Health Care Management During Covid-19: Insights from Complexity Science

“Health care delivery organizations have faced a myriad of important management challenges during the Covid-19 pandemic. Some of the challenges are idiosyncratic to the individual organization; others, however, are broadly faced by almost every health care delivery organization and are likely to be faced in any major disaster. The first key challenge is the lack of adequate capacity to handle the surging patient volume. [..] A second challenge is the need for real-time redesign of care models for patients. Given the highly contagious nature and severity of the infection, it is necessary for physicians, nurses, and other clinicians to discover … Read More

Using Health IT to Support the Surgeon General’s Call to Action to Control Hypertension

On October 7th, the US Department of Health & Human Services published the Surgeon General’s Call to Action to Control Hypertension. The report uses a blood pressure threshold of 130/80 mm Hg as its definition of control. The manuscript includes a goal to optimize patient care for hypertension control and sector-specific recommendations to influence hypertension. Healthy lifestyle changes that could influence blood pressure control include: Losing weight Reducing sodium intake (more specifically, following the Dietary Approaches to Stop Hypertension [DASH] diet promoted by the National Heart, Lung and Blood Institute) Increasing physical activity, and Quitting smoking The report suggests referring … Read More

Intensive Smoking Cessation Counseling for Patients With Cancer

“tobacco cessation after cancer diagnosis is often associated with improved quality of life, fewer complications related to cancer treatment, and longer survival. In a 2018 study, the prevalence of cigarette smoking among adult cancer survivors was 11.8%, and many cancer survivors who quit smoking after a diagnosis may resume smoking. Failure to address the unique challenges of cessation contributes to lack of success in initial cancer treatment due to ongoing smoking and has been associated with an estimated incremental cost of nearly $11,000 per year per smoking patient. Tobacco abstinence is the strongest predictor of cancer survival, after cancer type … Read More

Effect of Patient Financial Incentives on Statin Adherence and Lipid Control: A Randomized Clinical Trial

“Initially, eligibility was limited to individuals with diabetes, LDL-C level greater than 130 mg/dL (to convert LDL-C to mmol/L, multiply by 0.0259), and an annual statin medication possession ratio in pharmacy records of less than 80%. We subsequently broadened eligibility criteria to include individuals with a statin prescription who self-reported nonadherence and had either (1) LDL-C level greater than 100 mg/dL and a diagnosis of ASCVD or an American College of Cardiology/American Heart Association Task Force 10-year cardiovascular disease risk score of at least 7.5%, or (2) LDL-C level greater than 190 mg/dL with no other risk factors, or (3) … Read More

Association of the National Health Guidance Intervention for Obesity and Cardiovascular Risks With Health Outcomes Among Japanese Men

“evidence is limited as to whether population-level screening programs and accompanied lifestyle interventions for obesity and cardiovascular risk factors reduce mortality or the incidence of cardiovascular diseases. In 2008, Japan introduced a nationwide screening program to identify individuals with high obesity and cardiovascular risks (known as metabolic syndrome) and to provide health guidance to reduce weight and improve cardiovascular risk. All adults aged 40 to 74 years were required by law to participate every year, and approximately 29 million people in Japan received the screening program in 2017. [..] in addition to screening individuals, it provides lifestyle intervention programs for … Read More

A Novel Health-Transportation Partnership Paves The Road For Young Driver Safety Through Virtual Assessment

“Almost all crashes among young novice drivers (95.6 percent) are a result of driver error.4 Relatively few crashes result from errors associated with intentional risk taking (for example, aggressive driving). Rather, nearly half of all crashes involve errors associated with inadequate skills and experience, primarily recognition errors (for example, poor scanning and distraction, 46.3 percent), decision errors (for example, following too closely, speed management, 40.1 percent), and performance errors (for example, losing control, 8.0 percent). As a consequence, crash rates among novice drivers peak in the months immediately after licensure and then slowly decline over the first two years of … Read More

Effect of Peer Mentors in Diabetes Self-management vs Usual Care on Outcomes in US Veterans With Type 2 Diabetes: A Randomized Clinical Trial

“Diabetes self-care activities take place primarily outside of clinical encounters. Intensive clinic-based programs have been reported to be effective in improving self-care behaviors; however, they are often resource intensive, and participant engagement wanes over time. Peer support models that include peers with the same chronic illness and experiential knowledge may help augment patients’ existing social support structures and improve self-care. Models using peers, such as shared medical appointments and community health worker programs, have been shown to improve diabetes clinical outcomes. A more informal, flexible, and potentially inexpensive means of providing peer support is through volunteer peer coaches or mentors. … Read More

Clover, Walmart launch Medicare Advantage plans in Georgia

“A new health insurance plan will include Walmart’s Health Centers as a feature. The retailer is teaming up with insurance startup Clover to offer Medicare Advantage plans across the state of Georgia. The “Live Healthy” plans will be structured as a PPO — consistent with Clover’s other MA plans in the eight states where it operates. Members will have access to Walmart Health’s clinics across the state, which offer primary care, dental, hearing, x-rays and other services. [..] The plans have no copay for primary care visits, lab tests, and preventive dental exams. They also include other benefits, including $100 … Read More

Pharmacists in Ohio managing care as providers—and getting paid for it too

“Franklin Pharmacy is part of a UnitedHealthcare experiment in Ohio to put community pharmacists on the team of clinicians who care for a patient in hope of controlling chronic conditions and reducing hospital readmissions. The insurer is paying pharmacists to have these conversations, uncover any health and medication issues, and then do something about them. “We tend to have better results in getting people care when we’re working with them within their communities,” said Michael Roaldi, who leads UnitedHealthcare’s Medicaid business in the state. “It occurred to us that pharmacies—community pharmacies and chain pharmacies—are literally thousands of examples of medical … Read More