scholarly journals Towards Excellence in Asthma Management: Final Report of an Eight-Year Program Aimed at Reducing Care Gaps in Asthma Management in Quebec

2008 ◽  
Vol 15 (6) ◽  
pp. 302-310 ◽  
Author(s):  
Louis-Philippe Boulet ◽  
Eileen Dorval ◽  
Manon Labrecque ◽  
Michel Turgeon ◽  
Terrence Montague ◽  
...  
Keyword(s):  
Health Care ◽  
Disease Management ◽  
Health Care System ◽  
Inhaled Corticosteroids ◽  
Asthma Management ◽  
Final Report ◽  
Asthma Care ◽  
Treatment Needs ◽  
Care Gaps ◽  
Care System

BACKGROUND AND OBJECTIVES: Asthma care in Canada and around the world persistently falls short of optimal treatment. To optimize care, a systematic approach to identifying such shortfalls or ‘care gaps’, in which all stakeholders of the health care system (including patients) are involved, was proposed.METHODS: Several projects of a multipartner, multidisciplinary disease management program, developed to optimize asthma care in Quebec, was conducted in a period of eight years. First, two population maps were produced to identify regional variations in asthma-related morbidity and to prioritize interventions for improving treatment. Second, current care was evaluated in a physician-patient cohort, confirming the many care gaps in asthma management. Third, two series of peer-reviewed outcome studies, targeting high-risk populations and specific asthma care gaps, were conducted. Finally, a process to integrate the best interventions into the health care system and an agenda for further research on optimal asthma management were proposed.RESULTS: Key observations from these studies included the identification of specific patterns of noncompliance in using inhaled corticosteroids, the failure of increased access to spirometry in asthma education centres to increase the number of education referrals, the transient improvement in educational abilities of nurses involved with an asthma hotline telephone service, and the beneficial effects of practice tools aimed at facilitating the assessment of asthma control and treatment needs by general practitioners.CONCLUSIONS: Disease management programs such as Towards Excellence in Asthma Management can provide valuable information on optimal strategies for improving treatment of asthma and other chronic diseases by identifying care gaps, improving guidelines implementation and optimizing care.

scholarly journals Potential Benefits and Risks Resulting From the Introduction of Health Apps and Wearables Into the German Statutory Health Care System: Scoping Review (Preprint)

2019 ◽  
Author(s):  
Alexandra Heidel ◽  
Christian Hagist
Keyword(s):  
Health Care ◽  
Disease Management ◽  
Health Care System ◽  
Data Privacy ◽  
Digital Health ◽  
Treatment Quality ◽  
Exclusion Criterion ◽  
Health Apps ◽  
Risks And Benefits ◽  
Care System

BACKGROUND Germany is the first country worldwide that has introduced a digital care act as an incentive system to enhance the use of digital health devices, namely health apps and wearables, among its population. The act allows physicians to prescribe statutory financed and previously certified health apps and wearables to patients. This initiative has the potential to improve treatment quality through better disease management and monitoring. OBJECTIVE The aim of this paper was to outline the key concepts related to the potential risks and benefits discussed in the current literature about health apps and wearables. Furthermore, this study aimed to answer the research question: Which risks and benefits may result from the implementation of the digital care act in Germany? METHODS We conducted the scoping study by searching the databases PubMed, Google Scholar, and JMIR using the keywords health apps and wearables. We discussed 55 of 136 identified articles published in the English language from 2015 to March 2019 in this paper using a qualitative thematic analysis approach. RESULTS We identified four key themes within the articles: Effectivity of health apps and wearables to improve health; users of health apps and wearables; the potential of bring-your-own, self-tracked data; and concerns and data privacy risks. Within these themes, we identified three main stages of benefits for the German health care system: Usage of health apps and wearables; continuing to use health apps and wearables; and sharing bring-your-own; self-tracked data with different agents in the health care sector. CONCLUSIONS The digital care act could lead to an improvement in treatment quality through better patient monitoring, disease management, personalized therapy, and better health education. However, physicians should play an active role in recommending and supervising health app use to reach digital-illiterate or health-illiterate people. Age must not be an exclusion criterion. Yet, concerns about data privacy and security are very strong in Germany. Transparency about data processing should be provided at all times for continuing success of the digital care act in Germany.

Resolving Pediatric Preventive Care Gaps Through Hospital Inreach

PEDIATRICS ◽  
2021 ◽  
Author(s):  
John F. Morehous ◽  
Cynthia White ◽  
William B. Brinkman ◽  
Dominick J. DeBlasio ◽  
Allison Reyner ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Quality Improvement ◽  
Health Care System ◽  
Preventive Care ◽  
Failure Modes ◽  
Hospital Medicine ◽  
Primary Care Settings ◽  
Care Gaps ◽  
Care System

OBJECTIVES: Panel management processes have been used to help improve population-level care and outreach to patients outside the health care system. Opportunities to resolve gaps in preventive care are often missed when patients present outside of primary care settings but still within the larger health care system. We hypothesized that we could design a process of “inreach” capable of resolving care gaps traditionally addressed solely in primary care settings. Our aim was to identify and resolve gaps in vaccinations and screening for lead exposure for children within our primary care registry aged 2 to 66 months who were admitted to the hospital. We sought to increase care gaps closed from 12% to 50%. METHODS: We formed a multidisciplinary team composed of primary care and hospital medicine physicians, nursing leadership, and quality improvement experts within the Division of General and Community Pediatrics. The team identified a smart aim, mapped the process, predicted failure modes, and developed a key driver diagram. We identified, tested, and implemented multiple interventions related to role assignment, identification of admitted patients with care gaps, and communication with the inpatient teams. RESULTS: After increasing the reliability of our process to identify and contact the hospital medicine team caring for patients who needed action to 88%, we observed an increase in the preventive care gaps closed from 12% to 41%. CONCLUSIONS: A process to help improve preventive care for children can be successfully implemented by using quality improvement methodologies outside of the traditional domains of primary care.

Abgewickelte Gesundheitsinstitutionen als (Quasi-)Innovationen

2020 ◽  
Vol 69 (6-7) ◽  
pp. 467-487
Author(s):  
Marlene Haupt ◽  
Christian Römhild ◽  
Charlotte Fechter
Keyword(s):  
Health Care ◽  
Disease Management ◽  
Health Care System ◽  
Profit Maximization ◽  
Well Being ◽  
Consumer Sovereignty ◽  
Prävention Und Gesundheitsförderung ◽  
German Healthcare System ◽  
Prevention And Health Promotion ◽  
Care System

Zusammenfassung Zum Abbau von Ineffizienzen im deutschen Gesundheitssystem wurden Institutionen wieder eingeführt, welche in ähnlicher Form bereits im Gesundheitssystem der DDR existiert haben. Drei Beispiele wurden ausgewählt: Die heutigen Medizinischen Versorgungszentren ähneln den Polikliniken der DDR, die Disease-Management-Programme sind mit der Dispensaire-Versorgung der DDR vergleichbar und die Bereiche Prävention und Gesundheitsförderung gab es in der DDR in Form der Gesundheitserziehung. Diese heutigen Institutionen werden dahingehend untersucht, inwiefern sie dazu beitragen, Ineffizienzen abzubauen und vor dem Hintergrund der Ökonomisierung im deutschen Gesundheitswesen zur Steigerung des Patientenwohls beitragen. Dabei wird betrachtet, wie sie hinsichtlich der Dimensionen Gewinnmaximierung, Wettbewerb, Preisbildung und Kundensouveränität wirken. Abstract: Liquidated Healthcare Institutions as (Quasi-)innovations To reduce inefficiencies in the German health care system, institutions have been reintroduced that have already existed in a similar form in the health care system of the GDR. Three examples have been selected: Today’s medical care centers (MVZ) are similar to the GDR’s so called „Polikliniken“, the disease management programs are comparable to the GDR’s dispensaire care, and the prevention and health promotion today were called health education („Gesundheitserziehung“) in the GDR. These institutions are being examined to what extent they serve to reduce inefficiencies and, regarding the economization in the German healthcare system, contribute to increasing patient well-being. In detail, this analysis uses the dimensions of profit maximization, competition, pricing and consumer sovereignty.

Chronic disease management and the home-care alternative in Ontario, Canada

2009 ◽  
Vol 22 (3) ◽  
pp. 136-139 ◽  
Author(s):  
Peter Tsasis
Keyword(s):  
Health Care ◽  
Chronic Disease ◽  
Disease Management ◽  
Home Care ◽  
Health Care System ◽  
System Integration ◽  
Health Care Policy ◽  
Chronic Disease Management ◽  
Public Health Care ◽  
Care System

The pressure on our health-care system to deliver efficient, quality and cost-effective care is increasing. The debate on its sustainability is also expanding. These challenges can be managed with revisions to our health-care policy frameworks governing how and what public health-care services are delivered. Chronic disease management and home care can together ease many of the present and future pressures facing the health-care system. However, the current level of investment and the present policy are not effectively supporting movement in this direction. Updating the Canada Health Act to reflect the realities of our health-care system, and developing policies to support the areas of interdisciplinary teamwork and system integration are needed to facilitate chronic disease management and home care in Canada. This article lays out the challenges, highlights the impending issues and suggests a framework for moving forward.

scholarly journals Potential Benefits and Risks Resulting From the Introduction of Health Apps and Wearables Into the German Statutory Health Care System: Scoping Review

10.2196/16444 ◽  
2020 ◽  
Vol 8 (9) ◽  
pp. e16444 ◽  
Author(s):  
Alexandra Heidel ◽  
Christian Hagist
Keyword(s):  
Health Care ◽  
Disease Management ◽  
Health Care System ◽  
Data Privacy ◽  
Digital Health ◽  
Treatment Quality ◽  
Exclusion Criterion ◽  
Health Apps ◽  
Risks And Benefits ◽  
Care System

Background Germany is the first country worldwide that has introduced a digital care act as an incentive system to enhance the use of digital health devices, namely health apps and wearables, among its population. The act allows physicians to prescribe statutory financed and previously certified health apps and wearables to patients. This initiative has the potential to improve treatment quality through better disease management and monitoring. Objective The aim of this paper was to outline the key concepts related to the potential risks and benefits discussed in the current literature about health apps and wearables. Furthermore, this study aimed to answer the research question: Which risks and benefits may result from the implementation of the digital care act in Germany? Methods We conducted the scoping study by searching the databases PubMed, Google Scholar, and JMIR using the keywords health apps and wearables. We discussed 55 of 136 identified articles published in the English language from 2015 to March 2019 in this paper using a qualitative thematic analysis approach. Results We identified four key themes within the articles: Effectivity of health apps and wearables to improve health; users of health apps and wearables; the potential of bring-your-own, self-tracked data; and concerns and data privacy risks. Within these themes, we identified three main stages of benefits for the German health care system: Usage of health apps and wearables; continuing to use health apps and wearables; and sharing bring-your-own; self-tracked data with different agents in the health care sector. Conclusions The digital care act could lead to an improvement in treatment quality through better patient monitoring, disease management, personalized therapy, and better health education. However, physicians should play an active role in recommending and supervising health app use to reach digital-illiterate or health-illiterate people. Age must not be an exclusion criterion. Yet, concerns about data privacy and security are very strong in Germany. Transparency about data processing should be provided at all times for continuing success of the digital care act in Germany.

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