Real World Health Care Blog

Tag Archives: doctor

Keeping Boston Strong: How Disaster Training at Osteopathic Medical School Helped Save Lives

VCOM Image 2

The Bioterrorism and Disaster Response Program equips students at VCOM with critical skills through field exercises and more (photo courtesy of VCOM).

When Danielle Deines crossed the finish line of the Boston Marathon on April 15, she had no idea her unique medical training as Doctor of Osteopathic Medicine would make a real difference in the life-and-death events that would soon unfold.

A 2012 graduate of the Edward Via College of Osteopathic Medicine – Virginia Campus (VCOM), Dr. Deines immediately sprang into action after the explosions violently rocked the most prestigious race in the country. Triaging people in the medical tent to ensure they received the care they needed, she helped make room for victims on a moment’s notice:

“They asked all of the runners to move to the back of the tent,” Dr. Deines said. “Once there as the volunteer physicians headed to the explosion sites, I made an effort to get to my feet and informed the nurse near me that I wanted to help. I was asked to discharge runners who were able and interested in leaving to help make room for the victims who were starting to be brought in from the street. I cleared those wishing to leave and signed off on their discharge paperwork, then helped to get them out of an entrance that had been made in the side of the tent.  We then moved the freed up cots to form triage areas. The back corner became the most severe triage area, nearest the entrance where the ambulances were arriving. I saw victims with traumatic amputations of the lower extremities, legs that had partially severed or had shrapnel embedded, and clothing and shoes literally blown off of victims’ bodies.”

Dr. Deines’ ability to help at the time of urgent need did not come coincidentally. Her education at VCOM equipped her — and all other graduates of the Blacksburg, Virginia school — with the critical life-saving skills that are needed when attacks or other emergencies strike.

The Bioterrorism and Disaster Response Program, a two-day, mandatory training curriculum for all second-year osteopathic students at VCOM, has immersed students in real-life disaster training, field exercises and specialized courses since its inception in 2003. This comprehensive approach gives participants expertise in areas including terrorist and major disaster response, hospital planning, behavioral risk factors, psychological response to trauma, and media relations.

Students who have completed the program now serve as lifelines, having the ability to respond to catastrophes locally, nationally and internationally – from Hurricane Katrina to the Virginia Tech shootings, tsunamis and tornado damage in Virginia.

Now more than ever, a working knowledge of disaster response issues is central to providing quality patient care.

“All medical students and practicing physicians need to be able to respond to natural and manmade disasters.  With changing global weather patterns such as global warming and changing political climates, disasters are now a part of the framework,” said Dr. James Palmieri, Associate Professor and Dept. Chair at VCOM. “I always teach the students that no matter what kind of disaster takes place, both natural and manmade, it will always begin in someone’s neighborhood and the local medical community will be part of the initial response.  In light of today’s instant communication, if and when you respond, the world will see you as the local expert.  You had better know how to respond properly for both your benefit and that of your patients.”

How can VCOM’s leadership role in disaster response training be replicated by other medical training programs?  In what ways can more medical schools develop and leverage their curricula to prepare students for disaster response?

Today, more than one in five medical students in the United States are training to be osteopathic physicians, who can pursue any specialty, prescribe drugs, perform surgeries and practice medicine anywhere in the U.S. Osteopathic physicians bring the additional benefits of osteopathic manipulative techniques to diagnose and treat patients, helping patients achieve a high level of wellness by focusing on health education, injury prevention, and disease prevention.

For students who are interested in going into osteopathic medicine, visit the American Association of Colleges of Osteopathic Medicine, www.AACOM.org; and VCOM at http://www.vcom.vt.edu/.

Telehealth Opens Doors to Enhance Health Outcomes and Reduce Costs

Telehealth solutions are making significant inroads to reverse high health care expenditures and reduce noncompliance with prescription therapies – issues that especially impact those living with chronic disease.

By engaging patients in health education through classes, patient portals, real-time patient-provider consultations, online discussion forums and more, telehealth strategies empower providers to monitor disease progression and intervene with patients at an earlier stage, when conditions may be more easily treated.

A digital conduit that delivers medical care, health education, and public health services, telehealth connects multiple users in separate locations. Telehealth services consist of diagnosis, treatment, assessment, monitoring, communications and education. It includes a broad range of telecommunications, health information, videoconferencing, and digital image technologies.

And what’s best of all? Telehealth is working in many situations. Here are a few examples:

Case Study #1: Telehealth plays an instrumental role in supporting the care of veteran patients with chronic conditions. They are part of a national program from the US Veterans Health Administration to coordinate the care of veterans with chronic conditions at home and avoid unnecessary admission to long-term institutional care. The program included the systematic implementation of health informatics, home telehealth, and disease management technologies for six conditions including diabetes mellitus, congestive heart failure, hypertension, posttraumatic stress disorder, chronic obstructive pulmonary disease, and depression.

Patients involved in the program benefitted from a 25 percent reduction in the number of bed days of care and a 20 percent reduction in hospital readmissions. According to a study of the program, the basis for reduced utilization of health care resources for the patients involved was due to the program’s foundation in patient self-management, disease management and the use of virtual visits.

Case Study #2: At Partners HealthCare in Boston, a home telehealth program focusing on cardiac care resulted in a 50 percent reduction in heart failure hospital readmissions, for a total cost savings of more than $10 million since 2006. The Connected Cardiac Care Program is a centralized telemonitoring and self-management and preventive care program for heart failure patients that combines telemonitoring with nurse intervention and care coordination, coaching and education. The daily transmission of weight, heart rate, pulse and blood pressure data by patients enables providers to more effectively assess patient status and provide just-in-time care and patient education.

Patients in the program use equipment – a home monitoring device with peripherals to collect weight, blood pressure, and heat rate measurements, and a touch-screen computer to answer questions about symptoms – on a daily basis for four months. Telemonitoring nurses monitor these vitals, respond to out-of-parameter alerts, and guide patients through structured biweekly heart failure education.

Cost to the patients? Zero.

Case Study #3: A telehealth strategy using webinars had a small but “positive impact on hypertensive patients” in Brazil, in terms of their adherence to antihypertensive drugs, low salt diet and physical activity. The program was managed by Family Health Teams (FHTs) consisting of doctors, nurses, nurse technicians and community health agents. According to researchers studying the program, the vast majority of practitioners do not specialize in primary care, and only recently have specialized courses emerged to provide that training.

“Given the country’s continental dimensions, high demand, and inadequate amount of training and continuing education centers for primary care professionals, telehealth presents itself as a promising strategy to improve access to training, leading to the improvement of hypertension,” they noted.

Despite growing evidence that telehealth is working for more and more patients, concerns remain about security, privacy and medical liability, with critics also arguing that telehealth lacks common standards. Government agencies, they say, have often been slow to reimburse patients for many telehealth services. Further, some health professionals argue that telehealth threatens to compromise the doctor-patient relationship.

Tell us what you think. Do the advantages of telehealth outweigh possible drawbacks? Have you leveraged telehealth services, either as a patient or provider?

For more information on how telehealth is changing the concept of health care delivery, dowload the White Paper from Tunstall Americas: “Telehealth Solutions Enhance Health Outcomes and Reduce Healthcare Costs.”

Categories: Cost-Savings

Three Pillars of Health Care Success: Cost Savings, Prevention/Patient-Centered Care, and Access to Care

Welcome to www.RealWorldHealthCare.org, a blog dedicated to showing what’s working to  improve health care in the U.S.

Why are we talking about improving access to good medical care? Rising costs could bankrupt us, and most people need to do a better job of preventing illness. But digging deeper, you may be surprised to learn that almost 10 percent of the U.S. population (that’s 29 million Americans) can’t afford the health insurance copayments, coinsurances and deductibles required to cover out-of-pocket costs for necessary treatments of certain chronic and life-altering medical conditions. The situation is so dire that about 60 percent of the personal bankruptcies filed in the U.S. are due to medical expenses.

As we see every day in the news, patients are facing more obstacles in accessing affordable, quality care. As across-the-board cuts to health care programs are now taking effect with implementation of the sequester – along with projected layoffs to health providers across fields – available funds to cover the rising cost of care will be strained even further. Staying abreast of the latest proven solutions to the increasingly complex challenges of our health care system is more important than ever, for patients and providers alike.

We want our blog to be the go-to source for demonstrating what’s working in our health care system by focusing on three important pillars of health care success:  Cost Savings, Prevention/Patient-Centered Care, and Access to Care.

Cost Savings: No patient – adult or child – should go without health care because he or she cannot afford it. The first step to finding solutions to the increasing cost of care is enabling health care systems and health care professionals to share their practical knowledge with one another as well as the patients who often have to choose between paying their medical bills and putting food on the table. From paying for prescription drug copayments and deductibles to affording health insurance premiums, our Cost Savings posts will explore proven strategies to help patients and families reduce the financial strain associated with the rising price of care.

Prevention/Patient-Centered Care: What’s the first thing you think of when given the words “health care?” Most people think “trip to the doctor,” or “medication.” Our attention has to shift more aggressively to find ways to help people stay healthy. Seeing a dietitian could be vital for millions of Americans hoping to live healthier and longer. Annual lab work can find vitamin deficiencies. Sometimes very simple things, like removing carpeting from the home, can contribute to better cardiovascular health, resulting in increased life expectancy. It takes a village to care for a patient. Partnerships among practitioners, payers, patients and their families are crucial for ensuring that health care decisions are made in a way that respects patients’ needs and that patients have the knowledge and support they need to make reasoned decisions and participate in their own care. In our Prevention/Patient-Centered Care blog posts, we’ll focus on the many strategies available for staying healthy and recognize ways that patients are taking an active role in decision-making about treatment options.

Access to Care: We are so fortunate to live in a world where scientists are developing novel, breakthrough therapies. But those therapies can’t result in positive health outcomes if the patients who so desperately need them can’t access them. The evidence is clear: Proper medication compliance and adherence – consistently the right medication, at the right dosage, for the right patient – is essential to mitigating chronic disease. Continued and properly managed care and staying on treatment will be the focus of our Access to Care blog posts.

We’ll be sharing real-life examples of positive health outcomes in this space, and we encourage you to join in the dialogue. How would you tackle the problem of unaffordable health care? How can business and philanthropy work together to reduce the financial burden on patients? Have you or someone you know received help paying for needed therapies? Let us know in the comments section.

Categories: General