Addressing the Health Needs of an Aging America: New Opportunities for Evidence-Based Policy Solutions

This report systematically maps research findings to policy proposals intended to improve the health of the elderly. The study identified promising evidence-based policies, like those supporting prevention and care coordination, as well as areas where the research evidence is strong but policy activity is low, such as patient self-management and palliative care. Future work of the Stern Center will focus on these topics as well as long-term care financing, the health care workforce, and the role of family caregivers

Business Models for e-Health: Evidence from Ten Case Studies

An increasingly aging population and spiraling healthcare costs have made the search for financially viable healthcare models an imperative of this century. The careful and creative application of information technology can play a significant role in meeting that challenge. Valuable lessons can be learned from an analysis of ten innovative telemedicine and e-health initiatives. Having proven their effectiveness in addressing a variety of medical needs, they have progressed beyond small-scale implementations to become an established part of healthcare delivery systems around the world

Redesigning Health Care for an Older America

With the goal of creating a new vision of health care for an older America, the International Longevity Center assembled a Health Care Task Force, a cadre of specialists in the fields of economics, social work, political science, and medicine. Its mandate is to focus on the development of an intergenerational life-span perspective of disease prevention and health maintenance, built on a strong foundation of structural reform medical care, by showing how strategies that enhance healthy aging can save money as well as improve quality of life. Midway into this ambitious four-year project, and with the hope of contributing to the national debate on health care, the Task Force established a list of guiding principles, with the belief that the longevity and healthy aging of today's older adults, the aging baby boomer generation and the generations that will follow, depend upon the health care decisions that are made today

The Veterans Health Administration: Taking Home Telehealth Services to Scale Nationally

Since the 1990s, the Veterans Health Administration (VHA) has used information and communications technologies to provide high-quality, coordinated, and comprehensive primary and specialist care services to its veteran population. Within the VHA, the Office of Telehealth Services offers veterans a program called Care Coordination/Home Telehealth (CCHT) to provide routine noninstitutional care and targeted care management and case management services to veterans with diabetes, congestive heart failure, hypertension, post-traumatic stress disorder, and other conditions. The program uses remote monitoring devices in veterans' homes to communicate health status and to capture and transmit biometric data that are monitored remotely by care coordinators. CCHT has shown promising results: fewer bed days of care, reduced hospital admissions, and high rates of patient satisfaction. This issue brief highlights factors critical to the VHA's success -- like the organization's leadership, culture, and existing information technology infrastructure -- as well as opportunities and challenges

Complex Care Management Program Overview

This report includes brief updates on various forms of complex care management including: Aetna - Medicare Advantage Embedded Case Management ProgramBrigham and Women's Hospital - Care Management ProgramIndependent Health - Care PartnersIntermountain Healthcare and Oregon Health and Science University - Care Management PlusJohns Hopkins University - Hospital at HomeMount Sinai Medical Center -- New York - Mount Sinai Visiting Doctors Program/ Chelsea-Village House Calls ProgramsPartners in Care Foundation - HomeMeds ProgramPrinceton HealthCare System - Partnerships for PIECEQuality Improvement for Complex Chronic Conditions - CarePartner ProgramSenior Services - Project Enhance/EnhanceWellnessSenior Whole Health - Complex Care Management ProgramSumma Health/Ohio Department of Aging - PASSPORT Medicaid Waiver ProgramSutter Health - Sutter Care Coordination ProgramUniversity of Washington School of Medicine - TEAMcar

Emerging needs in behavioral health and the integrated care model

Medically vulnerable populations are constantly at risk of having poor health related outcomes, low satisfaction in the healthcare system and increased mortality. Studies have shown the increased prevalence rates of various medical comorbidities in patients with severe mental illness. These patients are obviously vulnerable because of their mental illness but they are also more likely to have severe cases of medical conditions commonly seen in the general population. Expenditures and utilization of resources is often inappropriate due to frequent visits for acute needs and low rates of preventative care and primary care appointments. My proposed model focuses on the implementation of the integrated care model which encourages collaboration between mental health professionals and primary care physicians through referral programs or integrated clinic settings. This model is initiated with education to both current clinicians as well as future clinicians through medical schools and residency programs. Once the education component has begun, the next steps are formal exploration, preparation, implementation and evaluation of the model in clinics. The aim is to improve health outcomes by increasing preventative care and using behavioral techniques to assist with adherence, increase satisfaction in the healthcare system and contain expenditures by utilizing primary care services instead of emergency services when appropriate

Our Parents, Ourselves: Health Care for an Aging Population; A Report of the Dartmouth Atlas Project

The new Dartmouth Atlas, funded by The John A. Hartford Foundation, is a report card that analyzes Medicare data to show us where the United States is making progress in patient-centered, evidence-based care for Medicare beneficiaries and where improvement is still needed. It also offers insight into regional variations in care.Filling in the gaps in our knowledge about the state of care across the country will help health care providers, health systems, and patients and families work together to improve care for all older adults.This Dartmouth Atlas report looks at a number of measures from Medicare data, including:The number of days older adults spend in contact with the health care system;Use of high-risk medications;Cancer screening rates (and how they compare with recommendations);30-day hospital readmission rates;Annual Wellness Visit (AWV) rates;Late hospice referral; andThe number of days spent in intensive care.The report also offers a historical look at key practices, comparing data from 2003-05 and 2012

Palliative Care Academic Career Awards: A Public-Private Partnership to Improve Care for the Most Vulnerable

Palliative care, an increasingly important medical field that focuses on the relief of pain and suffering, is in danger of not being able to meet the needs of America's aging population, or anyone of any age suffering from serious or life-threatening illness

Systemic infections after acute stroke

After an acute stroke, systemic infection can complicate the recovery process and lead to a worse clinical outcome, including a higher risk of mortality. Post-stroke infection (PSI) is responsible for the majority of the mortality occurring between 1 week and 1 month after stroke, peaking towards the end of the second week. The effects of PSI on longer-term outcome and other aspects of recovery, such as cognition, mood and quality of life, are largely unknown. The cerebrovascular event itself may result in a systemic immunosuppressed state, hence lowering the threshold for subsequent systemic bacterial infections. Although there have been advances in the basic understanding of the pathophysiological mechanisms of PSI, clinical studies have not provided any clear guidelines on the best methods of managing or preventing PSI. This article provides a review of the current knowledge of the phenomenon of PSI and the possible future developments in the understanding and treatment of PSI