further stated the bill will help Solvency to expand for 75 years without increasing taxes for those who earn less than $250,000, the only people who will see a change are those earn more than $250,000. According to the Congressional Research Service as stated by the author, removing the cap would eliminate 84% of the projected shortfall. The author stated that, the top 200 CEOs would have to contributed $341,291,106 towards Social Security when the tax cap is removed. In addition, the author stated that, removing the cap would eliminate 84% of the projected shortfall. The author proposes an increase in the taxable payroll from 12.40% to 12.83% to keep it solvent.
According to Morrish, the blame for the ever-growing problem of disc.docxronak56
According to Morrish, the blame for the ever-growing problem of discipline in schools rests at least in part on popular discipline theories, which he believes have gone to excess in allowing students to make choices concerning how they will conduct themselves in school. What are your thoughts about Morrish’s ideas?
.
According to DuBrin (2015), Cultural intelligence is an outsiders .docxronak56
According to DuBrin (2015), "Cultural intelligence is an outsider's ability to interpret someone's unfamiliar and ambiguous behavior the same way that person's compatriots would" (p. 177). In this case, how would you incorporate cultural intelligence within a team setting? Please explain.
Your journal entry must be at least 200 words
.
According to Edgar Schein, organizational culture are the shared.docxronak56
According to Edgar Schein, organizational culture are the shared beliefs and values among a group of people which influences how they perceive, think, and react in the organization. There are four types of organizational culture:
Clan-Internal focus that values flexibility
Adhocracy-A risk taking culture with an external focus on flexibility
Market-A competitive culture with an external focus on profits over employee satisfaction
Hierarchy-A structured culture valuing stability and effectiveness internally
How would you describe the organizational culture of a pr
evious or current place of employment? And why?
Do you think this type of culture is best suited to help the company achieve its strategic goals? Explain.
.
According to DuBrin (2015), the following strategies or tactics are .docxronak56
According to DuBrin (2015), the following strategies or tactics are identified for enhancing your career:
develop career goals,
capitalize on your strengths and build your personal brand,
be passionate about and proud of your work,
develop a code of professional ethics and prosocial motivation,
develop a proactive personality,
keep growing through continuous learning and self-development,
document your accomplishments,
project a professional image, and
perceive yourself as a provider of services. (p. 430)
Identify and explain three career-enhancing techniques or tactics in advancing your career.
Your essay should be at least two pages and should include an introduction, a body of supported material (paragraphs), and a conclusion. Be sure to include two references (on a reference page), and follow all other APA formatting requirements. The reference page does not count toward the total page requirement.
Be sure to apply the proper APA format for the content and references provided.
.
According to DuBrin (2015), the following strategies or tactics .docxronak56
According to DuBrin (2015), the following strategies or tactics are identified for enhancing your career:
develop career goals,
capitalize on your strengths and build your personal brand,
be passionate about and proud of your work,
develop a code of professional ethics and prosocial motivation,
develop a proactive personality,
keep growing through continuous learning and self-development,
document your accomplishments,
project a professional image, and
perceive yourself as a provider of services. (p. 430)
Identify and explain three career-enhancing techniques or tactics in advancing your career.
Your essay should be at least two pages and should include an introduction, a body of supported material (paragraphs), and a conclusion. Be sure to include two references (on a reference page), and follow all other APA formatting requirements.
.
Access the Mental Measurements Yearbook, located in the Univer.docxronak56
Access
the Mental Measurements Yearbook, located in the University Library.
Select
two assessments of intelligence and two achievement tests.
Prepare
a 13 slide presentation about your selected instruments. In your analysis, address the following:
Critique the major definitions of intelligence. Determine which theory of intelligence best fits your selected instruments. Explain how the definition and the measures are related.
Evaluate the measures of intelligence you selected for reliability, validity, normative procedures, and bias.
Your selected intelligence and achievement assessments. How are the goals of the tests similar and different? How are the tests used? What are the purposes of giving these differing tests?
.
How to Create Map Views in the Odoo 17 ERPCeline George
The map views are useful for providing a geographical representation of data. They allow users to visualize and analyze the data in a more intuitive manner.
The Roman Empire A Historical Colossus.pdfkaushalkr1407
The Roman Empire, a vast and enduring power, stands as one of history's most remarkable civilizations, leaving an indelible imprint on the world. It emerged from the Roman Republic, transitioning into an imperial powerhouse under the leadership of Augustus Caesar in 27 BCE. This transformation marked the beginning of an era defined by unprecedented territorial expansion, architectural marvels, and profound cultural influence.
The empire's roots lie in the city of Rome, founded, according to legend, by Romulus in 753 BCE. Over centuries, Rome evolved from a small settlement to a formidable republic, characterized by a complex political system with elected officials and checks on power. However, internal strife, class conflicts, and military ambitions paved the way for the end of the Republic. Julius Caesar’s dictatorship and subsequent assassination in 44 BCE created a power vacuum, leading to a civil war. Octavian, later Augustus, emerged victorious, heralding the Roman Empire’s birth.
Under Augustus, the empire experienced the Pax Romana, a 200-year period of relative peace and stability. Augustus reformed the military, established efficient administrative systems, and initiated grand construction projects. The empire's borders expanded, encompassing territories from Britain to Egypt and from Spain to the Euphrates. Roman legions, renowned for their discipline and engineering prowess, secured and maintained these vast territories, building roads, fortifications, and cities that facilitated control and integration.
The Roman Empire’s society was hierarchical, with a rigid class system. At the top were the patricians, wealthy elites who held significant political power. Below them were the plebeians, free citizens with limited political influence, and the vast numbers of slaves who formed the backbone of the economy. The family unit was central, governed by the paterfamilias, the male head who held absolute authority.
Culturally, the Romans were eclectic, absorbing and adapting elements from the civilizations they encountered, particularly the Greeks. Roman art, literature, and philosophy reflected this synthesis, creating a rich cultural tapestry. Latin, the Roman language, became the lingua franca of the Western world, influencing numerous modern languages.
Roman architecture and engineering achievements were monumental. They perfected the arch, vault, and dome, constructing enduring structures like the Colosseum, Pantheon, and aqueducts. These engineering marvels not only showcased Roman ingenuity but also served practical purposes, from public entertainment to water supply.
Students, digital devices and success - Andreas Schleicher - 27 May 2024..pptxEduSkills OECD
Andreas Schleicher presents at the OECD webinar ‘Digital devices in schools: detrimental distraction or secret to success?’ on 27 May 2024. The presentation was based on findings from PISA 2022 results and the webinar helped launch the PISA in Focus ‘Managing screen time: How to protect and equip students against distraction’ https://www.oecd-ilibrary.org/education/managing-screen-time_7c225af4-en and the OECD Education Policy Perspective ‘Students, digital devices and success’ can be found here - https://oe.cd/il/5yV
Instructions for Submissions thorugh G- Classroom.pptxJheel Barad
This presentation provides a briefing on how to upload submissions and documents in Google Classroom. It was prepared as part of an orientation for new Sainik School in-service teacher trainees. As a training officer, my goal is to ensure that you are comfortable and proficient with this essential tool for managing assignments and fostering student engagement.
Welcome to TechSoup New Member Orientation and Q&A (May 2024).pdfTechSoup
In this webinar you will learn how your organization can access TechSoup's wide variety of product discount and donation programs. From hardware to software, we'll give you a tour of the tools available to help your nonprofit with productivity, collaboration, financial management, donor tracking, security, and more.
Ethnobotany and Ethnopharmacology:
Ethnobotany in herbal drug evaluation,
Impact of Ethnobotany in traditional medicine,
New development in herbals,
Bio-prospecting tools for drug discovery,
Role of Ethnopharmacology in drug evaluation,
Reverse Pharmacology.
The French Revolution, which began in 1789, was a period of radical social and political upheaval in France. It marked the decline of absolute monarchies, the rise of secular and democratic republics, and the eventual rise of Napoleon Bonaparte. This revolutionary period is crucial in understanding the transition from feudalism to modernity in Europe.
For more information, visit-www.vavaclasses.com
The Art Pastor's Guide to Sabbath | Steve ThomasonSteve Thomason
What is the purpose of the Sabbath Law in the Torah. It is interesting to compare how the context of the law shifts from Exodus to Deuteronomy. Who gets to rest, and why?
Operation “Blue Star” is the only event in the history of Independent India where the state went into war with its own people. Even after about 40 years it is not clear if it was culmination of states anger over people of the region, a political game of power or start of dictatorial chapter in the democratic setup.
The people of Punjab felt alienated from main stream due to denial of their just demands during a long democratic struggle since independence. As it happen all over the word, it led to militant struggle with great loss of lives of military, police and civilian personnel. Killing of Indira Gandhi and massacre of innocent Sikhs in Delhi and other India cities was also associated with this movement.
Research the requirements to sit for the PMP Exam (both paper and .docx
1. 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
2. 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
3. (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 oral switch is no longer
considered to be necessary or justifiable. However, a
survey of physicians responsible for deciding whether
to discharge patients with CAP revealed that the most
important factors defining clinical stability that sup-
ported the decision to discharge the patient included
normal temperature; return to baseline respiratory
Reprints or correspondence: Dr Lawrence Eron, 3288 Moanalua
4. Rd, Honolulu,
HI 96819 ([email protected]).
Clinical Infectious Diseases 2010; 51(S2):S224–S230
� 2010 by the Infectious Diseases Society of America. All
rights reserved.
1058-4838/2010/5106S2-0008$15.00
DOI: 10.1086/653524
status, mental status, and oxygenation; and the ability
to maintain oral intake of antibiotics [9]. The survey
respondents also believed that 120% of patients re-
mained in the hospital beyond the point at which they
had reached clinical stability. The most frequently cited
services that would definitely or probably have allowed
earlier hospital discharge were home intravenous an-
timicrobial treatment, home visits by nurses, and home
visits by physicians.
Early discharge may also present problems for pa-
tients who are still sick and, therefore, anxious about
not receiving professional care and for family members
who may be equally anxious about the patient’s safety
and intimidated by their responsibility for his or her
5. treatment. Physicians may also have some trepidation
about discharging patients to home before they are clin-
ically stable because of safety issues and the ever-present
problem of potential litigation. Discharge to home from
the emergency department or early in the course of
hospitalization of febrile, acutely infected patients is
now possible through the use of telemedicine [10].
TELEMEDICINE
The first formal and published definition of teleme-
dicine was “the practice of medicine without the usual
physician-patient confrontation…via [an] interactive
audio-video communication system” [11, p 614]. This
definition was soon expanded to include the concept
a
t U
n
ive
rsity o
f C
8. cluding patient and provider education, and health services
administration, as well as patient care” [11, p 614]. Currently,
every state has at least one telemedicine program. Some are
statewide, offer a comprehensive range of clinical services and
continuing education, and involve a large number of hospitals
and clinics.
According to a 1997 survey of all nonfederal rural hospitals
in the United States [12], ∼1 in 4 had telemedicine programs,
although almost two-thirds were teleradiology. These applica-
tions have led to the hub-and-spoke concept, whereby rural
hospitals are connected to tertiary care centers by telemedicine.
To date, ∼200 such networks are operating in the United States,
linking 13500 institutions nationwide [13].
Transmission of video images, audio, and vital signs data
from a remote site to a central location has been used in homes
to monitor chronically ill patients, including those with con-
gestive heart failure, chronic obstructive pulmonary disease,
and diabetes mellitus [10]. In a home health care study by a
nonprofit health maintenance organization, chronically ill pa-
9. tients who were eligible for home health care were offered
either
routine in-person and phone visits or the routine program and
telemedicine visits [14]. Routine care included initial assess-
ment in the home and in-person follow-up by nurses, as well
as the ability of the patient to reach a home health nurse by
phone from 8:30 AM through 5:00 PM for additional infor-
mation or triage. Additional verbal contact after normal work-
ing hours was available through the hospital’s telephone advice
center or at the emergency department. Patients also had the
option of being transported to an emergency department or
urgent care clinic for assessment if necessary.
The telemedicine intervention group had access to a home
health nurse 24 h per day; an on-call home health nurse could
contact the patient using the remote video equipment, which
allows in-depth assessment and triage without patients having
to leave home [14]. Installation of the home video system and
instruction of the patient in its use required ∼30 min. Peripheral
units of the system included an analog stethoscope and a digital
10. blood pressure machine; thus, nurses at the hospital site were
able to assess cardiopulmonary status, evaluate bowel sounds,
and view facial expression and signs of infection. A magnifying
lens that attached to the camera was used to assess correct
medication doses when patients were being taught how to use
medications, such as insulin.
No differences in the quality indicators (ie, medication com-
pliance, knowledge of disease, and ability for self care), patient
satisfaction, or use were seen. Moreover, the video technology
in the home health care setting yielded mean cost savings per
patient, although the savings were less than expected because
the intervention included the full cost of equipment and tel-
ecommunications start-up; in practice, the equipment would
be leased or amortized over several years. The investigators
concluded that telemedicine can be an asset for patients and
providers and has the potential to reduce costs [14]. However,
these results are based on a nonrandomized, case-control study,
which could have introduced biases into the conclusions.
11. TELEMEDICINE AND ACUTE CARE
Adaptation of telemedicine to the home care of acutely infected
patients who would normally be hospitalized was introduced
in a 2004 pilot study comparing 25 moderately to severely ill
patients treated by telemedicine in the home with a control
group that remained in the hospital [10]. The study was at
least partially based on a 2001 observational study that chal-
lenged the conventional hospital discharge process for patients
admitted with an acute infection [4]. According to this process,
patients undergo 3 stages of recovery from a severe infection
(Figure 1). Stage 1 extends from admission to clinical stability,
implying that the condition of the patient is no longer wors-
ening and has thus stabilized [10], and stage 2 devolves to early
improvement, suggesting a trend toward normality of temper-
ature and other inflammatory indicators. By the end of stage
3, which represents normalization of most clinical parameters,
the patient is sufficiently healthy to be discharged. The out-
comes in acutely infected patients with cellulitis, CAP, and uri-
12. nary tract infection who were discharged after defervescence
and definite clinical improvement were compared with those
in similarly infected patients discharged while still febrile (Fig-
ure 2) [4]. In addition to a shorter mean length of hospital
stay, patients discharged early returned to normal activities of
daily living more rapidly than did those whose discharge re-
quired a return of normal temperature.
In the 2004 study, patients with CAP, skin and soft-tissue
infections, urinary tract infection, and bacterial endocarditis
were referred from either the emergency department or the
hospital for telemedicine in the home [10]. Inclusion criteria
included a home with a person to assist the patient, willingness
to self-administer intravenous antibiotics when necessary, and
a low predicted 30-day mortality rate. Patients had to be ill
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enough to require hospitalization but not intensive care mon-
itoring. These patients were not conventional home-care or
OPAT candidates. All were screened for severity of illness, and
those with mild or life-threatening infections were excluded.
Of 41 patients evaluated using the Karnofsky performance scale
[15] and the Charlson comorbidity index [16, 17], 25 were
candidates for telemedicine in the home. Examples of the types
of treated patients are shown in Table 1 [10].
The Karnofsky performance scale measures a patient’s ability
to perform activities of daily living from 100% (ie, normal, no
complaints, and no evidence of disease) to 10% (ie, moribund,
with fatal processes progressing rapidly) and 0% [15]. The
Charlson comorbidity index, originally designed to classify
prognostic comorbidity in longitudinal studies, uses age and
specific comorbidities to predict survival [16, 17]. The score is
calculated for each patient as the total of the patient’s comorbid
conditions, which are weighted. Thus, a patient with moderately
16. severe CAP may have a high pneumonia severity index but can
still be treated as an outpatient if he or she has a reasonably
high Karnofsky score of 80% (ie, normal activity with effort
and some signs and symptoms of disease). The opposite is also
true: a patient with mild CAP and a low pneumonia severity
index may be at high risk on the basis of a low Karnofsky score
and a number of comorbidities.
Telemedicine equipment consisted of an Aviva Tower central
station and 4 Aviva 1010 XR patient stations, with a station
kept in reserve [18]. The connection between each patient’s
home station and the central station in the hospital was through
plain old telephone service lines. The telemedicine team in-
cluded a physician, 2 nurse practitioners, an information tech-
nology consultant, and a project coordinator.
After discharge from the hospital, telemedicine candidates
were met in the home by a member of the telemedicine team
who had transported the patient’s telemedicine equipment, or
station [10]. Installment of the station required a nearby tele-
17. phone outlet, through which the audiovisual and vital signs
were
transmitted, and adequate lighting. A second member of the
team, a nurse practitioner or physician, communicated with the
patient from a central station at the hospital (Figure 3) [10].
Eight patients started home telemedicine without being hos-
pitalized; 12 had been hospitalized for �4 days, and 5 had been
hospitalized for 5–10 days before discharge. The mean number
of combined hospital and home televisit days (8.3 days) was
similar to the mean duration of hospitalization (8.0 days) in
the control group.
None of the telemedicine patients had to be rehospitalized,
although 3 had recurrent infections. Three control patients had
recurrent CAP, and 1 of these patients was readmitted to the
hospital. A fourth control patient experienced nosocomial Clos-
tridium difficile enterocolitis. Patients receiving telemedicine
re-
turned to normal activities of daily living several weeks earlier
than did control subjects (Table 2) [10].
18. TELEMEDICINE COSTS
On the basis of the projected enrollment of 50 patients by the
end of 1 year, the number of hospital-days for control subjects
(8 days) and patients receiving telemedicine (2.8 days), and the
hypothesis that each telemedicine-day equals 1 hospital-day
saved [10], the trial investigators calculated that telemedicine
would have saved up to 5.2 days (range, 2.8–8.0 days) of hos-
pitalization for each patient treated, or 260 ( ) patient-5.2 � 50
days per year. Because the cost of a hospital bed is $500–$2000
per day, the pilot trial would have saved $130,000–$520,000 in
one year.
The cost of equipment (amortized over 2 years), personnel,
and information technology consultation amounted to
$120,000. Thus, the program would have netted $10,000–
$400,000 in 1 year [10].
TELEMEDICINE REIMBURSEMENT
Medicare
Clinical services. Although the Balanced Budget Act of 1997
19. mandated that Medicare reimburse telemedicine services to phy-
sicians on a fee-for-service basis, it also required the presence
of
a Medicare-participating telepresenter (a clinician at the patient
end of the televisit) [19]. This mandate, in addition to the lim-
itations on the telecommunications infrastructure in remote or
hostile environments, meant that only live telemedicine services
(10% of the total) were cost-effective. Moreover, an additional
requirement that the telepresenter and the consulting physician
share the fee suggested the potential for violating Medicare’s
own
prohibition against payment for referrals.
The 2000 omnibus appropriations bill HR 5661 dramatically
revised Medicare rules for reimbursement as of 1 October 2001.
The revisions included elimination of the requirement for a
Medicare-participating telepresenter; expansion of telemedicine
services to include direct patient care, physician consultations,
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22. Table 1. Representative Patients Treated by Home Telecare
Condition Patient Course and outcome
Community-acquired pneumonia A 78-year-old man with
leukemia and an absolute
neutrophil count of 400 neutrophils/mm3 who
developed bibasilar infiltrates, a temperature of
38.8�C, and an oxygen saturation of 90%
Recovered rapidly while receiving intravenous cef-
epime and oral moxifloxacin, using telemedi-
cine in the home
Skin and soft-tissue infection A 48-year-old woman with
metatastic carcinoma
of the breast and a white blood cell count of
2500 cells/mm3 who developed cellulitis ex-
tending from her hip to her axilla
Received intravenous ceftriaxone and recovered
uneventfully using telemedicine in the home
Urinary tract infection A morbidly obese 53-year-old man with
a me-
chanical aortic valve prosthetic who developed
high-grade enterococcal urosepsis (5 of 5 blood
culture and urine culture results were positive)
A transesophageal echocardiogram did not reveal
vegetations on the aortic valve, and the patient
was treated successfully with 6 weeks of am-
picillin and gentamicin using home telemedi-
cine; although classified as urinary tract infec-
tion, it may have been bacterial endocarditis
23. Bacterial endocarditis A 66-year-old man with severe aortic
insufficiency
and a previous right-side nephrectomy for a re-
nal cell carcinoma who developed Gemella en-
docarditis with a vegetation on his aortic valve
Successfully treated with ceftriaxone using tele-
medicine in the home
Reprinted from [10].
and office psychiatry services; payment for physicians or prac-
titioners at distant sites at rates generallly applicable to
services;
expansion of originating site definition to include physician
and practitioner offices, critical access hospitals, rural health
clinics, and federally qualified health centers and hospitals,
with
exclusion of nursing homes; and expansion of originating sites
to include rural areas outside the medical service area where
there are shortages of health professionals [19].
Home care. Medicare’s Prospective Payment System pro-
vides a fixed payment for each Medicare beneficiary for a 60-
day period on the basis of the assigned Home Health Resource
Group, which in turn provides a fixed payment for an unlimited
24. number of medically necessary episodes of care [20]. The per-
episode payment covers all skilled nursing visits, home health
aide visits, physical therapy, occupational therapy, speech pa-
thology, medical social services, and nonroutine medical sup-
plies. Payment is adjusted according to the number of necessary
visits, which reflects severity of illness.
The Prospective Payment System creates an incentive for
home health providers to proactively manage the delivery of
care and to use innovative means to deliver care while reducing
costs. When costs are lower than Medicare payment rates, pro-
viders are entitled to retain the difference as a profit. Although
HR5661 specifically permits the use of telemedicine services to
satisfy home health care delivery obligations under the Pro-
spective Payment System, telemedicine visits do not constitute
a visit under the Outcome Assessment and Information Set
evaluation tool [21] for purposes of determining assignment
to a Home Health Resource Group. Therefore, home care pro-
viders should assess the benefits of telemedicine services and
25. the effect that substitution of telemedicine visits will have on
reimbursement in accordance with the Medicare Prospective
Payment System.
Medicaid
Many states that struggle to find cost-effective ways to provide
care and to seek reducing geographic and provider-network
barriers have considered telemedicine programs. However, not
all states have embraced this technology, in part because of
significant challenges involving service reimbursement. State
Medicaid programs vary with regard to whether they provide
telemedicine and how they structure it. A nationwide survey
of Medicaid programs regarding telemedicine services was pub-
lished in 2005 [22]. Although focused on children with special
health care needs, the survey’s first goal was to identify
common
strategies related to Medicaid reimbursement.
Among the 50 states surveyed, Medicaid programs in 24
states reported that they reimburse for telemedicine, and pro-
26. grams in 4 were planning to implement reimbursement in the
future [22]. All 24 programs reimbursed for some physician
consultations via video teleconferencing; 19 reimbursed for
real-time consultations only, and of these, 3 specified that the
patient must be present at the time of consultation. The most
common reimbursable services are medical and behavioral and/
or mental health diagnostic consultations or treatments. Lim-
itations on service included reimbursement for behavioral and/
or mental health only (1 state), no reimbursement for mental
health (1), no reimbursement for ancillary services (2), reim-
bursement only when the spoke site is in the hospital emergency
department or outpatient setting (1), and reimbursement only
to clients enrolled in fee-for-service Medicaid (3). Licensed
physicians are reimbursed in all 24 states. In general, any pro-
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29. dicine. All 24 states reimbursed in accordance with fee-for-
service arrangements.
Twenty-two states reported that Medicaid does not reim-
burse, including 1 state that discontinued telemedicine reim-
bursement after determining that it was not cost-effective [22].
Medicaid programs in 4 of the 22 states have ongoing pilot
projects and expressed the intent to establish a reimbursement
program.
Commercial Insurers
Payment policies for telemedicine services vary widely among
commercial insurers [19]. An organization may have the lev-
erage to require payment for such services as a condition to
enter a contract before negotiation. On the other hand, con-
tracts that do not specifically provide for payments for tele-
medicine services may incorporate reference to Medicare for
coverage of services rules. Finally, it is advisable to consult
with
legal counsel or contracting specialists to determine whether
contracts provide, directly or indirectly, for reimbursement.
30. The recognition of telemedicine visits as allowable visits for
reimbursement varies among insurers [19]. Many are interested
in demonstration projects to provide treatment to chronically
ill patients, and some allow payment for telemedicine-based
equipment in the home.
Although the lack of private payer reimbursement has been
seen as a major barrier to the acceptance and growth of tele-
medicine, a 2003 survey of members of the American Tele-
medicine Association found that 38 of 72 programs were re-
ceiving reimbursement from private payers [23]. At that time,
payers were reimbursing in at least 25 states. Moreover, in
many
cases, payers were following the lead of Blue Cross/Blue Shield
rather than Medicaid and/or Medicare.
As of 2000, 5 states (California, Kentucky, Louisiana,
Oklahoma, and Texas) had passed legislation mandating private
payer reimbursement for telemedicine services [23]. For ex-
ample, Oklahoma’s SB 48 (1997) provides that health care plans
31. cannot deny coverage for health care services provided through
audio, video, or data communications. This would allow com-
pensation for patient consultations, diagnoses, and the transfer
of medical data through telecommunication technology. The
measure excludes telephone and facsimile communications
from the term “telemedicine.” Kentucky’s HB 177 (2000) pro-
hibits Medicaid and private insurers from requiring face-to-
face contact between a health care provider and patient for
services appropriately provided through telemedicine, subject
to the terms of the contract.
A follow-up survey in 2007 found that at least 35 states were
receiving Medicaid reimbursement for telemedicine services,
with the same mandates in the same 5 states [24]. A total of
116 telemedicine programs were identified, with a 55% re-
sponse rate. Of the 64 respondents, 61 provide billable services
and 58% receive private pay (42% do not). The percentage of
programs receiving private payer reimbursement increased by
5% from 2003. The majority of programs (81%) reported no
32. difference in the amount of reimbursement between teleme-
dicine services and traditional consultations.
TELEMEDICINE ISSUES
For telemedicine in the home to enter the conventional medical
care network, 4 major issues must be examined: technical prob-
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Telemedicine and Outpatient Therapy • CID 2010:51 (Suppl 2) •
S229
Table 2. Comparison of Patients Treated by Home Telecare and
by Hospitalization
Outcome
Telemedicine
group
Hospitalized
control group P
No. of patients with unsuccessful clinical outcome 3 4 .30a
Satisfaction level
Comfort 4.9b 3.0b .35c
Safety 3.8b 4.7b .09c
Time to return to activities of daily living, mean daysd 8 21
!.001c
NOTE. Reprinted from [10].
35. a By the Fisher exact test.
b Five-point scale: 5, very positive; 4, mildly positive; 3,
neutral; 2, mildly negative; and 1, very negative.
c By 2-sample Student t test.
d No. of days was calculated after completion of telemedicine
or discharge from the hospital.
lems, patient and clinician acceptance, reimbursement from
third-party payers, and legal challenges [10]. Technical prob-
lems, such as video freeze-ups and spontaneous termination of
connections caused by the low bandwidths of plain old tele-
phone service, remain for many programs because of the lack
of available broadband service in some areas. (In Hawaii, how-
ever, 80% of homes have cable service [Time Warner Oceanic
Cable] through which broadband service is available for tele-
medicine communication.) Although catastrophic earthquakes,
as occurred in 2010 in Haiti and Chile, could disrupt telephone
and cable lines, crippling snowstorms, such as the ones in the
United States and Europe during the winter of 2009–2010 that
shut down transportation services to and from hospitals and
clinics, should not interfere with telehealth visits between pro-
viders and patients.
36. Although patients treated by telemedicine have had satisfac-
tory clinical outcomes, more rapid convalescence, and increased
comfort at home, some patients have reported feeling safer in
a hospital environment than at home. Care providers may be
unwilling to bear the entire burden of caring for a patient; it
may be necessary to provide respite workers to shop, cook, and
clean and to provide companionship for some patients.
In general, clinicians remain skeptical about whether the
evidence is sufficient to change the current practice of not
discharging febrile patients before clinical improvement is
achieved. This reaction may be based on traditional teachings
and clinicians’ fear of unsuccessful outcomes and, in turn, the
potential threat of litigation. Telemedicine may increase the
work load of physicians. Appropriate compensation will be a
prerequisite to physician buy-in. Some believe that use of tel-
ecommunications technology threatens basic components of
medical care. One author warned “against excessive reliance on
technology to the detriment of traditional clinician-patient re-
37. lationships and against complacency regarding the risks and
responsibilities—many of which are as yet unknown—that dis-
tant medical intervention, consultation, and diagnosis carry”
[25, p 615]. The author emphasized that an intangible aspect
of traditional health care is threatened, specifically “the comfort
and compassion human beings can only bring each other when
they are face to face” [25].
Despite a large number of success stories attesting to the
cost-effectiveness of telemedicine in the home, not all com-
mercial third-party insurers reimburse for home televisits. More
positive outcome-based data from randomized comparison
studies are needed to confirm the efficacy and cost savings of
home telemedicine.
Medical-legal challenges for poor outcomes related to tele-
medicine in the home may occur, as did during the early days
of OPAT 13 decades ago. With time and satisfactory outcomes
data, however, OPAT became a standard of care, and fear of
litigation dissipated.
38. CONCLUSION
Telemedicine in the home has several advantages over hospi-
talization. It promotes more efficient use of hospital beds, re-
sulting in cost savings, and patients tend to convalesce more
rapidly at home. This latter phenomenon may be related to
several factors, including removal of the patient from a passive-
dependent posture in the hospital to more active participation
in his or her own medical care at home. The active involvement
of patients in their own care results in a sense of empowerment
over their illness.
Although the clinical use of telemedicine in the United States
is still limited, in the future, there may be increased numbers
of health care providers seeing patients at remote sites on a
desktop or laptop computer. Clinicians will select interactive
video and store-and-forward modes as needed and seamless
access to pertinent patient records, radiographs, pathology
slides, pharmacy information, and billing records. They will
have at hand the content of online libraries of medical infor-
39. mation, diagnosis and treatment algorithms, and patient in-
structional materials. Referral to specialists and allied health
personnel will be made by computer-based scheduling. Patient
information will be stored in archives accessed by authorized
medical personnel anywhere in the world.
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S230 • CID 2010:51 (Suppl 2) • Eron
As both a means of communication and a new diagnostic
and therapeutic modality, telemedicine should be approached
with scientific skepticism and caution. Research into its safety,
efficacy, cost-effectiveness, and patient and clinician
satisfaction
must be a high priority. Telemedicine may still be medicine at
a distance, but its range of applications has changed it from a
technological augmentation of medical care to a novel system
of health care. This integration of information technology with
the health care system is a process that will redefine future
medical care.
Acknowledgments
42. Potential conflicts of interest. L.E.: no conflict.
Financial support. Cubist Pharmaceuticals.
Manuscript preparation. Jean Fitzpatrick of the Curry
Rockefeller
Group provided assistance in preparing and editing the
manuscript.
Supplement sponsorship. This article is part of a supplement
entitled
“Meeting the Challenges of Methicillin-Resistant
Staphylococcus aureus with
Outpatient Parenteral Antimicrobial Therapy,” which is based
on the pro-
ceedings of an advisory board meeting of infectious diseases
specialists in
November 2007 that was sponsored by Cubist Pharmaceuticals.
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