A disturbing thought: when post-transplant medication costs more than $1,000 a month, how much of a girlfriend's appeal might be because she comes from a country that provides universal health care?
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Saturday, March 21, 2009
Friday, March 6, 2009
Hurdle for Health Reform: Patients and Their Doctors
In today's consumerism culture, we always want to the "best" - the latest and greatest that high-tech has to offer. Now consider this:
What role do patients and doctors play? Is it our consumerism attitude that drives up costs? Should we not demand the best possible care considering it is our health and our lives at stake? The question is not whether or not we should demand the best - and we should since our health is our own responsibility. What we have to accept is that the "best" doesn't always mean the newest drug or the latest treatment, but rather, the "best" is getting the most appropriate care possible.
read more digg story
"As a conversation about health care reform intensifies in Washington, much of the focus is on the role the government and insurance companies will play in a revamped health system. But surprisingly little attention has been paid to the role that patients and their doctors have played in shaping the way medical care is delivered."
What role do patients and doctors play? Is it our consumerism attitude that drives up costs? Should we not demand the best possible care considering it is our health and our lives at stake? The question is not whether or not we should demand the best - and we should since our health is our own responsibility. What we have to accept is that the "best" doesn't always mean the newest drug or the latest treatment, but rather, the "best" is getting the most appropriate care possible.
read more digg story
Friday, February 27, 2009
Future of Hospitals
by Sterling Planning Alliance staff
We can imagine a hospital without walls…at least one without the traditional walls of hospitals as we know them today.
Consider these disparate, but perhaps intersecting factors…
As his first major legislative success, US President Obama signed into law an economic stimulus bill that includes $19 billion for conversion to electronic medical records for all providers of care, which when realized, would make it possible to transmit health records instantly to any provider, anywhere in the US.
Technology currently exists whereby an individual’s entire medical history can be downloaded and stored on incredibly small disks which can then be inserted subcutaneously, allowing each person to literally carry his/her own medical history with them all the time.
The summer of 2007, surgeons at Baystate Medical Center in Springfield, Massachusetts became the first in the world to perform a revolutionary new procedure—a cystgastrostomy using natural orifice translumenal endoscopic surgery or NOTES™, taking the concept of ‘minimally invasive surgery’ to a whole new level of practice and understanding. Imagine some day removing a gallbladder through the nose!
The explosion of Picture Archiving Communication Systems (PACS) for storing, transmitting across long distances, and viewing incredibly large, detailed imaging files, and the rapid development and use of telemedicine capabilities both allow around-the-world, real-time consults. These innovations, coupled with sophisticated webcam teleconferencing also enable specialists to remotely provide consults during surgical procedures.
Robots are now routinely used to assist in a variety of surgical procedures, and are beginning to be used as caregiver communications surrogates in some hospitals as a tool for communicating directly with patients when the caregiver cannot be physically present with the patient. It may have taken almost 50 years for her to get from the animated cartoon to real life, but the Jetsons’ “Rosie” has finally arrived; and it does not require much of a leap of faith to envision a perhaps not-so-distant future marriage of these technologies enabling remotely-controlled surgery.
Japan is leading the way with entirely new concepts of health management. A company has designed a ‘smart toilet’ that can perform a urinalysis screen and measure blood pressure, pulse, temperature, and body weight – displaying the results on a built-in monitor. Can stick-free diabetic blood testing and monitoring be far behind?
A British company has developed airline seats that monitor occupants’ movements and signal when an occupant has been sitting too long in the seat and needs to get up and move around to avoid forming a dangerous deep vein thrombosis. What if the same technology was adopted by furniture manufacturers and used in standard home furniture lines? Probably only the most die-hard ‘couch potatoes’ would be able to ignore the warnings of their favorite sofa or easy chair.
Remote home monitoring systems which measure vital signs are already beginning to be widely used by ‘Visiting Nurse’ and other Home Care agencies to aid in the efficient management of care for home-bound patients. This technology could easily be expanded for use by patients with a variety of chronic illnesses such as diabetes, high cholesterol, chronic obstructive pulmonary disease (COPD), to name a few. Results could be transmitted on a daily, or more frequent, basis via high-speed broadband Internet access to a physician’s BlackBerry or health monitoring center, providing real-time disease management.
In an entirely different health conscious vein, a Japanese hosiery company has created pantyhose that are embedded with millions of microcapsules of Vitamin C and seaweed extract which are slowly absorbed into the wearer’s skin. Might our clothes become the standard delivery system for beneficial minerals, vitamins, and perhaps even some medications?
In the field of new concepts in cancer treatment, research is underway using the gene that activates a firefly’s bioluminescence, inserting it into certain cancer cells, causing them to glow. A photosensitizing agent is then added which together with the firefly gene triggers the cells to produce toxic substances that destroy the cancer cells. Can nanotechnology which could allow diagnosis, treatment, even potentially surgery, at the microscopic and cellular level be far behind? What about Star Trek- like replicator technology, which serves up the best food to maintain your health – how distant in the future might that be?
More down-to-earth, but revolutionary, gaming technology is fast becoming an excellent adjunct to many therapies and for maintaining health and fitness in fun ways. The use of Wii systems such as Wii Fit and Wii Sports in rehab hospitals for post-stroke physical therapy, in senior centers for maintaining fitness and physical dexterity is simply exploding. Soon we could be seeing hospitals and other providers forming partnerships with ‘gamers’ or Wii clubs to sponsor Wii competitions for patients, as they begin to see real results and far better compliance with prescribed beneficial physical activity simply because it is so fun and imminently doable.
The lines between different specialty areas are beginning to overlap in previously unanticipated ways. Some hospitals are beginning to view their traditional physical therapy and rehab programs in a different light, and are developing “Healthplex” wellness centers – sophisticated rehab/health club/ fitness center-type facilities managed by hospital clinical staff. Developers in various European and Middle Eastern countries are actively envisioning large, combined luxury living and healthcare, and in some cases, mega sports complexes, as a new model of care. The blurring of the lines between hospitals and other healthcare settings, fitness centers, luxury spas, assisted living environments and home care delivery models are triggering a morphing into as yet undefined new paradigms.
Hospitals across the US are actively developing formal relationships with private clinicians, ambulatory care facilities, and other providers to manage the continuity of the full spectrum of care for disease management or injury/surgery recovery processes, not just the discrete episode of hospital care. In other words, they are creating networks of interconnected ‘medical homes’.
What might all of these disparate events have in common? Each in its own way makes it possible to envision a future where the focus shifts from ‘healing’ to ‘health’ and wellness – from getting well to staying and living well – and shifts the control from external ‘providers’ of care to taking control of your own health in a place, aesthetic, method, and time of your choice.
While it is uncertain what new model or models for maintaining our health will emerge, it is clear that they will likely have only a passing resemblance to the hospital as we know it today, and in its place, we can imagine…an integrated wellness or health network with no specific boundaries, limitations, or walls.
What can you imagine?
We can imagine a hospital without walls…at least one without the traditional walls of hospitals as we know them today.
Consider these disparate, but perhaps intersecting factors…
As his first major legislative success, US President Obama signed into law an economic stimulus bill that includes $19 billion for conversion to electronic medical records for all providers of care, which when realized, would make it possible to transmit health records instantly to any provider, anywhere in the US.
Technology currently exists whereby an individual’s entire medical history can be downloaded and stored on incredibly small disks which can then be inserted subcutaneously, allowing each person to literally carry his/her own medical history with them all the time.
The summer of 2007, surgeons at Baystate Medical Center in Springfield, Massachusetts became the first in the world to perform a revolutionary new procedure—a cystgastrostomy using natural orifice translumenal endoscopic surgery or NOTES™, taking the concept of ‘minimally invasive surgery’ to a whole new level of practice and understanding. Imagine some day removing a gallbladder through the nose!
The explosion of Picture Archiving Communication Systems (PACS) for storing, transmitting across long distances, and viewing incredibly large, detailed imaging files, and the rapid development and use of telemedicine capabilities both allow around-the-world, real-time consults. These innovations, coupled with sophisticated webcam teleconferencing also enable specialists to remotely provide consults during surgical procedures.
Robots are now routinely used to assist in a variety of surgical procedures, and are beginning to be used as caregiver communications surrogates in some hospitals as a tool for communicating directly with patients when the caregiver cannot be physically present with the patient. It may have taken almost 50 years for her to get from the animated cartoon to real life, but the Jetsons’ “Rosie” has finally arrived; and it does not require much of a leap of faith to envision a perhaps not-so-distant future marriage of these technologies enabling remotely-controlled surgery.
Japan is leading the way with entirely new concepts of health management. A company has designed a ‘smart toilet’ that can perform a urinalysis screen and measure blood pressure, pulse, temperature, and body weight – displaying the results on a built-in monitor. Can stick-free diabetic blood testing and monitoring be far behind?
A British company has developed airline seats that monitor occupants’ movements and signal when an occupant has been sitting too long in the seat and needs to get up and move around to avoid forming a dangerous deep vein thrombosis. What if the same technology was adopted by furniture manufacturers and used in standard home furniture lines? Probably only the most die-hard ‘couch potatoes’ would be able to ignore the warnings of their favorite sofa or easy chair.
Remote home monitoring systems which measure vital signs are already beginning to be widely used by ‘Visiting Nurse’ and other Home Care agencies to aid in the efficient management of care for home-bound patients. This technology could easily be expanded for use by patients with a variety of chronic illnesses such as diabetes, high cholesterol, chronic obstructive pulmonary disease (COPD), to name a few. Results could be transmitted on a daily, or more frequent, basis via high-speed broadband Internet access to a physician’s BlackBerry or health monitoring center, providing real-time disease management.
In an entirely different health conscious vein, a Japanese hosiery company has created pantyhose that are embedded with millions of microcapsules of Vitamin C and seaweed extract which are slowly absorbed into the wearer’s skin. Might our clothes become the standard delivery system for beneficial minerals, vitamins, and perhaps even some medications?
In the field of new concepts in cancer treatment, research is underway using the gene that activates a firefly’s bioluminescence, inserting it into certain cancer cells, causing them to glow. A photosensitizing agent is then added which together with the firefly gene triggers the cells to produce toxic substances that destroy the cancer cells. Can nanotechnology which could allow diagnosis, treatment, even potentially surgery, at the microscopic and cellular level be far behind? What about Star Trek- like replicator technology, which serves up the best food to maintain your health – how distant in the future might that be?
More down-to-earth, but revolutionary, gaming technology is fast becoming an excellent adjunct to many therapies and for maintaining health and fitness in fun ways. The use of Wii systems such as Wii Fit and Wii Sports in rehab hospitals for post-stroke physical therapy, in senior centers for maintaining fitness and physical dexterity is simply exploding. Soon we could be seeing hospitals and other providers forming partnerships with ‘gamers’ or Wii clubs to sponsor Wii competitions for patients, as they begin to see real results and far better compliance with prescribed beneficial physical activity simply because it is so fun and imminently doable.
The lines between different specialty areas are beginning to overlap in previously unanticipated ways. Some hospitals are beginning to view their traditional physical therapy and rehab programs in a different light, and are developing “Healthplex” wellness centers – sophisticated rehab/health club/ fitness center-type facilities managed by hospital clinical staff. Developers in various European and Middle Eastern countries are actively envisioning large, combined luxury living and healthcare, and in some cases, mega sports complexes, as a new model of care. The blurring of the lines between hospitals and other healthcare settings, fitness centers, luxury spas, assisted living environments and home care delivery models are triggering a morphing into as yet undefined new paradigms.
Hospitals across the US are actively developing formal relationships with private clinicians, ambulatory care facilities, and other providers to manage the continuity of the full spectrum of care for disease management or injury/surgery recovery processes, not just the discrete episode of hospital care. In other words, they are creating networks of interconnected ‘medical homes’.
What might all of these disparate events have in common? Each in its own way makes it possible to envision a future where the focus shifts from ‘healing’ to ‘health’ and wellness – from getting well to staying and living well – and shifts the control from external ‘providers’ of care to taking control of your own health in a place, aesthetic, method, and time of your choice.
While it is uncertain what new model or models for maintaining our health will emerge, it is clear that they will likely have only a passing resemblance to the hospital as we know it today, and in its place, we can imagine…an integrated wellness or health network with no specific boundaries, limitations, or walls.
What can you imagine?
Wednesday, February 4, 2009
Disruptive Innovation - a cure to Health Care System
The health care system in the United Stated is on critical life support.
The Symptoms?
The Symptoms?
- crowded EDs
- many uninsured
- inequitable distribution of resources
- inequitable access to services
- lack of transparency (in care delivered and in pricing of services/procedures)
- discontinuity of care
- inconsistent quality of care
- inappropriate care (timing, amount)
- unsustainable business practices
- new business model - one that reduces costs yet improves both quality and accessibility. (currently, hospitals and physician’s practices are compensated for treating illness, not promoting wellness. hospitals profit from full beds and doctors profit from repeat visits; there is no financial incentive to keep patients healthy.)
- e.g., disruptive innovators in health care are aiming to shape a new system that provides a continuum of care focused on each individual patient’s needs rather than focused on crises. the continuum of care follows the patients wherever they go within an integrated system, allowing provider to stay on top of what preventative measures and therapies are most effective and preventing providers from prescribing competing medications and ordering needless duplication of tests
Thursday, July 31, 2008
A viable future for evidence-based hospital design - only time will tell
Dublin Methodist Hospital - an example of how "form fits function" can be beautiful, even in healthcare. But can it be sustainable? How about affordable?
Thursday, November 29, 2007
the new ergonomic chair may be no chair at all
The workplace trend has been ergonomics--the application of scientific information concerning humans to the design of objects, systems and environment for human use. Offices are filled with ergonomic desks, keyboards, chairs. Some companies even let employees choose their own ergonomic furniture to be ordered. But...
Will the new ergonomic chair be no chair at all? Will the new workspace be designed to allow you to work out while working?
read more digg story
"Scientists have found intriguing evidence that one major reason so many people are overweight these days may be as close as the seat of their pants. Literally. According to the researchers, most of us sit too much. In most cases, exercise alone, according to a team of scientists at the University of Missouri, isn't enough to take off those added pounds. The problem, they say, is that all the stuff we've heard the last few years about weight control left one key factor out of the equation. When we sit, the researchers found, the enzymes that are responsible for burning fat just shut down..."
Will the new ergonomic chair be no chair at all? Will the new workspace be designed to allow you to work out while working?
read more digg story
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