After you read this medical tourism does not seem to be a bad option
Nurse admits stealing body parts of dead - Yahoo! News: "Nurse admits stealing body parts of dead By MARYCLAIRE DALE, Associated Press Writer
Wed Jan 30, 10:18 PM ET
PHILADELPHIA - A nurse admitted Wednesday he cut body parts from 244 corpses and helped forge paperwork so the parts, some of them diseased, could be used in unsuspecting patients.
ADVERTISEMENT
Authorities say nurse Lee Cruceta was the lead cutter in a group that trafficked in more than 1,000 stolen body parts for the lucrative transplant market."
Thursday, January 31, 2008
Monday, January 28, 2008
Friday, January 18, 2008
Health & Fitness - Basic Exercises - ArcaMax Publishing
Health & Fitness - Basic Exercises - ArcaMax Publishing: "Basic Exercises:
Here are some exercises that target specific areas of the body that can help you organize your workouts. These exercises can add variety to you workout and eliminate the potential for burnout that comes with consistent exercise as well as help both the serious and casual exercisers who are looking to tone their bodies."
Here are some exercises that target specific areas of the body that can help you organize your workouts. These exercises can add variety to you workout and eliminate the potential for burnout that comes with consistent exercise as well as help both the serious and casual exercisers who are looking to tone their bodies."
Holidays - Making Resolutions Stick - ArcaMax Publishing
Holidays - Making Resolutions Stick - ArcaMax Publishing: "Making Resolutions Stick
Dawn-Elise Snipes
Every year I watch at the gym as it floods in January, then slows to a trickle by March. Why is it that we seem unable to make behavior change goals that last? Well, there are several reasons.
Failing to consider why you currently do (or do not) engage in certain behaviors."
Dawn-Elise Snipes
Every year I watch at the gym as it floods in January, then slows to a trickle by March. Why is it that we seem unable to make behavior change goals that last? Well, there are several reasons.
Failing to consider why you currently do (or do not) engage in certain behaviors."
Holidays - Questions to Ask Yourself for Your Best Year Ever in 2008 - ArcaMax Publishing
Holidays - Questions to Ask Yourself for Your Best Year Ever in 2008 - ArcaMax Publishing: "Questions to Ask Yourself for Your Best Year Ever in 2008
Art Sobczak
Early Happy New Year!
Today's issue is a New Year's tradition. It's usually one of our most popular issues of the year, and most-visited in the archives.
If you're serious about having your best year ever in 2008, TODAY is the best time to start. I do suggest you take some time to sit down with these questions Think about your answers. Challenge yourself. Write them down. Them go to work!
It's quite simple: if you want to be better in 2008, YOU need to do more than simply WANT it. You need to make some changes. Start now.
What are you going to do to improve your industry and product knowledge in 2008?"
Art Sobczak
Early Happy New Year!
Today's issue is a New Year's tradition. It's usually one of our most popular issues of the year, and most-visited in the archives.
If you're serious about having your best year ever in 2008, TODAY is the best time to start. I do suggest you take some time to sit down with these questions Think about your answers. Challenge yourself. Write them down. Them go to work!
It's quite simple: if you want to be better in 2008, YOU need to do more than simply WANT it. You need to make some changes. Start now.
What are you going to do to improve your industry and product knowledge in 2008?"
YOU Staying Young Center -- Brain Foods
YOU Staying Young Center -- Brain Foods: "Brain Foods
Generally, what’s harmful to your heart is also harmful to your brain. Make no mistake about it -- while fried potato skins"
Generally, what’s harmful to your heart is also harmful to your brain. Make no mistake about it -- while fried potato skins"
Thursday, January 17, 2008
how much does your love and caring caring cost? Doing right can be expensive- This useful article makes this point -Qj
The Costs For Family Caregivers Continues to Rise
Doing the right thing is an expensive proposition
By Mike Magee, MD
In the United States nearly a quarter of our multi-generational families have a family member working in a job that they never trained for, never asked for, and have never been paid for. That job is the informal family caregiver.1 It is estimated that there are 34 million Americans providing care for older family members and friends.2 They are drawn in primarily by a sense of responsibility and pressing need. For activities of daily living, which we often take for granted, like feeding, bathing, and toileting, success requires mobility, strength, balance and normal mental capacities. But the truth is that as we age, many of us lose the ability to care for ourselves. And as we do, family members step in to fill the gap. But they do so at great cost to themselves.How much cost? Well, if we are just looking at the dollars, on average, in a recent study of 1,000 informal family caregivers, the annual cost was $5,500 dollars. And if you were caring for a family member from afar, let’s say from another state or distant community, the average cost was $8,728 dollars per year. Where did the money go? It splits up almost evenly into four pieces: direct medical expenses; household items, including food; extra help and travel; and home repairs and basic day-to-day equipment. More specifically, 42 percent of respondents in this study had paid for household goods or food in the past year; 39 percent had funded transportation; 31 percent had covered the co-payment costs of an elder’s drugs or medical payments; 21 percent had purchased clothing and 13 percent had paid for home improvements.3Where does the money come from? Half of the family caregivers cut back on hobbies, leisure activities and vacations. One third dipped into savings and deferred major purchases for themselves. And a quarter cut back on their own groceries and seeing their doctors to cover the costs. Not surprising then, informal family caregivers, isolated in this complex world, overwhelmed and lacking system support and financial aid, often become sick themselves as they struggle to do the right thing.3
The Costs For Family Caregivers Continues to Rise
Doing the right thing is an expensive proposition
By Mike Magee, MD
In the United States nearly a quarter of our multi-generational families have a family member working in a job that they never trained for, never asked for, and have never been paid for. That job is the informal family caregiver.1 It is estimated that there are 34 million Americans providing care for older family members and friends.2 They are drawn in primarily by a sense of responsibility and pressing need. For activities of daily living, which we often take for granted, like feeding, bathing, and toileting, success requires mobility, strength, balance and normal mental capacities. But the truth is that as we age, many of us lose the ability to care for ourselves. And as we do, family members step in to fill the gap. But they do so at great cost to themselves.How much cost? Well, if we are just looking at the dollars, on average, in a recent study of 1,000 informal family caregivers, the annual cost was $5,500 dollars. And if you were caring for a family member from afar, let’s say from another state or distant community, the average cost was $8,728 dollars per year. Where did the money go? It splits up almost evenly into four pieces: direct medical expenses; household items, including food; extra help and travel; and home repairs and basic day-to-day equipment. More specifically, 42 percent of respondents in this study had paid for household goods or food in the past year; 39 percent had funded transportation; 31 percent had covered the co-payment costs of an elder’s drugs or medical payments; 21 percent had purchased clothing and 13 percent had paid for home improvements.3Where does the money come from? Half of the family caregivers cut back on hobbies, leisure activities and vacations. One third dipped into savings and deferred major purchases for themselves. And a quarter cut back on their own groceries and seeing their doctors to cover the costs. Not surprising then, informal family caregivers, isolated in this complex world, overwhelmed and lacking system support and financial aid, often become sick themselves as they struggle to do the right thing.3
Probiotic Drink Helps Prevent Diarrhea from Antibiotics
Probiotic Drink Helps Prevent Diarrhea from Antibiotics
A persistent and alarming problem among elderly hospital patients is diarrhea -- which is sometimes even life-threatening. A frequent cause, ironically, is the antibiotic used to address either the original illness or an infection that develops during the hospital stay, to which elderly patients are even more vulnerable than others. It is a frustrating situation for everyone involved.
A recent study conducted at Imperial College in London investigated probiotic drinks as a way to help resolve the problem, in much the same way some non-hospital patients eat yogurt when on antibiotics. (Note: This should be high-quality yogurt with live cultures.) The study randomized 135 hospitalized elderly patients on antibiotics into two groups. Twice a day during the course of treatment and for one week after finishing the antibiotics, one group was given a dairy drink containing three types of probiotics -- Lactobacillus casei, L. bulgaricus and Streptococcus thermophilus -- while the other had a dairy drink with no probiotics. The probiotic drink used in the study was Actimel, sold in US supermarkets as DanActive from Danone, which partially funded the study.
The result: Risk of diarrhea relating to antibiotics was reduced by 21.6%.
WHICH PROBIOTIC FOR WHOM?
Probiotic use appears to be a no-brainer, but the picture is more complicated than it may seem. Lead author Mary Hickson, PhD, RD, a research dietician and honorary senior lecturer of investigative science at the Imperial College in London, told me the issue of using probiotics as standard hospital protocol is still open. The reason is, dose and timing cannot be as carefully controlled in a hospital setting as in a highly monitored research study. Probiotics may actually turn out to be even more useful than this research indicates, since some high-risk patients had to be excluded. Also, since the treatment did not prevent all diarrhea, it may be that different patients respond to probiotic bacteria differently. In other words, what is effective in certain situations for some individuals does not work all the time. Indeed, another strain of bacteria might work even better at preventing antibiotic-caused diarrhea than the ones in the drink used, and only further research will reveal the answer.
In this study there were no adverse events for patients, which has been true of previous published trials using probiotics -- though some questions remain relative to people with weak immune systems. In a very few cases, probiotic bacteria may have caused an infection in such patients, says Dr. Hickson, though it remains inconclusive. According to the National Center for Complementary and Alternative Medicine (NCCAM), the safety of probiotics has not been thoroughly studied so research should continue, especially in the elderly, children and anyone with a compromised immune system.
Next steps for the medical community? Dr. Hickson says that another study is now in order to see if using probiotics as a standard measure for post-antibiotic treatment causes diarrhea rates to fall in a broader hospital population. Next step for individuals? Based on years of work with probiotics, Daily Health News contributing editor Andrew L. Rubman, ND, points out that since each of us is unique, results may vary. While probiotic products will probably not be harmful, the same solution won't work for everyone. Consider working with a physician knowledgeable in this area.
Source(s): Mary Hickson, PhD, RD, honorary senior lecturer of investigative science at the Imperial College in London.
A persistent and alarming problem among elderly hospital patients is diarrhea -- which is sometimes even life-threatening. A frequent cause, ironically, is the antibiotic used to address either the original illness or an infection that develops during the hospital stay, to which elderly patients are even more vulnerable than others. It is a frustrating situation for everyone involved.
A recent study conducted at Imperial College in London investigated probiotic drinks as a way to help resolve the problem, in much the same way some non-hospital patients eat yogurt when on antibiotics. (Note: This should be high-quality yogurt with live cultures.) The study randomized 135 hospitalized elderly patients on antibiotics into two groups. Twice a day during the course of treatment and for one week after finishing the antibiotics, one group was given a dairy drink containing three types of probiotics -- Lactobacillus casei, L. bulgaricus and Streptococcus thermophilus -- while the other had a dairy drink with no probiotics. The probiotic drink used in the study was Actimel, sold in US supermarkets as DanActive from Danone, which partially funded the study.
The result: Risk of diarrhea relating to antibiotics was reduced by 21.6%.
WHICH PROBIOTIC FOR WHOM?
Probiotic use appears to be a no-brainer, but the picture is more complicated than it may seem. Lead author Mary Hickson, PhD, RD, a research dietician and honorary senior lecturer of investigative science at the Imperial College in London, told me the issue of using probiotics as standard hospital protocol is still open. The reason is, dose and timing cannot be as carefully controlled in a hospital setting as in a highly monitored research study. Probiotics may actually turn out to be even more useful than this research indicates, since some high-risk patients had to be excluded. Also, since the treatment did not prevent all diarrhea, it may be that different patients respond to probiotic bacteria differently. In other words, what is effective in certain situations for some individuals does not work all the time. Indeed, another strain of bacteria might work even better at preventing antibiotic-caused diarrhea than the ones in the drink used, and only further research will reveal the answer.
In this study there were no adverse events for patients, which has been true of previous published trials using probiotics -- though some questions remain relative to people with weak immune systems. In a very few cases, probiotic bacteria may have caused an infection in such patients, says Dr. Hickson, though it remains inconclusive. According to the National Center for Complementary and Alternative Medicine (NCCAM), the safety of probiotics has not been thoroughly studied so research should continue, especially in the elderly, children and anyone with a compromised immune system.
Next steps for the medical community? Dr. Hickson says that another study is now in order to see if using probiotics as a standard measure for post-antibiotic treatment causes diarrhea rates to fall in a broader hospital population. Next step for individuals? Based on years of work with probiotics, Daily Health News contributing editor Andrew L. Rubman, ND, points out that since each of us is unique, results may vary. While probiotic products will probably not be harmful, the same solution won't work for everyone. Consider working with a physician knowledgeable in this area.
Source(s): Mary Hickson, PhD, RD, honorary senior lecturer of investigative science at the Imperial College in London.
medical tourism tips and overview
If you are dying or need something to be better or healthy now -be proactive , knowledgeable and check the alternatives and the risks- Your knowledge is your power qj
Dangers of Overseas Surgery
You may have heard about medical tourism, as it is a concept that has recently taken flight in the media. Hundreds of thousands of Americans now travel overseas for medical procedures each year, which sounds exotic -- but may not provide such a great outcome. Health experts urge extreme caution to those considering medical travel.
For insight into the medical tourism trend, I contacted Ann Marie Kimball, MD, a professor of epidemiology and health services at the University of Washington School of Public Health in Seattle and author of Risky Trade: Infectious Disease in the Era of Global Trade (Ashgate). She told me there are several reasons behind the growth of medical tourism, including the fact that surgery often costs far less overseas. Other factors may include privacy (for elective cosmetic surgeries, for example) and accessibility to operations, such as transplants, that are harder to get or not available at all in the US.
TRIP OF A LIFETIME?
Patients fly to exotic destinations such as India for coronary bypass surgery, heart valve replacement and cancer therapy... Thailand for knee and hip replacement surgery and eye surgery... and Costa Rica, South Africa or Malaysia for plastic surgery, usually because it is far less expensive. Procedures people can have overseas but that are not available in the United States include stem-cell-infusion therapy for myocardial ischemia (end-stage heart disease) in Thailand and, believe it or not, pancreatic transplants from pigs in India.
Specialized medical tourism companies help travelers find the overseas doctors and facilities for the procedures they are seeking, and often assign "case managers" to serve as patient liaisons. These tourism companies advertise directly to consumers over the Internet and through promotional campaigns that tout state-of-the-art medical care at bargain prices. Public Citizen, a national, nonprofit consumer advocacy organization, warns that the reason alternative treatments may not be offered in the US is because of our more stringent safety or efficacy standards.
So just how much money are medical tourists saving? It's hard to know for sure, as most information on cost savings is supplied by organizations with a vested interest. However, according to some reports, costs can be as little as one-tenth or less of what such procedures cost in the United States. For instance, heart-valve replacement surgery that may cost $160,000 or more here could be as little as $10,000 in India. A knee replacement in Thailand costs about 75% of the price here. A facelift that would cost $20,000 can be had for $1,250 in South Africa. Some packages may also include travel and vacation expenses.
YOUR MONEY OR YOUR LIFE
Cheap, yes, but many health experts in our country call medical tourism a risky venture. The United States Department of Health and Human Services' Centers for Disease Control and Prevention (CDC) warns that the quality of health care in overseas facilities may not be on par with what is available in the United States, and that foreign facilities are not always subject to the same health standards and regulations. Few overseas health facilities are accredited by the Joint Commission International (JCI), an organization that accredits overseas hospitals according to quality and safety standards similar to those in the United States. Additionally, surgery abroad can put patients at risk of infection or other complications when they return home. In fact, the CDC has received several reports of nontuberculous mycobacterial infections after people received elective cosmetic surgery abroad. There are also concerns about the quality of post-operative care and, of course, medical errors. Such problems can happen in the US too, of course -- but the fact that your local physician may be unfamiliar with your case may pose additional challenges.
Dr. Kimball concurs. "My priority is from the point of view of infectious disease and infection control," she said. "People are the best vectors for disease. When you go to a hospital overseas, you run the risk of bringing new microbial agents into the United States. The problem is that your own health care provider may not be aware of them or how to treat them."
Dr. Kimball voiced special concerns about organ transplant surgery and most specifically from animal sources, such as those pancreatic transplants from pigs mentioned above. There's a frightening risk with xenotransplant (the transfer of organs or tissue from animals to humans), she told me. "We fear that transmission of infectious agents or a retrovirus could emerge. It's a theoretical but scientific possibility."
IF YOU ARE STILL INTERESTED...
Unfortunately, there is little reliable data regarding the efficacy, safety and outcomes of overseas health care. This is because most information about the safety of medical tourism has been generated by the medical tourism industry. "Medical tourism businesses are much more similar to travel businesses than to medical businesses," said Dr. Kimball. "It's not in their interest to do surveillance or track outcomes."
If you are considering having a procedure done overseas, keep the following in mind:
Involve your US doctor with all medical travel decisions. Don't view this as a travel decision, warns Dr. Kimball: "It's an important medical decision to be made only with professional advice." Your doctor at home should be in communication with your foreign doctor and should also be aware of any potential complications that may arise, and how to deal with them.
Get a second opinion at home before you travel. "Be really sure of the procedure that you need, because once you get to a far-away destination, it's hard to get a second opinion," said Dr. Kimball. "For instance, if your own doctor or cardiologist says you need a stent placed in your coronary artery, and you decide to go overseas for this, the doctors there may look at your films and suggest that you need bypass surgery instead. At that point you won't have the chance to go back and say, 'wait a minute' because you've just spent thousands of dollars traveling, and you can't get a second opinion. This is why communication with your own doctor about what you need is very, very key."
Find the best surgeon and hospital for your procedure. Research the surgeon's education, training, credentials and experience with your particular procedure. Learn as much as you can about where the surgery will be performed, and whether or not the facility is JCI-accredited, which means it meets quality and safety standards. (A list of accredited international health-care facilities is available at jointcommissioninternational.org.)
Determine whether or not your health insurance will cover the procedure and any complications. "Most insurance companies have non-portability, meaning medical insurance doesn't work outside of the country," said Dr. Kimball. "If you are considering medical travel, you may want to check whether or not your insurance company is not only covering the service, but would cover complications that arise."
Understand everything about your procedure, and what may happen after it -- before you leave home. Remember, there may be a language barrier between you and those who know the answers to questions that arise, so be sure to know everything about your procedure before you leave home. Learn about the benefits and the risks involved, whether or not travel is compatible with your procedure, what to expect during recovery time, what kind of follow-up care you may need during your recovery, and what would happen if there were any complications.
It is understandable that at times, desperate situations call for desperate measures -- and so there are terminally ill individuals who will try anything in their effort to regain health. Be careful and do your homework. As for those procedures of convenience or bargain hunting, let the buyer beware.
Source(s): Ann Marie Kimball, MD, a professor of epidemiology and health services at the University of Washington School of Public Health and Community Medicine in Seattle and author of Risky Trade: Infectious Disease in the Era of Global Trade (Ashgate).
Dangers of Overseas Surgery
You may have heard about medical tourism, as it is a concept that has recently taken flight in the media. Hundreds of thousands of Americans now travel overseas for medical procedures each year, which sounds exotic -- but may not provide such a great outcome. Health experts urge extreme caution to those considering medical travel.
For insight into the medical tourism trend, I contacted Ann Marie Kimball, MD, a professor of epidemiology and health services at the University of Washington School of Public Health in Seattle and author of Risky Trade: Infectious Disease in the Era of Global Trade (Ashgate). She told me there are several reasons behind the growth of medical tourism, including the fact that surgery often costs far less overseas. Other factors may include privacy (for elective cosmetic surgeries, for example) and accessibility to operations, such as transplants, that are harder to get or not available at all in the US.
TRIP OF A LIFETIME?
Patients fly to exotic destinations such as India for coronary bypass surgery, heart valve replacement and cancer therapy... Thailand for knee and hip replacement surgery and eye surgery... and Costa Rica, South Africa or Malaysia for plastic surgery, usually because it is far less expensive. Procedures people can have overseas but that are not available in the United States include stem-cell-infusion therapy for myocardial ischemia (end-stage heart disease) in Thailand and, believe it or not, pancreatic transplants from pigs in India.
Specialized medical tourism companies help travelers find the overseas doctors and facilities for the procedures they are seeking, and often assign "case managers" to serve as patient liaisons. These tourism companies advertise directly to consumers over the Internet and through promotional campaigns that tout state-of-the-art medical care at bargain prices. Public Citizen, a national, nonprofit consumer advocacy organization, warns that the reason alternative treatments may not be offered in the US is because of our more stringent safety or efficacy standards.
So just how much money are medical tourists saving? It's hard to know for sure, as most information on cost savings is supplied by organizations with a vested interest. However, according to some reports, costs can be as little as one-tenth or less of what such procedures cost in the United States. For instance, heart-valve replacement surgery that may cost $160,000 or more here could be as little as $10,000 in India. A knee replacement in Thailand costs about 75% of the price here. A facelift that would cost $20,000 can be had for $1,250 in South Africa. Some packages may also include travel and vacation expenses.
YOUR MONEY OR YOUR LIFE
Cheap, yes, but many health experts in our country call medical tourism a risky venture. The United States Department of Health and Human Services' Centers for Disease Control and Prevention (CDC) warns that the quality of health care in overseas facilities may not be on par with what is available in the United States, and that foreign facilities are not always subject to the same health standards and regulations. Few overseas health facilities are accredited by the Joint Commission International (JCI), an organization that accredits overseas hospitals according to quality and safety standards similar to those in the United States. Additionally, surgery abroad can put patients at risk of infection or other complications when they return home. In fact, the CDC has received several reports of nontuberculous mycobacterial infections after people received elective cosmetic surgery abroad. There are also concerns about the quality of post-operative care and, of course, medical errors. Such problems can happen in the US too, of course -- but the fact that your local physician may be unfamiliar with your case may pose additional challenges.
Dr. Kimball concurs. "My priority is from the point of view of infectious disease and infection control," she said. "People are the best vectors for disease. When you go to a hospital overseas, you run the risk of bringing new microbial agents into the United States. The problem is that your own health care provider may not be aware of them or how to treat them."
Dr. Kimball voiced special concerns about organ transplant surgery and most specifically from animal sources, such as those pancreatic transplants from pigs mentioned above. There's a frightening risk with xenotransplant (the transfer of organs or tissue from animals to humans), she told me. "We fear that transmission of infectious agents or a retrovirus could emerge. It's a theoretical but scientific possibility."
IF YOU ARE STILL INTERESTED...
Unfortunately, there is little reliable data regarding the efficacy, safety and outcomes of overseas health care. This is because most information about the safety of medical tourism has been generated by the medical tourism industry. "Medical tourism businesses are much more similar to travel businesses than to medical businesses," said Dr. Kimball. "It's not in their interest to do surveillance or track outcomes."
If you are considering having a procedure done overseas, keep the following in mind:
Involve your US doctor with all medical travel decisions. Don't view this as a travel decision, warns Dr. Kimball: "It's an important medical decision to be made only with professional advice." Your doctor at home should be in communication with your foreign doctor and should also be aware of any potential complications that may arise, and how to deal with them.
Get a second opinion at home before you travel. "Be really sure of the procedure that you need, because once you get to a far-away destination, it's hard to get a second opinion," said Dr. Kimball. "For instance, if your own doctor or cardiologist says you need a stent placed in your coronary artery, and you decide to go overseas for this, the doctors there may look at your films and suggest that you need bypass surgery instead. At that point you won't have the chance to go back and say, 'wait a minute' because you've just spent thousands of dollars traveling, and you can't get a second opinion. This is why communication with your own doctor about what you need is very, very key."
Find the best surgeon and hospital for your procedure. Research the surgeon's education, training, credentials and experience with your particular procedure. Learn as much as you can about where the surgery will be performed, and whether or not the facility is JCI-accredited, which means it meets quality and safety standards. (A list of accredited international health-care facilities is available at jointcommissioninternational.org.)
Determine whether or not your health insurance will cover the procedure and any complications. "Most insurance companies have non-portability, meaning medical insurance doesn't work outside of the country," said Dr. Kimball. "If you are considering medical travel, you may want to check whether or not your insurance company is not only covering the service, but would cover complications that arise."
Understand everything about your procedure, and what may happen after it -- before you leave home. Remember, there may be a language barrier between you and those who know the answers to questions that arise, so be sure to know everything about your procedure before you leave home. Learn about the benefits and the risks involved, whether or not travel is compatible with your procedure, what to expect during recovery time, what kind of follow-up care you may need during your recovery, and what would happen if there were any complications.
It is understandable that at times, desperate situations call for desperate measures -- and so there are terminally ill individuals who will try anything in their effort to regain health. Be careful and do your homework. As for those procedures of convenience or bargain hunting, let the buyer beware.
Source(s): Ann Marie Kimball, MD, a professor of epidemiology and health services at the University of Washington School of Public Health and Community Medicine in Seattle and author of Risky Trade: Infectious Disease in the Era of Global Trade (Ashgate).
Thursday, January 10, 2008
Experts cite must-haves for effective rehab - CNN.com
Experts cite must-haves for effective rehab - CNN.com: "Experts cite must-haves for effective rehab"
google and medical records breakthroughs
They are your medical records
In fact, by 2005 it had become quite clear to many leaders in the field that “the record” properly resided with the patient from whom health data emerged, and that the data that flowed through the hands of hospitals, doctors and nurses was only a part of the overall picture. Thus the concept of a “personal health record” is gradually subsuming the vision of an electronic medical record.3,4,5,6
This is a good development. The personal health record combines data, knowledge and software tools, which help patients become participants in their health care. But if we are truly to anticipate where health care trends are taking us, even this is not enough.
It is now clear that in a truly preventive system, “health” is not a collection of late-stage, reactive interventions. That kind of thinking will soon be a relic of the past.8
Rather, health should be defined as a life fully lived – hopeful, productive, fulfilling, rewarding and manageable. The determinants of such a life begin before birth, embedded in the healthful behaviors of ones’ future parents, and they extend beyond death to ones’ survivors.
Considering this broader view of health, the right concept for our health record system should be a Lifespan Planning Record -- or LPR.7
In fact, by 2005 it had become quite clear to many leaders in the field that “the record” properly resided with the patient from whom health data emerged, and that the data that flowed through the hands of hospitals, doctors and nurses was only a part of the overall picture. Thus the concept of a “personal health record” is gradually subsuming the vision of an electronic medical record.3,4,5,6
This is a good development. The personal health record combines data, knowledge and software tools, which help patients become participants in their health care. But if we are truly to anticipate where health care trends are taking us, even this is not enough.
It is now clear that in a truly preventive system, “health” is not a collection of late-stage, reactive interventions. That kind of thinking will soon be a relic of the past.8
Rather, health should be defined as a life fully lived – hopeful, productive, fulfilling, rewarding and manageable. The determinants of such a life begin before birth, embedded in the healthful behaviors of ones’ future parents, and they extend beyond death to ones’ survivors.
Considering this broader view of health, the right concept for our health record system should be a Lifespan Planning Record -- or LPR.7
Thursday, January 03, 2008
Cures for Our Ailing Health-Care System | Newsweek Health for Life | Newsweek.com
Cures for Our Ailing Health-Care System Newsweek Health for Life Newsweek.com: "Cures for an Ailing System
With health care emerging as a major issue in the 2008 presidential race, NEWSWEEK asked seven Harvard experts to identify specific problems that ought to be addressed, and the steps that should be taken to solve them"
With health care emerging as a major issue in the 2008 presidential race, NEWSWEEK asked seven Harvard experts to identify specific problems that ought to be addressed, and the steps that should be taken to solve them"
Grey solutions for the aging of America
this is an insight artile on what are the solutions to the greying of America. qj
Home Centered Health: Part 1
What will it take to create the ideal healthy home?
(Note: This article is from the Health Politics archives)
By Mike Magee, MD
Some 40 years ago, I recall visiting General Electrics’ “Carousel of Progress” at the World’s Fair in New York. The attraction, now housed at Disney World in Florida, documented the changes in the technology and social structure of the American home over five or six decades, ultimately creating a vision of the future, a case for progress. I think the time has come to build something similar for health care. This “Carousel of Progress” would provide a vision of the past, present and future for something far more important than refrigerators and toasters – our nation’s health. At the core of this carousel would be a vision that’s just within our reach – something that will change health care as we now know it. I’m talking about the concept of home-centered health, in which technology, advanced information systems and a new, more team-oriented medical approach would make it possible for more health care to take place in the home than we ever imagined possible. A key role in this scenario is a home health manager to link the patient with the physician. In fact, the home health manager will certainly help make home-centered health a reality in the coming years.
What are some of the issues that designers of this “Carousel of Progress” will need to consider as they try to capture our health care movement from 1960 to 1980 to 2000 to 2020?
Home Centered Health: Part 1
What will it take to create the ideal healthy home?
(Note: This article is from the Health Politics archives)
By Mike Magee, MD
Some 40 years ago, I recall visiting General Electrics’ “Carousel of Progress” at the World’s Fair in New York. The attraction, now housed at Disney World in Florida, documented the changes in the technology and social structure of the American home over five or six decades, ultimately creating a vision of the future, a case for progress. I think the time has come to build something similar for health care. This “Carousel of Progress” would provide a vision of the past, present and future for something far more important than refrigerators and toasters – our nation’s health. At the core of this carousel would be a vision that’s just within our reach – something that will change health care as we now know it. I’m talking about the concept of home-centered health, in which technology, advanced information systems and a new, more team-oriented medical approach would make it possible for more health care to take place in the home than we ever imagined possible. A key role in this scenario is a home health manager to link the patient with the physician. In fact, the home health manager will certainly help make home-centered health a reality in the coming years.
What are some of the issues that designers of this “Carousel of Progress” will need to consider as they try to capture our health care movement from 1960 to 1980 to 2000 to 2020?
First is aging. Fifty percent of current 60 year olds have a parent alive, and by 2050 there will be more than 1 million Americans over age 100. This means that the four- and five-generation family, not the three-generation family, will be the norm. 1
Second is health consumerism. In the past 25 years, we have moved from paternalistic health care doctor says/patient does – to partnership models. Educational empowerment and direct consumer engagement are increasingly the rule. As patients are placed at clinical and financial risk for their decisions, physicians are restructuring to create both clinical and educational teams, with patients themselves as team members. 2
Third is the Internet, a critical technologic advance that has ended the age of information segregation. The general public is rapidly absorbing the scientific lexicon, a basic knowledge of organ function, and regularly updated theories regarding causes, diagnoses, and treatments of diseases. Patients are pursuing their own research, double-checking facts, and connecting with other patients with similar conditions. Those few physicians who have created nurse-led virtual education teams have found rapid enrollment of their patients, seeking knowledge, guidance, emotional support, and encouragement. 3
Fourth, the caregiver revolution. One quarter of American households have elder caregivers in place. Eighty-five percent of these caregivers are family members -- the vast majority being third-generation women. To manage these roles, the caregivers are rapidly growing in the understanding of the seven major chronic diseases; the mechanics of Medicare and Medicaid reimbursement; basic health law; and the hiring and management of additional help if they can afford it. These caregivers are also learning how to stretch and prioritize resources; define and personalize quality of life; and avoid unnecessary doctors’ office visits and hospitalization. As third-generation home health managers gain knowledge and confidence caring for fourth- and fifth-generation family members, they are slowly realizing that the strategies and tactics mastered could apply equally well downstream to the benefit of themselves and the younger generations below. 4
Fifth is the shifting health care value proposition. Americans are attempting to move from reactive intervention to proactive prevention, and this changes the playing field for everyone – hospitals, doctors’ offices, health insurers, and pharmaceutical and medical device companies alike. It implies healthy behaviors, early diagnosis, regular screenings, knowing your numbers, effective long-term treatments with excellent adherence, and a personalized, information- and relationship-rich support system that is equitable and just. It suggests that to be valued in our future health care system, each player, in addition to his or her traditional unique contributions, will also need to be engaged in educational and behavioral modification to claim insider status. 5,6,7
With these in mind, the health care “Carousel of Progress” has been created. Now, we’re circling counter-clockwise and the last set appears. Ten realities have been skillfully integrated into this calm and well-organized vision of a healthy home:
A home health manager, previously the informal family caregiver, has been designated for each extended family.
Health insurance covers nearly all Americans, and a medical information highway has been constructed primarily around the patient, with caregivers integrated in, rather than the other way around.
The majority of prevention, behavioral modification, monitoring and treatment of chronic diseases now takes place at home.
Physician-led, nurse-directed virtual health networks of home health managers provide a community-based, 24/7, educational and emotional support team.
Health care insurance premiums for families have just gone down due to expert performance of the home health manager, as reflected in outcome measures of family members.
Basic diagnostics, including blood work, imaging, vital signs, and therapeutics are performed by the home health manager and transmitted electronically to the physician-led, nurse-directed educational network, which provides feedback, coaching, and treatment options as necessary.
Sophisticated behavioral modification tools, age adjusted for each generation, are present and utilized, funded in part by diagnostic and therapeutic companies who have benefited from expansion of insurance coverage and health markets as early diagnosis and prevention has taken hold.
Physician office capacity has grown, as most care does not require a visit. Physician reimbursement has increased in acknowledgement of their roles in managing clinical and educational teams and multigenerational complexity. Nursing school enrollment is up as the critical role as educational director of home health manager networks has become a major magnet for the profession.
Family nutrition is carefully planned and executed; activity levels of all five generations are up; weight is down; cognition is up; mental and physical wellbeing are also up.
Hospitals continue to right size – they’re more specialized and safer, with better outcomes. And scientific advances have allowed early diagnosis and more effective treatment, making the need for hospitalization increasingly rare.
Is this all a far-fetched scenario? Not really. Many of these elements are well within the reach of an integrated and progressive vision for tomorrow’s health.
References
1. Alliance for Aging Research. Medical Never-Never Land: Ten Reasons Why America is Not Ready for the Coming Age Boom. 2002.
2. Magee M. The Best Medicine
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