INSIGHTS TO SOME OF THE TOPICS IN INFOMED’S APRIL-JUNE 2016 ISSUE
UP CLOSE WITH PATIENT-CENTERED CARE
On the new strategy of prioritising medicine around patients
The current challenge in healthcare is on how to reprioritise medicine around patients who have actually become consumers of health
The many challenges in the delivery of healthcare is putting pressure on the many traditional delivery models with rising costs and the preventive services expectation from the healthcare consumers and purchasers. The trust is on how to reprioritise medicine around patients who have actually become consumers. Thus in facing this new reality of a consumer-driven market, many providers and systems are undertaking new initiatives to improve access to healthcare and the overall patient experience.
It’s time for a fundamentally new strategy. At its core is maximizing value for patients: that is, achieving the best outcomes at the lowest cost. We must move away from a supply-driven health care system organized around what physicians do and toward a patient-centered system organized around what patients need. We must shift the focus from the volume and profitability of services provided—physician visits, hospitalizations, procedures, and tests—to the patient outcomes achieved.”
Patient-centered care is now driving the future of healthcare delivery representing a holistic approach to health. The business of healthcare is no more about simply treating the sick but is more about addressing a wide range of factors that are intertwined with the patients’ health.
IT’S COMPLICATED; GUYS AS WE GET OLDER – THIS RELATIONSHIP OF OURS – Guys get to know from the expert about benign prostate enlargement and erectile dysfunction.
It was Francis Bacon who once said, “Age appears to be best in four things; old wood to burn, old wine to drink, old friends to trust, and old authors to read.”
The way I understand it, the English philosopher, scientist, author and statesman (among many of his other roles) probably implied that age itself also dragged in a multitude of issues, not the least of which involves one’s health. Benign prostate enlargement and erectile dysfunction are two conditions that men fret about, or secretly fear (especially the latter), as they grow old.
A normal prostate is a gland that weighs about 20-25 grams and is about the size of a walnut. When a man reaches age 50, this gland would have begun to grow as part of the aging process, possibly causing it to squeeze or press against the urethra. This essentially constricts the flow of urine and results in lower urinary tract symptoms (LUTS).
Erectile dysfunction, as a popular topic, needs no in-depth introduction. It is the inability to get or keep an erection firm enough to have satisfactory sexual intercourse. While it is normal for men to occasionally experience erectile dysfunction, especially during times of stress, a frequent occurrence may be a sign of more serious health issues.
Prostate enlargement and erectile dysfunction are typically managed as different urological conditions. However, a growing number of experts in this field see a link between both conditions. This view potentially impacts treatment and management methods in the long run.
COLUMBIA ASIA HOSPITAL PETALING JAYA – The new kid on the block is all set to celebrate its first birthday.
As the new provider in town it was an opportune moment to speak with Josephine Siew Chuei Li, the General Manager of Columbia Asia Hospital – Petaling Jaya (CAH-PJ) who has over 15 years of experience in managerial position in medical centers in Malaysia on her outlook and direction for CAH-PJ located in a developed and matured community of Petaling Jaya.
It was refreshing to know from Josephine that CAH-PJ has planned to stay ahead of the curve by engaging with the population and drive efficiencies.
The model of the CAH-PJ fits in well in the current and future scene for the delivery of quality healthcare, particularly for better outcomes for the patients and keeping the population on wellness and prevention mode.
Josephine reiterated the importance of preventive care and wellness program and the plans to reach and have interactions with corporate clients and the community. Working with the community particularly with the GPs in the community to prove a seamless patient management program that provides better outcomes for the patients at reduced cost.
SENIORS TELL MEDICAL STUDENTS WHAT THEY NEED FROM DOCTORS – Listen doctors!
Six people all over the age of 90 were invited to talk to the second-year medical students at Case Western Reserve School of Medicine, USA. The annual panel discussion, called “Life Over 90,” is aimed at nudging students toward choosing geriatric medicine, the primary care field that focuses on the elderly. It is among the lowest-paid specialties, and geriatricians must contend with complex cases that are time consuming and are often not reimbursed adequately by Medicare or private insurance. And their patients can have diseases that can only be managed but never cured.
Students often are attracted to more lucrative specialties such as orthopaedics or cardiology, said Jeremy Hill, who was in the audience.
“Successful outcomes depend on the patient’s cooperation and that requires an understanding of who the patient is,” said Elizabeth O’Toole, a geriatrician.
“DOCTOR, WHICH SUNSCREEN PRODUCTS SHOULD I USE?”
By Dr Sue Ann Chan, Dermatology Specialist Registrar, UK
A practical guideline on sunscreen products for all
Cosmetic sun products originated in the 1930s and were promoted my Coco Chanel initially designed to be tanning aids. Approximately 40 years later, the concept of sun protective factor emerged. There are many brands of sunscreen products available now for us to choose from.
What to look out for?
When choosing a sunscreen lotion, take note of the A-Star Rating and Sun Protection Factor (SPF). As its name suggests, the A-Star Rating refers to the amount of UVA protection the lotion offers – 1 star (mild), 2 star (moderate) , 3 star (good), 4 star (superior), 5 star (ultra-protection). It is important to protect ourselves from excessive UVA radiation as excessive UVA radiation promotes fine lines, wrinkles, pigmentation and reduction in elasticity of the skin.
The SPF refers to the UVB protection that the lotion offers. For example, SPF 15 means that the lotion when applied adequately, would require 15 times longer for the same quantity of sun to cause redness on the skin at a particular time of the day. In Europe, the maximum amount of SPF stated in sunscreen products is SPF 50. In other parts of the world, sunscreen products companies may be allowed to promote their products up to SPF 70 or even SPF 100. It is important to note that UVB radiation is the main contributor to skin cancers and skin pigmentation. If you have any underlying dermatological conditions that predispose you to getting skin cancers or photosensitivity to the sun (for example Vitiligo or Systemic Lupus Erythematosus (SLE)), you would be advised to use a high factor SPF lotion on a regular basis.
NEW HOPE BEATS FOR HEART PATIENTS AND HOSPITALS
On the new transcatheter aortic valve replacement or TAVR
Inch by inch, two doctors working side by side in an operating room guide a long narrow tube through a patient’s femoral artery, from his groin into his beating heart. They often look intently, not down at the 81-year-old patient, but up at a 60-inch monitor above him that’s streaming pictures of his heart made from X-rays and sound waves.
The big moment comes 40 minutes into the procedure at Morton Plant Hospital. Dr. Joshua Rovin unfurls from the catheter a metal stent containing a new aortic valve that is made partly out of a pig’s heart and expands to the width of a quarter outside the catheter. The monitor shows it fits well over the old one. Blood flow is normal again. “This is pretty glorious,” Rovin said.
TAVR – TRANSCATHETER AORTIC VALVE REPLACEMENT
The surgeon has performed one of the fastest-growing procedures in U.S. heart care known as a transcatheter aortic valve replacement, or TAVR. The operation was approved in the U.S. in late 2011 to help patients too ill or frail for traditional “open-heart” valve surgery. The procedure has rapidly gained doctors’ acceptance, particularly for patients in their 80s and 90s.
UNZIPPING THE ZIKA CODE
Zika, how it is transmitted and the preventive measures
Zika, an infectious disease is caused by the Zika virus, which is transmitted to humans by the Aedes mosquito, the same mosquito that transmits dengue and chikungunya. It can be transmitted by either Aedes aegypti mosquitoes (also known as yellow fever mosquitoes) or by Aedes albopictus mosquitoes (also known as asian tiger mosquitoes).
Since its discovery in 1947 in Uganda, the major outbreaks of Zika virus infection were reported in 2007 (Island of Yap), 2014 (French Polynesia) and 2015 (Brazil). Between January 2014 and February 2016, a total of 33 countries have reported autochthonous circulation of this virus. There is also an indirect evidence of local transmission in 6 additional countries. By February 2016, as the infection spread rapidly across the Americas, the WHO declared the Zika infection as a Public Health Emergency of International Concern (PHEIC).
How it is transmitted?
An Aedes mosquito can only transmit Zika virus after it bites a person with the virus in their blood. The virus is not spread by casual contact like touching or hugging an infected person. Other possible modes of transmission include maternal-fetal, sexual, blood transfusion and organ or tissue transplantation.
Most people infected by the Zika virus develop symptoms like fever, rashes, myalgia, headaches, joints pain, red eyes and post-infection fatigue. Some of the rarely observed symptoms are abdominal pains associated with diarrhea, ulcerations of mucous membranes and severe pruritis. Symptoms usually manifest within 3 to 7 days after being bitten by an infected mosquito and can last for several days to weeks.
There is no specific vaccine or treatment for this infection. Treatment is usually supportive and includes rest, fluids, antipyretics, analgesics and NSAIDs. Diagnostic tests include real time PCR assay to detect the viral RNA in serum and serological assays to detect serum IgM or IgG for both Zika-specific and cross-reactive antibodies.
YOU WILL FIND MORE INTERESTING TOPICS IN THIS ISSUE……
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