Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

P1 Fall 2023 > US. Health exam 3 nations, literacy, conflict, digit. > Flashcards

US. Health exam 3 nations, literacy, conflict, digit. Flashcards

1
Q

Germany

A

Mandatory sickness funds
Predominantly private
Government-mandated, employment-based private insurance
7.3% is employer responsibility; 7.3% withheld from pay; equals 14.6% for each employee
2009-government run health fund distributes health funds based on risk adjustment
Not allowed to exclude, or raise rates according to age or medical condition
Remain in fund if ill, retired, lose job
Higher income can select private insurance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Germany: Medical Care

A

Appointments with Primary Care is common

Allowed to make appointments with specialists without a referral

Over 40% of physicians are generalists

Little coordination between hospitalists and generalists

Appointments, labs, prescriptions, hospitalization=No bill to the patient

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Germany: Payment Structure

A

Primary physician Bills regional Association of Physicians
- 1986- began to cap spending- Rationing

  • Physicians are reviewed quarterly, with each quarter affecting the following quarter

Hospitalists bill via Episode- Based funding or Bundle payment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Germany: Cost Control

A

Concerted Action
- Guideline Fees
- Hospital Rates
- Pharmaceuticals

Controls physician fees, capping physician fees

Throughout time still Germany has Gross Domestic Product (GDP) that has been rising since 1990

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Canada: Overview

A

Health insurance: show provincial government card

Hospital Insurance Act: Hospital coverage but no MD coverage

Universal medical insurance 1966

Tax financed, public, single-payer health care system

Funded with provincial and federal tax revenues

Not attached to employment at all

Everyone contributes through taxes-everyone benefits

No bill if part of provincial health service

Private insurance allowed for gaps: some pharmaceutical coverage or private hospital rooms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Canada: Medical Care

A

Family physician  referral to specialist

Specialists get paid best if referred

Longer waiting for elective procedures

Less services per capita than US for example: MRIs and surgery

Despite everyone being covered, inequities still happen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

US (days) vs. Canada (weeks): Long Waits

A

canada waits longer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Canada: Payers/Payment

A

Physician bills provincial government (and the government pays using the taxes!)

Paid in full according to fee schedule

Physicians must agree with payment, cannot bill patient

Blended models

Fee-for-service

Capitation

Hospital services slow-not enough money to pay extra

Hospitals do not need to prepare itemized bills

Approval process for capital projects of hospitals

Regulation of pharmaceutical prices

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Canada: Cost Control

A

Canada vs. US
- Less administrative costs
- Less expensive high tech costs
- Lower pharmaceutical prices

Caps on payment (Similar to Germany)

Changes in 2010 due to lack of confidence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

United Kingdom: Overview

A

Being on the “soil” entitled to receive tax supported medical care through NHS –National Health Service

Private health insurance can compete with NHS

11% buy private health insurance

Private insurance can pay for care of private hospitals not NHS facilities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

United Kingdom: Medical Care

A

NHS – need referral to specialist

Must have general practitioner

GP is primary care, local hospital is secondary care, regional/national hospitals is tertiary care

GPs not in hospitals, but with social services

Home care is highly developed in UK

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

United Kingdom: Payer/Payment

A

Capitation for MD

Preventive care fee for service

Home visits, nights and weekends, fee for service

Consultants=Specialists

Quality is awarded

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

United Kingdom: Cost Control

A

Queues lengthened
Capitation and salary for physicians
Limited consultant slots- controls supply of personnel and facilities
Fewer surgeons
Fewer meds
Fewer x-rays
More skeptical of new technology than US

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Japan: Overview

A

Large companies- required to operate self-insured plan for employees and dependents

Smaller companies-single national health insurance plan

Self-employed workers and Retirees- National Health
Insurance or Citizen’s Health Insurance

Government workers- society managed insurance

All have standard comprehensive coverage

Mix of employment-based insurance, social insurance, universal insurance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Japan: Medical Care

A

No pre-authorizations

No restrictions

Less hospitalizations

Less surgery

Longer hospital stays

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Japan: Payer/Payments

A

Fee-for service was the basis

2003 hospitals paid per diagnosis, physicians still paid fee-for-service

Government strictly regulates physician fees, hospital payments, medication pricing, number of expensive services

Physicians have high volume of seeing patients

Average physician visits: 13 per capita in Japan versus 4 per capita in US

Physicians may see 60 patients in a day

Physicians can dispense medications and profit from medications dispensed

Some patients see physicians just for refills

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Japan: Cost Control

A

GDP increasing 7.7% in 2000 to 10.3% in 2012
Healthcare system relies greatly on employer taxes
Low birth rate and longer life expectancy is problematic for this structure
Japan estimated 65 and older population is projected to increase from 12% 1990 to 39% in 2050
US 65 and older population also growing but not as quickly from 13% in 1990 to 21% in 2050
Costs are contained with strict fee schedules but may not be able to sustain with older facilities and potential underfunding of the healthcare system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

the U.S is a world outlier when it comes to spending

A

spends a lot on health care

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

the U.S is the only high inncome country that does not guarantee health coverage

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

the U.S spends 3 to 4 times more on health care than south korea, new zealand and japan

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

the U.S has among the lowest rates of physicians visits and practicing physicians

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

hospital stays are shortest in the netherlands and the U.S

A

the U.S has amongst the lowest number of hospital beds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

the US spends more on admin. costs but less on long term healthcare than other wealthy countries

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Secondary Features of National Health Insurance Plans

A

Benefit Package: What is covered or what is NOT covered? Just emergency care or is prevention care covered? Are prescriptions covered? Think about discrepancies such as women’s health?

Patient Cost Sharing: What is covered or what is NOT covered? How much are copayments, coinsurance, premiums, deductibles? Is there a maximum out of pocket? ACA has high cost sharing is a criticism of the system. Single-payer models tend to have low cost sharing.

Effects on existing health care coverage: National health care needs to look at all current health care options and understand effects on each type of coverage for example Medicare, Medicaid.

Cost Containment: Many models exist, including patient cost sharing, limiting percentage of health care premiums that can be retained for overhead and profit, review of medical loss ratio, or the amount of claims being paid for actual health services.

Reform Health Care Delivery: Expanding roles of nurses, pharmacists, and other health care providers, development of Accountable Care Organizations, financial incentives for rewarding higher value care.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

what were the results of the favorite label survey

A

patients liked the label with
- largest lettering
- most space
- easy to read directions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

things to know abt literacy and numeracy

A

make everything up to a 5th grade reading level

literacy: reading and understanding

numeracy: able to calculate how much insulin they need or how much sugar they take in from a meal that could effect blood sugar

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Patient Literacy Assessment Tools

A

Diabetes Numeracy Test

REALM-R: Rapid Estimate of Adult Literacy in Medicine, Revised

Short Assessment of Health Literacy–Spanish and English (SAHL-S&E)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Health Literacy Readability Assessment Tools

A

SMOG (“Simple Measure of Gobbledygook”) Readability Test
- make shorter sentences
- sentences with less syllable

Fry Readability Test
- out of 100 words, how many sentences and syllables are there

Flesch-Kincaid Grade Level Readability Formula
- average number of words used per sentence.
- average number of syllables per word.

SAM (Suitability Assessment of Materials)
- Content
- Literacy Demand
Graphics
Layout and Typography
Learning Stimulation and Motivation
Cultural Appropriateness
Each category rated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Making a Difference

What are some of the issues     with over-the-counter labels?
A

crowded

hard to read

small lettering

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Health Literacy and….

Drug Coverage

Prescription Label Instructions

A
31
Q

Four Major Actors in Conflicts, Change, Tensions, and Challenges

A

purchasers
insurers
providers
suppliers

took us through 80 years of healthcare

32
Q

Conflict of the actors and dollars

A

Insurers, providers, and suppliers make up the health care industry.

             Previously:
              Gain for health industry   Thought of as an investment in economics of the nation

              Now:
             Too much to pay, purchasers want to reduce the amount spent while health care wants       		the number to increase
33
Q

Provider-Insurance Pact 1945-1970

A

Alliance of insurers and providers
– Many independent hospitals
– Lack of competition

Hospitals and insurers decided payment provisions of Medicare and Medicaid
– Providers had the “upper hand” in negotiating generous payments
– Insurers paid without much question
* so providers benefitted and insurers did too

Employers paying for insurance and receiving tax benefits; no real complaints of increased costs
Businesses growing and profitable
Able to pay for benefits
Hospitals even charged for facilities and new construction

everyone was benefitting!!!!!

34
Q

Changed Perception of 1970s

A

US share of world industrial production decreasing from 60% in 1950 to 30% in 1980–decline!

    - Lower profits
    - Purchase cash flow decreased
    - Inflation and unemployment on the rise

New economic reality of less money for individuals and companies, becomes increased concern for the rising costs of health care

    - Hospitals being regulated for new construction
    - Government begins health planning agencies

Regulation begins after Blue Cross increase of premiums 25% to 50% in a single year

Utilization reviews begin by insurers
- Provider-insurer tensions rise
- Insurance-provider pact unravels-Blue Cross separates from the AHA

benefitting:
- purchasers are not benefitting
- insurers are benefitting
- providers are not benefitting, things are tightling up for them, more regulation for them. 50/50 benefit
- suppliers are not benefitting

more regulation and more changes
so really insurers are benefitting

35
Q

1980’s Purchasers Pay Attention

A

Costs increase for employer-sponsored health plans

By 1989 =20.4% of business expenses (it was a fraction of the cost from1945-1970)

Almost a double increase (from 5% to 9%) of payroll spent on health care benefits

Business more attentive to costs and health care issues

Large companies start self-insurance
	
More companies use managed care options such as HMOs as cost-control
	
Individuals and labor unions see shift of costs to them; complain of health care costs

Rising premiums and policy cancellations for those with chronic illnesses become media headlines; people with cancer get dropped

Selective contracting of purchasers = In-network and Out-of-Network

 Insurers choose providers to contract with (those that provide cost containment)
	 
Shift from fee for service to capitated reimbursement-causes providers to cost-control as well

Medicare payments are tighter controlled and Medicaid is scaled back

benefitting
- purchasers are not benefitting; speding more and being dropped from coverage if they have cancer
- insurers are benefitting due to HMOs and such
- providers are not benefitting because there are less people covered and sign contracts
- suppliers…not clear but we can guess that there is not a big increase and that they are pretty steady

36
Q

Coverage Landscape Changes-1990’s

what changed about the plan

what do employers do.

what happened to providers

what did purchasers have

A

Plan become very specific as to where and from whom care can be provided and covered

Employers shop around more for insurers

Providers would lose contracts due to poor rates and unwillingness of insurers to negotiate

Purchasers had some negotiating power with HMOs and saw a drop in premium growth in the earlier 1990’s

benefit
- purchasers benefit
- insurers 50/50, more competitionn
- providers are not benefitting due to contracts and rating
- suppliers pretty much the same, nothing happenigng for them

37
Q

2000’s

what do providers and insurers doo

A

Counter-revolution by providers/Consolidation in health care market

       Provider and insurance negotiations are intense
				 
       Costs accelerate especially for the individual employee-Premiums and deductibles rise 34%
				 
       Large HMOs emerge due to buy-outs and consolidation

Growing power of specialists and specialty services

      For-profit services, physician owned imaging facilities
				
      Specialist physician groups grow and negotiate for higher payment rates from insurers
				
      Ambulatory centers for day surgery and clinics grew and are physician owned
				
      Hospitalists are a growing specialty
				
				benefit
				- providers finally have the upper hand and are benefitting
				- suppliers are benefitting too, more equipement due to more small offices
				- purchasers and insurers are not benefittng
38
Q

2000’s

A

Pharmaceutical industry criticisms

    -   1988 Rx was 5.5% of national health expenses versus in  2009 10.1
				
     - Shift of insurance coverage of Rxs occur; Insurances take notice and begin to challenge   pharmaceutical costs; Tiers 	begin
				
    -   Most profitable companies: earning 20% of revenues compared to other Fortune 500 	companies that earn 5% of 	revenues
				
      No regulations by government to regulate prices
				
      Brand to generic tactics to continue market share-Hatch-Waxman Act
				- with the act there is 6 months and then manufacturers can add their generic products
				
      Generic manufactures are consolidating driving up generic costs
				
       “Evergreening”- Immediate release vs extended release after/close to 6 monhs time to extend their branding for longer than 17 years
				 
				 – Rx to OTC
				 
				 trying to cost control

Pharmacy Benefit Managers (PBM)
- Part of the supply chain and responsible for formularies
- billing

benefitting
suppliers benefit

39
Q

2000’s

A

Primary Care Shifts

 Primary care practices looking at capitation versus fee-for-service
	 
 Choosing Wisely campaign spotlights overuse of health care 
	 - might nt treat an older adult because it is not appropritate to do that
	 - ex: don't do mammogram yearly for elderly that are 80 y.o + 
              
 Payment for value versus volume
	 
 Patient-Oriented care on the rise
	 
 Primary care teams are forming
40
Q

The Perfect Health Care System

A

Noble aspirations but most likely impossible to attain 100%

Important factors of health care system:
- Improve health
- Control costs
- Prioritize allocation of resources
- Enhance quality of care
- Distribute services fairly

everyone would benefit!

41
Q

Blurring of the Actors

A

Insurers acquiring Providers: UnitedHealthcare acquired DaVita Medical Group

Providers acquiring Insurers: CVS merging with Aetna

Providers acquiring Suppliers: CVS merging with Caremark

Insurers acquiring Suppliers: Cigna merging with ExpressScripts

Companies moving into health care: Amazon

42
Q

in US

A

Shortage of primary care providers with substantial health deserts.

Mental health providers in sharp decline despite a growing need.

43
Q

Many conditions have increased during the pandemic.

Report Increase in Symptoms
- 67%

Additional Barriers to Care

A

60% of mental health providers cannot take new patients

Additional Barriers to Care
Travel costs and arrangements
Childcare
Time off work
Therapy costs and insurance coverage

44
Q

RISE OF HYBRID CARE MODELS

In person care

virtual care

A

IN-PERSON CARE
- Patients will need care in hospitals, rehabilitation centers

  • Majority of diagnostics & acute treatments will be handled in person
  • Health systems will adjust what services offered

VIRTUAL CARE
- Expansion of care models to embrace treatment of patients remotely where available

  • Scale up the use of technology to triage patients for in-person or remote care where applicable
  • Use of technology to collect and measure data remotely or provided digitalized treatment options
45
Q

HEALTHCARE IS CHANGING

what have patients adopted

what is home considered

how can providers meet patients

A

Patients have adopted a consumer mentality towards engaging in their health seeking to meet their needs on demand.

Home as the center of health is a quickly growing area of focus in medicine including the ‘Hospital at Home’ model

Meeting patients where they are at is a growing healthcare business structure across multiple care modalities.

46
Q

progression of health and digitalization

A

E-Health
- Rise of the Internet
(1990s)

mHealth
- Integration of IoT
(Early 2000s)

Digital Health
- Wearables and more
(2010s to Present)

47
Q

Why Digitalize Healthcare?

A

Digital tools are giving providers a more holistic view of patient health through access to data and giving patients more control over their health.

Digital health offers real opportunities to improve medical outcomes and enhance efficiency.

They can help address the following issues:
- Reduce inefficiencies,
- Improve access,
- Reduce costs,
- Increase quality, and
- Make medicine more personalized for patients.

48
Q

DIGITAL HEALTH TECHNOLOGIES

A

Enterprise System
& Support
- Platforms for healthcare systems, clinics, and enterprise settings.

Clinician Services & Support
- Platforms for clinicians and healthcare staff such as EHRs (Electronic health record).

Patient-Facing Wellness
& Support
- Products that capture, collect, store, or transmit patient health-related data.

Patient-Facing Diagnostics & Monitoring
- Products that diagnose, guide diagnosis, or actively monitor patients health.

Patient-Facing Therapeutic Interventions
- Products that deliver medically therapeutic interventions for patients.

49
Q
A

As of 2021, nearly 4 in 5 office-based physicians (78%) and nearly all non-federal acute care hospitals (96%) adopted a certified EHR. This marks substantial 10-year progress since 2011 when 28% of hospitals and 34% of physicians had adopted an EHR.

50
Q

TELEHEALTH

where does provider access patient

A

Telehealth — sometimes called telemedicine — lets your health care provider care for you without an in-person
office visit. Telehealth is done primarily online with internet access on your computer, tablet, or smartphone
.
Talk to your health care provider live over the phone or video chat.

Send and receive messages from your health care provider using secure messaging, email, and secure file exchange.
Majority of payers cover telehealth services for members
Expansion of services available pre-pandemic
Mental and psychological health over state lines

51
Q

Remote Patient Monitoring (RPM)

what do devices monitor

what can RPM be used for

A

Devices monitor physiological data from patients

CPT codes for setting up and monitoring data available from CMS

RPM can be used for many conditions that require physiological data indicative of disease management

Some patients will need in-person testing, diagnostics, or monitoring. This depends on their condition, Internet capabilities, or personal preferences and abilities.

But there are many ways that remote patient monitoring can help with chronic conditions, pregnancy complications, and short-term illness.

High blood pressure
Diabetes
Weight loss or gain
Heart conditions
Chronic obstructive pulmonary disease
Sleep apnea
Asthma

52
Q

Remote Therapeutic Monitoring (RTM)

what is it a combination of

what can it include

A

Combination of technology like RPM devices and disease management for therapeutic outcomes

This can include medication adherence and physiological data

Interventions can include education and coaching

Currently, CMS covers pulmonary and musculoskeletal conditions

CPT code 98976 - RTM (e.g., respiratory system status, musculoskeletal system status, therapy adherence, therapy response); device(s) supply with scheduled (e.g., daily) recording(s) and/or programmed alert(s) transmission to monitor respiratory system, each 30 days.

53
Q

DIGITALIZATION OF DEVICES

A
  • Integration of health devices into the ‘Internet of Things (IoT) landscape

Approaches include:
- Integration of Bluetooth to tether to an external device (e.g., smartphone or peripheral)
- Wireless integration (e.g., cellular, WiFi)

Mobile app integration for data collection and user engagement

Enabled the movement towards:
- Remote Patient Monitoring (RPM)
- Remote Therapeutic Monitoring (RTM)

Ongoing Issues:
- Accuracy, data interoperability, coverage, patient education, user adherence

54
Q

RISE OF CGM

A

Increased desire amongst PwD to utilize CGM ( continuous glucose monitor) over other BGM (Blood Glucose Meters) interventions due to fewer finger pricks and convenience

Visually impaired patients have benefited from easier BGM

Digital affinity closely related towards acceptance of the use of CGM technologies

This is likely to increase over time with digital natives

Increased recommendation of CGM use in clinical practice guidelines influencing clinician behavior

Limitations still present:
- Cost barriers
- Clinician and patient buy-in
- Technology barriers

55
Q

SMART BLOOD PRESSURE WATCH

A

Cuffless blood pressure monitors integrated with a smartwatch form factor have been gaining traction

Some technologies to facilitate BP/HR measurement include:
- Wrist-worn watch-type oscillometric BP monitoring (WBPM)
- Waveform measurement

Accuracy has been a concern and has limited integration within clinical practice guidelines
- Likely due to the variable sensitivity of BP measurement through location and patient difference

Technology continues to evolve and improve

56
Q

FOOT SENSORS

A

Utilization of sensors that PwD can utilize to detect the development of foot ulcers in the presence of neuropathy

Several pathways:
- Image capture of the foot (camera)
- Temperature sensor (socks with embedded sensors, smart mat)

Aim to remotely monitor high-risk patients for ulceration and reduction of foot infections

57
Q

SMART TOILETS

A

In May 2023, the FDA cleared a smart toilet seat to measure heart rate and SpO2 in adults at least 22 years of age weighing 90 to 350 pounds.

R&D is ongoing to create smart toilets that can measure biometrics, which could also:
- Track renal function
- BGM
- Medication adherence
- BP/HR

Data can be collected via:
- Excretion collection (stool & urine)
- toilet seat sensors

58
Q

Passive Monitoring vs Active Intervention

A

Passive Monitoring
- Continuous Patient Outcome Assessment
- Real-Time Patient Adherence Tracking
- Real-Time Patient Data

Active Intervention
- Establish New Patient Goals
- Adjust Care Plan
- Remote Intervention

59
Q

hospital at home model

A

ER/Provider identification of valid patients

conditions of defined treatment protocols
- HF, COPD, CAP, cellulitis

patient’s home is within hospital range to provide emergent care

Home as the center of health is a quickly growing area of focus in medicine including the ‘Hospital at Home’ model

home must have space and fit patient needs (ex: food, heat/cooling, water)

health staff visit patient in the home (ex, respiratory therapist, nursing)

tests conducted in the patient’s home and therapy (ex: medications) given as well

RPM will play a significant role

60
Q

PROGRAM IMPLEMENTATION BARRIERS

A

Education amongst multiple sites to have a cohesive approach to patient care

Leadership buy-in beyond the idea but providing logistical and staff support to allow the programs to develop (upfront investment)

Time and training for staff (turnover) that had no prior exposure to RPM/virtual care
- As education evolves, it should diminish

Leveraging ancillary staff (CDEs, Pharmacists) can help alleviate cognitive loads and expand workload

Launching RPM/Virtual services requires an initial evaluation of on-site needs and implementation considerations

61
Q

PATIENT BUY-IN

A

Modules related to diabetes education be enhanced and personalized for the individual rather than a set approach

Patients have variable health literacy and needs

Technical and physician support when adopting telemedicine

Onboarding patients may be what makes sure that patients will want to commit and engage or abandon

Data use needs to be explained (privacy & security)

Patients also express the importance of having a sufficiently flexible platform that could be adapted to their needs

RPM technology options account for patient diversity and technical support and education

Virtual care will not be for everyone and SDoH may be a barrier that needs to be addressed for adoption

62
Q

PAYER COVERAGE CONCERNS

A

Scope of RPM and telehealth services are still in flux post-pandemic

Concern related to reimbursement models and incentives for providers to utilize RPM/virtual care models vs in-person services due to margins

Increased risk of fraud of overbilling for services utilizing RPM and telehealth services

Codes (CPT) for RPM and RTM for diabetes management

Coverage for RPM devices and OOP costs
- Many studies gave devices for free or limited duration

Many employer-based programs are exploring the use of standalone DM-focused programs

63
Q

what is the difference between remote patient monitoring vs remote therapeutic monitoring

A

RTM enables patients’ self-reported data and digitally uploaded non-physiologic and therapeutic data.

RPM, on the other hand, requires physiologic data that is automatically transmitted and not manually uploaded.

64
Q

scenario
Lydia knows she is sick. She doesn’t know what it is, but she wants to feel better. But, how will she seek care?

WHAT ARE LYDIA’S OPTIONS?

A

Schedule a visit with her PCP
good:
- provider knows her
- prior billing set up

bad
- may not have availability

Go to urgent care clinic
good:
- Increased likelihood of being seen in person

bad
- Likely will have to wait
- Complete medical history may be unavailable

Use a telehealth service
- Can ‘meet’ at her personal convenience
- May only cover certain conditions
- May be referred to in-person

65
Q

THE RISE OF DIGITAL HEALTH TECHNOLOGIES

A
  • Omnimetrics of Health
  • Biosensors and Wearable Devices
  • Smart Precision Medicines
  • Mobile Integration
  • Continuous Feedback Loops
  • Scalable Services
66
Q

Drug Delivery System Milestones

A

1970 - insulin pumps come to market

1980 - insulin pens come to market

1990 - smart insulin pump development

2000s - rise of med adherence apps, GLP-1 agonist autoinjectors come to market

2010s - 2020s-
- smart insulin pens widley available
- first insulin dosing DTx cleared
- first bluetooth connected BGM approved
- rise of connected CGM devices

67
Q

STATEWIDE RPM PROGRAM MODEL (SC)

A

RPM program to improve the management of type 2 diabetes in low-income and rural populations, to identify patient-level variables that influence the likelihood of achieving HbA1c reduction at 6 and 12 months.

Patients included A1c > 8.0% and enrolled in community clinics

RPM Process:
- 2-in-1 blood pressure and glucose-monitoring device (FORA D40g)
- 4G cellular connection
- Central hub (academic center) oversaw training for clinic staff to handle data and adjust therapy

Results (2017-19)
- A1c reduction of 1.8% at 6 mo (n=302)
- A1c reduction of 1.3% at 12 mo
- (n = 125)
- Rural and underserved populations achieved significant improvements in HbA1c
- HbA1c reductions were sustained at 6 and 12 months of RPM program participation
- Patients of varying demographics and clinic types achieved similar clinical benefit

68
Q

weak AI vs strong AI

A

used in different areas of medicine

69
Q

LOOKING TO THE FUTURE

A

AI INTEGRATION

PAYER COVERAGE EXPANSION

IoT INTEGRATION

RWE INTEGRATION

VR/AR TECHNOLOGIES

DRUG + APP

REGULATORY OVERSIGHT

DIGITAL FORMULARIES

70
Q

Germany

A

Payment PCP

Cap spending

Care from PCP

No bill, no referrals

71
Q

Canada

A

Hospital insurance act but no MD coverage

Specialty referral and specialists get paid more if they are referred

Long wait

less service per capita

Tax financed insurance

72
Q

U.K

A

Staff supported care

Private insurance, private hospital only

Need referral to specialist

Need PCP

Home care is highly developed

Longer queues

Limited consultant slots

Fewer surgeons, X-Rays

More sceptical to new technology

73
Q

Japan

A

Pay from employer

Retiree pays a premium

No pre authorization or restraints

Less surgery, less hospital stay

Longer hospital stays

Low birth rate and longer life expectancy

P1 Fall 2023 (66 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions