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https://www.readbyqxmd.com/read/28738685/assessing-the-effect-of-the-vha-pcmh-model-on-utilization-patterns-among-veterans-with-ptsd
#1
Ian Randall, Charles Maynard, Gary Chan, Beth Devine, Chris Johnson
OBJECTIVES: The Veterans Health Administration (VHA) implemented a patient-centered medical home (PCMH)-based Patient Aligned Care Teams (PACT) model in 2010. We examined its effects on the utilization of health services among US veterans with posttraumatic stress disorder (PTSD). STUDY DESIGN: We analyzed VHA clinical and administrative data to conduct an interrupted time series study. Encounter-level data were obtained for the period of April 1, 2005, through March 31, 2014...
May 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/28720558/my-team-of-care-study-a-pilot-randomized-controlled-trial-of-a-web-based-communication-tool-for-collaborative-care-in-patients-with-advanced-cancer
#2
Teja Voruganti, Eva Grunfeld, Trevor Jamieson, Allison M Kurahashi, Bhadra Lokuge, Monika K Krzyzanowska, Muhammad Mamdani, Rahim Moineddin, Amna Husain
BACKGROUND: The management of patients with complex care needs requires the expertise of health care providers from multiple settings and specialties. As such, there is a need for cross-setting, cross-disciplinary solutions that address deficits in communication and continuity of care. We have developed a Web-based tool for clinical collaboration, called Loop, which assembles the patient and care team in a virtual space for the purpose of facilitating communication around care management...
July 18, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28694266/comparing-medical-ecology-utilization-and-expenditures-between-1996-1997-and-2011-2012
#3
Michael E Johansen
PURPOSE: This study compared ecology (number of individuals using a service), utilization (number of services used), and expenditures (dollars spent) for various categories of medical services between primarily 1996-1997 and 2011-2012. METHODS: A repeated cross-sectional study was performed using nationally representative data mainly from the 1996, 1997, 2011, and 2012 Medical Expenditure Panel Survey (MEPS). These data were augmented with the 2002-2003 MEPS as well as the 1999-2000 and 2011-2012 National Heath and Nutrition Examination Survey...
July 2017: Annals of Family Medicine
https://www.readbyqxmd.com/read/28648218/innovative-information-technology-powered-population-health-care-management-improves-outcomes-and-reduces-hospital-readmissions-and-emergency-department-visits
#4
Sharon Anderson, Michele Campbell, Donna Mahoney, Ann Kathryn Muther, Janice Nevin, Patricia Resnik, Tabassum Salam, Terri Steinberg
BACKGROUND: Patients with chronic conditions are often the most frequent users of health care. Moreover, adapting to developments in one's illness, understanding how to self-manage a chronic illness, and sharing information between primary care and specialty providers, can be a full-time job for someone with a chronic illness. In response to these challenges, Christiana Care Health System (Wilmington, Delaware) developed Care Link, an information technology (IT)-enhanced care management support to enable populations of patients to achieve better clinical outcomes at lower cost...
July 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28641378/staff-perceptions-of-key-factors-guiding-nursing-home-search-and-selection-within-the-veterans-health-administration
#5
Edward Alan Miller, Stefanie Gidmark, Emily Gadbois, James L Rudolph, Orna Intrator
Background and Objectives: Veterans enter nursing homes (NHs) for short-term postacute, rehabilitation, respite, or end-of-life care. They also enter NHs on a long-term basis due to frailty, disability, functional deficits, and cognitive impairment. Little is known about how a particular NH is chosen once the decision to enter a NH has been made. This study identified VA staff perceptions of the key factors influencing the search and selection of NHs within the Veterans Health Administration (VHA)...
June 21, 2017: Gerontologist
https://www.readbyqxmd.com/read/28561691/improving-quality-and-value-of-cancer-care-for-older-adults
#6
Erika E Ramsdale, Valerie Csik, Andrew E Chapman, Arash Naeim, Beverly Canin
The concepts of quality and value have become ubiquitous in discussions about health care, including cancer care. Despite their prominence, these concepts remain difficult to encapsulate, with multiple definitions and frameworks emerging over the past few decades. Defining quality and value for the care of older adults with cancer can be particularly challenging. Older adults are heterogeneous and often excluded from clinical trials, severely limiting generalizable data for this population. Moreover, many frameworks for quality and value focus on traditional outcomes of survival and toxicity and neglect goals that may be more meaningful for older adults, such as quality of life and functional independence...
2017: American Society of Clinical Oncology Educational Book
https://www.readbyqxmd.com/read/28557774/the-primary-care-pediatrician-and-the-care-of-children-with-cleft-lip-and-or-cleft-palate
#7
Charlotte W Lewis, Lisa S Jacob, Christoph U Lehmann
Orofacial clefts, specifically cleft lip and/or cleft palate (CL/P), are among the most common congenital anomalies. CL/P vary in their location and severity and comprise 3 overarching groups: cleft lip (CL), cleft lip with cleft palate (CLP), and cleft palate alone (CP). CL/P may be associated with one of many syndromes that could further complicate a child's needs. Care of patients with CL/P spans prenatal diagnosis into adulthood. The appropriate timing and order of specific cleft-related care are important factors for optimizing outcomes; however, care should be individualized to meet the specific needs of each patient and family...
May 2017: Pediatrics
https://www.readbyqxmd.com/read/28554209/real-world-evidence-and-the-behavioral-economics-of-physician-prescribing
#8
Bruce Feinberg
The projections for the rising cost of healthcare have spurred robust dialogue, and among the many targets for cost control are specialty drugs. An important question thus becomes: Are behavioral economic factors driving physician prescribing? This article presents a review of leading behavioral economic theories and their application to the results of an Oncology Medical Home pilot that reversed incentives from drug administration to patient care. A host of these theories may explain the irrational economic actors in regard to physician prescribing, including heuristics, framing, and defaults...
April 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/28525311/telerehabilitation-of-patients-with-injuries-of-the-lower-extremities
#9
Andriy I Tsvyakh, Andriy J Hospodarskyy
INTRODUCTION: Timely access to orthopedic rehabilitation is an important problem for the Ukrainian healthcare system. The international orthopedic community aims to achieve the best possible outcome for patient care by modifying rehabilitation methods and using telemedicine technology. The theme of this article is to discuss the integration of telemedicine technology in the rehabilitation of patients with injuries of the lower extremities. MATERIALS AND METHODS: Consecutive patients were recruited over a 2-year period...
May 19, 2017: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/28516492/telemedicine-in-dermatology-findings-and-experiences-worldwide-a-systematic-literature-review
#10
REVIEW
L Eissing, A Trettel, M Augustin
Telemedicine has become an important element of health care in many countries and profited from the technological progress of the last two decades. Due to the visual character of the dermatological specialty, teledermatology in particular participated in that development and is becoming a major tool in dermatological consultation. The objective of this article was to identify the use of teledermatology across the world based on published original articles. A systematic literature search of the Medline and Embase databases for eligible publications (predefined inclusion and exclusion criteria) and a cross-validation search were conducted...
May 18, 2017: Journal of the European Academy of Dermatology and Venereology: JEADV
https://www.readbyqxmd.com/read/28485085/the-educational-impact-of-experience-overseas
#11
Thomas A Fox, Ged Byrne, Lucie M Byrne-Davis
BACKGROUND: Health care professionals are increasingly seeking overseas experience as part of their training. In the UK and Ireland, spending time overseas is becoming increasingly common during the first few years of training, with 10.8 per cent of Foundation Year-2 (Postgraduate Year-2) doctors working outside the UK in 2015. Although we know that doctors in training are increasingly seeking overseas experience, the reasons behind this are unknown. Many travel with the intention of returning after a period of time...
May 9, 2017: Clinical Teacher
https://www.readbyqxmd.com/read/28481843/vha-patient-centered-medical-home-associated-with-lower-rate-of-hospitalizations-and-specialty-care-among-veterans-with-posttraumatic-stress-disorder
#12
Ian Randall, David C Mohr, Charles Maynard
OBJECTIVE: The Veterans Health Administration (VHA) implemented a patient-centered medical home (PCMH) model, termed Patient Aligned Care Teams (PACT), in 2010. We assessed the association between PACT and the use of health services among U.S. veterans with posttraumatic stress disorder (PTSD). METHODS: VHA clinical and administrative data were obtained for the pre-PACT period of April 1, 2009 to March 31, 2010 and post-PACT period of June 1, 2011 to May 31, 2012...
May 2017: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/28461356/medical-group-structural-integration-may-not-ensure-that-care-is-integrated-from-the-patient-s-perspective
#13
Michaela J Kerrissey, Jonathan R Clark, Mark W Friedberg, Wei Jiang, Ashley K Fryer, Molly Frean, Stephen M Shortell, Patricia P Ramsay, Lawrence P Casalino, Sara J Singer
Structural integration is increasing among medical groups, but whether these changes yield care that is more integrated remains unclear. We explored the relationships between structural integration characteristics of 144 medical groups and perceptions of integrated care among their patients. Patients' perceptions were measured by a validated national survey of 3,067 Medicare beneficiaries with multiple chronic conditions across six domains that reflect knowledge and support of, and communication with, the patient...
May 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28417587/healthcare-utilization-and-spending-by-children-with-cancer-on-medicaid
#14
Emily L Mueller, Matt Hall, Jay G Berry, Aaron E Carroll, Michelle L Macy
BACKGROUND: Children with cancer are a unique patient population with high resource, complex healthcare needs. Understanding their healthcare utilization could highlight areas for care optimization. PROCEDURE: We performed a retrospective, cross-sectional analysis of the 2014 Truven Marketscan Medicaid Database to explore clinical attributes, utilization, and spending among children with cancer who were Medicaid enrollees. Eligible patients included children (ages 0-18 years) with cancer (Clinical Risk Group 8)...
April 18, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28397131/making-a-medical-home-for-ibd-patients
#15
REVIEW
Lawrence R Kosinski, Joel Brill, Miguel Regueiro
PURPOSE OF REVIEW: The transformation from fee for service to fee for value requires structural changes to the way gastroenterologists manage patients with inflammatory bowel disease (IBD). A team-based approach using technology to engage patients is necessary for success. The Patient-Centered Medical Home (PCMH) represents a unique model that brings together these essential features. This paper describes how the PCMH model has been successfully applied to the management of patients with IBD...
May 2017: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/28373156/an-analysis-of-2-3-million-participations-in-the-continuing-medical-education-program-of-a-general-medical-journal-suitability-user-characteristics-and-evaluation-by-readers
#16
Hildegard Christ, Jeremy Franklin, Reinhard Griebenow, Christopher Baethge
BACKGROUND: Physicians frequently use continuing medical education (CME) in journals. However, little is known of the evaluation of journal CME by readers and also user and participation characteristics. Deutsches Ärzteblatt, the journal of the German Medical Association, is distributed to every physician in Germany and regularly offers its readers CME articles. Therefore, it provides a unique opportunity to analyze a journal CME program directed at an entire population of physicians...
April 3, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28339689/genomic-decision-support-needs-in-pediatric-primary-care
#17
Jeffrey W Pennington, Dean J Karavite, Edward M Krause, Jeffrey Miller, Barbara A Bernhardt, Robert W Grundmeier
Clinical genome and exome sequencing can diagnose pediatric patients with complex conditions that often require follow-up care with multiple specialties. The American Academy of Pediatrics emphasizes the role of the medical home and the primary care pediatrician in coordinating care for patients who need multidisciplinary support. In addition, the electronic health record (EHR) with embedded clinical decision support is recognized as an important component in providing care in this setting. We interviewed 6 clinicians to assess their experience caring for patients with complex and rare genetic findings and hear their opinions about how the EHR currently supports this role...
February 19, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28336202/medical-surgical-activity-and-the-current-state-of-training-of-urology-residents-in-spain-results-of-a-national-survey
#18
M E Rodríguez-Socarrás, J Gómez Rivas, M García-Sanz, L Pesquera, L Tortolero-Blanco, M Ciappara, A Melnick, J Colombo, G Patruno, Á Serrano-Pascual, J Bachiller-Burgos, J M Cozar-Olmo
OBJECTIVES: To determine the actual state of medical-surgical activity and training for urology residents in Spain. MATERIAL AND METHOD: We designed 2 anonymous surveys, which were uploaded with the Google Docs(©) tool so that the respondents could answer the surveys online. The online collection period was September 2015 to January 2016. The collected data were processing using the statistical programme IBM SPSS for Windows, Version 21.0 and the programme R version 3...
March 20, 2017: Actas Urologicas Españolas
https://www.readbyqxmd.com/read/28334566/improving-communication-with-primary-care-physicians-at-the-time-of-hospital-discharge
#19
Lauren A Destino, Amy Dixit, Julie L Pantaleoni, Matthew S Wood, Natalie M Pageler, Joe Kim, Terry S Platchek
BACKGROUND: Communication with primary care physicians (PCPs) at the time of a patient's hospital discharge is important to safely transition care to home. The goal of this quality improvement initiative was to increase discharge communication to PCPs at an academic children's hospital. METHODS: A multidisciplinary team at Lucile Packard Children's Hospital Stanford used Lean A3 problem solving methodology to address the problem of inadequate discharge communication with PCPs...
February 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28328735/building-workforce-capacity-abroad-while-strengthening-global-health-programs-at-home-participation-of-seven-harvard-affiliated-institutions-in-a-health-professional-training-initiative-in-rwanda
#20
Corrado Cancedda, Robert Riviello, Kim Wilson, Kirstin W Scott, Meenu Tuteja, Jane R Barrow, Bethany Hedt-Gauthier, Gene Bukhman, Jennifer Scott, Danny Milner, Giuseppe Raviola, Barbara Weissman, Stacy Smith, Tej Nuthulaganti, Craig D McClain, Barbara E Bierer, Paul E Farmer, Anne E Becker, Agnes Binagwaho, Joseph Rhatigan, David E Golan
A consortium of 22 U.S. academic institutions is currently participating in the Rwanda Human Resources for Health Program (HRH Program). Led by the Rwandan Ministry of Health and funded by both the U.S. Government and the Global Fund to Fight AIDS, Tuberculosis and Malaria, the primary goal of this seven-year initiative is to help Rwanda train the number of health professionals necessary to reach the country's health workforce targets. Since 2012, the participating U.S. academic institutions have deployed faculty from a variety of health-related disciplines and clinical specialties to Rwanda...
May 2017: Academic Medicine: Journal of the Association of American Medical Colleges
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