An introduction to SAMHSA's SBIRT program, its role in addressing problematic drug and alcohol use and a call for occupational therapy leadership in its implementation.
Office-Based Opioid Treatment: What You Need to Know: Trends in Behavioral He...Epstein Becker Green
Presented by David Shillcutt (Associate, Epstein Becker Green) and Kristina Sherry (Attorney, Nelson Hardiman) on April 4, 2019.
Office-based opioid treatment providers are on the front lines of the response to the opioid epidemic, but recent developments in federal and state legislation have significant implications for provider business models and service delivery strategies.
This webinar will examine provider capacity issues for medication assisted treatment, the opportunities and challenges of telemedicine for addiction services, and the expansion of innovative service delivery networks including the “Hub and Spoke” system and related models.
Part of a "first Thursdays" webinar series hosted by Behavioral Health Association of Providers, Epstein Becker & Green, P.C., and Nelson Hardiman, LLP.
More info: https://www.ebglaw.com/events/office-based-opioid-treatment-what-you-need-to-know-trends-in-behavioral-health-webinar-series/
These materials have been provided for informational purposes only and are not intended and should not be construed to constitute legal advice. The content of these materials is copyrighted to Epstein Becker & Green, P.C. ATTORNEY ADVERTISING.
Opioid Epidemic - Causes, Impact and FutureCitiusTech
In 2017, everyday, more than 130 people died in the US after overdosing on opioids. This document talks about America's worst drug crisis ever and shares how technology can play a role to cope up with this epidemic.
The Health Home project is evaluating a new program that is part of healthcare reform in New York State. The program identifies individuals with substance use disorders who have other medical and psychiatric problems and offers them a new form of integrated care. The evaluation will study whether this program results in better quality of care and a reduction in health care costs for this vulnerable and chronically ill population.
Engaging Non-State Actors in Governing Health: Key to Improving Quality of Care?HFG Project
USAID’s Health Finance and Governance (HFG) and the Joint Learning Network hosted an hour-long webinar on engaging non-state actors in governing quality of care. The webinar presented in-country examples of private sector contributions in governing health quality — providing technical inputs on policy development, monitoring health service delivery, and promoting accountability in the health system.
Office-Based Opioid Treatment: What You Need to Know: Trends in Behavioral He...Epstein Becker Green
Presented by David Shillcutt (Associate, Epstein Becker Green) and Kristina Sherry (Attorney, Nelson Hardiman) on April 4, 2019.
Office-based opioid treatment providers are on the front lines of the response to the opioid epidemic, but recent developments in federal and state legislation have significant implications for provider business models and service delivery strategies.
This webinar will examine provider capacity issues for medication assisted treatment, the opportunities and challenges of telemedicine for addiction services, and the expansion of innovative service delivery networks including the “Hub and Spoke” system and related models.
Part of a "first Thursdays" webinar series hosted by Behavioral Health Association of Providers, Epstein Becker & Green, P.C., and Nelson Hardiman, LLP.
More info: https://www.ebglaw.com/events/office-based-opioid-treatment-what-you-need-to-know-trends-in-behavioral-health-webinar-series/
These materials have been provided for informational purposes only and are not intended and should not be construed to constitute legal advice. The content of these materials is copyrighted to Epstein Becker & Green, P.C. ATTORNEY ADVERTISING.
Opioid Epidemic - Causes, Impact and FutureCitiusTech
In 2017, everyday, more than 130 people died in the US after overdosing on opioids. This document talks about America's worst drug crisis ever and shares how technology can play a role to cope up with this epidemic.
The Health Home project is evaluating a new program that is part of healthcare reform in New York State. The program identifies individuals with substance use disorders who have other medical and psychiatric problems and offers them a new form of integrated care. The evaluation will study whether this program results in better quality of care and a reduction in health care costs for this vulnerable and chronically ill population.
Engaging Non-State Actors in Governing Health: Key to Improving Quality of Care?HFG Project
USAID’s Health Finance and Governance (HFG) and the Joint Learning Network hosted an hour-long webinar on engaging non-state actors in governing quality of care. The webinar presented in-country examples of private sector contributions in governing health quality — providing technical inputs on policy development, monitoring health service delivery, and promoting accountability in the health system.
Myanmar Strategic Purchasing 5: Continuous Learning and Problem SolvingHFG Project
This is the fifth in a series of briefs examining practical considerations in the design and implementation of a strategic purchasing pilot project among private general practitioners (GPs) in Myanmar. This pilot aims to start developing the important functions of, and provide valuable lessons around, contracting of health providers and purchasing that will contribute to the broader health financing agenda. More specifically, it is introducing a blended payment system that mixes capitation payments and performance-based incentives to reduce households’ out-of-pocket spending and incentivize providers to deliver an essential package of primary care services.
Quality and Outcome Framework (QOF) is a voluntary annual incentive programme for GPs in England, detailing practice achievement results. The primary objective of QOF is to drive the quality of primary care and reduce variations in the quality of care amongst GPs
This webinar will discuss the major federal laws that impact workplace wellness program design, including the Affordable Care Act/HIPAA Nondiscrimination rules on the use of financial incentives, the Americans with Disabilities Act (ADA), the Genetic Information Nondiscrimination Act (GINA), federal tax laws as well as recent EEOC action such as the proposed ADA rules and lawsuits against Honeywell, Flambeau and Orion Energy Systems. Through case examples, the speaker will explain how each of these laws interact with one another, who enforces these laws, what to expect in terms of future guidance, and how health promotion professionals can use these laws as tools in designing more effective and inclusive workplace wellness programs.
Maximizing Performance Incentives Through Star RatingsCitiusTech
The main aim of this document is to provide a high level understanding of the Star rating quality program of CMS and it’s impact on plans (at contract level) offered by the payers which are in Medicare Advantage line of business
It describes the various measure categories and their weightages, domains and sources required by CMS to assess quality of care and patient experience.
Evolving Role of Digital Biomarkers in HealthcareCitiusTech
As the adoption of remote monitoring, wearable devices and mobile applications grows, digital biomarkers will play a significant role in better disease identification and health management.
The 2013 Healthcare Benefits Trends Benchmark Study report provides insights into the adoption of new healthcare benefits, health exchanges, wellness, and related topics. The survey polled more than 300 human resources (HR) executives, benefit specialists, and other benefit decision-makers across the country to explore the current state of employee healthcare benefits, as well as the expected healthcare benefits outlook in response to sweeping healthcare reform legislation, also known as the Affordable Care Act (ACA). This includes the shift to defined contribution health plans, the launch of insurance exchanges, and the implementation of wellness plans.
Marketing proposal to Hartford HealthcareArchit Patel
The presentation is a brief description to the proposed marketing strategy for the Hartford healthcare specifically targeting on the New Health Enhancement Program proposed for Connecticut state employees.
Rising Importance of Health Economics & Outcomes ResearchCitiusTech
Health Economics & Outcomes Research (HE&OR) guides stakeholders to make informed decisions regarding patient access to drugs and services. This document highlights specific use cases for healthcare information technology that add value to HE&OR.
Presentation Objectives:
1) Define SBIRT and identify components of this evidence-based intervention for identifying, reducing, & preventing problematic use, abuse & dependence on alcohol & illicit drugs
2) Learn how to use the all the components of the SBIRT app, including, but not limited to the screening, brief interventions & referral to treatment features included in this app
3) Recognize the critical need for more research related to occupational therapy intervention and SBIRT, as well as potential obstacles to implementation of SBIRT in treatment settings & resources for continuing education on this topic.
Evidence on Improving Health Service Delivery in Developing CountriesIDS
This presentation by David Peters of the Future Health Systems Consortium was given at the Global Symposium on Health Systems Research in November 2010.
This e-book focuses on Health Management Solutions the value it adds alongside other systems that are already in place throughout the care lifecycle...
CMMI, in partnership with Million Hearts® at the Centers for Disease Control and Prevention (CDC), will sponsor a webinar entitled Value-Based Insurance Design, Opportunities to Improve Medication Adherence for Cardiovascular Disease Prevention on October 21, 2021 from 3:00-4:00 PM ET. The webinar will present evidence-based high impact strategies for MAOs to improve care and outcomes for beneficiaries with cardiovascular disease (CVD), including underserved populations.
- - -
CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
Myanmar Strategic Purchasing 5: Continuous Learning and Problem SolvingHFG Project
This is the fifth in a series of briefs examining practical considerations in the design and implementation of a strategic purchasing pilot project among private general practitioners (GPs) in Myanmar. This pilot aims to start developing the important functions of, and provide valuable lessons around, contracting of health providers and purchasing that will contribute to the broader health financing agenda. More specifically, it is introducing a blended payment system that mixes capitation payments and performance-based incentives to reduce households’ out-of-pocket spending and incentivize providers to deliver an essential package of primary care services.
Quality and Outcome Framework (QOF) is a voluntary annual incentive programme for GPs in England, detailing practice achievement results. The primary objective of QOF is to drive the quality of primary care and reduce variations in the quality of care amongst GPs
This webinar will discuss the major federal laws that impact workplace wellness program design, including the Affordable Care Act/HIPAA Nondiscrimination rules on the use of financial incentives, the Americans with Disabilities Act (ADA), the Genetic Information Nondiscrimination Act (GINA), federal tax laws as well as recent EEOC action such as the proposed ADA rules and lawsuits against Honeywell, Flambeau and Orion Energy Systems. Through case examples, the speaker will explain how each of these laws interact with one another, who enforces these laws, what to expect in terms of future guidance, and how health promotion professionals can use these laws as tools in designing more effective and inclusive workplace wellness programs.
Maximizing Performance Incentives Through Star RatingsCitiusTech
The main aim of this document is to provide a high level understanding of the Star rating quality program of CMS and it’s impact on plans (at contract level) offered by the payers which are in Medicare Advantage line of business
It describes the various measure categories and their weightages, domains and sources required by CMS to assess quality of care and patient experience.
Evolving Role of Digital Biomarkers in HealthcareCitiusTech
As the adoption of remote monitoring, wearable devices and mobile applications grows, digital biomarkers will play a significant role in better disease identification and health management.
The 2013 Healthcare Benefits Trends Benchmark Study report provides insights into the adoption of new healthcare benefits, health exchanges, wellness, and related topics. The survey polled more than 300 human resources (HR) executives, benefit specialists, and other benefit decision-makers across the country to explore the current state of employee healthcare benefits, as well as the expected healthcare benefits outlook in response to sweeping healthcare reform legislation, also known as the Affordable Care Act (ACA). This includes the shift to defined contribution health plans, the launch of insurance exchanges, and the implementation of wellness plans.
Marketing proposal to Hartford HealthcareArchit Patel
The presentation is a brief description to the proposed marketing strategy for the Hartford healthcare specifically targeting on the New Health Enhancement Program proposed for Connecticut state employees.
Rising Importance of Health Economics & Outcomes ResearchCitiusTech
Health Economics & Outcomes Research (HE&OR) guides stakeholders to make informed decisions regarding patient access to drugs and services. This document highlights specific use cases for healthcare information technology that add value to HE&OR.
Presentation Objectives:
1) Define SBIRT and identify components of this evidence-based intervention for identifying, reducing, & preventing problematic use, abuse & dependence on alcohol & illicit drugs
2) Learn how to use the all the components of the SBIRT app, including, but not limited to the screening, brief interventions & referral to treatment features included in this app
3) Recognize the critical need for more research related to occupational therapy intervention and SBIRT, as well as potential obstacles to implementation of SBIRT in treatment settings & resources for continuing education on this topic.
Evidence on Improving Health Service Delivery in Developing CountriesIDS
This presentation by David Peters of the Future Health Systems Consortium was given at the Global Symposium on Health Systems Research in November 2010.
This e-book focuses on Health Management Solutions the value it adds alongside other systems that are already in place throughout the care lifecycle...
CMMI, in partnership with Million Hearts® at the Centers for Disease Control and Prevention (CDC), will sponsor a webinar entitled Value-Based Insurance Design, Opportunities to Improve Medication Adherence for Cardiovascular Disease Prevention on October 21, 2021 from 3:00-4:00 PM ET. The webinar will present evidence-based high impact strategies for MAOs to improve care and outcomes for beneficiaries with cardiovascular disease (CVD), including underserved populations.
- - -
CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
Innovative Marketing Practices for Optimization in Selected Pharmaceutical In...iicecollege
Pharmaceutical Industry is regulated by the production, distribution, selling and the marketing of the products or services which directly or indirectly includes medical, diagnostic and healthcare.It is regulated by economical, political and administrative authority to manage at all levels. So, the industry is governed by both the public and private sector. Therefore innovation is done in various pharma stakeholder and is needed in chronic and acute therapeutic segment.
For more details please visit
www.iicecollege.com
Health Equity Investments: Opportunities and Challenges in 2023Health Catalyst
Trudy Sullivan and Dr. Melissa Welch will discuss how to establish mechanisms using data you already have for ongoing health equity evaluation and how to drive data-informed decisions. Trudy Sullivan and Dr. Melissa Welch will discuss how to establish mechanisms using data you already have for ongoing health equity evaluation and how to drive data-informed decisions.
Guidance for commissioners of drug and alcohol servicesJCP MH
This guide has been written to provide practical advice on developing and delivering local plans and strategies to commission the most effective and efficient drug and alcohol services for adults.
Based upon clinical best practice guidance and drawing upon the range of available evidence, it describes what should be expected of a modern drug and alcohol service in terms of effectiveness, outcomes and value for money.
Dr. Shuli Brammli Greenberg Presentation 2017-10-25mjbinstitute
A presentation on how the work of the Myers-JDC-Brookdale Institute's Smokler Center for Health Policy impacts national reform of health policy, presented by Dr. Shuli Brammli Greenberg, Senior Researcher at the Smokler Center.
Dr. Shuli Brammli Greenberg Presentation 2017-10-25Etan Diamond
A presentation on how the work of the Myers-JDC-Brookdale Institute's Smokler Center for Health Policy impacts national reform of health policy, presented by Dr. Shuli Brammli Greenberg, Senior Researcher at the Smokler Center.
Goals: The goal of this training is to help participants develop their knowledge, skills and abilities as Substance Use Screenng, Brief Intervention, and Referral to Treatment (SBIRT) Trainers.
At the end of this training participants will be able to understand the information screening does and does not provide,define brief intervention, describe the goals of conducting a BI, understand the counselor's role in providing BI, describe referral to treatment, identify SBIRT as a system change initiative, introduce the public health approach, and understand the continuum of substance use.
Audience: Social Workers, counselors and other behavioral health providers from all settings can benefit from understanding substance use across a continuum and its impact on clients behavioral health and other psychosocial interactions.
Impact of Real world data in Pharmacovigilance and Regulatory Decision MakingClinosolIndia
Real-world data (RWD) has emerged as a transformative force in the field of pharmacovigilance, significantly influencing regulatory decision-making processes. Unlike data generated in controlled clinical trials, RWD reflects the everyday clinical experiences and outcomes of patients in real-world settings. The impact of integrating RWD into pharmacovigilance and regulatory decision-making is multifaceted and has profound implications for patient safety, drug development, and healthcare policymaking
As part of a broader partnership, CMMI, the Office of the Assistant Secretary for Health (OASH) and the Administration for Community Living (ACL) are jointly sponsoring a webinar titled, Unleashing the Capabilities of MAOs to Deliver Health Innovation for Older Adults in Underserved Settings on October 7 from 2:30-4:00 PM ET to highlight the emerging, numerous opportunities for MAOs to support beneficiaries in more fully meeting their care needs and goals through novel approaches and services enabled by technology.
The webinar will provide an overview of the data supporting these opportunities and will include a panel of three speakers from payer organizations, each of whom will provide an overview of their experience and results in innovating in the use of technology to address unmet enrollee health needs. Panelists include Mona Siddiqui MD, MPH, Senior Vice President for Enterprise Clinical Strategy and Quality at Humana, who will discuss Humana’s approach to the use of data and predictive modeling to proactively engage and provide care for the highest risk and most vulnerable populations; John Wiecha, Medical Director, Senior Products Division at Point32Health, representing the newly combined organizations of Harvard Pilgrim Health Care and Tufts Health Plan will provide an overview of a recent pilot project to improve dementia care through a digital caregiver support program; and Caesar A. DeLeo, MD, MHSA Vice President & Executive Medical Director Strategic Initiatives, Highmark Health Enterprise Clinical Organization, Highmark BCBS who will discuss Highmark’s experience with telemedicine to approach substance use disorders during the pandemic and results from a five-year data driven program addressing appropriate opiate prescribing through profiling and academic detailing.
The webinar offers attendees the opportunity to gain a better understanding of the evidence and potential of several technology-enabled services in improving access, quality and outcomes of care, including, importantly, for underserved populations and will provide MAOs with insights more broadly on the challenges and solutions in design, implementation and evaluation of innovative and technology-enabled service. MAOs that are considering such innovations who may wish to target the use of technology-enabled and/or other services based on chronic illness and/or Low-Income Subsidy (LIS) status through the VBID Model are encouraged to attend.
- - -
CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
CHAPTER 1 SEMESTER V - ROLE OF PEADIATRIC NURSE.pdfSachin Sharma
Pediatric nurses play a vital role in the health and well-being of children. Their responsibilities are wide-ranging, and their objectives can be categorized into several key areas:
1. Direct Patient Care:
Objective: Provide comprehensive and compassionate care to infants, children, and adolescents in various healthcare settings (hospitals, clinics, etc.).
This includes tasks like:
Monitoring vital signs and physical condition.
Administering medications and treatments.
Performing procedures as directed by doctors.
Assisting with daily living activities (bathing, feeding).
Providing emotional support and pain management.
2. Health Promotion and Education:
Objective: Promote healthy behaviors and educate children, families, and communities about preventive healthcare.
This includes tasks like:
Administering vaccinations.
Providing education on nutrition, hygiene, and development.
Offering breastfeeding and childbirth support.
Counseling families on safety and injury prevention.
3. Collaboration and Advocacy:
Objective: Collaborate effectively with doctors, social workers, therapists, and other healthcare professionals to ensure coordinated care for children.
Objective: Advocate for the rights and best interests of their patients, especially when children cannot speak for themselves.
This includes tasks like:
Communicating effectively with healthcare teams.
Identifying and addressing potential risks to child welfare.
Educating families about their child's condition and treatment options.
4. Professional Development and Research:
Objective: Stay up-to-date on the latest advancements in pediatric healthcare through continuing education and research.
Objective: Contribute to improving the quality of care for children by participating in research initiatives.
This includes tasks like:
Attending workshops and conferences on pediatric nursing.
Participating in clinical trials related to child health.
Implementing evidence-based practices into their daily routines.
By fulfilling these objectives, pediatric nurses play a crucial role in ensuring the optimal health and well-being of children throughout all stages of their development.
Medical Technology Tackles New Health Care Demand - Research Report - March 2...pchutichetpong
M Capital Group (“MCG”) predicts that with, against, despite, and even without the global pandemic, the medical technology (MedTech) industry shows signs of continuous healthy growth, driven by smaller, faster, and cheaper devices, growing demand for home-based applications, technological innovation, strategic acquisitions, investments, and SPAC listings. MCG predicts that this should reflects itself in annual growth of over 6%, well beyond 2028.
According to Chris Mouchabhani, Managing Partner at M Capital Group, “Despite all economic scenarios that one may consider, beyond overall economic shocks, medical technology should remain one of the most promising and robust sectors over the short to medium term and well beyond 2028.”
There is a movement towards home-based care for the elderly, next generation scanning and MRI devices, wearable technology, artificial intelligence incorporation, and online connectivity. Experts also see a focus on predictive, preventive, personalized, participatory, and precision medicine, with rising levels of integration of home care and technological innovation.
The average cost of treatment has been rising across the board, creating additional financial burdens to governments, healthcare providers and insurance companies. According to MCG, cost-per-inpatient-stay in the United States alone rose on average annually by over 13% between 2014 to 2021, leading MedTech to focus research efforts on optimized medical equipment at lower price points, whilst emphasizing portability and ease of use. Namely, 46% of the 1,008 medical technology companies in the 2021 MedTech Innovator (“MTI”) database are focusing on prevention, wellness, detection, or diagnosis, signaling a clear push for preventive care to also tackle costs.
In addition, there has also been a lasting impact on consumer and medical demand for home care, supported by the pandemic. Lockdowns, closure of care facilities, and healthcare systems subjected to capacity pressure, accelerated demand away from traditional inpatient care. Now, outpatient care solutions are driving industry production, with nearly 70% of recent diagnostics start-up companies producing products in areas such as ambulatory clinics, at-home care, and self-administered diagnostics.
Deep Leg Vein Thrombosis (DVT): Meaning, Causes, Symptoms, Treatment, and Mor...The Lifesciences Magazine
Deep Leg Vein Thrombosis occurs when a blood clot forms in one or more of the deep veins in the legs. These clots can impede blood flow, leading to severe complications.
R3 Stem Cells and Kidney Repair A New Horizon in Nephrology.pptxR3 Stem Cell
R3 Stem Cells and Kidney Repair: A New Horizon in Nephrology" explores groundbreaking advancements in the use of R3 stem cells for kidney disease treatment. This insightful piece delves into the potential of these cells to regenerate damaged kidney tissue, offering new hope for patients and reshaping the future of nephrology.
Navigating Challenges: Mental Health, Legislation, and the Prison System in B...Guillermo Rivera
This conference will delve into the intricate intersections between mental health, legal frameworks, and the prison system in Bolivia. It aims to provide a comprehensive overview of the current challenges faced by mental health professionals working within the legislative and correctional landscapes. Topics of discussion will include the prevalence and impact of mental health issues among the incarcerated population, the effectiveness of existing mental health policies and legislation, and potential reforms to enhance the mental health support system within prisons.
India Clinical Trials Market: Industry Size and Growth Trends [2030] Analyzed...Kumar Satyam
According to TechSci Research report, "India Clinical Trials Market- By Region, Competition, Forecast & Opportunities, 2030F," the India Clinical Trials Market was valued at USD 2.05 billion in 2024 and is projected to grow at a compound annual growth rate (CAGR) of 8.64% through 2030. The market is driven by a variety of factors, making India an attractive destination for pharmaceutical companies and researchers. India's vast and diverse patient population, cost-effective operational environment, and a large pool of skilled medical professionals contribute significantly to the market's growth. Additionally, increasing government support in streamlining regulations and the growing prevalence of lifestyle diseases further propel the clinical trials market.
Growing Prevalence of Lifestyle Diseases
The rising incidence of lifestyle diseases such as diabetes, cardiovascular diseases, and cancer is a major trend driving the clinical trials market in India. These conditions necessitate the development and testing of new treatment methods, creating a robust demand for clinical trials. The increasing burden of these diseases highlights the need for innovative therapies and underscores the importance of India as a key player in global clinical research.
Health Education on prevention of hypertensionRadhika kulvi
Hypertension is a chronic condition of concern due to its role in the causation of coronary heart diseases. Hypertension is a worldwide epidemic and important risk factor for coronary artery disease, stroke and renal diseases. Blood pressure is the force exerted by the blood against the walls of the blood vessels and is sufficient to maintain tissue perfusion during activity and rest. Hypertension is sustained elevation of BP. In adults, HTN exists when systolic blood pressure is equal to or greater than 140mmHg or diastolic BP is equal to or greater than 90mmHg. The
The dimensions of healthcare quality refer to various attributes or aspects that define the standard of healthcare services. These dimensions are used to evaluate, measure, and improve the quality of care provided to patients. A comprehensive understanding of these dimensions ensures that healthcare systems can address various aspects of patient care effectively and holistically. Dimensions of Healthcare Quality and Performance of care include the following; Appropriateness, Availability, Competence, Continuity, Effectiveness, Efficiency, Efficacy, Prevention, Respect and Care, Safety as well as Timeliness.
Artificial Intelligence to Optimize Cardiovascular Therapy
SBIRT & OT 10.21.18
1. SBIRT: A Promising Approach to
Addressing Problematic Use of Alcohol
and Drugs
Allison F. Sullivan, OT, DOT, MS, OTR
Hannah Sullivan, MPH
October 26th, 2018
MAOT 2018
2. Learning Objectives
1. Define drug and alcohol abuse as a modern public health
disaster and the context in which SBIRT has been introduced.
2. Identify components of this evidence-based intervention for
identifying, reducing, & preventing problematic use, abuse &
dependence on alcohol & illicit drugs.
3. Recognize the critical need for more research related to
occupational therapy intervention and SBIRT, as well as
potential obstacles to implementation of SBIRT in treatment
settings & resources for continuing education on this topic.
2
8. What Constitutes a Public Health
Disaster?
● A situation becomes an emergency or
disaster when the magnitude of health
consequences has the potential to
overwhelm a community in situations not
routinely encountered.
● Disaster preparedness is an area of study
in public health that instructs the public
on how to prepare for disasters, both man-
made and natural. 8
10. What is Addiction?
● Addiction is characterized by inability to consistently abstain,
impairment in behavioral control and diminished recognition of
problems with one’s behaviors & interpersonal relationships
● Addiction is a primary, chronic disease of brain reward, motivation,
memory and related circuitry which results in an individual
pathologically pursuing reward/relief by substance use.
● Addiction often involves cycles of relapse and remission.
● Without treatment or engagement in recovery activities, addiction is
progressive and can result in disability or premature death.
ASDM (2011)
10
11. Public Health Model of Addiction & Recovery
● Harm Reduction is a specific type of public health strategy
which accepts that it is not possible to eliminate addiction.
● Instead, the public health goal becomes reducing the harmful
effects of addiction.
11
12. Public Health Model of Addiction & Recovery
● Social Determinants of Health tells us that addiction affects
both individuals with addictions and their communities
● Harm reduction principles seek to reduce harm through any
means necessary.
● The goal is an overall improvement in public health.
12
19. What is SBIRT?
1. Screening
2. Brief
Intervention
3. Referral to
Treatment
19
20. What is SBIRT?
● SBIRT is an evidence-based intervention practice for
identifying, reducing & preventing problematic use, abuse &
dependence on alcohol & illicit drugs
● Emphasizes screening and early intervention for substance
use disorders
● Aims to help identify people at risk for developing
substance use disorders.
● SBIRT utilizes a combined effort of screening and treatment
services as part of a cooperative system of early intervention.
Madras BK, Compton WM, Avula, D et al., 2009
20
21. Historical Background of the SBIRT Initiative
In 2001, the Institute of Medicine’s Committee on the Quality of
Health Care in America released Crossing the Quality Chasm: A
New Health System for the 21st Century:
•Identified in this report was the need for community-based
screening for health risk behaviors including substance use
with appropriate assessment and referral activities
•The SBIRT model was specifically cited as a promising
practice in this report
Institute of Medicine, 2001
21
22. Goal of SBIRT Initiative
• Prevent the unhealthy
consequences of alcohol and
drug use among those
whose use may not have
reached the diagnostic level
of a substance use disorder
• Help those with the disease
of addiction enter and stay
with treatment.
SAMHSA-HRSA, nd
22
23. Where are SBIRT Programs?
● Typically, SBIRT is conducted in medical settings, including
community health centers
● SBIRT has been proven successful in hospitals, specialty
medical practices such as HIV/STD clinics, emergency
departments, and workplace wellness programs such as
Employee Assistance ProgramsSAMHSA-HRSA
23
25. SBIRT Decreases Healthcare Costs
Substance misuse & abuse is a
significant factor in poor health
outcomes and preventable
healthcare costs
● Societal cost of $600 billion annually
● One study estimated the net value of
SBIRT adoption was $771 per employee
25
26. SBIRT Reduces Severity of Substance Misuse
● Screening and brief intervention
was the single most effective
treatment method of the more
than 40 treatment approaches
SAMHSA studied, particularly
among groups of people not
actively seeking treatment
26
27. SBIRT Diminishes Risk of Physical Trauma for
Patients without Specialized Substance Treatment
● Studies on brief intervention identified outcomes
such as patients’: reducing their alcohol intake,
successful referral to & participation in treatment
programs & decreases in repeat injuries and injury
hospitalizations
● Following a U.S. Preventive Services Task Force
recommendation, in 2011 Medicare began
reimbursing alcohol and drug screening &
counseling in the primary care setting
Open Cancer Network (2017); SBIRT (nd) 27
28. OTs Can Demonstrate Leadership in SBIRT programs
✓OT is intended to be a holistic, client-centered
practice which addresses the needs of the whole
client (Law, Baum & Dunn, 2005)
✓OT takes place in settings where SBIRT was
intended
✓As direct service providers, OT practitioners
occupy a place of trust in the patient care
continuum (Birkhauer, et al., 2017)
28
29. OTs Can Demonstrate Leadership in SBIRT programs
✓Occupational therapy practitioners possess mental
health skills and knowledge as core components of
their educational background
✓Occupational therapists are skillful evaluators of
patient needs, trained to collaborate with the client
for the development of meaningful goals & outcomes
of treatment
(Law, Baum & Dunn, 2005)
29
31. Free training in SBIRT from the SAMHSA website
follow the link to the training here:
http://www.integration.samhsa.gov/clinical-practice/SBIRT#bmb=1 …
34. Use Apps like the OHN SBIRT app from Open Cancer Network
35. SBIRT Basics
Click on
“Review”:
This opens to a
menu of
SBIRT Basics,
including helpful
information on:
• The Epidemiology of Drug & Alcohol abuse
• Drugs of abuse
• Consequences of Drug & Alcohol Abuse
• A brief explanation of SBIRT & its value
• Graphic illustrations and information regarding risky use
36. Screening
If the patient answers yes to the one question screen, the assessment continues to
a more comprehensive tool, the 3-question AUDIT-C or 10-question AUDIT (for
alcohol use in adults), the DAST (for adult drug use) or the CRAFFT, which screens
for drug and alcohol use by adolescents
37. Brief Interventions
Brief interventions are typically provided to patients with less severe alcohol or
substance use problems who do NOT need a referral to additional treatment.
In addition to behavioral health professionals, medical personnel, including OTs
can conduct these interventions and need only minimal training
38. Referral to treatment
The referral to treatment process consists of helping patients access specialized
treatment, selecting treatment facilities, and facilitating the navigation of any
barriers that might prevent them from receiving treatment at a specialty setting
39. SBIRT Funding Available through CCBHCs
● Certified Community Behavioral Health Clinics or CCBHCs,
were created through Section 223 of the Protecting Access to
Medicare Act (PAMA)
● CCBHCs are responsible for directly providing (or
contracting with partner organizations to provide) nine
required types of services:
● Emphasis on the provision of 24-hour crisis care, SBIRT,
utilization of evidence-based practices, care coordination,
and integration with physical health care.
39
40. Obstacle 1: Barriers to Reimbursement
Coding and billing policies are essential to widespread use of
SBIRT.
● The good news is that reimbursement is available through
commercial insurance, Current Procedural Terminology (CPT)
codes, Medicare G codes, and Medicaid Healthcare Common
Procedure Coding System (HCPCS) codes
● The bad news is that while Medicare currently pays for
screening and brief intervention as preventive services in the
primary care setting, many states have not yet “activated”
Medicaid codes for SBIRT reimbursement.
41. Obstacle 2: Workflow
One common barrier to implementing SBIRT in primary care settings is the
additional time the practice will add to already short visits.
● Successful programs employ a multi-disciplinary change team to identify
which existing clinical and administrative staff will be responsible for
various SBIRT functions.
● The keys to successful implementation have included collaboration with
health staff to tailor SBIRT to existing infrastructure and resources,
ongoing training, data collection for quality monitoring, and process
revision based on results.
● Visit SAMHSA-HRSA Center for Integrated Health Solutions for
resources that address workflow issues (SAMHSA-HRSA)
42. YOUR TAKE AWAY TODAY: SBIRT NEEDS
YOU!
• There are currently NO studies to date on the use and
implementation of SBIRT by occupational therapists
• Nurses and social workers are once again gaining an edge in primary
care settings by providing another revenue-generating service for
their facilities
• Occupational therapists are missing out on an effective, evidence-
based preventive intervention that will make use of our mental
health skills and knowledge
42
There is a critical need for more research related to
occupational therapy intervention & SBIRT
43. Acknowledgements
● American International College School of Health Sciences
● Tulane University School of Public Health and Tropical
Medicine
● Behavioral Health Network Inc.
43
44. Contact Information
Allison F. Sullivan,
OT, DOT, MS,
OTR/L
Email: Allison.Sullivan@aic.edu
Website: www.allisulli.com
Twitter: @_Allisulli
Hannah L. Sullivan,
MPH
Email: Hannah.Sullivan@bhninc.org
Twitter: @HannahMPH
44
45. References
Centers for Disease Control and Prevention (2017). Opioid Overdose. Retrieved from <https://www.cdc.gov/drugoverdose/epidemic/index.html>.
ClinicalTools, Inc. (2015). About Us - SBIRT Training. Retrieved from <https://www.sbirttraining.com/>.
Joynt, M., Train, M. K., Robbins, B. W., Halterman, J. S., Caiola, E., & Fortuna, R. J. (2013, June 25). The Impact of Neighborhood Socioeconomic Status and
Race on the Prescribing of Opioids in Emergency Departments Throughout the United States. Retrieved December 01, 2017, from
https://link.springer.com/article/10.1007/s11606-013-2516-z.
Kaiser Family Foundation (2017). Opioid Overdose Death Rates. Retrieved from https://www.kff.org/other/state-indicator/opioid-overdose-death-
rates/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D.
Kaiser Family Foundation (2017). Opioid Overdose by Age Group. Retrieved from https://www.kff.org/other/state-indicator/opioid-overdose-deaths-by-age-
group/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D.
Loesche, D (2017). America has the Highest Drug Related Deaths in North America and in the World. Retrieved from
https://www.statista.com/chart/9973/drug-related-deaths-and-mortality-rate-worldwide/
Maxwell, J. (2014). Brief Report on the Current Epidemic of Drug Poisoning Death. Retrieved from
https://socialwork.utexas.edu/dl/files/cswr/institutes/ari/pdf/opioid-overdose-2014.pdf.
Matrix Global Advisors, LLC. (2015). Healthcare Costs from Opioid Abuse: A State-by State Analysis. Retrieved from https://drugfree.org/wp-
content/uploads/2015/04/Matrix_OpioidAbuse_040415.pdf.
Mukherjee (2017). These Opioids Are Killing an Increasing Number of American Teens. Retrieved from <http://fortune.com/2017/08/16/opioid-crisis-teen-
overdose-deaths/>
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46. References
National Institute on Drug Abuse (2016). Misuse of Prescription Drugs. Retrieved from <https://www.drugabuse.gov/publications/research-reports/misuse-
prescription-drugs/what-scope-prescription-drug-misuse>
National Institute on Drug Abuse (2017). Opioid Overdose Crisis. Retrieved from https://www.drugabuse.gov/drugs-abuse/opioids/opioid-overdose-
crisis#five
Council on Recovery, The. (n.d). Fighting the Opioid Epidemic Using New Technology. Retrieved from https://www.councilonrecovery.org/fighting-opioid-
epidemic-using-new-technology/
U.S. Department of Health and Human Services (2017). Trump Administration Awards Grants to States to Combat Opioid Crisis. Retrieved from
<https://www.hhs.gov/about/news/2017/04/19/trump-administration-awards-grants-states-combat-opioid-crisis.html>.
Van Handel MM et al (2016). County-Level Vulnerability Assessment for Rapid Dissemination of HIV or HCV Infections Among Persons Who Inject
Drugs, United States. Retrieved from <http://opioid.AmfAR.org/TX>.
Van Zee A. The Promotion and Marketing of OxyContin: Commercial Triumph, Public Health Tragedy. Am J Public Health. 2009;99(2):221-227.
doi:10.2105/AJPH.2007.131714.
Vowles KE, McEntee ML, Julnes PS, Frohe T, Ney JP, van der Goes DN. Rates of opioid misuse, abuse, and addiction in chronic pain: a systematic review
and data synthesis. Pain. 2015;156(4):569-576. doi:10.1097/01.j.pain.0000460357.01998.f1.
World Health Organization (2014). Information sheet on opioid overdose. Retrieved from <http://www.who.int/substance_abuse/information-sheet/en/>
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47. References
American Occupational Therapy Association (2010). Specialized knowledge and skills in mental health promotion, prevention, and intervention in
occupational therapy practice. American Journal of Occupational Therapy, 64:S30-S43
Birkhäuer, J., Gaab, J., Kossowsky, J., Hasler, S., Krummenacher, P., Werner, C. & Gerger, H. (2017) Trust in the health care professional and health outcome:
A meta-analysis. PLOS One. Retrieved from: https://doi.org/10.1371/journal.pone.0170988
George Washington University Medical Center. Ensuring Solutions to Alcohol Problems (2008). The promise of the new reimbursement codes. Retrieved
from: www.ensuringsolutions.org/moreresources/moreresources_show.htm?doc_id=67293
Law, M, Baum, C, & Dunn, W. (2005). Measuring occupational performance: Supporting best practice in occupational therapy. Thorofare, NJ: Slack,
Incorporated.
Madras BK, Compton WM, Avula D et al. (2009). Screening, brief interventions, referral to treatment (SBIRT) for illicit drug and alcohol use at multiple
healthcare sites: Comparison at intake and six months later. Drug and Alcohol Dependence; 280‐295.
Institute of Medicine (2001). Committee on Quality of Health Care in America (IOM). Crossing the quality chasm: A new health system for the 21st century.
Washington, DC.
OHN SBIRT. Open Cancer Network (2017). [Mobile application software]. Retrieved from http://itunes.apple.com
Quanbeck A, Lang K, Enami K, & Brown RL. (2010). A cost-benefit analysis of Wisconsin's screening, brief intervention, and referral to treatment
program: adding the employer's perspective. State Medical Society of Wisconsin, 109(1):9-14
SAMHSA-HRSA (n.d.) In SBIRT: Screening, brief intervention, and referral to treatment: Opportunities for implementation and points for consideration.
Retrieved from: https://www.integration.samhsa.gov/SBIRT_Issue_Brief.pdf
47
Reference: https://www.mentalhelp.net/articles/public-health-model-of-addiction-and-recovery-implications/
For instance, IV drug users who become HIV+ can spread this disease to addicts and non-addicts alike. A harm reduction approach could be a needle exchange program (providing free, clean needles to IV drug users). People who abuse alcohol can kill someone with their car. A harm reduction approach might be a public health campaign that encourages the use of a sober "designated drivers." This approach accepts that people will get drunk but reduces harm by providing an alternative to drunk driving.
Image: https://www.tehrantimes.com/news/426120/Harm-reduction-prevents-spread-of-HIV-says-official
Screening
Screening is a quick, simple method of identifying patients who use substances at at risk or hazardous levels and who may already have substance use related disorders. The screening instrument provides specific information and feedback to the patient related to his or her substance use. The typical screening process involves the use of a brief 1-3 question screen such as the National Institute on Alcohol Abuse and Alcoholism’s single question screen or National Institute on Drug Abuse’s quick screen. If a person screens positive on one of these instruments, s/he is then given a longer alcohol or drug use evaluation, using a standardized risk assessment tool such as AUDIT or DAST. The screening and risk assessment instruments are easily administered and provide patient reported information about substance use that any healthcare professional can easily score.
Brief Intervention
Brief Intervention is a time-limited, patient-centered strategy that focuses on changing a patient’s behavior by increasing insight and awareness regarding substance use. Depending on severity of use and risk for adverse consequences, a 5-10 minute discussion or a longer 20-30 minute discussion provides the patient with personalized feedback showing concern over drug and/or alcohol use. The topics discussed can include how substances can interact with medications, cause or exacerbate health problems, and/or interfere with personal responsibilities
Referral to Treatment
In some cases, a more advanced treatment option is necessary and the patient is referred to a higher level of care. This care is often provided at specialized addiction treatment programs. The referral to treatment process consists of helping patients access specialized treatment, selecting treatment facilities, and facilitating the navigation of any barriers such as cost of treatment or lack of transportation that would hinder them from receiving treatment in a specialty setting.
An Office of National Drug Control Policy study estimated that in 2011 substance use accrued a societal cost of $193 billion
Illness, hospitalizations, motor vehicle injuries, and premature deaths.
This training includes not only information on how to administer the SBIRT components, but also how to complete coding and reimbursement for the services that are provided
The Home Page of the SBIRT app is divided into four sections:
Review, Apply, Report & Tools
Click on “Review” to open a menu of SBIRT Basics, which includes helpful information on
The Epidemiology of Drug and Alcohol abuse
Drugs of Abuse
Consequences of drug and alcohol abuse
A brief explanation of SBIRT & its value
As well as graphic illustrations and information regarding risky use
Review these sections to become better informed about SBIRT rationale & goals
Click on “Apply” to open a menu for applying the 3 main components of the SBIRT:
Screening, Brief Interventions & Referral tips
as well as a section of graphic illustrations for visual support when providing your brief interventions
When you open the Screening section, you are asked what you want to screen for, and are given a brief set of demographic questions which once answered, initiate a report and select an appropriate initial assessment, a one question screen for alcohol or drugs.
If the patient answers yes to the one question screen, the assessment continues to a more comprehensive tool, the 3-question AUDIT-C, the 10-question AUDIT, for alcohol use in adults, the DAST, for drug use in adults, or the CRAFFT, which screens for drug and alcohol use by adolescents
The result of the comprehensive screen will prompt the service provider to the next component of this tab, brief interventions
In the app, the brief interventions section has tips and scripts for brief advice, brief negotiated interviews & motivational interviewing
Brief intervention is designed to motivate patients to change their behavior and prevent the progression of substance use. During the intervention, patients are:
Given information about their substance use based on their risk assessment scores.
Advised in clear, respectful terms to decrease or abstain from substance use.
Encouraged to set goals to decrease substance use and to identify specific steps to reach those goals
Taught behavior change skills that will reduce substance use and limit negative consequences.
Provided with a referral for further care, if needed.
Brief interventions are typically provided to patients with less severe alcohol or substance use problems who do not need a referral to additional treatment and services. In addition to behavioral health professionals, medical personnel (e.g., doctors, nurses, physician assistants, nurse practitioners) can conduct these interventions and need only minimal training. In the case of patients with addictions, more intensive interventions may be needed. Much of the discussion in intensive intervention is similar to that of the brief intervention; however, the intensive sessions tend to be longer (20-30 minute) and can include multiple sessions, a referral to an addiction
specialty program, and the addition of a specific pharmacological therapy. While medical personnel who have received additional training may conduct intensive interventions, behavioral health professionals often conduct these longer counseling sessions
In this section of the app, you will find information for making a referral, considerations for co-occurring mental health disorders, and a treatment locator, as well as information specific to the San Francisco area, where the app was developed
Referral to Treatment
In some cases, a more advanced treatment option is necessary and the patient is referred to a higher level of care. This care is often provided at specialized addiction treatment programs. The referral to treatment process consists of helping patients access specialized treatment, selecting treatment facilities, and facilitating the navigation of any barriers such as cost of treatment or lack of transportation that would hinder them from receiving treatment in a specialty setting.
In December 2016 the Substance Abuse and Mental Health Services Administration announced the selection of the eight participating states: Minnesota, Missouri, Nevada, New Jersey, New York, Oklahoma, Oregon and Pennsylvania.
Source: https://www.thenationalcouncil.org/topics/certified-community-behavioral-health-clinics/
According to the most recent information from SAMHSA, 16 states have approved SBIRT codes in their respective Medicaid plans; of these, five states have activated codes that allow providers to bill and receive payment for the services, four have activated SBIRT codes to allow for reimbursement of non-physician professionals, including Alaska, Tennessee, Colorado, and Virginia and two states —Indiana and Oklahoma —have activated SBIRT codes to allow for reimbursement of physicians only
http://ireta.org/webinar-library/sbirt/
https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/downloads/SBIRT_Factsheet_ICN904084.pdf
https://www.integration.samhsa.gov/clinical-practice/sbirt/financing