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https://www.readbyqxmd.com/read/28199277/funding-accountable-care-in-oregon-financial-models-in-two-coordinated-care-organizations
#1
Lauren Broffman, Kristin Brown, Bruce K Bayley, Lucy Savitz, Jill Rissi
Oregon's coordinated care organizations (CCOs) are an integral part of a massive statewide reform that brings accountable care to Medicaid. CCOs are regional collaboratives among health plans, providers, county public health, and communitybased organizations that administer a single global budget covering physical, mental, and dental healthcare for low-income Oregonians. CCOs have been given freedom within the global budget to implement reforms that might capture efficiencies in cost and quality. For this study-fielded between 2012 and 2015-we traced the path of the global budget through the interior structures of two of Oregon's most promising CCOs...
July 2016: Journal of Healthcare Management / American College of Healthcare Executives
https://www.readbyqxmd.com/read/28190514/transluminal-attenuation-gradient-and-corrected-models-in-coronary-ct-angiography-for-determining-stenosis-severity-a-primary-study-using-dual-source-ct
#2
K Peng, N Xu, L Zhang, F Xiao, N Indima, J Zhang, Y Shen, W Peng, G Tang
AIM: To compare the incremental value of transluminal attenuation gradient (TAG), TAG with corrected contrast opacification (TAG-CCO), and TAG with exclusion of calcified coronary segments (TAG-ExC) in determining the stenosis severity of coronary arteries using coronary angiography (CAG) as the reference standard. MATERIALS AND METHODS: One hundred and fifteen patients who underwent computed tomography coronary angiography (CTCA) and confirmed by coronary angiography (CAG) were included in the retrospective analysis...
February 9, 2017: Clinical Radiology
https://www.readbyqxmd.com/read/28178891/up-regulation-of-cerebral-cytochrome-c-oxidase-and-hemodynamics-by-transcranial-infrared-laser-stimulation-a-broadband-near-infrared-spectroscopy-study
#3
Xinlong Wang, Fenghua Tian, Divya D Reddy, Sahil S Nalawade, Douglas W Barrett, Francisco Gonzalez-Lima, Hanli Liu
Transcranial infrared laser stimulation (TILS) is a noninvasive form of brain photobiomulation. Cytochrome-c-oxidase (CCO), the terminal enzyme in the mitochondrial electron transport chain, is hypothesized to be the primary intracellular photoacceptor. We hypothesized that TILS up-regulates cerebral CCO and causes hemodynamic changes. We delivered 1064-nm laser stimulation to the forehead of healthy participants ( n = 11), while broadband near-infrared spectroscopy was utilized to acquire light reflectance from the TILS-treated cortical region before, during, and after TILS...
January 1, 2017: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/28152942/communities-of-practice-a-jurisdictional-approach-to-improving-the-quality-of-care-in-radiation-medicine-in-ontario
#4
Michelle Ang, Lindsay Elizabeth Reddeman, Michael Sharpe, Margaret Hart, Carina Simniceanu, Stephen Breen, Joon-Hyung J Kim, Dani Scott, Khaled Zaza, David D'Souza, Michael F Milosevic, Stewart Gaede, Andrea Marshall, Brian P Yaremko, Katharina Sixel, Nicole Harnett, Eric Gutierrez, Padraig Richard Warde
: 122 Background: The Radiation Treatment Program (RTP) at Cancer Care Ontario (CCO) established several Communities of Practice (CoPs), with the goal of improving radiation treatment (RT) quality and safety. The RTP identifies variation in practice and quality improvement (QI) opportunities in the 14 Regional Cancer Centres (RCCs) and facilitates the development of CoPs to share best practices and standardize care. METHODS: Since 2010, the RTP has formed 7 CoPs ( > 185 members in total): 4 intra-disciplinary (Radiation Therapy, Medical Physics, Advanced Practice Radiation Therapy, Radiation Safety) and 3 inter-disciplinary (Head and Neck (HN), Gynecological (GYNE) and Lung Cancer)...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152935/optimizing-the-collection-and-reporting-of-wait-time-data
#5
Deanna Langer, Melissa Kaan, Jonathan Norton, Brian Ho, Ann Thomas, Julian Dobranowski
: 121 Background: Wait times for critical interventional radiology (IR) procedures have long been reported as barriers to access for cancer patients. Wait times have been difficult to measure in the province of Ontario as no mechanisms exist to capture IR data. Three individual programs at Cancer Care Ontario (CCO) began collection of CT-guided biopsies wait time data, with nuances dependent on program area of focus. The Cancer Imaging Program collects appointment availability for lung biopsies through a monthly email survey...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152934/an-approach-to-implementing-meaningful-change-in-a-provincial-health-care-system
#6
Elizabeth Lockhart, Michael Donald Brundage, Margaret Hart, Mark Hartman, Sophie Foxcroft, Lindsay Elizabeth Reddeman, Carina Simniceanu, Marissa Mendelsohn, Lisa Favell, Jonathan Wang, Elaine Meertens, Eric Gutierrez, Padraig Richard Warde
: 120 Background: Radiation treatment (RT) is essential to cancer management, contributing to cure and symptom control. With increasing cancer incidence and treatment complexity, health systems must adapt to ensure patients (pts) receive the highest quality of care. METHODS: With the objective of ensuring equitable access to high-quality, safe care, Cancer Care Ontario (CCO), a provincial government agency, identified provincial variability in RT activities. As a result, CCO prioritized 3 quality initiatives over the past 7 years: 1) Access to Intensity Modulated RT (IMRT) (2008-2013); 2) Peer Review of RT plans due to increasing RT planning complexity and the existence of high-profile RT errors (2012-present); and 3) Ensuring equitable access to RT (RT Utilization) (2014-present)...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152922/psychosocial-oncology-quality-indicators-prioritization-exercise
#7
Zahra Ismail, Lesley Moody, Maria Rugg
: 277 Background: One of Cancer Care Ontario's (CCO) roles is to monitor and report on cancer system performance to support quality improvement. CCO's Psychosocial Oncology (PSO) program developed a measurement plan with potential indicators to evaluate patient access to and the effectiveness of PSO services across the province. The objective of this study was to conduct a modified Delphi process to build consensus and prioritize PSO indicators based on their relevance to provincial goals, ability to measure regional and provincial performance and result in tangible actions...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152875/validation-of-a-real-time-patient-reported-experience-measurement-tool-for-cancer-patients-in-ontario
#8
Sarah Benn, Luciano Ieraci, Saurabh Ingale, Simron Singh
: 174 Background: Cancer Care Ontario (CCO) organizes and ensures quality cancer care for 16 million residents in Ontario. CCO's goal is to create a tool to enable reporting of the patient experience in real time. The study objective was to develop a validated real-time (close to or at point of care) patient reported experience measurement (PREM) tool to drive quality improvement, advance system planning and ensure cost effective resource allocation based on patients' needs, wants and preferences in ambulatory oncology treatment phase...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152855/cervical-screening-reminder-calls-pilot-utilizing-emrs-to-improve-cancer-screening
#9
Aaron Randall
: 163 Background: Cancer screening detects pre-cancerous changes, or cancer at an early stage when there is a better chance of treating it successfully. Research shows that that physician encouragement improves the odds of patients getting screened. Furthermore, systematic reviews demonstrate that efforts to encourage screening can be more effective through telephone reminders when compared to other methods of outreach. Electronic Medical Records (EMRs) are a powerful tool for the coordination, recording, monitoring and reporting of patient care in primary care...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152845/standardizing-architecture-and-governance-of-radiology-clinical-checklist-development
#10
Priyanka Jain, Deanna Langer, David Kwan, Julian Dobranowski
: 193 Background: To improve quality of radiology reporting, Cancer Care Ontario's (CCO) Cancer Imaging Program established synoptic radiology reporting as a priority area. Program goals are to implement standardized radiology reports across the province, improving communication between referring and interpreting physicians and providing a standardized foundation for staging data collection and population health research. Although there are libraries of structured radiology clinical checklists, development methodologies quality vary...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152773/bringing-person-centered-care-to-practice-with-cco-s-guideline-for-person-centred-care-in-adult-oncology-services
#11
Brett Nicholls, Hannah Shamji, Neil Johnson, Caroline Zwaal, Christian Stevens, Rhonel Biddy, Carly Griffin, Gail Laroque, Hans Messersmith, Simron Singh
: 65 Background: CCO ensures quality cancer care for 16 million residents in Ontario. CCO has identified person-centered care (PCC) as a top strategy in driving the quality agenda. CCO, in collaboration with the Program in Evidence-Based Care, developed a PCC Guideline to set the standard of care for people experiencing cancer in Ontario. A PCC video was developed as a tool for translating this knowledge to support healthcare providers to integrate Guideline recommendations into their practice...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152718/ontario-s-approach-to-tackling-drug-funding-sustainability
#12
Scott Gavura, Robin McLeod, Virginia McLaughlin, Craig Earle, Jessica Arias, Michelle Rey, Hasina Jamal
: 38 Background: One of the challenges facing Ontario relates to managing the rising costs of cancer drug treatments. The annual growth rate of cancer drug spending has increased by 10-20% since 2010, exceeding other therapeutic categories and is expected to continue to grow significantly faster than expenditures in other areas. Paradoxically, the price of a drug seems to have little relation to its demonstrated efficacy ( http://www.asco.org/practice-research/cancer-care-america-2015/focus-cost )...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152695/improving-anti-emetics-in-chemotherapy-induced-nausea-and-vomiting
#13
Ron Fung, Katherine Enright
: 220 Background: Chemotherapy induced nausea and vomiting (CINV) remains one of the most feared treatment-related toxicities in cancer patients. CINV has been shown to decrease quality of life and to increase dose modifications and unplanned hospital visits. Cancer Care Ontario (CCO) and the American Society of Clinical Oncology (ASCO) updated their CINV guidelines in 2013. These changes included a reclassification of many regimens from moderate (MEC) to highly emetogenic (HEC) and a decrease in the duration of serotonin inhibitors (5HT3i)...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152694/using-a-disease-pathway-management-approach-to-improve-the-quality-of-breast-cancer-care-in-ontario
#14
Jasmin Soobrian, Ashley Tyrrell, Clement Li, Derek Muradali, Margaret F Forbes, Angelika Gollnow, Jillian Ross, Claire Holloway
: 109 Background: Disease Pathway Management (DPM) is used by Cancer Care Ontario (CCO) to set priorities for cancer control, plan cancer services, and improve the quality of care in Ontario by promoting standardization. The DPM approach applies a framework to examine the performance of the entire system from prevention to end of life care, and to identify any gaps within the system. In 2014, DPM began its breast cancer pathway initiative by mapping the patient journey, depicting evidence-based best practice along the breast cancer care continuum, identifying where further guidance is needed for clinical decision making, and identifying gaps in quality of care and performance measurement indicators...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152692/pathway-map-development-as-an-approach-to-identifying-priority-areas-for-quality-improvement-in-ontario
#15
Jasmin Soobrian, Joan Murphy, Lorraine Elit, Michael F Milosevic, Angelika Gollnow, Jillian Ross, Claire Holloway
: 108 Background: Disease Pathway Management (DPM) is the unifying approach to the way in which Cancer Care Ontario (CCO) sets priorities for cancer control, plans cancer services and improves the quality of care in Ontario. In 2014 DPM began developing a cervical cancer pathway map (CCPM) to map the patient journey along the cervical cancer care continuum. OBJECTIVE: to report on the CPPM development process as a tool to identify key priorities for cervical cancer management in Ontario...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28150085/influence-of-scan-technique-on-intracoronary-transluminal-attenuation-gradient-in-coronary-ct-angiography-using-128-slice-dual-source-ct-multi-beat-versus-one-beat-scan
#16
Hae Jin Kim, Sung Mok Kim, Jin-Ho Choi, Yeon Hyeon Choe
The purpose of our study was to investigate the impact of temporal uniformity and adjustment by the contrast opacification enhancement in the aorta on the performance of transluminal attenuation gradient (TAG) for obstructive coronary artery disease. A total of 274 coronary arteries from 94 patients who underwent both multi- and single-beat scan using 128-slice scanner at the same time were enrolled. TAG and corrected coronary opacification (CCO) of both scan technique were compared against obstructive coronary arteries defined by diameter stenosis ≥50%...
February 1, 2017: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/28129476/synthesis-of-the-smallest-member-of-the-silylketene-family-h3sic-h-cco
#17
Ralf I Kaiser, Gyorgy Tarczay, Marko Förstel, Sándor Góbi, Pavlo Maksyutenko
Exploiting photoionization reflectron time-of-flight mass spectrometry (PI-ReTOF-MS) combined with electronic structure calculations, the hitherto elusive silylketene molecule (H3Si(H)C=C=O) - the isovalent counterpart of the well-known methylketene molecule - is formed via interaction of energetic electrons with low-temperature silane - carbon monoxide ices. In combination with the infrared spectroscopically detected triplet dicarbon monoxide reactant, electronic structure calcu¬lations suggest that dicarbon monoxide reacts with silane via a de facto insertion of the terminal carbon atom into a silicon - hydrogen single bond...
January 27, 2017: Chemphyschem: a European Journal of Chemical Physics and Physical Chemistry
https://www.readbyqxmd.com/read/28095694/effect-of-a-ph-gradient-on-the-protonation-states-of-cytochrome-c-oxidase-a-continuum-electrostatics-study
#18
Pedro R Magalhães, A Sofia F Oliveira, Sara R R Campos, Cláudio M Soares, António M Baptista
Cytochrome c oxidase (CcO) couples the reduction of dioxygen to water with transmembrane proton pumping, which leads to the generation of an electrochemical gradient. In this study we analyze how one of the components of the electrochemical gradient, the difference in pH across the membrane, or ΔpH, influences the protonation states of residues in CcO. We modified our continuum electrostatics/Monte Carlo (CE/MC) method in order to include the ΔpH and applied it to the study of CcO, in what is, to our best knowledge, the first CE/MC study of CcO in the presence of a pH gradient...
January 31, 2017: Journal of Chemical Information and Modeling
https://www.readbyqxmd.com/read/28071629/clinical-characteristics-with-patterns-of-relapse-and-survival-analysis-of-ovarian-clear-cell-carcinoma
#19
S Kaur, R A Kerkar, A Maheshwari, T S Shylasree, S Gupta, K Deodhar
AIMS: To analyze clinical characteristics, patterns of relapse, and treatment outcomes of clearcell carcinoma of the ovary (CCO). MATERIALS AND METHODS: Case files of 51 patients diagnosed with CCO between 2003 and 2010 were reviewed. RESULTS: The median age at diagnosis was 48 years (27-64 years). Fifty percent presented with nonspecific gastrointestinal symptoms. The median serum Ca125 was 74 IU/ml (6-1567 U/ml). Optimal cytoreduction was achieved in 32 (62...
April 2016: Indian Journal of Cancer
https://www.readbyqxmd.com/read/28042184/the-palisades-of-vogt-in-congenital-corneal-opacification-an-american-ophthalmological-society-thesis
#20
Ken K Nischal, Kira L Lathrop
PURPOSE: The purposes of this study are first, to determine if the palisades of Vogt (POV) are present or absent in cases of congenital corneal opacification (CCO) by using spectral domain ocular coherence tomography (SD-OCT), and second, in those cases already undergoing penetrating keratoplasty (PKP), to see whether the absence or presence of POV corresponds to re-epithelialization following transplant. METHODS: This was a retrospective case review of 20 eyes (10 normal, 10 with CCO) evaluated with SD-OCT...
August 2016: Transactions of the American Ophthalmological Society
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