Preventive Health Guidelines for Adults
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Patient Care Through Telepharmacy September 2016
Patient Care through Telepharmacy September 2016 Gregory Janes Objectives 1. Describe why telepharmacy started and how it has evolved with technology 2. Explain how telepharmacy is being used to provide better patient care, especially in rural areas 3. Understand the current regulatory environment around the US and what states are doing with regulation Agenda ● Origins of Telepharmacy ● Why now? ● Telepharmacy process ● Regulatory environment ● Future Applications Telepharmacy Prescription verification CounselingPrescription & verification Education History Origins of Telepharmacy 1942 Australia’s Royal Flying Doctor Service 2001 U.S. has first state pass telepharmacy regulation 2003 Canada begins first telepharmacy service 2010 Hong Kong sees first videoconferencing consulting services US Telepharmacy Timeline 2001 North Dakota first state to allow 2001 Community Health Association in Spokane, WA launches program 2002 NDSU study begins 2003 Alaska Native Medical Center program 2006 U.S. Navy begins telepharmacy 2012 New generation begins in Iowa Question #1 What was the first US state to allow Telepharmacy? a) Alaska b) North Dakota c) South Dakota d) Hawaii Question #1 What was the first US state to allow Telepharmacy? a) Alaska b) North Dakota c) South Dakota d) Hawaii NDSU Telepharmacy Study Study from 2002-2008 ● 81 pharmacies ○ 53 retail and 28 hospital ● Rate of dispensing errors <1% ○ Compared to national average of ~2% ● Positive outcomes, mechanisms could be improved Source: The North Dakota Experience: Achieving High-Performance -
Preventive Health Care
PREVENTIVE HEALTH CARE DANA BARTLETT, BSN, MSN, MA, CSPI Dana Bartlett is a professional nurse and author. His clinical experience includes 16 years of ICU and ER experience and over 20 years of as a poison control center information specialist. Dana has published numerous CE and journal articles, written NCLEX material, written textbook chapters, and done editing and reviewing for publishers such as Elsevire, Lippincott, and Thieme. He has written widely on the subject of toxicology and was recently named a contributing editor, toxicology section, for Critical Care Nurse journal. He is currently employed at the Connecticut Poison Control Center and is actively involved in lecturing and mentoring nurses, emergency medical residents and pharmacy students. ABSTRACT Screening is an effective method for detecting and preventing acute and chronic diseases. In the United States healthcare tends to be provided after someone has become unwell and medical attention is sought. Poor health habits play a large part in the pathogenesis and progression of many common, chronic diseases. Conversely, healthy habits are very effective at preventing many diseases. The common causes of chronic disease and prevention are discussed with a primary focus on the role of health professionals to provide preventive healthcare and to educate patients to recognize risk factors and to avoid a chronic disease. nursece4less.com nursece4less.com nursece4less.com nursece4less.com 1 Policy Statement This activity has been planned and implemented in accordance with the policies of NurseCe4Less.com and the continuing nursing education requirements of the American Nurses Credentialing Center's Commission on Accreditation for registered nurses. It is the policy of NurseCe4Less.com to ensure objectivity, transparency, and best practice in clinical education for all continuing nursing education (CNE) activities. -
Primary Screening for Breast Cancer with Conventional Mammography: Clinical Summary
Primary Screening for Breast Cancer With Conventional Mammography: Clinical Summary Population Women aged 40 to 49 y Women aged 50 to 74 y Women aged ≥75 y The decision to start screening should be No recommendation. Recommendation Screen every 2 years. an individual one. Grade: I statement Grade: B Grade: C (insufficient evidence) These recommendations apply to asymptomatic women aged ≥40 y who do not have preexisting breast cancer or a previously diagnosed high-risk breast lesion and who are not at high risk for breast cancer because of a known underlying genetic mutation Risk Assessment (such as a BRCA1 or BRCA2 gene mutation or other familial breast cancer syndrome) or a history of chest radiation at a young age. Increasing age is the most important risk factor for most women. Conventional digital mammography has essentially replaced film mammography as the primary method for breast cancer screening Screening Tests in the United States. Conventional digital screening mammography has about the same diagnostic accuracy as film overall, although digital screening seems to have comparatively higher sensitivity but the same or lower specificity in women age <50 y. For women who are at average risk for breast cancer, most of the benefit of mammography results from biennial screening during Starting and ages 50 to 74 y. While screening mammography in women aged 40 to 49 y may reduce the risk for breast cancer death, the Stopping Ages number of deaths averted is smaller than that in older women and the number of false-positive results and unnecessary biopsies is larger. The balance of benefits and harms is likely to improve as women move from their early to late 40s. -
How Many Physicians Do You Need?
How Many Physicians Do You Need? Dear Reader: I hope you enjoy the following excerpt from the HealthLeaders Media book, The Hospital Executive’s Guide to Physician Staffing Complete with proven staffing models and current data on physician supply and demand, this book helps answer a ORDER question that healthcare analysts and policymakers have YOUR COPY debated for nearly 30 years: How many physicians do we need? ONLINE! This insightful, data-rich, and timely resource outlines proven approaches for determining physician need for a broad range of markets and specialties. The book also offers sound strategies for building productive relationships with physicians by creating a culture that embraces high-quality physicians and gives them a significant role in shared decision-making. Choose one of the following ways to order you copy today » Online: At HealthLeaders Media—www.healthleadersmedia.com/books » By phone: Call our customer service department at 800/753-0131 » By fax: Complete the order form on the last page and fax to 800/639-8511 Thank you, Matthew G. Cann Group Publisher HealthLeaders Media A division of HCPro, Inc P.O. Box 1168 | Marblehead, MA 01945 | 800/753-0131 | www.healthleadersmedia.com C HAPTER 4 How Many Physicians Make a Health System? As noted at the beginning of Chapter 3, determining community physician need is an important task for hospitals and health systems, especially those seeking to enhance clinical programs or dealing with current or anticipated physician shortages. However, there are many aspects of medical staff plan- ning and development that are outside the scope of a community need analy- sis or require more detailed investigation. -
Understanding the Randomized Controlled Trials By
Breast Cancer Screening: Understanding the Randomized Controlled Trials By: Phoebe Freer, MD, Linda Moy, MD, FSBI, Wendy DeMartini, MD, FSBI, and the Screening Leadership Group Screening mammography has been shown to decrease breast cancer mortality across multiple trials, and across many different study designs. Despite this, some opponents continue to question the value of mammography. Thus, it is increasingly important that breast imaging care providers understand the nature and results of the randomized controlled trials (RCTs), which have definitively demonstrated that screening mammography in women 40-74 years of age decreases deaths from breast cancer. Cancer localized in the breast is not what causes death; it is breast cancer spread (metastasis) to other organs that causes mortality. The goal of mammographic screening (and other breast cancer screening tests) is to detect breast cancer earlier than it would otherwise manifest clinically, when it is less likely to have spread. Data clearly show that detection of breast cancers at smaller sizes and lower stages is associated with better patient outcomes from lower morbidity and reduced breast cancer deaths. RCTs are the gold standard for proving that early detection with mammography decreases mortality from breast cancer. It is important to understand that the key evidence measure is the breast cancer death rate observed in the experimental group (women invited to have screening mammography) compared to that in the control group (women not invited to have screening mammography). It is not sufficient to use survival time (the time of discovery of the cancer to the date of death) between the groups, as this may reflect “lead-time” bias, in which a cancer is found earlier so survival time appears longer, but the date of death is not altered. -
Evidence Synthesis Number 197 Screening for Hypertension in Adults
Evidence Synthesis Number 197 Screening for Hypertension in Adults: A Systematic Evidence Review for the U.S. Preventive Services Task Force Prepared for: Agency for Healthcare Research and Quality U.S. Department of Health and Human Services 5600 Fishers Lane Rockville, MD 20857 www.ahrq.gov Contract No. HHSA-290-2015-000017-I-EPC5, Task Order No. 5 Prepared by: Kaiser Permanente Research Affiliates Evidence-based Practice Center Kaiser Permanente Center for Health Research Portland, OR Investigators: Janelle M. Guirguis-Blake, MD Corinne V. Evans, MPP Elizabeth M. Webber, MS Erin L. Coppola, MPH Leslie A. Perdue, MPH Meghan Soulsby Weyrich, MPH AHRQ Publication No. 20-05265-EF-1 June 2020 This report is based on research conducted by the Kaiser Permanente Research Affiliates Evidence-based Practice Center (EPC) under contract to the Agency for Healthcare Research and Quality (AHRQ), Rockville, MD (Contract No. HHSA-290-2015-000017-I-EPC5, Task Order No. 5). The findings and conclusions in this document are those of the authors, and do not necessarily represent the views of AHRQ. Therefore, no statement in this report should be construed as an official position of AHRQ or of the U.S. Department of Health and Human Services. The information in this report is intended to help health care decision makers—patients and clinicians, health system leaders, and policymakers, among others—make well-informed decisions and thereby improve the quality of health care services. This report is not intended to be a substitute for the application of clinical judgment. Anyone who makes decisions concerning the provision of clinical care should consider this report in the same way as any medical reference and in conjunction with all other pertinent information (i.e., in the context of available resources and circumstances presented by individual patients). -
Oklahoma Primary Care Health Care Workforce Gap Analysis
Oklahoma Primary Care Health Care Workforce Gap Analysis DRAFT Prepared by OSU Center for Rural Health OSU Center for Health Sciences Tulsa, Oklahoma June 2015 Table of Contents Table of Figures ..................................................................................................................................................... ii Tables........................................................................................................................................................................ iii Introduction ............................................................................................................................................................ 1 Background & Data Acquisition ...................................................................................................................... 2 Methodology ........................................................................................................................................................... 2 Primary Care Provider Supply ......................................................................................................................... 3 Primary Care Provider Demand ................................................................................................................... 10 Conclusions .......................................................................................................................................................... 12 Limitations ........................................................................................................................................................... -
Primary Care Network Listing | Healthpartners
DHS-6594C-ENG HealthPartners® Minnesota Senior Health Options (MSHO) (HMO SNP) Network April 2018 – September 2018 PRIMARY CARE NETWORK LISTING Minnesota Counties: Anoka, Benton, Carver, Chisago, Dakota, Hennepin, Ramsey, Scott, Sherburne, Stearns, Washington, Wright HealthPartners 8170 33rd Ave S. P.O. Box 1309 Minneapolis, MN 55440-1309 Member Services: 952-967-7029 or 1-888-820-4285 (TTY/TDD 711) Oct. 1 – Feb. 14 8 a.m. to 8 p.m. CT, seven days a week Feb. 15 – Sept. 30 8 a.m. to 8 p.m. CT, Monday – Friday healthpartners.com/msho HealthPartners is a health plan that contracts with both Medicare and the Minnesota Medical Assistance (Medicaid) program to provide benefits of both programs to enrollees. Enrollment in HealthPartners depends on contract renewal. HealthPartners MSHO Plan 16697_Print April 2018 H2422 108677 DHS Approved 1/25/2018 1-888-820-4285 Attention. If you need free help interpreting this document, call the above number. ያስተውሉ፡ ካለምንም ክፍያ ይህንን ዶኩመንት የሚተረጉምሎ አስተርጓሚ ከፈለጉ ከላይ ወደተጻፈው የስልክ ቁጥር ይደውሉ። مﻻحظة: إذا أردت مساعدة مجانية لترجمة هذه الوثيقة، اتصل على الرقم أعﻻه. သတိ။ ဤစာရြက္စာတမ္းအားအခမဲ့ဘာသာျပန္ေပးျခင္း အကူအညီလုုိအပ္ပါက၊ အထက္ပါဖုုန္းနံပါတ္ကုုိေခၚဆုုိပါ။ kMNt’sMKal’ . ebIG~k¨tUvkarCMnYyk~¬gkarbkE¨bäksarenHeday²tKit«f sUmehATUrs&BÍtamelxxagelI . 請注意,如果您需要免費協助傳譯這份文件,請撥打上面的電話號碼。 Attention. Si vous avez besoin d’une aide gratuite pour interpréter le présent document, veuillez appeler au numéro ci-dessus. Thov ua twb zoo nyeem. Yog hais tias koj xav tau kev pab txhais lus rau tsab ntaub ntawv no pub dawb, ces hu rau tus najnpawb xov tooj saum toj no. -
Enhancing Health Care Through Telehealth
Enhancing Health Care through Telehealth Telehealth is making a difference UnityPoint Health is using telehealth to provide greater access to high-quality care while driving down overall health care costs. ENHANCED ACCESS TO CARE Telehealth keeps patients and families connected to vital health care services. Over the last seven months, UnityPoint Health has: • Seen an increase in telehealth visits of more than 1,700%. • Grown the number specialties offering telehealth from 15 to 51. • Equipped more than 1,800 clinicians to provide telehealth services. Visits Specialties Clinicians 250,000 60 2000 1860 210,841 51 50 200,000 1500 40 150,000 30 1000 100,000 20 15 500 50,000 11,336 10 78 - 0 0 Pre During Pre During Pre During Pre = Aug 2019 - Jan 2020 During = Feb - Jul 2020 EXPANDING THE USE OF TELEHEALTH UnityPoint Health is making telehealth available in homes, workplaces, clinics, hospitals, emergency rooms, nursing facilities and much more. Direct to patient virtual care services, both on-demand and scheduled • Urgent care visits • Follow up visits with a primary care physician • Behavioral health visits • More than 50 other types of specialist visits Provider to provider telehealth services • Inpatient hospital support • Intensive care unit support • Emergency room support EMPHASIS ON PATIENT-CENTERED CARE A Patient's Perspective When it came time for his annual wellness visit, Scott Frank considered cancelling due to his busy schedule. He then learned he could have his visit virtually. Soon after scheduling his appointment, he was disking a field when he stopped his tractor to talk with his primary care provider. -
Update: Virginia Physician Workforce Shortage
UPDATE: VIRGINIA PHYSICIAN WORKFORCE SHORTAGE Joint Commission on Health Care September 17, 2013 Stephen W. Bowman Senior Staff Attorney/Methodologist 2 House Joint Resolution 687 (Del. Purkey) 1. Determine whether a shortage of medical doctors exists in the Commonwealth, by specialty and by geographical region 2. Project the future need for medical doctors in Virginia over the next 10 years by field of specialty 3. Identify and assess factors that contribute to the shortage of medical doctors 4. Identify the medical specialty fields primarily affected by the shortage of doctors 5. Recommend ways to alleviate shortages 1 3 Agenda • Physician Supply, Shortages, and Maldistribution • Medical School Graduates, Residencies, and Geriatric Training • Recent Impacts and State Policies • Policy Options 4 PHYSICIAN SUPPLY, SHORTAGES, AND MALDISTRIBUTION 2 5 Virginia Has Over 16,000 Practicing Physicians and 48% Are Primary Care Providers Specialty Number Percentage Family Medicine 2782 17% General Internal Medicine 2008 12% Pediatric 1744 11% Radiology 1255 8% Obstetrics and Gynecology 1236 8% Psychiatry 1209 7% Other* 6151 38% Total Physicians 16,385 100% *See Appendix for additional breakout of physician specialty counts Primary care specialties are highlighted Source: Virginia Health Chart Book at http://www.vahealthchartbook.org/ and email correspondence with GeoHealth Innovations. 6 46% of Physicians that Manage Patient Load Primary Work Practices Are “Far from Full” Primary Work Location (n= 11,621) 5% Secondary Work Location (n=2,602) 5% Practice is far from full 46% Practice is almost full 36% 49% Practice is full 59% Note: Number and percentage are weighted estimates of physicians that manage patient load from Department of Health Professions Physician Survey Source: Virginia Department of Health Professions, Healthcare Workforce Data Center, Virginia’s Physician Workforce: 2012, July 2013. -
PRIMARY CARE SECTOR OVERVIEW June 2016
PRIMARY CARE SECTOR OVERVIEW June 2016 Investment banking services are provided by Harris Williams LLC, a registered broker-dealer and member of FINRA and SIPC, and Harris Williams & Co. Ltd, which is and regulated by the Financial Conduct Authority. Harris Williams & Co. is a trade name under which Harris Williams LLC and Harris Williams & Co. Ltd conduct business. TABLE OF CONTENTS I PRIMARY CARE SECTOR OVERVIEW II APPENDIX: SELECT MARKET PARTICIPANTS PRIMARY CARE SECTOR OVERVIEW The delivery and coordination of primary care is taking on renewed and increasing importance as the system’s gatekeeper in the evolving U.S. healthcare landscape. Primary care accounts for nearly $250 billion of annual industry revenue and over 55% of total office-based physician visits1,2 . However, the systematic under-investment of this integral component of the healthcare system has created a number of well publicized challenges, including: • Insufficient supply of new primary care physicians from medical school • Lower compensation vis-à-vis other specialties • Demands of an aging population outstripping system resources • Under-supply of primary care to rural areas . As the initial contact point for patients, the primary care system will increasingly function as the gatekeeper for care coordination and patient referrals for public and private payors and for healthcare systems . Therefore primary care now fills a critical role in the transition from fee-for-service (“FFS”) to value-based care . To meet these challenges new, innovative primary care practice models have emerged to address care coordination, access and quality of care, and cost, including the following four models highlighted in this report: • Medicare Advantage/Managed Medicaid • Employer Sponsored Health Clinics • Retail Clinics • Concierge Clinics . -
(APC- APM) for Delivering Patient-Centered, Longitudinal, and Coordinated Care
Advanced Primary Care: A Foundational Alternative Payment Model (APC-APM) for Delivering Patient-Centered, Longitudinal, and Coordinated Care A Proposal to the Physician-Focused Payment Model Technical Advisory Committee From the American Academy of Family Physicians April 14, 2017 AAFP Contact: Kent Moore Senior Strategist for Physician Payment American Academy of Family Physicians 11400 Tomahawk Creek Parkway Leawood, KS 66211 Phone: 800-274-2237, extension 4170 Email: [email protected] April 14, 2017 Physician-Focused Payment Model Technical Advisory Committee c/o Assistant Secretary of Planning and Evaluation Office of Health Policy U.S. Department of Health and Human Services 200 Independence Avenue S.W. Washington, DC 20201 Proposal – Advanced Primary Care: A Foundational Alternative Payment Model (APC- APM) for Delivering Patient-Centered, Longitudinal, and Coordinated Care Dear PTAC Committee Members: The American Academy of Family Physicians (AAFP) is fully supportive of the Physician- Focused Payment Model Technical Advisory Committee’s (PTAC) role in evaluating physician-focused payment models (PFPMs) and making subsequent recommendations about those models to the U.S. Department of Health and Human Services (HHS). The AAFP believes that to be truly successful in improving care and reducing cost, PFPMs and alternative payment models (APMs) need a strong foundation of primary care. Therefore, on behalf of the AAFP, which represents 124,900 family physicians and medical students, I am particularly pleased to submit the following proposal—Advanced Primary Care: A Foundational Alternative Payment Model (APC-APM) for Delivering Patient-Centered, Longitudinal, and Coordinated Care. We request that the PTAC review the model, provide feedback to the AAFP on it, and promptly recommend it to HHS for approval and nationwide expansion.