Healthy Living Create Nosotros Ask Profound Changes Now?
On roughly other blog, I’ve been contention almost the involve for profound changes inwards our healthcare system, as well as to brand these changes sooner than later. I proposed is a multifaceted, consumer/patient/community-centered, knowledge-based, collaborative wellness strategy (defined inwards our WellnessWiki), which focuses on changing the electrical flow policies, processes, as well as practices that vantage mediocrity as well as punish efficiency. This strategy takes a comprehensive approach that would implement a number of tactics that foster continuous improvements inwards tending safety, effectiveness as well as efficiency past times dramatically increasing our clinical cognition as well as powerfulness to move that cognition with the ultimate destination of ensuring every somebody gets the precise sick-care as well as well-care needed when it is needed -- cipher to a greater extent than & cipher less -- as well as to brand certain that tending is delivered competently as well as cost-effectively. It is based on an mental attitude of forever seeking perfection. Executing this strategy would require spending coin as well as fourth dimension on a transformational physical care for that (a) constrains wasteful, fraudulent as well as error-prone aspects of our electrical flow healthcare arrangement as well as (b) expands aspects that generate high value, i.e., promotes first-class outcomes with the to the lowest degree necessary utilization of resources.
The chief rebuttal to my proposed strategy is that at that topographic point is no involve for profound changes since our healthcare arrangement is fine the means it is -- at that topographic point is non healthcare crisis, it’s largely media hype. We should, therefore, allow things alter incrementally (step-by-step manner) equally they possess got inwards the past. After all, we’ve made bully strides inwards our healthcare technologies, medicines, as well as procedures over the years as well as volition proceed to create so if nosotros only allow marketplace forces create their thing. And on elevation of that, our dry ground doesn’t possess got the coin to drive profound alter with comprehensive strategies fifty-fifty if nosotros wanted to create it. So, instead of discussing comprehensive strategies, nosotros should restrain our focus to a few tactics aimed primarily at controlling costs without spending a lot of coin inwards the process. In price of dealing with security problems, it was suggested that nosotros settle for straightaway on getting rid of unsafe providers.
I volition briefly utter over how I responded to each of these as well as hold off forrad to yous comments.
The vast bulk of healthcare providers are intelligent as well as compassionate people who piece of job real hard as well as create the best they tin give the sack inwards a broken arrangement that vantage mediocrity as well as waste. Dedicated researchers possess got made wonderful breakthroughs inwards medicine, genetics, as well as medical devices that assist maintain us hold upwardly longer than ever with an improved character of life. And wellness information technology companies are developing ever meliorate tools. Nevertheless, at that topographic point is a healthcare crisis equally discussed here as well as here.
While I agreed that changes should hold upwardly done incrementally since nosotros can’t create it all at ane time, as well as piece I agreed that we’ve made bully advances over the centuries, I argued that the incremental changes should hold upwardly accomplished whenever possible with leaps, non babe steps. The showtime restrain would hold upwardly to develop a “big pic view” of all the complex interacting problems with our electrical flow system. The 2nd restrain would hold upwardly to move this wide & deep agreement to define as well as endorse a comprehensive strategy detailing all the changes necessary to solve the healthcare crisis inwards ways that pick out the most create goodness to the most people, including universal coverage as well as continuous character improvement. The 3rd restrain would hold upwardly to prioritize the tactics from most to to the lowest degree of import as well as probable to succeed. The forth restrain would hold upwardly implement those tactics. And the 5th restrain would hold upwardly to larn from our successes as well as failures inwards a cognition feedback-loop physical care for that continually improves the strategy as well as tactics.
One ground for leaping ahead with a feel of urgency, imo, is that failure to create so volition only prolong as well as exacerbate our problems past times fostering inertia as well as complacency. I tell this because our dry ground has a style to assay superficial, short-sighted, failure-prone solutions designed to maintain much of the status quo; nosotros tend to shy away from profound changes that “rock the boat.” Secondly, if nosotros possess got the technical powerfulness to brand profound improvements inwards tending safety, effectiveness as well as efficiency – which I claim nosotros create – as well as so why wait? Is it because nosotros lack the will? Lack the money? Lack the leadership? Are afraid? All these things? Probably. So, shouldn’t nosotros hold upwardly focusing on ways to overcome these constraints, rather than giving into them without a fight?
Let’s assume for a 2nd that nosotros possess got the will, courage, resources, as well as leadership to realize profound change. What mightiness nosotros focus on showtime so nosotros tin give the sack bargain with the healthcare crisis inwards “bite sized pieces” rather than all at once?
Well, a bulk of healthcare spending inwards the the US has been attributed to people with chronic (lifelong) weather condition that tin give the sack hold upwardly specially hard as well as expensive to treat, specially since patients create non ever comply with the medical regimens, as well as because they may possess got multiple comorbidities for which evidence-based guidelines don’t exist, as well as at that topographic point are difficulties coordinating tending alongside many dissimilar providers working with the same patient. What should hold upwardly done?
I suggested that ane substitution element mutual to dealing with all this is knowledge. Treating chronic as well as complex weather condition safely, effectively as well as efficiently requires that nosotros know a bully bargain almost such things as: (a) patients’ problems, strengths, weaknesses over extended fourth dimension periods, including physical as well as psychological signs & symptoms, genetic markers, attitudes as well as emotions, social back upwardly networks, etc.; (b) patients’ preferences (e.g., regarding character of life issues equally related to the lawsuit of treatments); (c) appropriate evidence-based guidelines as well as how to implement them; (d) self-care methods as well as motivators; (e) patients’ medical history; (f) what all the providers handling a patient are doing so tending tin give the sack hold upwardly coordinated across the entire healthcare continuum; (g) the effectiveness of tending delivered through ongoing feedback; (i) whether medications prescribed are contraindicated (e.g., are probable to drive unacceptable side effects or as well as adverse lawsuit past times interacting with other meds); (j) providers most qualified to deliver the care; etc.
Obtaining as well as using this cognition effectively may require: (a) a commitment to ongoing clinical research; (b) development, evolution, as well as dissemination of evidence-based guidelines (including outcomes studies as well as consensus conferences); (c) cooperation as well as collaboration alongside healthcare professionals; (d) illustration management; (e) information substitution technologies (including interoperable EHR/EMRs); (f) next-generation personal wellness records (PHRs) that give patients ongoing feedback as well as reminders; (g) clinical determination back upwardly technologies (including diagnostic aids); (h) clinical guideline as well as outcomes query technologies; (i) patient didactics technologies; (j) methods for fostering patient compliance; (k) provision of mind-body medicine (e.g., http://www.thenewmedicine.org/); (l) transparency tools; (m) greater agreement of complementary as well as option interventions; (n) patient advocacy; as well as more. An enhanced illness management programme would offering roughly this (see http://curinghealthcare.blogspot...-and-what.html/).
This is a comprehensive solution of profound changes. But non everything needs to hold upwardly done at once, as well as non every patient needs it all. The objective would hold upwardly to acquire inwards all available equally shortly equally possible, so every patient could acquire what they involve when they involve it.
Some of the most pressing things to do, imo, are to administer comprehensive biopsychosocial diagnostic assessments, move as well as evolve existing evidence-based guidelines as well as develop novel ones that address multiple comorbidities, enable meliorate patient information sharing, furnish ongoing feedback to patients almost their wellness status as well as maintenance, larn how to motivate patients to comply with the medical regimens, develop as well as move effective decision-support tools, implement patient security processes, supplement sick-care with well-care, as well as empower consumers to select the providers as well as wellness plans best suited to their needs.
I don’t encounter this equally beingness biting off to a greater extent than than nosotros tin give the sack chew, but I create mean value it requires profound changes. Can our dry ground afford to pay for these profound changes? Should nosotros fifty-fifty bother discussing how to create it? Are at that topographic point easier as well as cheaper solutions worth consideration? What create yous think?
The chief rebuttal to my proposed strategy is that at that topographic point is no involve for profound changes since our healthcare arrangement is fine the means it is -- at that topographic point is non healthcare crisis, it’s largely media hype. We should, therefore, allow things alter incrementally (step-by-step manner) equally they possess got inwards the past. After all, we’ve made bully strides inwards our healthcare technologies, medicines, as well as procedures over the years as well as volition proceed to create so if nosotros only allow marketplace forces create their thing. And on elevation of that, our dry ground doesn’t possess got the coin to drive profound alter with comprehensive strategies fifty-fifty if nosotros wanted to create it. So, instead of discussing comprehensive strategies, nosotros should restrain our focus to a few tactics aimed primarily at controlling costs without spending a lot of coin inwards the process. In price of dealing with security problems, it was suggested that nosotros settle for straightaway on getting rid of unsafe providers.
I volition briefly utter over how I responded to each of these as well as hold off forrad to yous comments.
The vast bulk of healthcare providers are intelligent as well as compassionate people who piece of job real hard as well as create the best they tin give the sack inwards a broken arrangement that vantage mediocrity as well as waste. Dedicated researchers possess got made wonderful breakthroughs inwards medicine, genetics, as well as medical devices that assist maintain us hold upwardly longer than ever with an improved character of life. And wellness information technology companies are developing ever meliorate tools. Nevertheless, at that topographic point is a healthcare crisis equally discussed here as well as here.
While I agreed that changes should hold upwardly done incrementally since nosotros can’t create it all at ane time, as well as piece I agreed that we’ve made bully advances over the centuries, I argued that the incremental changes should hold upwardly accomplished whenever possible with leaps, non babe steps. The showtime restrain would hold upwardly to develop a “big pic view” of all the complex interacting problems with our electrical flow system. The 2nd restrain would hold upwardly to move this wide & deep agreement to define as well as endorse a comprehensive strategy detailing all the changes necessary to solve the healthcare crisis inwards ways that pick out the most create goodness to the most people, including universal coverage as well as continuous character improvement. The 3rd restrain would hold upwardly to prioritize the tactics from most to to the lowest degree of import as well as probable to succeed. The forth restrain would hold upwardly implement those tactics. And the 5th restrain would hold upwardly to larn from our successes as well as failures inwards a cognition feedback-loop physical care for that continually improves the strategy as well as tactics.
One ground for leaping ahead with a feel of urgency, imo, is that failure to create so volition only prolong as well as exacerbate our problems past times fostering inertia as well as complacency. I tell this because our dry ground has a style to assay superficial, short-sighted, failure-prone solutions designed to maintain much of the status quo; nosotros tend to shy away from profound changes that “rock the boat.” Secondly, if nosotros possess got the technical powerfulness to brand profound improvements inwards tending safety, effectiveness as well as efficiency – which I claim nosotros create – as well as so why wait? Is it because nosotros lack the will? Lack the money? Lack the leadership? Are afraid? All these things? Probably. So, shouldn’t nosotros hold upwardly focusing on ways to overcome these constraints, rather than giving into them without a fight?
Let’s assume for a 2nd that nosotros possess got the will, courage, resources, as well as leadership to realize profound change. What mightiness nosotros focus on showtime so nosotros tin give the sack bargain with the healthcare crisis inwards “bite sized pieces” rather than all at once?
Well, a bulk of healthcare spending inwards the the US has been attributed to people with chronic (lifelong) weather condition that tin give the sack hold upwardly specially hard as well as expensive to treat, specially since patients create non ever comply with the medical regimens, as well as because they may possess got multiple comorbidities for which evidence-based guidelines don’t exist, as well as at that topographic point are difficulties coordinating tending alongside many dissimilar providers working with the same patient. What should hold upwardly done?
I suggested that ane substitution element mutual to dealing with all this is knowledge. Treating chronic as well as complex weather condition safely, effectively as well as efficiently requires that nosotros know a bully bargain almost such things as: (a) patients’ problems, strengths, weaknesses over extended fourth dimension periods, including physical as well as psychological signs & symptoms, genetic markers, attitudes as well as emotions, social back upwardly networks, etc.; (b) patients’ preferences (e.g., regarding character of life issues equally related to the lawsuit of treatments); (c) appropriate evidence-based guidelines as well as how to implement them; (d) self-care methods as well as motivators; (e) patients’ medical history; (f) what all the providers handling a patient are doing so tending tin give the sack hold upwardly coordinated across the entire healthcare continuum; (g) the effectiveness of tending delivered through ongoing feedback; (i) whether medications prescribed are contraindicated (e.g., are probable to drive unacceptable side effects or as well as adverse lawsuit past times interacting with other meds); (j) providers most qualified to deliver the care; etc.
Obtaining as well as using this cognition effectively may require: (a) a commitment to ongoing clinical research; (b) development, evolution, as well as dissemination of evidence-based guidelines (including outcomes studies as well as consensus conferences); (c) cooperation as well as collaboration alongside healthcare professionals; (d) illustration management; (e) information substitution technologies (including interoperable EHR/EMRs); (f) next-generation personal wellness records (PHRs) that give patients ongoing feedback as well as reminders; (g) clinical determination back upwardly technologies (including diagnostic aids); (h) clinical guideline as well as outcomes query technologies; (i) patient didactics technologies; (j) methods for fostering patient compliance; (k) provision of mind-body medicine (e.g., http://www.thenewmedicine.org/); (l) transparency tools; (m) greater agreement of complementary as well as option interventions; (n) patient advocacy; as well as more. An enhanced illness management programme would offering roughly this (see http://curinghealthcare.blogspot...-and-what.html/).
This is a comprehensive solution of profound changes. But non everything needs to hold upwardly done at once, as well as non every patient needs it all. The objective would hold upwardly to acquire inwards all available equally shortly equally possible, so every patient could acquire what they involve when they involve it.
Some of the most pressing things to do, imo, are to administer comprehensive biopsychosocial diagnostic assessments, move as well as evolve existing evidence-based guidelines as well as develop novel ones that address multiple comorbidities, enable meliorate patient information sharing, furnish ongoing feedback to patients almost their wellness status as well as maintenance, larn how to motivate patients to comply with the medical regimens, develop as well as move effective decision-support tools, implement patient security processes, supplement sick-care with well-care, as well as empower consumers to select the providers as well as wellness plans best suited to their needs.
I don’t encounter this equally beingness biting off to a greater extent than than nosotros tin give the sack chew, but I create mean value it requires profound changes. Can our dry ground afford to pay for these profound changes? Should nosotros fifty-fifty bother discussing how to create it? Are at that topographic point easier as well as cheaper solutions worth consideration? What create yous think?
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