Improving Diagnosis in Health Care


Book Description

Getting the right diagnosis is a key aspect of health care - it provides an explanation of a patient's health problem and informs subsequent health care decisions. The diagnostic process is a complex, collaborative activity that involves clinical reasoning and information gathering to determine a patient's health problem. According to Improving Diagnosis in Health Care, diagnostic errors-inaccurate or delayed diagnoses-persist throughout all settings of care and continue to harm an unacceptable number of patients. It is likely that most people will experience at least one diagnostic error in their lifetime, sometimes with devastating consequences. Diagnostic errors may cause harm to patients by preventing or delaying appropriate treatment, providing unnecessary or harmful treatment, or resulting in psychological or financial repercussions. The committee concluded that improving the diagnostic process is not only possible, but also represents a moral, professional, and public health imperative. Improving Diagnosis in Health Care, a continuation of the landmark Institute of Medicine reports To Err Is Human (2000) and Crossing the Quality Chasm (2001), finds that diagnosis-and, in particular, the occurrence of diagnostic errorsâ€"has been largely unappreciated in efforts to improve the quality and safety of health care. Without a dedicated focus on improving diagnosis, diagnostic errors will likely worsen as the delivery of health care and the diagnostic process continue to increase in complexity. Just as the diagnostic process is a collaborative activity, improving diagnosis will require collaboration and a widespread commitment to change among health care professionals, health care organizations, patients and their families, researchers, and policy makers. The recommendations of Improving Diagnosis in Health Care contribute to the growing momentum for change in this crucial area of health care quality and safety.




Novel Technologies in the Diagnosis and Management of Sleep-disordered Breathing


Book Description

Sleep-disordered breathing, ranging from habitual snoring to severe obstructive sleep apnea, is highly prevalent and represents a growing global healthcare burden. Besides disrupting sleep, sleep-disordered breathing leads to detrimental outcomes such as excessive daytime sleepiness, neurocognitive impairment, and increased cardiometabolic morbidities. The gold standard diagnostic procedures (e.g., in-lab polysomnography) are cumbersome and standard parameters derived from sleep studies often yield poor long-term prognostic value. Hence, there is a need for innovative diagnostic technologies and novel sleep metrics to enable simple diagnosis and tailored disease management.




Neonatology Questions and Controversies: Neonatal Hemodynamics - E-Book


Book Description

Dr. Richard Polin's Neonatology Questions and Controversies series highlights the toughest challenges facing physicians and care providers in clinical practice, offering trustworthy guidance on up-to-date diagnostic and treatment options in the field. In each volume, renowned experts address the clinical problems of greatest concern to today's practitioners, helping you handle difficult practice issues and provide optimal, evidence-based care to every patient.The thoroughly updated, full-color, 4th Edition of Neonatal Hemodynamics: - Provides in-depth clinical overviews of the many hemodynamic conditions that are relevant for the neonatologist, offering guidance based on the most up-to-date understanding of underlying pathophysiology. - Places emphasis on controversial areas that can entail different approaches. - Features the most current clinical information throughout, covering everything from basic cardiovascular physiology to advanced monitoring and hemodynamic assessment. Several chapters have been revised to focus on the novel concepts of hemodynamic phenotypes, enhanced diagnostic precision, and phenotypic profiling, and are illustrated by demonstrative case presentations. - Includes new chapters on neonatal hemodynamic pharmacology, hemodynamic management in special circumstances (twin-twin transfusion, infant of a diabetic mother, arteriovenous malformations), neonatal hemodynamic care in the resource-challenged country, chronic pulmonary hypertension assessment and management, and more. - Utilizes a consistent chapter organization to help you find information quickly and easily, and contains numerous charts, graphs, radiographic images, and photographs throughout. - Offers the most authoritative advice available from world-class neonatologists with expertise in neonatal hemodynamics, who share their knowledge of new trends and developments in neonatal care. Purchase each volume individually, or get the entire 7-volume Neonatology Questions and Controversies set, which includes online access that allows you to search across all titles! - Gastroenterology and Nutrition - Hematology and Transfusion Medicine - Neonatal Hemodynamics - Infectious Disease, Immunology, and Pharmacology - Renal, Fluid, and Electrolyte Disorders - Neurology - The Newborn Lung




Cardiac Pacing and Monitoring


Book Description

Different artificial tools, such as heart-pacing devices, wearable and implantable monitors, engineered heart valves and stents, and many other cardiac devices, are in use in medical practice. Recent developments in the methods of cardiac pacing along with appropriate selection of equipment are the purpose of this book. Implantable heart rate management devices and wearable cardiac monitors are discussed. Indications for using specific types of cardiac pacemakers, cardiac resynchronization therapy devices, and implantable cardioverter defibrillators (ICDs) are of interest and their contraindications are considered. Special attention is paid to using leadless devices. The subcutaneous ICD obviates the need for transvenous leads and leadless pacemakers are entirely implantable into the right ventricle. Finally, applications of user-friendly wearable devices for the detection of atrial arrhythmia are debated.




Encyclopedia of Healthcare Information Systems


Book Description

Focusing on a healthcare organization's ability to improve access, quality, and value of care to the patient, this volume provides an extensive and rich compilation of international research which discusses the use, adoption, design, and diffusion of information communication technologies (ICTs) in healthcare.




A Nationwide Framework for Surveillance of Cardiovascular and Chronic Lung Diseases


Book Description

Chronic diseases are common and costly, yet they are also among the most preventable health problems. Comprehensive and accurate disease surveillance systems are needed to implement successful efforts which will reduce the burden of chronic diseases on the U.S. population. A number of sources of surveillance data-including population surveys, cohort studies, disease registries, administrative health data, and vital statistics-contribute critical information about chronic disease. But no central surveillance system provides the information needed to analyze how chronic disease impacts the U.S. population, to identify public health priorities, or to track the progress of preventive efforts. A Nationwide Framework for Surveillance of Cardiovascular and Chronic Lung Diseases outlines a conceptual framework for building a national chronic disease surveillance system focused primarily on cardiovascular and chronic lung diseases. This system should be capable of providing data on disparities in incidence and prevalence of the diseases by race, ethnicity, socioeconomic status, and geographic region, along with data on disease risk factors, clinical care delivery, and functional health outcomes. This coordinated surveillance system is needed to integrate and expand existing information across the multiple levels of decision making in order to generate actionable, timely knowledge for a range of stakeholders at the local, state or regional, and national levels. The recommendations presented in A Nationwide Framework for Surveillance of Cardiovascular and Chronic Lung Diseases focus on data collection, resource allocation, monitoring activities, and implementation. The report also recommends that systems evolve along with new knowledge about emerging risk factors, advancing technologies, and new understanding of the basis for disease. This report will inform decision-making among federal health agencies, especially the Department of Health and Human Services; public health and clinical practitioners; non-governmental organizations; and policy makers, among others.




Cardiac Arrhythmias


Book Description

This book covers all the major aspects associated with pathophysiological development of cardiac arrhythmias (covering enhanced or suppressed automaticity, triggered activity, or re-entry), from basic concepts through disease association, limitations of current pharmacotherapy and implant therapies and on-going trials and analysis of new biomarkers based on current knowledge of cellular interaction and signalling. The book describes novel and state-of-the-art methods for differentiating between the major types of arrhythmia, structural abnormalities and current practice guidelines and determination of risk stratification associated with sudden cardiac death. A particular focus is on arrhythmias associated with atrial fibrillation and includes details of associations with cardiac disease, current detection, analysis and imaging and future perspectives.​




The Role of Telehealth in an Evolving Health Care Environment


Book Description

In 1996, the Institute of Medicine (IOM) released its report Telemedicine: A Guide to Assessing Telecommunications for Health Care. In that report, the IOM Committee on Evaluating Clinical Applications of Telemedicine found telemedicine is similar in most respects to other technologies for which better evidence of effectiveness is also being demanded. Telemedicine, however, has some special characteristics-shared with information technologies generally-that warrant particular notice from evaluators and decision makers. Since that time, attention to telehealth has continued to grow in both the public and private sectors. Peer-reviewed journals and professional societies are devoted to telehealth, the federal government provides grant funding to promote the use of telehealth, and the private technology industry continues to develop new applications for telehealth. However, barriers remain to the use of telehealth modalities, including issues related to reimbursement, licensure, workforce, and costs. Also, some areas of telehealth have developed a stronger evidence base than others. The Health Resources and Service Administration (HRSA) sponsored the IOM in holding a workshop in Washington, DC, on August 8-9 2012, to examine how the use of telehealth technology can fit into the U.S. health care system. HRSA asked the IOM to focus on the potential for telehealth to serve geographically isolated individuals and extend the reach of scarce resources while also emphasizing the quality and value in the delivery of health care services. This workshop summary discusses the evolution of telehealth since 1996, including the increasing role of the private sector, policies that have promoted or delayed the use of telehealth, and consumer acceptance of telehealth. The Role of Telehealth in an Evolving Health Care Environment: Workshop Summary discusses the current evidence base for telehealth, including available data and gaps in data; discuss how technological developments, including mobile telehealth, electronic intensive care units, remote monitoring, social networking, and wearable devices, in conjunction with the push for electronic health records, is changing the delivery of health care in rural and urban environments. This report also summarizes actions that the U.S. Department of Health and Human Services (HHS) can undertake to further the use of telehealth to improve health care outcomes while controlling costs in the current health care environment.