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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. -
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 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 . -
Patient Self-Management Support Programs: an Evaluation
Final Contract Report ______________________________________________________________________________ Patient Self-Management Support Programs: An Evaluation Prepared for: Agency for Healthcare Research and Quality U.S. Department of Health and Human Services 540 Gaither Road Rockville, MD 20850 www.ahrq.gov Contract No. 282-00-0005 Prepared by: RAND Health Santa Monica, CA Marjorie L. Pearson, PhD, MSHS Soeren Mattke, MD, DSc Rebecca Shaw, MA M. Susan Ridgely, JD Shelley H. Wiseman, BA AHRQ Publication No. 08-0011 November 2007 This report was prepared by RAND Health under contract to the Agency for Healthcare Research and Quality (AHRQ), Rockville, MD (Contract No. 282-00-0005). The views expressed in this report are those of the authors, who are responsible for its content. No statement in this report should be construed as an official endorsement by the Agency for Healthcare Research and Quality or the U.S. Department of Health and Human Services. This document is in the public domain and may be used and reprinted without permission. AHRQ appreciates citation as to source. The suggested citation format is: Pearson ML, Mattke S, Shaw R, Ridgely MS, Wiseman SH. Patient Self-Management Support Programs: An Evaluation. Final Contract Report (Prepared by RAND Health under Contract No. 282-00-0005). Rockville, MD: Agency for Healthcare Research and Quality; November 2007. AHRQ Publication No. 08-0011. ii Acknowledgments The authors acknowledge and thank the following individuals who participated in interviews for this report. We are grateful -
HEALTH and SELF-CARE: a Look Inside Patient and Physician Perspectives on Self-Care
HEALTH AND SELF-CARE: A Look Inside Patient and Physician Perspectives on Self-care Summer 2019 DrWayneJonas.com HEALTH AND SELF-CARE: A Look Inside Patient and Physician Perspectives on Self-care EXECUTIVE SUMMARY . 3 A LETTER FROM DR . WAYNE JONAS . 5 NATIONAL SURVEY INFOGRAPHIC . 7 WHAT DO THE DATA TELL US ABOUT SELF-CARE? . 9 The Evidence Base for Self-Care .. 9 The Samueli Integrative Health Programs/Harris Poll Survey . 10 DEFINING SELF-CARE . 15 Types of Self-Care . 17 Correcting Patient Misconceptions About Self-Care . 18 HOW CAN INTEGRATIVE HEALTH LEAD TO MORE SELF-CARE? . 19 Self-Care’s Role in Integrative Health . 19 Self-Care and Shared Decision Making . 19 SURVEY METHODOLOGY . 20 REFERENCES . 21 Health and Self-Care: A Look Inside Patient and Physician Perspectives on Self-care 2 EXECUTIVE SUMMARY ix in ten adults in the U .S . have a chronic disease and four in ten adults have two or more, according Sto the latest data from the Centers for Disease Control and Prevention. Conditions such as heart disease, cancer, and diabetes are making more people sick every day and will continue to do so without behavior change and self-care. As rates of chronic disease continue to rise, self-care practices will become increasingly important to the nation’s health. This report – developed by Samueli Integrative Health Programs in concert with The Harris Poll – demonstrates the importance of self-care to patients’ health and well-being, explains how to implement self-care services in the healthcare care setting, and discusses the current trends in both doctors’ and patients’ self-care beliefs and practices. -
Quallty Cholces, NO TRADE-OFFS
QUALITY CHOICES, NO TRADE-OFFS. BLUE PERFORMANCESM ENHANCED (TWIN CITIES FOCUSED) Key providers: Multicare Associates Fairview Lakes Hospital TIER 1* Apple Valley Medical North Clinic Fairview Northland Center Hospital North Memorial Clinics Center for Diagnostic Fairview Ridges Hospital Imaging St. Croix Orthopedic Fairview Southdale Fairview Clinics St. Paul Radiology Hospital Family Health Services Stillwater Medical Group Lakeview Hospital 97% Minnesota Summit Orthopedic Maple Grove Hospital HealthPartners Clinics Twin Cities Orthopedic Covered providers North Memorial Hospital in Minnesota Midwest Radiology who are in Key hospitals: Regions Hospital Minnesota Blue Performance Gastroenterology Amplatz Children’s University of Minnesota Tier 1 or Tier 2 Hospital Medical Center, Fairview Minnesota Oncology Key providers: St. Cloud Hospital Clinic Mercy Hospital TIER 2* Affiliated Community University of Minnesota Methodist Hospital Medical Centers Physicians Sanford Hospitals Allina Medical Clinics Key hospitals: St. Cloud Hospital Aspen Medical Group Abbott Northwestern St. Francis Regional CentraCare Clinics Hospital Medical Center Children’s Clinics Bethesda Hospital St. John’s Hospital Essentia Health Clinics Children’s Hospitals St. Joseph’s Hospital HealthEast Clinics Essentia Health – St. Luke’s Hospital St. Mary’s Hospital Hennepin Faculty United Hospitals Associates Hennepin County Medical Center Unity Hospital Mayo Clinics Mayo Clinic Rochester Woodwinds Hospital Park Nicollet Clinics Methodist Hospital Sanford Clinics Mayo Clinic St. Mary’s Hospital Out of network/ nonparticipating OON *Provider listings are not all-inclusive. For a complete list of providers, visit bluecrossmn.com. BLUE PERFORMANCE REGIONAL (STATEWIDE) Key providers: North Memorial Clinics Fairview Ridges Hospital TIER 1* Allina Medical Clinics Park Nicollet Clinics Fairview Southdale Hospital Apple Valley Medical Sanford Clinics Center Lakeview Hospital St. -
The Role of the Health Professional in Supporting Self Care
Quality in Primary Care 2006;14:129–31 # 2006 Radcliffe Publishing Guest editorial The role of the health professional in supporting self care Ruth Chambers DM FRCGP Professor of Primary Care, Faculty of Health and Sciences, Staffordshire University, Stoke-on-Trent, and Director of Postgraduate General Practice Education, West Midlands Deanery, Birmingham, UK It is widely believed that patients who adopt self care Safety concerns practices, will reduce demand on general practitioners (GPs) and other providers of healthcare as a whole.1 The evidence base that justifies self care is wide- Safety concerns tend not to feature in research reports ranging, but robust evidence of the cost-effectiveness or policies of those advocating or trialling patients’ self of increased self care by patients is awaited, in terms of care;2,5,6 yet there are potential adverse events for most better health outcomes for patients, more appropriate health conditions if medical care is not sought or consultations with the healthcare team, and savings on obtained appropriately.7–10 So, inappropriate self care providing healthcare.1,2 There may be displaced costs. could be costly for the individual person if they suffer For example, more appropriate consultation behav- harm from waiting too long before seeking medical iour by patients with doctors could lead to increased help, or pursue self care with an ineffectual or harmful consultation rates with other primary care professionals treatment. It could rebound on the NHS if the result of such as pharmacists, or with primary -
How Primary Care Produces Better Outcomes: a Logic Model
How Primary Care Produces Better Outcomes: A Logic Model James W. Mold, MD, MPH Department of Family and Preventive Medicine University of Oklahoma Health Sciences Center Oklahoma City, Oklahoma Roger I. Lienke, MD Oklahoma City, Oklahoma Brendan Drew, BS Boulder, Colorado Word Count: Key Words: Primary care, logic model, patient-centered medical home, outcomes, attributes 1 ABSTRACT Context: Greater access to primary care is associated with lower health care costs and better health outcomes. The reasons for this are not entirely clear. In an attempt to clarify the links between primary care and outcomes, we constructed a “logic model” based upon a systematic review of the literature and our clinical experience. Methods: We reviewed all publications from a search of the English language literature from 1966 to the present using the search term, “primary care,” plus potentially relevant references from their bibliographies. We then constructed lists of desired outcomes and intermediate outcomes and summarized the evidence supporting the links between them. The principal attributes of primary care were derived from the Institute of Medicine’s 1996 report.1 To identify and categorize the mechanisms leading from attributes to intermediate outcomes, we relied upon our own clinical experience, the published literature, and from others in the field. Findings: We identified 6 primary attributes (accessibility, coordination, sustained care, comprehensiveness, partnership, and person-centeredness) and two encompassing constructs (integration and accountability) that constitute primary care. Proposed causal links to the 8 desired outcomes pass through 14 mechanisms and 14 intermediate outcomes. Conclusions: We hope this model will stimulate further discussion among policy-makers, researchers, educators, and clinicians working to strengthen primary care, the most logical foundation of the health care system. -
Your Guide to Medicare Preventive Services
Your Guide to Medicare Preventive Services C E N T E R S F O R M E D I C A R E & M E D I C A I D S E R V I C E S This is the official government booklet with important information about: • What disease prevention is and why it’s important • Which preventive services Medicare covers and how often • Who can get services • What you pay – you pay nothing for many services YOUR GUIDE TO MEDICARE PREVENTIVE SERVICES ow’s the time to get the most out of your Medicare. The best way to stay Nhealthy is to live a healthy lifestyle. You can live a healthy lifestyle and prevent disease by exercising, eating well, keeping a healthy weight, and not smoking. Medicare can help. Medicare pays for many preventive services to keep you healthy. Preventive services can find health problems early, when treatment works best, and can keep you from getting certain diseases. Preventive services include exams, shots, lab tests, and screenings. They also include programs for health monitoring, and counseling and education to help you take care of your own health. If you have Medicare Part B (Medical Insurance), you can get a yearly “Wellness” visit and many other covered preventive services. Whether it’s online, in person, or on the phone, Medicare is committed to helping people get the information they need to make smart choices about their Medicare benefits. MyMedicare.gov Register at MyMedicare.gov to get direct access to your preventive health information—24 hours a day, every day. -
Healthpartners
State of Wisconsin Network Listing Hospitals Lakewood Health System Staples, MN St. Michael’s Hospital Sauk Centre, MN Abbott Northwestern Hospital Minneapolis, MN LifeCare Medical Center Roseau, MN Stevens Community Medical Center Morris, MN Aitkin Community Hospital Aitkin, MN Madelia Community Hospital, Inc Madelia, MN Swift County-Benson Hospital Benson, MN Albany Area Hospital Albany, MN Madison Hospital Madison, MN Tri - County Hospital Wadena, MN Amery Regional Medical Center Amery, WI Mahnomen Health Center Mahnomen, MN Tyler Healthcare Center Tyler, MN Appleton Municipal Hospital Appleton, MN Meeker County Hospital Litchfield, MN United Hospital Saint Paul, MN Baldwin Area Medical Center Baldwin, WI Melrose Area Hospital Melrose, MN United Hospital District - Blue Earth Blue Earth, MN Bigfork Valley Hospital Bigfork, MN Mercy Hospital Coon Rapids, MN Unity Hospital Fridley, MN Bridges Medical Services Ada, MN Mercy Hospital & Health Care Center Moose Lake, MN University Medical Center - Mesaba Hibbing, MN Buffalo Hospital Buffalo, MN MeritCare Thief River Falls Northwest Virginia Regional Medical Center Virginia, MN Medical Center Thief River Falls, MN Cambridge Medical Center Cambridge, MN Weiner Memorial Medical Center Marshall, MN Mille Lacs Health System Onamia, MN CentraCare Health Service of Long Prairie Long Prairie, MN Westfields Hospital New Richmond, WI Minnesota Valley Health Center Le Sueur, MN Childrens Hospitals and Clinics Minneapolis, MN Wheaton Community Hospital Wheaton, MN New River Medical Center Monticello, -
Appendix V – Interpretive Guidelines – Responsibilities of Medicare Participating Hospitals in Emergency Cases ______(Rev
State Operations Manual Appendix V – Interpretive Guidelines – Responsibilities of Medicare Participating Hospitals in Emergency Cases _______________________________________________________________________ (Rev. 191, 07-19-19) Transmittals for Appendix V Part I- Investigative Procedures I. General Information II. Principal Focus of Investigation III. Task 1 - Entrance Conference IV. Task 2 - Case Selection Methodology V. Task 3- Record Review VI. Task 4- Interviews VII. Task 5-Exit Conference VIII. Task 6- Professional Medical Review IX. Task 7- Assessment of Compliance and Completion of the Deficiency Report X. Additional Survey Report Documentation ______________________________________________________________________ Part II - Interpretive Guidelines - Responsibilities of Medicare Participating Hospitals in Emergency Cases §489.20 Basic Section 1866 Commitments Relevant to Section 1867 Responsibilities §489.20(l) §489.20(m) §489.20(q) §489.20(r) §489.24(j) Availability of On-Call physicians §489.24 Special Responsibilities of Medicare Hospitals in Emergency Cases §489.24(a) Applicability of Provisions of this Section §489.24(c) Use of Dedicated Emergency Department for Nonemergency Services §489.24(d) Necessary Stabilizing Treatment for Emergency Medical Conditions §489.24(e) Restricting Transfer Until the Individual Is Stabilized §489.24(f) Recipient Hospital Responsibilities ________________________________________________________________________ Part I- Investigative Procedures (Rev. 191, Issued: 07-19-19, Effective: 07-19-19,