Although the health care reform movement has brought about positive changes, lingering inefficiencies and communication gaps continue to hamper system-wide progress toward achieving overarching goal-higher quality improved population outcomes at a lower cost. The multiple interrelated barriers improvement are most evident in for of patients with chronic conditions. During transitions care, lack integration among various silos inadequate providers cause delays delivering appropriate services...

Rural Aging in America: Proceedings of the 2017 Connectivity Summit Alexis Skoufalos, EdD, Janice L. Clarke, RN, BBA, Dana Rose Ellis, BA, Vicki Shepard, MSW, MPA, and Elizabeth Y. Rula, PhD Editorial: Creating a Movement to Transform AgingDavid B. Nash, MD, MBA, with Donato J. Tramuto, Joseph F. Coughlin, S-3 Introduction S-4 S-5 Roundtable 1: The Power Community – Enabling Social Connections Access Health Resources Through Community-Based Programs 2: Technology Health: Innovative Solutions...

Objective: The aim of this article is to evaluate the burden direct and indirect costs borne by recalled patients after a false positive screening mammogram. Methods: Women aged 40–75 years undergoing mammography were identified from U.S. commercial claims database. required have 12 months pre- 6 post-index enrollment identify utilization exclude with subsequent cancer diagnoses. Recall was defined as use diagnostic or breast ultrasound during post-index. Descriptive statistics presented for...

Overutilization, defined as use of unnecessary care when alternatives may produce similar outcomes, results in higher cost without increased value. Overutilization can be understood by focusing on settings where overuse is obvious. One example percutaneous coronary intervention (PCI) chronic stable angina. PCI a potentially lifesaving procedure an acute setting, but current practice guidelines indicate low-risk patients with angina should treated initially optimal medical therapy (OMT) and...

Industrial quality improvement (QI) methods such as continuous (CQI) may help bridge the gap between evidence-based "best care" and of care provided. In 2006, Baylor Health Care System collaborated with Jefferson Medical College Thomas University to conduct a QI demonstration project in select Pennsylvania hospitals using CQI techniques developed by Baylor. The training was provided over 6-month period focused on for rapid-cycle improvement; data system design; management; tools improve...

Surgical site infection (SSI) is recognized as a focus area by the Centers for Medicare and Medicaid Services, Joint Commission, Institute Healthcare Improvement, of Medicine. An estimated 47% to 84% SSIs present after discharge from hospital or ambulatory care facility and, result, go undetected standard SSI surveillance programs. Evidence-based processes practices that are known reduce incidence tend be underused in routine practice. This article describes multistakeholder process used...

Chronic instability in the health care environment has raised concerns among providers and patients, especially those who treat cope with chronic conditions. Changes to existing laws are unlikely alter what have become primary goals of US system: cost-effectiveness patient-centricity. To that end, it is vital patient physician voices be incorporated policy decisions and, importantly, access patient-reported outcomes considered when calculating "value." Following a discussion perceived...

The increasing prevalence of prediabetes and diabetes in the United States poses a serious threat to health population. Closely associated with obesity, hypertension, dyslipidemia, cardiovascular disease, diagnosis or carries it life-altering demands. Critically important among these is requirement for frequent glucose level checks-typically performed blood obtained from fingerstick. Innovative real-time continuous monitoring (rtCGM) technology makes possible patients their clinicians...

On May 11, 2018, a panel of experts was convened at the Jefferson College Population Health in Philadelphia, PA, to provide multi-stakeholder perspectives on this innovative product terms its potential role optimizing clinical and cost outcomes for population patients who require EN support treatment EPI.

When given the opportunity to become actively involved in decision-making process, patients can positively impact their health outcomes. Understanding how empower informed consumers of care services is an important strategy for addressing disparities and variability care. Patient credentialing identifies people who have a certain diagnosis achieved levels competency understanding managing disease. was developed meet 3 core purposes: (1) enhance patient engagement by increasing personal...

New Jersey's 3-year Medicaid Accountable Care Organization (ACO) Demonstration Project was the result of a bipartisan effort to address quality and cost issues regarding State's safety net population. The legislation sets forth framework that allows communities customize ACOs meet unique needs their Camden, Trenton, Newark are currently experimenting with implementation at various levels. This article documents context, journey, challenges, future direction through accounts 7 stakeholders...

Voluntary and mandatory hospitalist models the challenge they face of ensuring that patient care interests retain priority. Virtual Mentor is a monthly bioethics journal published by American Medical Association.