IOM: One Third of Healthcare Dollars Wasted .


Roughly one third of the money spent on U.S. healthcare in 2009 — about $750 billion — didn’t improve patients‘ health, according to an Institute of Medicine report released Thursday.

The report, Best Care at Lower Cost: The Path to Continuously Learning Health Care in America, outlined six categories of waste — unnecessary services, inefficient delivery of care, unnecessary administrative costs, inflated prices, missed opportunities for prevention, and fraud.

Among the group’s recommendations to help improve care while reducing cost:

  • Decision-support tools and knowledge management systems at point of care should be an integral part of the healthcare system.
  • Clinicians should use digital systems to capture patient care experiences.
  • Patients and caregivers should be encouraged to partner with clinicians in making healthcare decisions.
  • Clinicians should partner with community-based organizations and public health agencies to coordinate interventions to improve health, including use of Web-based tools.
  • The payment system should be reformed to reward quality care.

Source:Institute of Medicine

Can Doctors Predict the Future?


There are lots of myths and misconceptions surrounding personalized healthcare. Over the next few weeks, I am going to address some of these beliefs to help you better understand the truths about this exciting field.

Myth: Personalized healthcare is a “crystal ball” into my future health

Using personalized healthcare tools such as family history, doctors can predict the likelihood that you will develop a particular disease or whether a medication will be more or less effective for you. Personalized healthcare can direct your care, but it cannot predict the future with certainty.

Doctorscan look at your family health history for patterns of disease. They can use that information to assess your risk of developing diseases. If you are more likely to develop a disease, doctors can advise you about ways to slow the disease process or prevent it altogether. However, they can’t say for certain, “You will develop this disease.”

The same holds true for predicting how you will respond to medication — pharmacogenetics — although sometimes there is a more definite yes or no answer. It varies from drug to drug, and genetic testing for drugs can focus on safety, efficacy in dosing, or both.

For example, before doctors can prescribe abacavir, a drug used to treat human immunodeficiency virus (HIV) infections, patients are strongly recommended to have a specific genetic test done. This genetic test can tell if they are likely to have a hypersensitivity reaction (allergic reaction) to the drug. Because such reactions can be so severe, including death, it is important to know who can safely take abacavir.

Genetic testing for other drugs may have a different focus: efficacy. For example, clopidogrel is used to prevent blood clots in the body, and a genetic test can help determine if a patient will metabolize the drug quickly or slowly. People who metabolize the drug slowly may require a higher dose for the medication to work as intended. If these “poor metabolizers” are not identified before starting treatment with clopidogrel, they may receive too low a dose, leading to the formation of blood clots.

As you can see, personalized healthcare is not a crystal ball, but rather more like eyeglasses — it can’t predict the future, but it can help you see it more clearly!

Source: Heath Club

Diabetes management enhanced through successful home health care.


According to Karen A. McKnight, RD, LD, CDE, and Mary Teipen, RN, CDE, from the Indiana HomeCare Network, home health care is an effective and cost-effective option for patients with diabetes.

Using their personal experiences as home health providers, McKnight and Teipen shared insight on their home health care company, and made suggestions on how others can successfully handle the sometimes challenging feat of managing diabetes and other chronic illnesses in a home care setting.

“We all know that patients do better in their home setting, it’s a lot safer for them, there’s less risk for infection and it’s more cost-effective,” Teipen said during a presentation.

While the benefits seem obvious, Teipen said many patients and physicians aren’t even aware this form of health care is available.

“A lot of our elder Americans don’t take advantage of their home health benefit in Medicare because medical providers don’t refer them. Providers are so confused about that terminology – being ‘homebound,’” Teipen said. “Homebound doesn’t mean that you’re bedridden or that you can never leave your home. It basically means that they (patients) need assistance to leave the home, or when they do leave the home it’s a very taxing effort.”

McKnight said that one of the biggest challenges of home care is not getting patients interested in the opportunity, but reimbursement. Since 2006, McKnight said, home health reimbursement has declined by 8.5%.

“It seems each year Medicare cuts the amount that they’re paying home health, little by little. Some agencies are seeing as much as a 10% decrease, and some are seeing less, depending on certain factors. The National Association for Hospice and Home Care has estimated that this year 53% of the nation’s home care agencies will be operating at break-even or at a loss. It’s a huge issue and a big concern for those of us in this room who work in home care, in terms of what the future holds there,” McKnight said.

When coupled with deductibles and copayments that are beyond the aging patient’s budget, the impact is greater, she said.

McKnight said other issues have plagued the home health arena, despite its benefit. She and Teipen’s home health company has managed to pull through this complex area of disease management by focusing on four main specialties, one of which is diabetes due to its current trend.

“Our diabetes program is customized to meet the specialty needs of home health patients and it is very self-management education-focused for the patient and for the caregiver. In addition to that patient and caregiver focus, we have been advancing in developing the staff training component,” McKnight said.

All of their clinical staff is trained in basic diabetes patient care, Certified Diabetes Educators (CDEs) attend case conferences to discuss ever-changing complex needs of patients, and the RNs and CDEs visit the most challenging patients to develop a team approach.

Looking to the future, McKnight and Teipen said they will utilize technology at the highest level; with tele-health monitoring, video conferencing, web-based resources, physician portals, transitional care through electronic medical records and telephone patient follow-up time.

Their advice to physicians, nurses and other diabetes educators is to “just get started,” and make staff education a priority from orientation to ongoing training. Additionally, they said each home health company needs a champion with leadership and support to influence the process. Communication is the key, they said. – By Samantha Costa

Disclosure: Ms. McKnight and Teipen report no relevant financial disclosures.

For more information:

McKnight KA, Teipen M. #W20. Presented at: The American Association of Diabetes Educators 2012 Annual Meeting & Exhibition. August 1-4; Indianapolis, IN.

Perspective

  • I got into diabetes education through home care. My goal was to provide home care services to the homebound; it’s always been my first love. I really do agree with what they said – people get better when they’re in their own environment. That’s when you’re going to find out what they really have in their cupboards. Do they have the Rice Krispies or the whole wheat cereal, and so on?

With the new health care reform, I think that home care is going to become an entity that needs to be incorporated because it is cost-effective. Monies are going to have to be spent to facilitate the transition from acute care to home care, and yet still have some sort of follow-up.

So, ACOs or whatever we’re going to call them, medical homes, it’s all going to have to be related. They’re going to have to include the home care perspective. Patients appreciate it. I think the expertise that the nurses are going to have to develop is only going to increase. The diabetes field is just exploding with new products and new technologies.

    • Anne Cannon, BSN, RN, CDE
    • Senior Medical Liaison for Novo Nordisk

 

  • Source: Endocrine Today.

Diabetes management enhanced through successful home health care.


According to Karen A. McKnight, RD, LD, CDE, and Mary Teipen, RN, CDE, from the Indiana HomeCare Network, home health care is an effective and cost-effective option for patients with diabetes.

Using their personal experiences as home health providers, McKnight and Teipen shared insight on their home health care company, and made suggestions on how others can successfully handle the sometimes challenging feat of managing diabetes and other chronic illnesses in a home care setting.

“We all know that patients do better in their home setting, it’s a lot safer for them, there’s less risk for infection and it’s more cost-effective,” Teipen said during a presentation.

While the benefits seem obvious, Teipen said many patients and physicians aren’t even aware this form of health care is available.

“A lot of our elder Americans don’t take advantage of their home health benefit in Medicare because medical providers don’t refer them. Providers are so confused about that terminology – being ‘homebound,’” Teipen said. “Homebound doesn’t mean that you’re bedridden or that you can never leave your home. It basically means that they (patients) need assistance to leave the home, or when they do leave the home it’s a very taxing effort.”

McKnight said that one of the biggest challenges of home care is not getting patients interested in the opportunity, but reimbursement. Since 2006, McKnight said, home health reimbursement has declined by 8.5%.

“It seems each year Medicare cuts the amount that they’re paying home health, little by little. Some agencies are seeing as much as a 10% decrease, and some are seeing less, depending on certain factors. The National Association for Hospice and Home Care has estimated that this year 53% of the nation’s home care agencies will be operating at break-even or at a loss. It’s a huge issue and a big concern for those of us in this room who work in home care, in terms of what the future holds there,” McKnight said.

When coupled with deductibles and copayments that are beyond the aging patient’s budget, the impact is greater, she said.

McKnight said other issues have plagued the home health arena, despite its benefit. She and Teipen’s home health company has managed to pull through this complex area of disease management by focusing on four main specialties, one of which is diabetes due to its current trend.

“Our diabetes program is customized to meet the specialty needs of home health patients and it is very self-management education-focused for the patient and for the caregiver. In addition to that patient and caregiver focus, we have been advancing in developing the staff training component,” McKnight said.

All of their clinical staff is trained in basic diabetes patient care, Certified Diabetes Educators (CDEs) attend case conferences to discuss ever-changing complex needs of patients, and the RNs and CDEs visit the most challenging patients to develop a team approach.

Looking to the future, McKnight and Teipen said they will utilize technology at the highest level; with tele-health monitoring, video conferencing, web-based resources, physician portals, transitional care through electronic medical records and telephone patient follow-up time.

Their advice to physicians, nurses and other diabetes educators is to “just get started,” and make staff education a priority from orientation to ongoing training. Additionally, they said each home health company needs a champion with leadership and support to influence the process. Communication is the key, they said. – By Samantha Costa

Disclosure: Ms. McKnight and Teipen report no relevant financial disclosures.

For more information:

McKnight KA, Teipen M. #W20. Presented at: The American Association of Diabetes Educators 2012 Annual Meeting & Exhibition. August 1-4; Indianapolis, IN.

Perspective

  • I got into diabetes education through home care. My goal was to provide home care services to the homebound; it’s always been my first love. I really do agree with what they said – people get better when they’re in their own environment. That’s when you’re going to find out what they really have in their cupboards. Do they have the Rice Krispies or the whole wheat cereal, and so on?

With the new health care reform, I think that home care is going to become an entity that needs to be incorporated because it is cost-effective. Monies are going to have to be spent to facilitate the transition from acute care to home care, and yet still have some sort of follow-up.

So, ACOs or whatever we’re going to call them, medical homes, it’s all going to have to be related. They’re going to have to include the home care perspective. Patients appreciate it. I think the expertise that the nurses are going to have to develop is only going to increase. The diabetes field is just exploding with new products and new technologies.

    • Anne Cannon, BSN, RN, CDE
    • Senior Medical Liaison for Novo Nordisk

 

  • Source: Endocrine Today.

 

Pocket sized ultrasound.


Vscan is a new, innovative pocket sized ultrasound which allows obstetricians a “quick look” to provide helpful information during office visits or in labor and delivery.

Advanced visualization capabilities for an improved workflow

Vscan is optimized for high-quality abdominal, urological, cardiac, obstetric and pediatric imaging—helping you provide more efficient patient care with fewer referrals.

In-your-pocket portability for imaging at the point of care

Small and lightweight, Vscan can travel with you—from patient to patient—within your primary, critical, or specialty care clinical environment.

Ease of use

With a one-hand user interface, Vscan is intuitive to use—allowing for straightforward implementation into your patient care routine.

Functionality that fits your needs
Ample battery capacity means you can count on Vscan for patient scans throughout your busy day—a single charge provides up to one hour of continuous scanning.

watch the video:

Source: GE