health care – Surround Health http://surroundhealth.net/ Tue, 15 Mar 2022 14:12:57 +0000 en-US hourly 1 https://wordpress.org/?v=5.9.3 https://surroundhealth.net/wp-content/uploads/2021/10/icon-68-120x120.png health care – Surround Health http://surroundhealth.net/ 32 32 How Maastricht UMC+ is moving towards population health management https://surroundhealth.net/how-maastricht-umc-is-moving-towards-population-health-management/ Tue, 15 Mar 2022 14:12:57 +0000 https://surroundhealth.net/how-maastricht-umc-is-moving-towards-population-health-management/ HBI+Insights offers / News Max Hotopf March 15, 2022 Population health management is the new mantra of many health systems. Maastricht UMC+ in the Netherlands has been doing this for years, building a stronger primary healthcare network called Primary 1.5. We chat with Helen Mertens, CEO of UMC+. By launching prevention programs, ensuring that the […]]]>

HBI+Insights offers / News

Max Hotopf
March 15, 2022

Population health management is the new mantra of many health systems. Maastricht UMC+ in the Netherlands has been doing this for years, building a stronger primary healthcare network called Primary 1.5. We chat with Helen Mertens, CEO of UMC+.

By launching prevention programs, ensuring that the chronically ill are less likely to visit the emergency room, UMC can also invest more in tertiary health care. And he has the results to prove that the new models work.

Helen Mertens would like to take stock of the inhabitants of Maastricht and its province of Limburg. “Especially in the south of the province, people have the worst health compared to the rest of the country, the shortest life expectancy and the highest incidence of chronic diseases in the country. Worse still, young people are leaving for the big coastal cities like Amsterdam, Rotterdam and Utrecht, leaving a rapidly aging population that will only get sicker.

Thus, for 15 years Maastricht UMC+, the university hospital and its twin research institute have focused on this topic. The objective is to achieve a 30% improvement in the life expectancy of the lowest decile within five years.

Primary 1.5

More than a decade ago, Maastricht came up with the idea of ​​strengthening primary care to ensure that far fewer patients end up in emergency departments, occupying hospital beds and attending outpatient clinics.

This covers a number of strategies: specialist doctors see patients alongside family doctors in the so-called “Stadspoli” (City Outpatient), the introduction of apps to monitor chronic diseases and enable patients and their families to take better care of themselves.

At its core is the idea that specialist physicians from the University Hospital will visit primary care practices and see patients alongside their primary care physicians. Mertens says “most departments” do this today.

And the results are impressive. “It allows us to educate primary care physicians so they can do more. It also means that patients enjoy greater continuity and can remain under the care of their family doctor. And most importantly, it meant fewer retention interventions.

Mertens says initially there was resistance. “The doctors said it was more convenient for them if the patient came to them. And that also meant that we received less money as a hospital, because there would be fewer patients. But, on the other hand, there is a financial advantage for individual Dutch patients, because they have to pay an initial fee (“own fee”) when they go to the hospital, which they don’t have to pay the family doctor. In addition, waiting times are often shorter at the general practitioner.

1.5 also saw Maastricht roll out apps to give patients more control over their condition. For example, patients with irritable bowel syndrome have an app that monitors their health. “We used to see every IBS patient every three months. The app means we can eliminate that and only see the patient at the right time. Using the app reduced hospital admissions and outpatient visits A Lancet article showed this reduction in admissions Nieky

A month ago, Dutch legal insurers also approved the use of telemonitoring for patients with arrhythmia. And the Dutch Care Authority has recognized this form of e-health.

Maastricht has also done more to empower patients and their loved ones to take care of themselves, reduce hospital stays and pressure on home care organisations. For example, they are shown how to handle dressings and injections and how to apply eye drops.

All of this led to some interesting results. One study showed a major reduction in healthcare costs per patient and shorter waiting lists, as well as an increase in patient satisfaction without adverse effects on health outcomes.

Use data

Mertens says Maastricht have a big advantage. “We don’t have another general hospital in our city, so we are the only university hospital in the Netherlands that takes care of all secondary and tertiary care.” This means that Maastricht can capture a total data set.

But that doesn’t mean there aren’t data silos. Mertens says each hospital district has so far been allowed to choose its own patient record system. And primary health care records are kept separately.

Maastricht, however, is working hard on how best to share clinical data, both with primary care networks and with other providers by connecting data pools.

Maastricht has also developed what it calls a FAIR (Findable, Accessible, Interoperable and Reusable) federated learning and data sharing infrastructure that does not require data to leave the hospital – called Personal Health Train (www.personal healthtrain.nl). This has reduced many of the ethical and other barriers to sharing health data. Users can then ask questions such as “Which data elements are the most predictive of lung cancer survival given all the data in the Netherlands?” or more specifically ‘Which data stations contain data about me?’

Prevention

For Mertens, the key word is prevention. “We need to do a lot more across the spectrum, from educating patients following early diagnosis about diet and exercise to more general smoking and alcohol cessation programs.” It is an area that Maastricht already knows well, thanks to a cohort study of 10,000 Maastricht citizens, which is still being followed up a decade later. “We’re also developing lifestyle interventions with, say, diabetes where we can see and measure the impact of, say, giving patients a smartwatch.” Maastricht also launched a unique healthy breakfast program at school which assessed the health and educational level of children in care.

Here, she says the ministry has also asked UMCs to take a lead role in setting up the regional health networks. “In our region, we have set up a knowledge and innovation agenda. Together with partners in our network (other hospitals, local governments, insurers and industry), we looked at the future challenges of population health management and how we should address them. »

What about the future?

To what extent is what Maastricht does shared across the Netherlands?

She says the Department of Health is taking a keen interest in it, as are insurers. But, ultimately, whether Maastricht’s best practices are shared depends on other university hospital groups in the Netherlands.

Mertens is optimistic: “Our goal is to assess what we are doing and share it with the rest of the country and the world. We work closely with the other six UMCs in the Netherlands and we all adopt and share. For example, other hospitals are deploying our IBS app and we have adopted a home pregnant monitoring system from Utrecht UMC. »

But ask Mertens about the cost savings and she sighs. “Our biggest problem is the very large number of patients who come to see us. The truth is that bed occupancy has not gone down. Yes, we can keep the chronic disease cohort in better conditions and with fewer hospital visits, but the beds are now occupied by other patients. Due to demographics, I can see a lot of additional demand in the next decade. We will therefore continue to invest in prevention and promote a healthy lifestyle and, on the other hand, add smart innovations and medical technologies to improve our healthcare while keeping an eye on profitability.

We would like your opinion on this story. Email your views to Max Hotopf or call 0207 183 3779.



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Can the “fantasy equation” of population health be solved? Should it be? https://surroundhealth.net/can-the-fantasy-equation-of-population-health-be-solved-should-it-be/ Thu, 03 Mar 2022 12:48:09 +0000 https://surroundhealth.net/can-the-fantasy-equation-of-population-health-be-solved-should-it-be/ Let’s start at the end – the last sentence of “Understanding Population Health Terminology”, an article published by one of us, Kindig, in 2007: “The overarching question of population health is what is the optimal balance of investments (e.g., dollars, time, policies) in the multiple determinants of health (e.g., behavior, environment, socioeconomic status , medical […]]]>

Let’s start at the end – the last sentence of “Understanding Population Health Terminology”, an article published by one of us, Kindig, in 2007: “The overarching question of population health is what is the optimal balance of investments (e.g., dollars, time, policies) in the multiple determinants of health (e.g., behavior, environment, socioeconomic status , medical care) across the lifespan that will maximize overall health outcomes and minimize population-level health inequities? This is an important challenge that will require decades of academic attention. and decision makers.

This idea stems from the 1990 Evans-Stoddart population field model it has been the intellectual foundation of our field for decades. This paper and its final figure, Exhibit 1, show the evolution from the medical model presented in the health care and disease boxes on the right to the broader model with expanded concepts of outcomes and the addition of multiple determinants of health.

Exhibit 1: A field model of population health

Source: Evans RG, Stoddart GL. Produce health, consume health care. In: Why are some people healthy and others not? New York (NY): Routledge; 1994. p. 27-66.

It is certainly a complex model that one of its creators later called a “fantasy equation”, stating that “at present we only vaguely understand the relative magnitudes of the coefficients on the independent variables that would inform specific policies rather than general directions, although we are beginning to see the variables themselves more clearly. Robert Evans and Greg Stoddart rated again in 2003 that “most students of population health cannot confidently and accurately answer the question, ‘Well, where? you put the money?'” That hasn’t stopped us from calling his solution for the past 25 years here and here but with little to show for it.

One of us, Kindig, presented this conundrum to a group of students during an invited lecture for the course “Introduction to population health” of the other, Mullahy. At this point, Kindig asked, “How is this possible? It can’t be as difficult as all the modeling and equations needed to land on the moon, can it? »

Here are the answers we found on the class whiteboard.

It’s harder

It’s social science, not physics and engineering. Causality is difficult to conceptualize and, even if well conceptualized, to demonstrate empirically.

There are several results

With the significant expansion of the model beyond disease to health and function and even well-being, the number of outcomes explodes: overall mortality, morbidity, health-related quality of life, as well as disparities and inequalities in each of them. Summary measures, while sometimes useful, add complexity to the weighting components. This seemingly constant instability led one student to wonder if the “fantastic equation” exists, is it only applicable in a steady state, where the systems or process variables are immutable over time? Since we live in a dynamic state, such a fixed solution to the “fantasy equation” probably does not exist and even if it did, it might not be applicable in a decade or two.

There are several units of analysis

Another outstanding question is: what population? What is of primary concern and relevant to clinical or social policy: individuals, communities, nations, the world, marginalized groups, separately or all together?

Many, many complex empirical problems

To speak of a “solution” to the fantasy equation is in itself a fantasy. Its essential nature is that of a complex set of cause and effect relationships. For data to illuminate these relationships, not only must specific causes and outcomes have clear definitions, but those definitions must find empirical equivalents in the available data. So what follows is a litany of additional questions:

  • What are the individual and/or population health indicators of interest?
  • What specific determinants are likely to be manipulated by policy interventions? (A reminder that, as is sometimes claimed in the literature on causation, there is “No causality without manipulation. »
  • What conceivable policies can be designed or modified to bring about such manipulation?
  • How quickly do determinants and policies take effect?

The empirical task at hand is hardly simplified when one recognizes that the confusion and interactions between determinants and between policies at a given point in time and over time are almost certainly of fundamental importance. Even if such interactions could be characterized conceptually, learning them from existing data would be a formidable task.

Another student suggested that the “fantasy equation” is too complex, too fluid, and filled with too many unknowns to solve. External forces and trade-offs add additional layers of complexity, so changing one variable or coefficient will change many other variables that affect downstream results.

Data limits

We can only review what we have data on. We know a lot about Medicare since it is a massive program in the public sector. Data on other determinants is more limited and some issues such as armed violence cannot be fully understood due to policy restrictions. Additionally, in the spirit of privacy protection, various statistical agencies, such as the Census Bureau, are increasingly creating obstacles for researchers to access data at the individual level.

At the end of the discussion, the majority of students agreed that the moon landing was much less complex.

Where does that leave us?

One of the students asked, “For how long do we weigh the pros and cons and discuss how much to invest and where? How long does an idea ruminate in a think tank before it becomes relevant to the very people it aims to help? »

We refuse to accept a political scenario in which investment decisions are based on guesswork, hunches, political whims or opinions. New datasets and new analytical approaches should bring more precision, and these efforts could potentially have an impact worthy of a Nobel Prize in medicine or economics.

Despite the slow progress, we are asking the question of the optimal balance of investments more often, and answers are beginning to emerge. New disciplines are tackling the problem from a systems science perspective. Bobby Milstein and his colleagues, for example, have asked “What are the health and wellness priorities that emerge after considering the entangled threats and costs? » and found that “poverty reduction and social support were the highest ranked interventions for all outcomes in all counties. Interventions addressing smoking, substance abuse, routine care, health insurance, violent crime, and youth education also contributed significantly to some outcomes.

After this course, we contacted Gregory Stoddart and invited him to join us in writing this piece. He declined, citing his satisfactory retirement from McMaster University, but sent this e-mail message: “Although, as you know, I think the fantastic equation may be unsolvable, that does not mean that we do not know in which directions to reallocate resources. The concept of marginal returns can and should guide us here, even within rough orders of magnitude. We don’t need precision to help more people be healthy or to be more equitable.

In other words, solid estimates of directions and orders of magnitude can be just as important in serving decision-makers as precise but unreliable results. In a clinical research setting, John Mullahy and his colleagues described this challenge this way“If the massive investment in transforming discovery into health is to bear fruit, it is essential to understand when research efforts do or do not lead to full discovery. When research fails to lead to a complete discovery, the fact that it can partially identify quantities of interest is to be celebrated, not bemoaned.

That said, there remains an equally urgent step in solving the “equation” of fantasy, whether in whole or in part. It is about studying what kinds of information about these cause and effect relationships are actually useful to know. A valuable practical step in this direction would be to engage real-world decision-makers in learning what kind of information about the causes and effects of population health would be most useful in shaping policy and practice.

George Box wrote the famous that “all models are wrong, but some are useful”. The task at hand is to determine the willingness of decision-makers to exchange the “right” for the “useful”. We assume that many will tolerate a reasonable degree of vagueness. Knowing this should usefully guide the next generation of population health research on the fantasy equation.

Author’s note

We appreciate student contributions from the Fall 2021 “Introduction to Population Health” course PHS 795 University of Wisconsin Madison School of Medicine and Public Health.

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Government has created health infrastructure in the spirit of One India One Health: PM Modi https://surroundhealth.net/government-has-created-health-infrastructure-in-the-spirit-of-one-india-one-health-pm-modi/ Sat, 26 Feb 2022 08:18:00 +0000 https://surroundhealth.net/government-has-created-health-infrastructure-in-the-spirit-of-one-india-one-health-pm-modi/ Our correspondent / NEW DELHI Prime Minister Narendra Modi said the government is striving to build a health infrastructure in the country that goes beyond major cities with a One India One Health spirit. He pointed out that essential sanitation facilities will be brought to villages at block and district level. The Prime Minister said […]]]>

Our correspondent / NEW DELHI

Prime Minister Narendra Modi said the government is striving to build a health infrastructure in the country that goes beyond major cities with a One India One Health spirit.

He pointed out that essential sanitation facilities will be brought to villages at block and district level.

The Prime Minister said the government has taken a holistic approach to the health system and the focus is on health and wellbeing equally to make the country’s health care more inclusive and robust.
Addressing the webinar on the post-union budget of the Ministry of Health, Mr. Modi said that this budget expands the health system reform and transformation efforts over the past seven years.

The Prime Minister said the effort is the expansion of infrastructure and human resources related to modern medical science, the promotion of research in the Indian traditional medicine system like AYUSH and its active engagement in the health system and to provide better and affordable healthcare facilities to every person, every part of the country through modern and futuristic technology.

Mr. Modi said that this infrastructure needs to be maintained and upgraded from time to time. He said that for this, the private sector and other sectors will also have to show more energy.

The prime minister said that to strengthen the primary healthcare network, the construction of 1.5 lakh health and wellness centers is underway. He said that so far more than 85,000 centers provide facilities for routine check-ups, vaccinations and testing.

Mr Modi said that in this budget, the mental health care facility has also been added to it.

He said that the 2022-23 Union budget in the health sector focuses on three major pillars, the expansion of modern medical science infrastructure and human resources, the integration of research in modern and futuristic medicine and technology for better and affordable health care.

The Prime Minister said the health budget saw the upgrade of two lakh Anaganwadis to Saksham Aanganwadi. Mr. Modi urged the private sector to play a proactive role and respond to the operational requirements of the sector.

He said the country’s health sector should focus on becoming Aatma Nirbhar in building Indian-made healthcare targets, medicines and medical equipment. He said a quality and affordable healthcare system will evolve with the PLI program for the healthcare industry that can meet national and global demands in medicine. The Prime Minister said platforms like Cowin have shown India’s prowess in digital technology to the world. He said Ayushman Bharat Digital Mission has created a simple interface to connect consumers and healthcare providers.

Mr Modi said facilities such as telemedicine, remote health care and teleconsultation will cater to mass audiences in times of emergency.

He said India has an opportunity to show its capabilities to the world and AYUSH will play a key role in improving the health sector and meeting global demands for healthcare.

The Prime Minister hailed Indian medical professionals, who have been hailed around the world for their prowess in this sector.

Mr. Modi also praised the medical professionals involved in the sector for successfully carrying out the largest vaccination campaign in India.

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As One Insurance Group launches population health strategy that revolutionizes healthcare https://surroundhealth.net/as-one-insurance-group-launches-population-health-strategy-that-revolutionizes-healthcare/ Thu, 24 Feb 2022 23:00:00 +0000 https://surroundhealth.net/as-one-insurance-group-launches-population-health-strategy-that-revolutionizes-healthcare/ Forged from over 100 years of industry experience, As One Insurance Group is changing the insurance landscape PHOENIX, 24 Feb. 10, 2022 (GLOBE NEWSWIRE) — Phoenix-based private insurance brokerage As One Insurance Group (“As One”) announced the launch of its already revolutionizing healthcare-industry population health strategy. As One quickly achieved benchmark status in the world […]]]>

Forged from over 100 years of industry experience, As One Insurance Group is changing the insurance landscape

PHOENIX, 24 Feb. 10, 2022 (GLOBE NEWSWIRE) — Phoenix-based private insurance brokerage As One Insurance Group (“As One”) announced the launch of its already revolutionizing healthcare-industry population health strategy. As One quickly achieved benchmark status in the world of population health.

Brandon Bullock, Chief Strategy Officer of As One, said: “Over the years we have seen the number of people without access to health care decrease, the numbers are a positive sign, 10% of Americans still have no no access to care. seeks to bridge this gap. As One offers Health Navigator in addition to its proprietary sales platform that leverages electronic processing to accelerate the sales cycle.

The leading company specializes in life, health and incidental insurance and simplifies insurance for insurers, agents and customers with distinct offerings, including:

An innovative population health strategy
A proprietary sales platform and a CRM for direct electronic processing
An impressive national distribution channel
Advanced agent training and sales tools

JR Jordan, CEO of As One, said: “With the right tools at hand, our team and our agents show extraordinary courage every day in the fight to fix health insurance, a strong team working as one”.

Meet the management team

As One is led by a strong team of insurance industry professionals with over 100 years of experience. The management team is made up of industry leaders:

JR Jordan, Managing Director
James Jordan, Revenue Manager
Brandon Bullock, Chief Strategy Officer
Brandon Diggs, Chief Technology Officer
Caterina Pontoriero, Vice President, Marketing and Branding
Ryan Sharrah, Vice President, Business Development

Cost of Healthcare in America

The cost of health care in the United States is a major factor preventing people from getting needed care or filling prescriptions. Half of American adults said they had postponed or completely mitigated some dental or health care in the past year due to high cost. Three in 10 people also said they had not taken their necessary medications as prescribed at some point for the same reason. High health care costs disproportionately affect uninsured adults and those with lower household incomes. Larger proportions of American adults also reported difficulty affording different types of care, further delaying them and attributing to them forgoing medical care due to cost.

However, people covered by health insurance are not immune to the burden of health care expenses. Nearly half (46%) of policyholders said they had trouble paying personal expenses and 27% said they had trouble paying their deductible. Difficulty paying medical bills has had significant consequences for American families. Medical bill issues also disproportionately affect adults in households where they or a member of their household has a serious health condition.

As One Insurance knows insurance can get complicated, they are here to simplify the process. For more information on health insurance, benefits, employee benefits, or any other questions, visit www.asoneig.com.

About As One Insurance Group

As One Insurance Group (“As One”) is a Phoenix, Arizona-based private insurance brokerage firm specializing in life, health and incidental insurance. As One aims to simplify insurance by making the process simple and honest. With transparency of product information and open communications the norm, the company offers a range of life and health insurance products paired with the tools agents and customers need to manage their needs. This includes advanced education and training, innovative technology solutions and top-notch service. In short, they work with and for agents, clients and carriers together as one. For more information, individuals are advised to visit the company’s official website.

Media Relations

Catherine Pontoriero
As one insurance group
+1 201-463-7274

This content was published via the newswire.com press release distribution service.

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As One Insurance Group launches population health strategy https://surroundhealth.net/as-one-insurance-group-launches-population-health-strategy/ Thu, 24 Feb 2022 23:00:00 +0000 https://surroundhealth.net/as-one-insurance-group-launches-population-health-strategy/ PHOENIX, 24 Feb. 10, 2022 (GLOBE NEWSWIRE) — Phoenix-based private insurance brokerage As One Insurance Group (“As One”) announced the launch of its already revolutionizing healthcare-industry population health strategy. As One quickly achieved benchmark status in the world of population health. Brandon Bullock, Chief Strategy Officer of As One, said: “Over the years we have […]]]>

PHOENIX, 24 Feb. 10, 2022 (GLOBE NEWSWIRE) — Phoenix-based private insurance brokerage As One Insurance Group (“As One”) announced the launch of its already revolutionizing healthcare-industry population health strategy. As One quickly achieved benchmark status in the world of population health.

Brandon Bullock, Chief Strategy Officer of As One, said: “Over the years we have seen the number of people without access to health care decrease, the numbers are a positive sign, 10% of Americans still have no no access to care. seeks to bridge this gap. As One offers Health Navigator in addition to its proprietary sales platform that leverages electronic processing to accelerate the sales cycle.

The leading company specializes in life, health and incidental insurance and simplifies insurance for insurers, agents and customers with distinct offerings, including:

An innovative population health strategy
A proprietary sales platform and a CRM for direct electronic processing
An impressive national distribution channel
Advanced agent training and sales tools

JR Jordan, CEO of As One, said: “With the right tools at hand, our team and our agents show extraordinary courage every day in the fight to fix health insurance, a strong team working as one”.

Meet the management team

As One is led by a strong team of insurance industry professionals with over 100 years of combined experience. The management team is made up of industry leaders:

JR Jordan, Managing Director
James Jordan, Chief Revenue Officer
Brandon Bullock, Chief Strategy Officer
Brandon Diggs, Chief Technology Officer
Caterina Pontoriero, Vice President, Marketing and Branding
Ryan Sharrah, Vice President, Business Development

Cost of Healthcare in America

The cost of health care in the United States is a major factor that prevents people from getting needed care or filling prescriptions. Half of American adults said they had postponed or completely mitigated some dental or health care in the past year due to high cost. Three in 10 people also said they had not taken their necessary medications as prescribed at some point for the same reason. High health care costs disproportionately affect uninsured adults and those with lower household incomes. Larger proportions of American adults also reported difficulty affording different types of care, further delaying them and attributing to them forgoing medical care due to cost.

However, people covered by health insurance are not immune to the burden of health care expenses. Nearly half (46%) of policyholders said they had trouble paying personal expenses and 27% said they had trouble paying their deductible. Difficulty paying medical bills has had significant consequences for American families. Medical bill issues also disproportionately affect adults in households where they or a member of their household has a serious health condition.

As One Insurance knows insurance can get complicated, they are here to simplify the process. For more information on health insurance, benefits, benefits, or any other questions, visit www.asoneig.com.

About As One Insurance Group

As One Insurance Group (“As One”) is a Phoenix, Arizona-based private insurance brokerage firm specializing in life, health and incidental insurance. As One aims to simplify insurance by making the process simple and honest. With transparency of product information and open communications the norm, the company offers a range of life and health insurance products paired with the tools agents and customers need to manage their needs. This includes advanced education and training, innovative technology solutions and top-notch service. In short, they work with and for agents, clients and carriers together as one. For more information, individuals are advised to visit the company’s official website.

Media Relations

Catherine Pontoriero
As one insurance group
+1 201-463-7274

This content was posted through the press release distribution service on Newswire.com.

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Metabolism and Risk – The Lancet Child & Adolescent Health https://surroundhealth.net/metabolism-and-risk-the-lancet-child-adolescent-health/ Wed, 16 Feb 2022 23:31:29 +0000 https://surroundhealth.net/metabolism-and-risk-the-lancet-child-adolescent-health/ Metabolic epidemics have been developing for decades. They have not created sudden, disruptive effects, but their prevalence is vast, they pose risks to cardiovascular health and premature death, and multiple interventions have been advocated, yet they remain epidemic. Attention has focused on the epidemics of childhood obesity and diabetes, but given the underlying pathophysiology of […]]]>

Metabolic epidemics have been developing for decades. They have not created sudden, disruptive effects, but their prevalence is vast, they pose risks to cardiovascular health and premature death, and multiple interventions have been advocated, yet they remain epidemic.

Attention has focused on the epidemics of childhood obesity and diabetes, but given the underlying pathophysiology of type 2 diabetes and obesity, a broader view might be helpful. What we now call the metabolic syndrome has changed in name and conceptualization over the last half century, but it is essentially a collection of metabolic abnormalities. Today, its central component is often considered to be impaired glucose metabolism, with other key components being abdominal obesity, high blood pressure and disturbed lipid metabolism. Although debate continues over how many factors to include and how they should be measured (e.g. waist circumference, fasting blood sugar and high triglyceride levels), the group makes perfect sense as that set of risk factors for cardiovascular disease and type 2 diabetes; it is a risk marker for health threats later in life. In a new systematic review and modeling analysis, Jean Jacques Noubiap and colleagues estimated that the global prevalence of metabolic syndrome in 2020 was almost 3% in children aged 6 to 12 years and almost 5% in adolescents aged 13 to 18, which equates to approximately 26 million children and 36 million adolescents.
Health threats, however, are more imminent than many realize. Most patients with metabolic syndrome have type 2 diabetes, due to low fasting blood sugar, and in 2019 more than 16,000 deaths in people under 25 are thought to be due to diabetes. The importance of increasing access to affordable health care is evident, as diabetes mortality was higher in low-income countries and was inversely related to universal health care coverage. Diabetes mortality has decreased since 1990, mainly from type 1 diabetes, due to better access to care and better treatment (eg insulin pumps). But the incidence of type 2 diabetes has increased, and the decline in deaths from type 2 diabetes since 1990 has been small. Rising rates of type 2 diabetes in young people pose new challenges to health systems; adolescents with type 2 diabetes have a higher overall risk of complications during adolescence than with type 1 diabetes, including kidney disease, retinopathy, poor pregnancy outcomes and depressive symptoms.

The complications of diabetes and the risk of cardiovascular disease make it important to put the metabolic syndrome at the forefront of thinking about the health of young people. Some question the clinical value of diagnosing the metabolic syndrome, but tracking its prevalence and setting specific national targets will be helpful in assessing changes in current and potential health. Metabolic health could provide a useful focal point for policies and interventions. In turn, these interventions must focus on one of the components of the metabolic syndrome: obesity.

In addition to addressing its consequences, a new conceptual approach to type 2 diabetes emphasizes obesity as a key upstream driver. Up to 61 million children and adolescents were obese in 2020. Despite the heterogeneity of type 2 diabetes and the fact that pathology rather than the amount of fatty tissue can lead to complications, sustained weight loss is likely to help most people with type 2 diabetes. This is especially the case for adiposity-associated phenotypes, which younger people are more likely to have. A new review proposes a 15% body weight loss as a goal for this group, to reduce adipose tissue pathology and improve their metabolic milieu, with the aim of preventing diabetes for people with prediabetes and in remission or reduction for those already diagnosed with type 2 diabetes.

Unlike epidemics caused by infectious diseases, such as COVID-19, metabolic epidemics have no single identifiable cause against which to direct measures. They have multiple risk factors and single-component interventions are not effective. The rise in obesity, type 2 diabetes and metabolic syndrome has been accompanied by the growing dominance of sedentary activities in the lives of young people and changing food environments in which highly processed foods and beverages , nutrient-poor and energy-rich have become more available, accessible and desirable, linked to pervasive commercialization and economic growth. It has been established that interventions need to be multifaceted, multisectoral and appropriate to age and cultural and geographical context, but we are not on track to achieve the necessary gains. Metabolic health is at the heart of human health and well-being, and efforts to take care of it must be made with zeal.

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Brian Silverstein, MD, Joins Innovaccer Leadership Team as Director of Population Health | Your money https://surroundhealth.net/brian-silverstein-md-joins-innovaccer-leadership-team-as-director-of-population-health-your-money/ Wed, 16 Feb 2022 14:04:14 +0000 https://surroundhealth.net/brian-silverstein-md-joins-innovaccer-leadership-team-as-director-of-population-health-your-money/ SAN FRANCISCO, Feb. 16, 2022 (GLOBE NEWSWIRE) — Innovaccer Inc.., the Health Cloud company, announced the addition of Brian Silverstein, MD, to its management team. In his new role as the company’s director of population health, Dr. Silverstein will act as a thought leader and advisor to population health management (PHM), providing strategic direction to […]]]>

SAN FRANCISCO, Feb. 16, 2022 (GLOBE NEWSWIRE) — Innovaccer Inc.., the Health Cloud company, announced the addition of Brian Silverstein, MD, to its management team. In his new role as the company’s director of population health, Dr. Silverstein will act as a thought leader and advisor to population health management (PHM), providing strategic direction to the company. leadership team, healthcare system boards and Innovaccer customers. He will ensure the successful implementation of innovative care delivery models and population health strategies that promote high quality patient-centered care.

“The shift to value-based care is critical to bending the cost curve and improving clinical outcomes and experiences,” said Dr. Silverstein. “It’s also one of the most important use cases for digital transformation. In nearly two decades of working with healthcare systems, I’ve noticed that while there are some successes, which is holding people back is operations. I joined Innovaccer because Innovaccer Health Cloud enables rapid and cost-effective adoption of a holistic approach to PHM operations. It unifies patient data across the entire healthcare system. health, creates the workflow and management tools that enable effective population health management, and produces the executive dashboards needed for success.”

In 2010, Becker’s Hospital Review recognized Dr. Silverstein as one of the 10 people to know in the world of COAs. He served as Senior Vice President at CareFirst BlueCross BlueShield, where he implemented one of the first value-based care delivery programs. He has held leadership positions with The Chartis Group, Geisinger Consulting Group, The Camden Group and Sg2 Health Care Intelligence. Dr. Silverstein is also a faculty member and advisor to the Governance Institute and holds faculty positions with the American College of Healthcare Executives and the Thomas Jefferson School of Public Health QSLS. He serves on the editorial board of Population Health Management and serves as a system and CCO board member for OSF Healthcare.

As Director of Population Health at Innovaccer, Dr. Silverstein will work closely with healthcare leaders implementing value-based care programs that use holistic care to improve clinical, financial and financial outcomes. and operational. It will help clients understand the governance and technology changes required to move from volume-based care models to value-based care models. He will assist their teams in the implementation, operationalization and automation of these models with the Innovaccer Health Cloud Best of Ⓡ at KLAS Data Activation Platform for population health management.

“Healthcare delivery and reimbursement models continue to evolve, and healthcare system leaders need strong, highly experienced partners who can help them navigate the change,” said Abhinav Shashank, CEO of ‘Innovate. “Dr. Silverstein’s extensive experience will help our clients accelerate transformation initiatives in value-based delivery, governance, ACO strategy, clinically integrated network design, and population health management. We are excited to have him join our team and help our clients leverage data and technology to accelerate their transition to the value-based model of care.”

About Innovaccer

Innovaccer Inc., the Health Cloud Company, is a leading San Francisco-based health technology company committed to helping healthcare as a whole. InnovaccerⓇ Health Cloud unifies patient data across systems and settings, and enables healthcare organizations to rapidly develop modern, scalable applications that improve clinical, operational and financial outcomes. Innovaccer’s solutions have been deployed in more than 1,000 healthcare facilities across the United States, enabling more than 37,000 providers to transform healthcare delivery and work collaboratively with payers and life sciences companies . Innovaccer has helped organizations unify the health records of over 24 million people and generate over $600 million in savings. For more information, please visit innovaccer.com.

Press contacts:

Sachin Saxena Innovaccer Inc. sachin—saxena@innovaccer.com 415-504-3851

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Population Health and HIV PrEP https://surroundhealth.net/population-health-and-hiv-prep/ Tue, 15 Feb 2022 13:09:12 +0000 https://surroundhealth.net/population-health-and-hiv-prep/ Douglas Krakower, MD: As for trying to achieve the quadruple objective of [Institute for Healthcare Improvement], there are many ways to improve both patient experience and outcomes, as well as clinician experiences, satisfaction and outcomes. I think we have to recognize that PrEP [pre-exposure prophylaxis] at the moment is relatively complicated from the point of […]]]>

Douglas Krakower, MD: As for trying to achieve the quadruple objective of [Institute for Healthcare Improvement], there are many ways to improve both patient experience and outcomes, as well as clinician experiences, satisfaction and outcomes. I think we have to recognize that PrEP [pre-exposure prophylaxis] at the moment is relatively complicated from the point of view of the medical aspects. There’s a lot of follow-up. For example, right now, for people taking oral PrEP based on CDC guidelines, which were just updated last week, the idea is to have someone come in quarterly for their adherence. , their medications and their tests. It’s really important from a safety perspective, but it’s a burden on patients and providers. I think we need to think about ways to safely demedicalize PrEP to some degree so that it is more accessible. We meet patients where they are, because people have full lives and they can be otherwise perfectly healthy, and so we don’t want to overburden them to the point that they don’t choose to continue the PrEP or initiate it in the first place.

Same thing on the clinician side. I think we need to find ways to give clinicians tools to make HIV testing, PrEP conversations, prescribing, and follow-up much easier for them and their staff. This could relieve busy clinicians of other healthcare professionals who can do much of the work with clients and patients to ease some of the burden on the clinician prescribing it. We can think of ways to use the electronic health record and automated tools to help remind clinicians of patients who may be at increased risk for HIV based on their electronic health record history. For example, if they have ever had sexually transmitted infections, this would be a way to get them thinking about talking about PrEP.

In terms of monitoring, if you have large numbers of people on PrEP in a panel of clinicians, we really need population health management tools, whether it’s staff, where they can offload with a nurse, physician assistant, or other professional who can work on following up with people after the initial prescription and making sure they have what they need in terms of laboratory care, adherence counseling, and to get their questions answered. This can really positively impact the Quadruple Aim of everyone’s experience and results.

I think we need to think about innovative ways to bring PrEP to people where they are, including dispensing it completely from the healthcare system. It’s already underway with the idea of ​​telemedicine for PrEP, or tele-PrEP, where you can have people from any jurisdiction in the country accessing PrEP centrally with virtual visits, testing home laboratory or maybe local tests, but it avoids having to take a day off for example, and come to the clinic 4 times a year. There are many ways to innovate and improve the Quadruple Aim Lenses [Institute for Healthcare Improvement].

There are a number of population health challenges in terms of who might be eligible for or taking PrEP. The first is to raise awareness about PrEP, especially in communities where rates of new HIV infections have been high, such as the southeastern United States, and where PrEP use has been lower than in other regions, and particularly among black and Latino populations. I think some of these challenges can be addressed with well-designed public health campaigns where people are made aware of PrEP in the wider community. I think there have been misconceptions that PrEP is only for certain populations. We’ve heard from research we’ve done that cisgender women have heard that PrEP is only for gay men, for example, and we know that’s not true at all. In fact, PrEP is underused among cisgender women. We need to think of ways to inform the public that this is a benefit to them so that they can access it.

I think we also need to facilitate access instead of asking people to go exclusively to health care facilities where some people are otherwise healthy and don’t see a health care provider regularly. Others may have faced stigma and discrimination or judgments from health care providers regarding sexual health care. People may not want to see clinicians for things like PrEP. So if we can think of creative ways to use community organizations to implement PrEP in the future, I think those would be ways to improve access more broadly at the population level.

Once people are using PrEP and they’re engaged, I think having access to paraprofessionals who aren’t necessarily the clinician prescribing PrEP can also improve the number of people we can support on PrEP. For example, at the hospital where I work, there is a pharmacist who has been very motivated to work with the population using PrEP in the primary care clinic. It’s a large, busy primary care clinic, and there are a number of primary care providers who prescribe PrEP to their patients. But having the pharmacist as the central person who has expertise, maybe a little more time to manage the group, and also using the electronic health record to track people, those are ways you can really scale at the population level without overburdening clients or healthcare professionals managing PrEP.

Thinking about ways to use telemedicine for PrEP is a really creative way to do it also for people who are in rural areas, or frankly, people who just prefer to do things virtually. The COVID-19 pandemic has given people the opportunity to try new ways to access and use health care. While I don’t think the entire world will be virtual in terms of healthcare, in the indefinite future there is no doubt that some people and some aspects of healthcare can be delivered more effectively and efficiently using fully telemedicine or perhaps a combined-hybrid model. PrEP, I think, is a really good way to do that.

There are already academic, public health, and private organizations that have strong tele-PrEP programs that have been running for several years now. These have not yet been studied as rigorously as I would like to know the results, but I feel from speaking to people who have engaged in them that these are excellent opportunities for scaling up PrEP at the population level to more people. Colleagues of mine here in Boston are conducting studies with colleagues in the South to see if a tele-PrEP model keeps people engaged and adherent to PrEP compared to a standard in-person model. Over the next few years, we will also learn much more about some of these innovative approaches to delivering PrEP.

In terms of programs that can help make PrEP more effective for patients and for healthcare system providers, I think having a team-based approach is a great way to approach PrEP. There’s the prescribing clinician, but there are nurses, pharmacists, physician assistants, a whole host of people on the team who may have different levels of expertise and different amounts of time.

For example, in terms of adherence counseling, research has shown that using cognitive behavioral methodologies can be really effective in helping people address adherence issues, but a primary care clinician with a broad patient panel may not have time to do this. This involves hiring nurses who may be trained in some of these methods, or behavioral health specialists, and even peer navigators who can speak at a peer level with someone using PrEP about their experiences and how they overcame challenges to access PrEP. , incorporating into their lives some of the social considerations of PrEP use in terms of disclosure to partners, peers and family. I see the future and the present, frankly, uses a team approach.

At one of the places where I work, we have an excellent nurse who basically manages the PrEP program, except for the prescription and refills, and does an excellent job. This person has acquired all the expertise as a specialist as an infectious disease nurse, and so switching to PrEP is really quite simple. She is able to handle many more patient cases than I alone. Using team-based approaches and integrating these with technology tools, such as using population health management tools from the electronic health record, are ways to escalate that more effectively. I think it has been useful to me personally in our establishment. I know I’m not always at the clinic. I do research as well as clinical care, and even the busiest clinicians have been pulled in so many directions with everything they are asked to do, so we have to unburden ourselves and work as a team to make sure that is scalable and sustainable.

Ryan Bitton, PharmD, MBA: Strategies for managing PrEP use have evolved over the years. Initially, some plans had pre-clearance, others did not. They’re at the point where there’s not a lot of pre-clearance; PrEP is a pretty standard of care recommendation. There really is no utilization management for some of the therapies. Things like generic Truvada are available without prior authorization with a $0 copayment I assume for most plans including ours. There are obviously several therapies. Some of the other therapies may have prior authorization and requirements around a generic-Truvada-first type of policy. If Generic Truvada doesn’t work, which I don’t know if we see failure in this population, Truvada failure may not be the problem, but the contraindication or intolerance or reasons for which you would not like to use generic Truvada, there are allowances to enter other therapies.

Transcript edited for clarity.

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In the year 2025, will population health finally be real? McKnight’s https://surroundhealth.net/in-the-year-2025-will-population-health-finally-be-real-mcknights/ Mon, 14 Feb 2022 17:30:13 +0000 https://surroundhealth.net/in-the-year-2025-will-population-health-finally-be-real-mcknights/ Martie L. Moore, RN, MAOM, CPHQ For the past two years, we’ve been headlong, armor, swords up, and swinging in the air. The enemy we named COVID-19 is a narcissistic, selfish, ruthless little toad who doesn’t play by the rules, or even care about anyone but himself. Isn’t that like a narcissist? He can’t stand […]]]>
Martie L. Moore, RN, MAOM, CPHQ

For the past two years, we’ve been headlong, armor, swords up, and swinging in the air. The enemy we named COVID-19 is a narcissistic, selfish, ruthless little toad who doesn’t play by the rules, or even care about anyone but himself. Isn’t that like a narcissist?

He can’t stand having attention or eyes on anything other than his prickly little projections and his ability to travel where he wants to go, waving at us as he passes. You know what I mean by being selfish? He should follow the rules and act like a good citizen. But this is not the case.

I’ve always been a rule follower. Something must have happened during my potty training as a toddler that melted into my brain: not breaking, bending or getting out of lines. That’s not to say that I haven’t, or haven’t questioned, challenged, or moved the lines. Last week, I listened to one of health care’s greatest leaders talk about population health, value-based reimbursement, and “the year 2025.”

As we put on our armor in 2020, the Centers for Medicare & Medicaid Services announced that 2025 will be a special year for Medicare beneficiaries. This is the year of healthcare cost reductions, better outcomes, and seismic shifts from fee-for-service to value-based care and reimbursement finally coming together. The year of value was informed by the work seen by the CMS Innovation Center.

Due to the battle we fought, it was difficult to follow the nuances at CMS. I included a link providing a quick summary work done through the CMS Innovation Center. A thank you to the Healthcare Transformation Task Force for providing this easy-to-use reference.

Listening to the speaker describe the work being done by healthcare through COAs and other models, the shift to home care and the call for innovation, I found myself asking a metaphorical question: “ Are we trying to color the wrong lines? »

Population health refers to the health status and health outcomes among a group of people. Notice the word, healthnot sickness, is used. Yet when we look at the direction of CMS 2025, the thread of disease management is woven into the fabric of the models.

If we truly believe that population health is a viable model to pursue, then why would we focus on disease state and not health status? Expand the ranges to include reimbursement for actions that keep the skin, urinary tract, kidneys, heart, brain, lungs and joints as optimal as possible.

Let me give you an example. Like you, I have worked hard to reduce catheter-associated urinary tract infections (CAUTI). It makes sense that we do what we can to prevent CAUTI. Where logic fails is the lack of work done to keep the urinary tract healthy. If we follow the money, we’ll find that $1.3 billion is spent each year on urinary tract infections, not related to catheters.

What conversations have we had about urinary health and what can be done to reduce the likelihood of a UTI? Don’t get me started on skin health and the projected $26.8 billion cost and treatment of pressure injuries!

To achieve population health, we must realize what it will take to achieve the results we all want for those we love and care for and for ourselves. Let’s be realistic !

Martie L. Moore, MAOM, RN, CPHQ, is the CEO of M2WL Consulting. She has been a healthcare executive for over 20 years. She has served on advisory boards for the National Pressure Injury Advisory Panel and the American Nurses Association, and currently serves on the Dean’s Advisory Council for the University of Central Florida College of Nursing and Sigma, International Honor Society for Nursing. She was honored by Saint Martin’s University with an honorary doctorate for her service and achievements in advancing health care.

The opinions expressed in McKnight Long Term Care News guest submissions are those of the author and not necessarily those of McKnight Long Term Care News or its editors.

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‘Population Health’ hopes to foster health equity at UH https://surroundhealth.net/population-health-hopes-to-foster-health-equity-at-uh/ Thu, 10 Feb 2022 21:08:16 +0000 https://surroundhealth.net/population-health-hopes-to-foster-health-equity-at-uh/ By Haya Panjwani February 10, 2022 Juana Garcia / The Cougar UH launched a initiative called “Population Health” with the goal of creating health equity in Houston and the state. Led by the University’s population health officer, Bettina Beech, the program aims to address health issues by addressing areas such as diet, behaviors, the environment […]]]>


Juana Garcia / The Cougar

UH launched a initiative called “Population Health” with the goal of creating health equity in Houston and the state.

Led by the University’s population health officer, Bettina Beech, the program aims to address health issues by addressing areas such as diet, behaviors, the environment and the health system in its together.

“The way I like to explain it is that population health is sort of a bridge between public health and medicine,” Beech said. “It’s a way of taking the principles and sensitivities of public health, which look at large groups, the general population, but then translating them into medicine, looking at subgroups rather than individuals.”

Right now, medical professionals are looking at issues one patient at a time, according to Beech. Through this new initiative, UH hopes to examine patient panels and groups to address health issues.

Health care now needs to look at panels of patients within groups of patients, but that’s not the direction of medicine,” Beech said. “’Population health‘ is sort of a bridge between the two, with an intense focus on health equity. »

The initiative comes in response to improving the health of all populations and the hope of creating equity in health, Beech said.

“In order to really improve the health of populations, we really need changes that happen throughout our lives,” she said. “So we need healthy housing, we need accessible transportation, we need safe and equitable health care.”

The initiative will then integrate majors across UH to help achieve this goal that the initiative hopes to achieve.

“By bringing population health into all disciplines, we will train graduate architects who create healthier buildings and design healthier buildings,” Beech said. “We will have business people who keep these principles in mind when working in their industry, we will have medical graduates who better understand a population health approach and how to incorporate it into their clinical practice .

Beech hopes this initiative will have a lasting impact on the people of the city and state.

[email protected]

Key words: health care, health equity, population health


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