Organizing the U.S. Health Care Delivery System for High Performance

Analyzes the fragmentation of the healthcare delivery system and makes policy recommendations -- including payment reform, regulatory changes, and infrastructure -- for creating mechanisms to coordinate care across providers and settings

Increasing the Capacity of Primary Care Through Enabling Technology.

Primary care is the foundation of effective and high-quality health care. The role of primary care clinicians has expanded to encompass coordination of care across multiple providers and management of more patients with complex conditions. Enabling technology has the potential to expand the capacity for primary care clinicians to provide integrated, accessible care that channels expertise to the patient and brings specialty consultations into the primary care clinic. Furthermore, technology offers opportunities to engage patients in advancing their health through improved communication and enhanced self-management of chronic conditions. This paper describes enabling technologies in four domains (the body, the home, the community, and the primary care clinic) that can support the critical role primary care clinicians play in the health care system. It also identifies challenges to incorporating these technologies into primary care clinics, care processes, and workflow

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

Information management in healthcare organizations

The health care industry is currently experiencing numerous fundamental changes. Healthcare organizations (HCOs) are increasingly challenged to look at their operations and find new opportunities to reorganize their processes, in order to improve the efficiency and effectiveness of their services, reduce costs, be more competitive, and also provide high quality and more personalized patient care. This new business strategy requires HCOs to implement new Information and Communication Technologies, such as Internet applications, enterprise information systems, and mobile technologies, in order to achieve their desired business changes and results, mainly through better information management methods and techniques. Based on these perspectives, this article aims to initially define and discuss the key challenges and opportunities for promoting high quality and cost effective care in HCOs. It describes the fundamental and important aspects of information management, as well as the technology drivers that aim to improve the generation and flow of health information within HCOs.information technologies, management, healthcare organizations

Committed to Safety: Ten Case Studies on Reducing Harm to Patients

Presents case studies of healthcare organizations, clinical teams, and learning collaborations to illustrate successful innovations for improving patient safety nationwide. Includes actions taken, results achieved, lessons learned, and recommendations

How 5G wireless (and concomitant technologies) will revolutionize healthcare?

The need to have equitable access to quality healthcare is enshrined in the United Nations (UN) Sustainable Development Goals (SDGs), which defines the developmental agenda of the UN for the next 15 years. In particular, the third SDG focuses on the need to “ensure healthy lives and promote well-being for all at all ages”. In this paper, we build the case that 5G wireless technology, along with concomitant emerging technologies (such as IoT, big data, artificial intelligence and machine learning), will transform global healthcare systems in the near future. Our optimism around 5G-enabled healthcare stems from a confluence of significant technical pushes that are already at play: apart from the availability of high-throughput low-latency wireless connectivity, other significant factors include the democratization of computing through cloud computing; the democratization of Artificial Intelligence (AI) and cognitive computing (e.g., IBM Watson); and the commoditization of data through crowdsourcing and digital exhaust. These technologies together can finally crack a dysfunctional healthcare system that has largely been impervious to technological innovations. We highlight the persistent deficiencies of the current healthcare system and then demonstrate how the 5G-enabled healthcare revolution can fix these deficiencies. We also highlight open technical research challenges, and potential pitfalls, that may hinder the development of such a 5G-enabled health revolution

A High Performance Health System for the United States: An Ambitious Agenda for the Next President

Presents the recommendations of the Fund's Commission on a High Performance Health System on the reforms needed to reach and raise benchmark performance levels, such as universal coverage, cost containment, and implementing an electronic records system

Fall Prediction and Prevention Systems: Recent Trends, Challenges, and Future Research Directions.

Fall prediction is a multifaceted problem that involves complex interactions between physiological, behavioral, and environmental factors. Existing fall detection and prediction systems mainly focus on physiological factors such as gait, vision, and cognition, and do not address the multifactorial nature of falls. In addition, these systems lack efficient user interfaces and feedback for preventing future falls. Recent advances in internet of things (IoT) and mobile technologies offer ample opportunities for integrating contextual information about patient behavior and environment along with physiological health data for predicting falls. This article reviews the state-of-the-art in fall detection and prediction systems. It also describes the challenges, limitations, and future directions in the design and implementation of effective fall prediction and prevention systems

Remote Patient Monitoring: Decrease Rehospitalization for Spinal Cord Injury Patients

Practice Problem: The lengthy distance required to access specialty care, the overall higher cost of SCI/D care, complications associated with SCI, and the potential negative impact of shortened hospital stays are all compelling reasons to use telehealth technologies to deliver specialty services for medical issues. PICOT: The PICOT question that guided this project was in adult spinal cord injury patients with chronic disease receiving primary care at a spinal cord injury center (P), how does the implementation of a remote patient monitoring home telehealth for SCI patients recently discharged from acute-care setting (I) compared to the usual practice of one post-discharge follow up phone call at 7 days (C), improve early recognition of patient deterioration to prevent acute care rehospitalization (O) within 30 days of discharge (T). Evidence: Spinal Cord injury patients are at risk for developing complications after injury. Paststudies have demonstrated the effectiveness of telehealth to prevent rehospitalization, which suggests the potential of telehealth on post-discharge follow-up care. Intervention: Implement remote patient monitoring home telehealth for SCI patients meeting the criteria for high-risk rehospitalization. Outcome: The pilot project results have a positive correlation with the reduction of 30-day hospital readmission rates for SCI patients participating in the RPM. During the pilot period, no readmissions occurred for the RPM participants, whereas those who declined participation were readmitted at a rate of 22%. Clinical significant findings of improved outcomes and reduced 30-day readmissions are supported through this pilot project. Conclusion: The project utilized the Johns Hopkins evidence-based model’s three-step PET framework and Roger’s diffusion of innovation change theory to support reduced rehospitalization for SCI patients through RPM