Healthy Living Knowledge, Standards In Addition To The Healthcare Crisis: Business Office 8

I started this topic amongst the contestation that our healthcare organization needs radical transformation since:

• All patients "…are at run a peril for receiving pitiable wellness care, no affair where they live; why, where in addition to from whom they essay care; or what their race, gender, or fiscal status is"[1]
• Healthcare is increasingly to a greater extent than expensive in addition to less accessible[2], amongst to a greater extent than than 46 1 1000 k uninsured inward the U.S. of A. from every historic catamenia grouping in addition to at every income level, viii out of 10 beingness inward working families[3]
• There is a "knowledge gap"-the healthcare community is drowning inward oceans of information, yet doesn't know the best ways to forbid wellness problems in addition to care for them cost-effectively.[4]

I so went on to explicate how these daunting problems tin ship away hold upwards solved through creation of a knowledge-based healthcare organization that drives continuous improvements inward attention safety, character in addition to affordability past times enabling everyone to:

• Know the best ways to forbid illness, avoid complications of chronic diseases, in addition to care for wellness problems (i.e., inward the most effective in addition to efficient manner)
• Use this noesis to promote wellness, self-management, in addition to recovery
• Participate inward evolving this noesis to come inward ever-more useful in addition to effective.

And so I discussed how information in addition to technology standards are essential for obtaining, sharing in addition to using noesis effectively, in addition to how such standards are a double-edge sword (i.e., in that place are serious problems amongst many standards inward utilisation today).

I concluded amongst a review of how a secure, economical, node-to-node architecture-with universal translation, composite reporting, in addition to application integration-are essential components to the successful implementation of an intelligent in addition to efficient character improvement system.

I volition instantly necktie this all together every bit I introduce what powerfulness hold upwards considered the "holy grail" health-knowledge system.

Imagine patients in addition to other healthcare consumers, along amongst clinicians in addition to researchers, who collaborate to construct an evergreen (i.e., continually growing in addition to evolving) noesis base of operations of comprehensive information. This information comes from information obtained, which protect patients' privacy, via controlled clinical studies in addition to existent the world outcomes research. These information are received roughly the globe every 24-hour interval in addition to are analyzed on a regular the world inward venture to uncovering associations betwixt biological in addition to psychological signs & symptoms, lab studies, diagnoses, genetic data, demographics, wellness interventions, sick attention treatments, patient preferences, attention costs, in addition to clinical outcomes. The noesis emerging from all this information is so used to practise in addition to validate evidence-based guidelines promoting high-value (i.e., security & cost-effective) attention alternatives that are matched to the exceptional needs of dissimilar consumers in addition to providers. Understanding the relationships betwixt wellness problems, attention interventions in addition to results enables both professionals in addition to consumers to brand wiser decisions that improve outcomes in addition to command costs.

Underlying this information, noesis in addition to agreement are the information obtained from patients/consumers' PHAs (personal wellness applications) and providers' EHRs (electronic wellness records).

Clinicians in addition to hospitals who collaborate inward a patient's care, so part in addition to sentiment the patient information via next-generation CCRs (continuity of attention records) tailored to each practitioner's exceptional needs. These CCRs move good beyond the ones beingness developed today past times adding:

• Sophisticated clinical determination back upwards capabilities that introduce warnings in addition to alerts, every bit good every bit clinical guidelines (and pathways)
• Patient self-care information (i.e., "information therapy")
• Tools that runway compliance to the guidelines, reasons for non-compliance (i.e., "variance"), in addition to clinical & fiscal outcomes.

In addition, researchers (in universities, world wellness facilities, etc.) have in addition to study the de-identified wellness information on an ongoing basis-including details well-nigh patient health, medications, procedures in addition to other interventions done, in addition to the results of such care-which are used to develop evolving guidelines.

The information in addition to guidelines are transmitted through networks of networks[5] using a simple, secure, low-cost node-based architecture and email that require no construct out of existing information technology infrastructures. The nodes' "universal translation" role accommodates all information standards, every bit good every bit whatsoever non-standardized information sets in addition to terminologies. Furthermore, since the nodes communicate asynchronously via publisher-subscriber process, in addition to since they tin ship away introduce interactive reports through "desktop/standalone" applications (i.e., they are non express to Internet browsers), critical information tin ship away thence hold upwards accessed offline using rich, powerful tools. This means:

• There is no loss of information when a network connectedness drops out (i.e., unexpected disconnection), in addition to in that place is no unmarried betoken of failure to disrupt in addition to entire network when a key server develops problems
• All the information tin ship away hold upwards accessed anywhere/anytime, fifty-fifty if in that place is no Internet or other network connections
• A smashing bargain of information tin ship away hold upwards exchanged fifty-fifty when bandwidth is depression in addition to connectivity is intermittent (e.g., using dial-up)
• Each somebody controls their ain information since they are stored locally (in their ain computers) inward encrypted files
• Total toll of ownership is minimized since in that place is no take away to rely on expensive key servers in addition to server administrators
• Performance is greatly increased when performing complex, intensive computations since all information processing is done speedily in addition to easily using local reckoner resources, rather than waiting for a strained key server, or beingness restricted past times the limitations of a browser
• You tin ship away integrate multiple desktop applications, which cannot hold upwards done securely using a browser. [6] [7]

These innovative technological solutions, however, are precisely portion of the story. Other of import issues include determining:

• What information to collect in addition to exchange
• How to analyze, translate in addition to validate the information to generate useful information
• How to organize, access, part in addition to hash out the information to emerge useful knowledge
• How to utilisation the noesis to improve attention character in addition to command costs.

Dealing amongst these issues, I contend, requires valid & reliable data, information in addition to noesis (dik) that are comprehensive, complex in addition to comprehendible.

• " Comprehensive dik is required for agreement the "big picture" clearly. This large motion painting reflects a person's physical in addition to psychological risks, strengths, problems in addition to preferences, every bit good every bit the evidence-based well attention in addition to sick care intervention options best suited to that individual.
• Complex dik provides crucial insights into attention that are non possible using today's "minimum information set" standards. This higher score agreement comes from analyzing information that let out such complexities as:
• Medication-related interactions (e.g., drug-drug, drug-supplement, drug-metabolism in addition to drug-lab results interactions, every bit good every bit allergic reactions)
• Mind-body in addition to mind-body-environment interactions[8] (e.g., the adverse touching of psychological stress in addition to emotions on one's immune system, the affect of one's belief systems on one's health, etc.)
• Medication side-effects in addition to biomedical atmospheric condition that introduce every bit psychological symptoms
• Trends, including changes inward lab exam results, functionality in addition to signs & symptoms over a person's lifetime
• The correlation of treatments in addition to outcomes for dissimilar patient populations in addition to providers
• The reasons for non next exceptional recommended handling processes in addition to the results of such variance.
• Comprehendible dik:
• Are readily understandable (e.g., unambiguous, valid, reliable, relevant in addition to useful)
• Maintain of import nuances of pregnant (e.g., uses the right terminology standards)
• Do non overload people with irrelevancies or redundancies.

Two novel questions instantly arise, which I volition address in my adjacent post; they are:

1. How tin ship away nosotros know if the information beingness collected are complete, appropriately complex, comprehendible, relevant in addition to useful?
2. What has to occur for adept information to move useful noesis that leads to ever-better in addition to to a greater extent than affordable care?

References:

[1] The First National Report Card on Quality of Health Care inward America past times RAND Corp (2006)
[2] Health Care Coverage inward America: Understanding the Issues in addition to Proposed Solutions past times The Alliance for Health Reform (March 2007)
[3] The Current Situation - WellnessWiki
[4] The Knowledge Gap - WellnessWiki
[5] Linking Providers Via Health Information Networks. Alliance for Health Reform. (Dec 2006).
[6] Is the Browser Singularly Capable of Everything? Software Development Times (June 15, 2007)
[7] New Google Tool Gets Offline Access inward Gear. Eweek (June 11, 2007)

[8] Biopsychosocial Healthcare - WellnessWiki

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