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1.
BMC Med Educ ; 24(1): 987, 2024 Sep 10.
Artículo en Inglés | MEDLINE | ID: mdl-39256757

RESUMEN

Large-scale implementation of interprofessional education across the United States Veterans Health Administration has supported advancement of a new model of collaborative practice, the Whole Health System, centering on the patient and what matters most to them. Other health care systems can consider similar educational efforts for health care transformation.


Asunto(s)
Conducta Cooperativa , Educación Interprofesional , United States Department of Veterans Affairs , Estados Unidos , Humanos , Relaciones Interprofesionales , Grupo de Atención al Paciente , Modelos Educacionales
2.
Inquiry ; 61: 469580241255823, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38798065

RESUMEN

Health care price transparency is gaining momentum as a tangible policy intervention that can unleash market principles to increase competition, help begin to decrease U.S. health care expenditures, and provide Americans with access to affordable, high-quality health care. Indeed, pricing reform is required to facilitate patient shopping in health care. In this narrative policy review, we offer a brief history of health care price transparency efforts and an overview of the health care price transparency literature. Further, we highlight the current rules and legislative initiatives aimed at achieving the full potential of health care price transparency. Lastly, we offer key takeaways and highlight suggestions for future policy directions, including the need to ensure hospital and insurance compliance through more appropriate penalties and incentives, importance of reducing regulation to promote financial upside that can be obtained by both patients and providers who actively promote shopping for lower cost, higher quality health care goods and services, and the need for transparent and easily found quality metrics, including outcomes most important to patients, driven by physicians "on the ground" with patient input.


Asunto(s)
Política de Salud , Estados Unidos , Humanos , Gastos en Salud , Calidad de la Atención de Salud , Costos de la Atención en Salud , Reforma de la Atención de Salud/economía , Revelación
3.
Telemed J E Health ; 30(5): 1479-1483, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38197851

RESUMEN

Background: The COVID-19 pandemic has accelerated the adoption of Electronic health (e-Health), leveraging technologies such as telemedicine, electronic health records, artificial intelligence, and patient engagement platforms. This transformation underscores e-Health's role in providing efficient, patient-centered care. Our study explores health care professionals' readiness for these technologies, emphasizing the need for tailored education in this evolving landscape. Methods: In our study, conducted between February and March 2023, we administered a questionnaire-based survey to 500 staff members (82.4% female, 17.6% male) aged 25-70 from medical universities in Tbilisi, Georgia. The structured questionnaire covered topics such as computer literacy, telemedicine awareness, patient data security, and ethical considerations. We employed SPSS v21.0 for data analysis, encompassing descriptive statistics and thematic analysis of open-ended responses. Results: Our study included 500 participants categorized into five age groups. Notably, 31% considered themselves computer "experts," while 69% rated their skills as "intermediate" or "advanced." Furthermore, 85% used computers professionally, with 33% having practical computer training. Interestingly, 59% expressed interest in information technology training. Regarding e-Health, 15% believed it involves remote communication between health care professionals and patients, while 42% considered it "correct," and 37% "might be correct." Concerning its application in managing patients, opinions varied. In terms of e-Health's integration into Georgia's health care, responses ranged. Regarding patient data safety, participants exhibited diverse views. Finally, opinions on the necessity of informed consent for e-Health applications varied among participants. Conclusions: Our study explores health care professionals' readiness for e-Health adoption during the COVID-19 pandemic. It reveals varying computer literacy levels, a willingness to learn, differing views on e-Health applications, and mixed opinions on its integration into Georgian health care. These findings emphasize the need for clear e-Health terminology, education, tailored approaches, and a focus on data privacy and informed consent. Overall, e-Health's transformative role in modern health care is underscored.


Asunto(s)
COVID-19 , Alfabetización Digital , Personal de Salud , SARS-CoV-2 , Telemedicina , Humanos , COVID-19/epidemiología , Masculino , Femenino , Persona de Mediana Edad , Adulto , Anciano , Georgia (República) , Personal de Salud/psicología , Pandemias , Actitud del Personal de Salud , Encuestas y Cuestionarios , Seguridad Computacional , Actitud hacia los Computadores , Registros Electrónicos de Salud
5.
Musculoskeletal Care ; 20(2): 390-395, 2022 06.
Artículo en Inglés | MEDLINE | ID: mdl-34846805

RESUMEN

INTRODUCTION: The COVID-19 pandemic severely impacted musculoskeletal care. To better triage the notable backlog of patients, we assessed whether a digital medical history (DMH), a summary of health information and concerns completed by the patient prior to a clinic visit, could be routinely collected and utilised. METHODS: We analysed 640 patients using a rapid cycle, semi-randomised A/B testing approach. Four rapid cycles of different randomised interventions were conducted across five unique patient groups. Descriptive statistics were used to report DMH completion rates by cycle/patient group and intervention. Multivariable logistic regression was used to determine whether age or anatomic injury location was associated DMH completion. ETHICAL APPROVAL: N/A (Quality Improvement Project) RESULTS: Across all patients, the DMH completion rate was 48% (307/640). Phone calls were time consuming and resource intensive without an increased completion rate. The highest rate of DMH completion was among patients who were referred and called the clinic themselves (78% of patients [63 out of 81 patients]). Across all patients, increasing age (odds ratio [OR]: 0.985 (95% CI: 0.976-0.995), p = 0.002), patients with back concerns (OR: 0.395 (95% CI: 0.234-0.666), p = 0.001), and patients with non-specific/other musculoskeletal concerns (OR: 0.331 (95% CI: 0.176-0.623), p = 0.001) were associated with decreased odds of DMH completion. DISCUSSION AND CONCLUSION: DMHs can be valuable in helping triage orthopaedic patients in resource-strapped settings, times of crisis, or as we transition towards value-based health care delivery. However, further work is needed to continue to increase the completion rate about 50%.


Asunto(s)
COVID-19 , Anamnesis , Ortopedia , Humanos , COVID-19/epidemiología , Pandemias , Mejoramiento de la Calidad , Triaje
6.
Leadersh Health Serv (Bradf Engl) ; ahead-of-print(ahead-of-print)2021 06 25.
Artículo en Inglés | MEDLINE | ID: mdl-34170648

RESUMEN

PURPOSE: The purpose of this study is to explore strategies during transformation to obtain sustainable development and to identify the human-based factors contributing to the transformation. DESIGN/METHODOLOGY/APPROACH: This qualitative study explored the strategies that health-care leaders need to adopt during transformation to achieve the Sustainable Development of the United Nations' agenda by 2030. The study was conducted in early 2020 among ten health-care leaders in the USA. The research design was an exploratory qualitative approach that used a semi-structured, open-ended questionnaire asked of ten US health-care leaders who had experience in leading health-care transformation in their organizations. The study findings identified that health-care leaders can facilitate the achievement of Sustainable Development by establishing strategies in knowledge improvement, innovation development, motivation increment, global strategy and local strategy alignment, leadership support and partnership development. FINDINGS: Six major themes emerged from the data linked to the central research question: "What are the strategies during digital transformation to make progress in the achievement of Sustainable Development by 2030?" The compressed collection of themes for the study included the following six major themes: knowledge development; innovation development; motivation; global strategy establishment; leadership; collaboration enhancement; and two minor themes, namely, mindset change and vision creation. RESEARCH LIMITATIONS/IMPLICATIONS: Due to the few numbers of participants selected for this study (N = 10) may not be generalizable to other settings. The implication of this study is to identify the significant factors contributing to making progress in sustainable development in health-care organizations. The health-care leaders can learn what significant strategies can be helpful to establish future-based organizations toward achieving sustainability. PRACTICAL IMPLICATIONS: The results of this study provided actionable strategies to empower the employees and increase managerial innovation in health-care organizations. SOCIAL IMPLICATIONS: Promoting partnership of health-care organizations with social and global activities such as sustainable development goals that are contributing in 5Ps: People, Prosperity, Peace, Partnership and Planet. ORIGINALITY/VALUE: The main reason for the study was that health-care leaders worldwide could have a novel study that delineates the digital transformation strategies needed for creating impactful outcomes toward achieving sustainable development. Moreover, this unique study provided a useful outlook for health-care leaders to establish future-based health-care organizations while learning the dynamic of digital transformation is the key for health-care organizations to adapt their strategies for a sustainable future.


Asunto(s)
Liderazgo , Desarrollo Sostenible , Atención a la Salud , Humanos , Aprendizaje , Investigación Cualitativa
7.
Telemed J E Health ; 27(9): 964-973, 2021 09.
Artículo en Inglés | MEDLINE | ID: mdl-33124958

RESUMEN

Reading List: Select Healthcare Transformation Library 2.0 represents a broad-based, annotated, general reading list for students of health care innovation. The books were drawn from the 5,000-book private home library of Ronald S. Weinstein, MD, President Emeritus of the American Telemedicine Association. Weinstein is a lifelong book collector with special interests in the history of medical innovation and poetry. A Massachusetts General Hospital-trained pathologist and inductee into the US Distance Learning Association's Hall of Fame, he is known as a pioneer in telemedicine and the "father of telepathology" for his invention, patenting, and commercialization of telepathology, a subspecialty of telemedicine that is a billion-dollar worldwide industry today. This Reading List: Select Healthcare Transformation Library 2.0 consists of 41 books divided into 10 sections: (1) Human Intelligence, Behavior, and Creativity; (2) Societal Revolutions; (3) Innovation; (4) Healthcare System Transformations; (5) Education; (6) Transformational Technologies-Part 1 (AI, Automation, and Robotics); (7) Transformational Technologies-Part 2 (Telemedicine and Telehealth); (8) Digital Medicine; (9) Healthcare Transformation Implementation; and (10) COVID-19 Pandemic as an Innovation Accelerator.


Asunto(s)
COVID-19 , Telemedicina , Atención a la Salud , Humanos , Pandemias , SARS-CoV-2
9.
Clin Transl Allergy ; 9: 44, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31516692

RESUMEN

BACKGROUND: In all societies, the burden and cost of allergic and chronic respiratory diseases are increasing rapidly. Most economies are struggling to deliver modern health care effectively. There is a need to support the transformation of the health care system into integrated care with organizational health literacy. MAIN BODY: As an example for chronic disease care, MASK (Mobile Airways Sentinel NetworK), a new project of the ARIA (Allergic Rhinitis and its Impact on Asthma) initiative, and POLLAR (Impact of Air POLLution on Asthma and Rhinitis, EIT Health), in collaboration with professional and patient organizations in the field of allergy and airway diseases, are proposing real-life ICPs centred around the patient with rhinitis, and using mHealth to monitor environmental exposure. Three aspects of care pathways are being developed: (i) Patient participation, health literacy and self-care through technology-assisted "patient activation", (ii) Implementation of care pathways by pharmacists and (iii) Next-generation guidelines assessing the recommendations of GRADE guidelines in rhinitis and asthma using real-world evidence (RWE) obtained through mobile technology. The EU and global political agendas are of great importance in supporting the digital transformation of health and care, and MASK has been recognized by DG Santé as a Good Practice in the field of digitally-enabled, integrated, person-centred care. CONCLUSION: In 20 years, ARIA has considerably evolved from the first multimorbidity guideline in respiratory diseases to the digital transformation of health and care with a strong political involvement.

10.
J Am Coll Radiol ; 16(4 Pt B): 547-553, 2019 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-30947886

RESUMEN

The US health care system is in the midst of incredible transformation. High-value, high-quality health care is the ultimate goal. Guided by the Institute of Medicine report "Crossing the Quality Chasm," the focus is to deliver care that is safe, efficient, effective, timely, patient centered, and equitable. Equity is the principle that quality of care should not vary based on patient characteristics, such as race or ethnicity. Even with the same insurance and socioeconomic status and when comorbidities, stage of presentation, and other confounders are controlled for, minorities often receive a lower quality of health care than their white counterparts. These racial and ethnic disparities in quality of care contribute to disparities in health outcomes and higher costs. Radiology is not exempt from this issue, as disparities related to imaging services have been reported in the literature. The root causes of racial and ethnic disparities in health care are complex and include the negative impact of the social determinants of health, limited access to care, as well as health system, provider, and patient factors. The field of radiology has a unique opportunity to engage in efforts to improve quality, address disparities, and achieve equity. A call to action is necessary, with a focus on addressing social determinants of health; creating culturally, linguistically, and health literacy-appropriate outreach and services; investing in cross-cultural education; and diversifying the radiology workforce. Ultimately, radiologists can provide equitable access to radiology care and promote person-centered care solutions that are tailored to the needs of diverse populations.


Asunto(s)
Atención a la Salud/organización & administración , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Disparidades en Atención de Salud/etnología , Radiología/economía , Radiología/estadística & datos numéricos , Etnicidad/estadística & datos numéricos , Femenino , Humanos , Masculino , Evaluación de Necesidades , Defensa del Paciente , Grupos Raciales/estadística & datos numéricos , Factores Socioeconómicos , Estados Unidos
11.
J Health Organ Manag ; 31(6): 630-646, 2017 Sep 18.
Artículo en Inglés | MEDLINE | ID: mdl-29034825

RESUMEN

Purpose The Patient-Centered Medical Home (PCMH) has become a dominant model of primary care re-design. This transformation presents a challenge to many care delivery organizations. The purpose of this paper is to describe attributes shaping successful and unsuccessful practice transformation within four medical practice groups. Design/methodology/approach As part of a larger study of 25 practices transitioning into a PCMH, the current study focused on diabetes care and identified high- and low-improvement medical practices in terms of quantitative patient measures of glycosylated hemoglobin and qualitative assessments of practice performance. A subset of the top two high-improvement and bottom two low-improvement practices were identified as comparison groups. Semi-structured interviews were conducted with diverse personnel at these practices to investigate their experiences with practice transformation and data were analyzed using analytic induction. Findings Results show a variety of key attributes facilitating more successful PCMH transformation, such as empanelment, shared goals and regular meetings, and a clear understanding of PCMH transformation purposes, goals, and benefits, providing care/case management services, and facilitating patient reminders. Several barriers also exist to successful transformation, such as low levels of resources to handle financial expense, lack of understanding PCMH transformation purposes, goals, and benefits, inadequate training and management of technology, and low team cohesion. Originality/value Few studies qualitatively compare and contrast high and low performing practices to illuminate the experience of practice transformation. These findings highlight the experience of organizational members and their challenges in practice transformation while providing quality diabetes care.


Asunto(s)
Atención Dirigida al Paciente , Diabetes Mellitus/terapia , Objetivos , Humanos , Innovación Organizacional , Atención Dirigida al Paciente/organización & administración , Atención Dirigida al Paciente/normas , Poder Psicológico , Atención Primaria de Salud/organización & administración , Atención Primaria de Salud/normas , Indicadores de Calidad de la Atención de Salud , Calidad de la Atención de Salud
12.
J Clin Psychol Med Settings ; 24(2): 96-99, 2017 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-28401331

RESUMEN

Psychologists have made important contributions in academic health centers (AHC), but the reputation of psychology as a discipline has been mixed, by turns viewed as a superfluous soft science, or seen as an important contributor to the AHC mission. AHCs currently face exceptional challenges to the viability of AHCs, including: planned alterations from fee-for-service to value-based funding that requires high quality at lower cost; and rising demands to demonstrate competence in trainees. Now more than ever, psychologists can and must help AHCs to meet these challenges.


Asunto(s)
Centros Médicos Académicos , Psicología , Calidad de la Atención de Salud , Humanos , Estados Unidos
13.
J Clin Psychol Med Settings ; 24(2): 86-91, 2017 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-27752977

RESUMEN

The health care system of the United States has been in a period of dramatic transformation since the passage of the Affordable Care Act in 2010, and the rate of change is accelerating. Historically, health care delivery was focused on the efforts of independent individual providers related to single patients, but the future will require interprofessional teamwork to achieve successful transformation. Academic health centers must identify nimble leaders who can harness the expertise of every team member to succeed in yielding the triple aim-better care for individuals, better health for populations, and lower overall cost. To create this change, there are several critical success factors for academic health center leaders, including creating a culture of collaboration, becoming "multipliers," embracing innovation, adhering to core professional ethics, and working to promote resilience. Given their extensive training and predisposition to these skills, psychologists are well-positioned to serve as leaders in today's academic health systems.


Asunto(s)
Centros Médicos Académicos , Reforma de la Atención de Salud/métodos , Liderazgo , Psicología , Humanos , Patient Protection and Affordable Care Act , Estados Unidos
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