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Scooped by
Lionel Reichardt / le Pharmageek
April 7, 2015 1:09 AM
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Santé publique : faut-il passer le chômage en ALD ?
Permettre à des patients en souffrance psychologique et dans l'incapacité de consulter en cabinet d'être pris en charge, c'est la mission que souhaite accomplir une plateforme de visioconsultation. Mais pour quel résultat ?
Via Anne-Sophie Hardel
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Scooped by
Lionel Reichardt / le Pharmageek
April 3, 2015 12:32 PM
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Health plans have the power to improve medication adherence with easier access to prescriptions and cheaper out-of-pocket expenses for diabetic seniors.
L'étude PwC « Optimisation de la qualité de service et de l’expérience client dans l’assurance à l’ère du digital », fournit des conseils pratiques aux dirigea…
Via Esposito Christelle
recently had an interesting conversation with several co-residents about how our health care system should evaluate physician performance. If nothing else, the discussion highlighted how challenging this issue has been for almost all medical specialties, including internal medicine, where the controversy has been punctuated by debates about maintenance of certification (MOC) and licensure. It remains to be seen what will develop after the American Board of Internal Medicine recently changed its MOC programs in the face of intense criticism. What is clear, however, is that organizations, including ACP, must remain engaged to guide physicians through any future changes.
Part of the discontentment appears tied to the sentiment that MOC or other similar activities may not accurately affect individual practice realities. Among other things, case-mix and regional trends make certain topics crucial for some practitioners and less pertinent for others. Many feel that competence is multifaceted and not fully represented by MOC requirements. At the heart of these divergent experiences and perspectives, however, lies a common question: What should physicians be responsible for knowing?
For many decades, good physicians have been viewed, both within and outside the medical community, as those with the most encyclopedic knowledge. In academic centers, we often praise doctors who can offer historical perspectives, molecular explanations, and/or evidence-based literature related to a condition or disease. Older physicians frequently offer tales of internalizing vast amounts of information without outside help. (“We didn’t have iPhones or the Internet in those days.”) Medical student evaluations are frequently based on fund of knowledge, what doctors can recall or memorize in standardized formats. To the general public, the long, grueling nature of medical training is predicated largely on the fact that there is so much to memorize and retain.
To be fair, this is not without reason. It’s impossible to provide high-quality care without a solid body of clinical knowledge and understanding of pathophysiology. Much should be said and praised about clinicians with command of the clarity and uncertainty in guidelines or standards of care. There is indeed a great deal of information that goes into good doctoring.
Nonetheless, fund of knowledge cannot be the sole (or even main) proxy for physician quality. There are many reasons for this, but perhaps none more important than the fact that it will fail to capture how a new generation of doctors learn, while running contrary to the very spirit of continuing medical education.
The vast majority of medical learners these days are digitally native, meaning that they enter training having grown up on a steady diet of technology. They study and take exams using electronic interfaces. They engage much of the world around them, their friends, professional communities, and current events through the Internet and mobile media.
They are also facile at obtaining information in a thoroughly digital world. Students and residents are often far more adept at navigating electronic medical records than full-time practitioners. Many can obtain clinical information about drug doses, treatment algorithms, complication rates, and synopses of rare conditions in a fraction of the time it takes their attendings, many of whom trained in a time when information was available only in libraries or textbooks tucked under their arms. Digital “knowledge clouds” are emerging in many learning settings, putting an immense amount of information at a physician’s fingertips.
This is where a digital learning style will possess important implications for the future of physician evaluation. No longer can doctors be asked to “know it all,” an expectation that has been demystified by the impossibly large and expanding body of medical knowledge. Even within specific specialties, it is difficult to standardize requirements when individuals go down divergent career pathways. Internists, for example, often pursue work in academic research, quality improvement, clinical education, full-time practice, management and leadership, public health, or nonprofit work. Beyond this, competency goals will likely remain moving targets amid dynamic policy and payment pressures.
Under these conditions, “high-quality” physicians will not simply consist of encyclopedic, master clinicians or doctors who can internalize all standardized materials. Beyond fund of knowledge, quality must be understood through a clinician’s ability to solve problems and improve on his or her own deficiencies.
One promising way to do this is through an approach termed the “triple jump.” In this framework, physicians are subjected to 3 stages of evaluations. First, they make a “first pass” through a question, generating an initial score that reflects their current fund of knowledge. Next, they are given a period of independent research, time they can use to look up information and supplement their knowledge (their ability to do this second step well is measured through a “process score”). Finally, they are given a chance to apply this new information to the original question, generating a final “assisted” score. All three scores and the differences between them contribute to overall evaluation.
This kind of staged, assisted approach can better embody the spirit of what evaluation should be: the measurement of an individual’s experience as a “lifetime learner.” It also reflects 2 realities that are apparent to most digitally native trainees: that a significant proportion of what is needed for clinical care can be looked up at the point of care and that being a good doctor does not mean knowing it all.
As digital natives finish training and enter full-time practice, they will make staged approaches like the “triple jump” much more promising as solutions. In truth, modern learners are already learning and working under similar conditions, scouring the Internet, navigating apps, and pulling in data from a diverse collection of point-of-care sources to care for patients and amend gaps in their own knowledge.
Going forward, physician evaluation should test and utilize this innate learning style. Doing this will change more than the language and program requirements around MOC. It will also help produce significant gains in how we fundamentally understand our own competence and communicate that to patients and peers.
Joshua Liao is an internal medicine fellow and can be reached on Twitter @JoshuaLiaoMD and his self-titled site, Joshua Liao. From the March ACP Internist, copyright © 2015 by the American College of Physicians.
Via Plus91
In the United States, where the healthcare system is very expensive and notoriously unequal, new entrants to the health sector, who are focusing on patients as customers with needs, are beginning to shake up a sector that is widely regarded as far...
Via Herve Ansanay
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Scooped by
Lionel Reichardt / le Pharmageek
March 31, 2015 11:49 AM
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Note d'analyse Les médicaments et leurs usages (volet 1)
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Scooped by
Lionel Reichardt / le Pharmageek
March 30, 2015 12:06 PM
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POST SUMMARY: eHealth (also written e-health) is a relatively recent term for healthcare practice supported by electronic processes and communication, dating back to at least 1999. So why hasn’t ehealth really taken off when it comes to our current healthcare landscape?
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Scooped by
Lionel Reichardt / le Pharmageek
March 30, 2015 8:15 AM
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European Commission, eHealth is the encompassing name given to the generic use of tools based on information and communication technologies
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Scooped by
Lionel Reichardt / le Pharmageek
March 30, 2015 7:59 AM
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The European Commission has highlighted the three main areas of focus in its digital single market strategy, including improving EU digital networks and creating a European digital economy.
Premier site français d’information en continu sur les technologies de l’information et de la communication (TIC, NTIC) dans la santé - TIC santé
Via Paris Healthcare Week
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Scooped by
Lionel Reichardt / le Pharmageek
March 27, 2015 7:29 AM
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Le syndrome métabolique, ou syndrome d’insulino-résistance, correspond à la présence concomitante, chez un patient, de plusieurs facteurs de risque cardiovasculaire parmi les 5 suivant : obésité abdominale, anomalie lipidique, pression artérielle élevée et glycémie élevée.
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Scooped by
Lionel Reichardt / le Pharmageek
April 7, 2015 11:39 AM
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"New York, NY -- (ReleaseWire) -- 04/06/2015 -- Healthcare information technology (IT) is a vast field that involves the use of information technology for designing, creating, developing, using and maintaining information systems in the field of healthcare. Healthcare IT market is growing at a fast rate due to technological advancement in the field and increasing demand for improved healthcare facilities worldwide. Healthcare IT allows exchange of health-related information among organizations electronically. On the basis of applications, healthcare IT market can be segmented into clinical technology, non-clinical technology and payer technology. Various wireless technologies are available in the market such as radio frequency identification (RFID), bluetooth, WLAN, WWAN, WMAN, zigbee technology and others. Use of healthcare IT lowers the cost of treatment and reduces errors associated with healthcare facilities; thus improves the efficiency of the healthcare system."
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Scooped by
Lionel Reichardt / le Pharmageek
April 6, 2015 5:30 AM
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Trophées e-santé - startups, Castres vous attend !
Les Bulletins Electroniques des Ambassades de France - un service ADIT
Via Peggy Boncompain
Après des années de tests et d'expérimentations, les tablettes tactiles destinées aux soignants sont enfin mûres pour être utilisées dans le cadre sanitaire ultra-strict des hôpitaux et établissements de soins. Exit les relevés papiers. Place aux transmissions en temps réel !
Via Laetitia Steffen
Technology is advancing how medicine is practiced, giving patients the chance to participate more fully in their healthcare. These new developments have the potential to elevate the provider-patient
relationship, and are being welcomed, for the most part, by both groups.
Via Richard Meyer, Giuseppe Fattori
Les industriels des dispositifs médicaux et ceux du numérique en santé ont planché avec les pouvoirs publics pour définir les mesures qui vont permettre de faire émerger une véritable filière de télémédecine.
Via Herve Ansanay
BOB WACHTER: As the health-care world finally shifts from analog to digital, increasing numbers of patients have access to a patient portal–a site that allows them to schedule appointments, email their physicians, refill medications, and check the...
Via Denise Silber
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Scooped by
Lionel Reichardt / le Pharmageek
March 30, 2015 12:02 PM
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Scooped by
Lionel Reichardt / le Pharmageek
March 30, 2015 8:00 AM
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The EC's Digital Economy and Society Index ranked Denmark, Sweden and Finland as first, second and fourth most digital European nation
Dans son dernier livre, l'entrepreneur Gilles Babinet esquisse les prochains bouleversements provoqués par la révolution numérique.
Via Stéphane Hardel
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Scooped by
Lionel Reichardt / le Pharmageek
March 28, 2015 8:17 AM
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