Registries for Evaluating Patient Outcomes
Registries for Evaluating Patient Outcomes

Author: Agency for Healthcare Research and Quality/AHRQ

Publisher: Government Printing Office

Published: 2014-04-01

Total Pages: 385

ISBN-13: 1587634333

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This User’s Guide is intended to support the design, implementation, analysis, interpretation, and quality evaluation of registries created to increase understanding of patient outcomes. For the purposes of this guide, a patient registry is an organized system that uses observational study methods to collect uniform data (clinical and other) to evaluate specified outcomes for a population defined by a particular disease, condition, or exposure, and that serves one or more predetermined scientific, clinical, or policy purposes. A registry database is a file (or files) derived from the registry. Although registries can serve many purposes, this guide focuses on registries created for one or more of the following purposes: to describe the natural history of disease, to determine clinical effectiveness or cost-effectiveness of health care products and services, to measure or monitor safety and harm, and/or to measure quality of care. Registries are classified according to how their populations are defined. For example, product registries include patients who have been exposed to biopharmaceutical products or medical devices. Health services registries consist of patients who have had a common procedure, clinical encounter, or hospitalization. Disease or condition registries are defined by patients having the same diagnosis, such as cystic fibrosis or heart failure. The User’s Guide was created by researchers affiliated with AHRQ’s Effective Health Care Program, particularly those who participated in AHRQ’s DEcIDE (Developing Evidence to Inform Decisions About Effectiveness) program. Chapters were subject to multiple internal and external independent reviews.

When Doctors Become Patients
When Doctors Become Patients

Author: Robert Klitzman

Publisher: Oxford University Press

Published: 2008

Total Pages: 344

ISBN-13: 0195327675

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For many doctors, their role as powerful healer precludes thoughts of ever getting sick themselves. When they do, it initiates a profound shift of awareness-- not only in their sense of their selves, which is invariably bound up with the "invincible doctor" role, but in the way that they view their patients and the doctor-patient relationship. While some books have been written from first-person perspectives on doctors who get sick-- by Oliver Sacks among them-- and TV shows like "House" touch on the topic, never has there been a "systematic, integrated look" at what the experience is like for doctors who get sick, and what it can teach us about our current health care system and more broadly, the experience of becoming ill.The psychiatrist Robert Klitzman here weaves together gripping first-person accounts of the experience of doctors who fall ill and see the other side of the coin, as a patient. The accounts reveal how dramatic this transformation can be-- a spiritual journey for some, a radical change of identity for others, and for some a new way of looking at the risks and benefits of treatment options. For most however it forever changes the way they treat their own patients. These questions are important not just on a human interest level, but for what they teach us about medicine in America today. While medical technology advances, the health care system itself has become more complex and frustrating, and physician-patient trust is at an all-time low. The experiences offered here are unique resource that point the way to a more humane future.

Seeing Patients
Seeing Patients

Author: Augustus A. White III

Publisher: Harvard University Press

Published: 2019-11-19

Total Pages: 361

ISBN-13: 0674241371

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“A powerful and extraordinarily important book.” —James P. Comer, MD “A marvelous personal journey that illuminates what it means to care for people of all races, religions, and cultures. The story of this man becomes the aspiration of all those who seek to minister not only to the body but also to the soul.” —Jerome Groopman, MD, author of How Doctors Think Growing up in Jim Crow–era Tennessee and training and teaching in overwhelmingly white medical institutions, Gus White witnessed firsthand how prejudice works in the world of medicine. While race relations have changed dramatically since then, old ways of thinking die hard. In this blend of memoir and manifesto, Dr. White draws on his experience as a resident at Stanford Medical School, a combat surgeon in Vietnam, and head orthopedic surgeon at one of Harvard’s top teaching hospitals to make sense of the unconscious bias that riddles medical care, and to explore how we can do better in a diverse twenty-first-century America. “Gus White is many things—trailblazing physician, gifted surgeon, and freedom fighter. Seeing Patients demonstrates to the world what many of us already knew—that he is also a compelling storyteller. This powerful memoir weaves personal experience and scientific research to reveal how the enduring legacy of social inequality shapes America’s medical field. For medical practitioners and patients alike, Dr. White offers both diagnosis and prescription.” —Jonathan L. Walton, Plummer Professor of Christian Morals, Harvard University “A tour de force—a compelling story about race, health, and conquering inequality in medical care...Dr. White has a uniquely perceptive lens with which to see and understand unconscious bias in health care...His journey is so absorbing that you will not be able to put this book down.” —Charles J. Ogletree, Jr., author of All Deliberate Speed

Freud's Patients
Freud's Patients

Author: Mikkel Borch-Jacobsen

Publisher: Reaktion Books

Published: 2021-10-13

Total Pages: 303

ISBN-13: 178914454X

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Portraits of the thirty-eight known patients Sigmund Freud treated clinically—some well-known, many obscure—reveal a darker, more complex picture of the famed psychoanalyst. Everyone knows the characters described by Freud in his case histories: “Dora,” the “Rat Man,” the “Wolf Man.” But what do we know of the people, the lives behind these famous pseudonyms: Ida Bauer, Ernst Lanzer, Sergius Pankejeff? Do we know the circumstances that led them to Freud’s consulting room, or how they fared—how they really fared—following their treatments? And what of those patients about whom Freud wrote nothing, or very little: Pauline Silberstein, who threw herself from the fourth floor of her analyst’s building; Elfriede Hirschfeld, Freud’s “grand-patient” and “chief tormentor;” the fashionable architect Karl Mayreder; the psychotic millionaire Carl Liebmann; and so many others? In an absorbing sequence of portraits, Mikkel Borch-Jacobsen offers the stories of these men and women—some comic, many tragic, all of them deeply moving. In total, thirty-eight lives tell us as much about Freud’s clinical practice as his celebrated case studies, revealing a darker and more complex Freud than is usually portrayed: the doctor as his patients, their friends, and their families saw him.

The Role of Telehealth in an Evolving Health Care Environment
The Role of Telehealth in an Evolving Health Care Environment

Author: Institute of Medicine

Publisher: National Academies Press

Published: 2012-12-20

Total Pages: 159

ISBN-13: 0309262011

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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.

Remaking the American Patient
Remaking the American Patient

Author: Nancy Tomes

Publisher: UNC Press Books

Published: 2016-01-06

Total Pages: 560

ISBN-13: 1469622785

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In a work that spans the twentieth century, Nancy Tomes questions the popular--and largely unexamined--idea that in order to get good health care, people must learn to shop for it. Remaking the American Patient explores the consequences of the consumer economy and American medicine having come of age at exactly the same time. Tracing the robust development of advertising, marketing, and public relations within the medical profession and the vast realm we now think of as "health care," Tomes considers what it means to be a "good" patient. As she shows, this history of the coevolution of medicine and consumer culture tells us much about our current predicament over health care in the United States. Understanding where the shopping model came from, why it was so long resisted in medicine, and why it finally triumphed in the late twentieth century helps explain why, despite striking changes that seem to empower patients, so many Americans remain unhappy and confused about their status as patients today.

Safe Patients, Smart Hospitals
Safe Patients, Smart Hospitals

Author: Peter Pronovost

Publisher: Penguin

Published: 2010-02-18

Total Pages: 237

ISBN-13: 1101185279

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The inspiring story of how a leading innovator in patient safety found a simple way to save countless lives. First, do no harm-doctors, nurses and clinicians swear by this code of conduct. Yet in hospitals and doctors' offices across the country, errors are made every single day - avoidable, simple mistakes that often cost lives. Inspired by two medical mistakes that not only ended in unnecessary deaths but hit close to home, Dr. Peter Pronovost made it his personal mission to improve patient safety and make preventable deaths a thing of the past, one hospital at a time. Dr. Pronovost began with simple improvements to a common procedure in the ER and ICU units at Johns Hopkins Hospital. Creating an easy five-step checklist based on the most up-to-date research for his fellow doctors and nurses to follow, he hoped that streamlining the procedure itself could slow the rate of infections patients often died from. But what Dr. Pronovost discovered was that doctors and nurses needed more than a checklist: the day-to-day environment needed to be more patient-driven and staff needed to see scientific results in order to know their efforts were a success. After those changes took effect, the units Dr. Pronovost worked with decreased their rate of infection by 70%. Today, all fifty states are implementing Dr. Pronovost's programs, which have the potential to save more lives than any other medical innovation in the past twenty-five years. But his ideas are just the beginning of the changes being made by doctors and nurses across the country making huge leaps to improve patient care. In Safe Patients, Smart Hospitals, Dr. Pronovost shares his own experience, anecdotal stories from his colleagues at Johns Hopkins and other hospitals that have made his approach their own, alongside comprehensive research-showing readers how small changes make a huge difference in patient care. Inspiring and thought provoking, this compelling book shows how one person with a cause really can make a huge difference in our lives.

Five Patients
Five Patients

Author: Michael Crichton

Publisher: Arrow/Children's (a Division of Random House Group)

Published: 1995

Total Pages: 272

ISBN-13: 9780099601111

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"ER has become the most succesful television series in the world since CHARLIE'S ANGELS. Michael Crichton created the series from his own experiences as a medical doctor in the emergency rooms, operating rooms and wards of Massachusetts General Hospital. FIVE PATIENTS is Michael Crichton's true account of the real life dramas so vividly portrayed in ER. A construction worker is seriously injured in a scaffold collapse- a middle-aged despatcher is brought in suffering from a fever that has reduced him to a delirious wreck; a young man nearly severs his hand in an accident; an airline traveller suffers chest pains; a mother of three is diagnosed with a life-threatening disease."

The Patient Will See You Now
The Patient Will See You Now

Author: Eric Topol

Publisher: Basic Books

Published: 2016-10-25

Total Pages: 386

ISBN-13: 0465094473

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The essential guide by one of America's leading doctors to how digital technology enables all of us to take charge of our health A trip to the doctor is almost a guarantee of misery. You'll make an appointment months in advance. You'll probably wait for several hours until you hear "the doctor will see you now"-but only for fifteen minutes! Then you'll wait even longer for lab tests, the results of which you'll likely never see, unless they indicate further (and more invasive) tests, most of which will probably prove unnecessary (much like physicals themselves). And your bill will be astronomical. In The Patient Will See You Now, Eric Topol, one of the nation's top physicians, shows why medicine does not have to be that way. Instead, you could use your smartphone to get rapid test results from one drop of blood, monitor your vital signs both day and night, and use an artificially intelligent algorithm to receive a diagnosis without having to see a doctor, all at a small fraction of the cost imposed by our modern healthcare system. The change is powered by what Topol calls medicine's "Gutenberg moment." Much as the printing press took learning out of the hands of a priestly class, the mobile internet is doing the same for medicine, giving us unprecedented control over our healthcare. With smartphones in hand, we are no longer beholden to an impersonal and paternalistic system in which "doctor knows best." Medicine has been digitized, Topol argues; now it will be democratized. Computers will replace physicians for many diagnostic tasks, citizen science will give rise to citizen medicine, and enormous data sets will give us new means to attack conditions that have long been incurable. Massive, open, online medicine, where diagnostics are done by Facebook-like comparisons of medical profiles, will enable real-time, real-world research on massive populations. There's no doubt the path forward will be complicated: the medical establishment will resist these changes, and digitized medicine inevitably raises serious issues surrounding privacy. Nevertheless, the result-better, cheaper, and more human health care-will be worth it. Provocative and engrossing, The Patient Will See You Now is essential reading for anyone who thinks they deserve better health care. That is, for all of us.

Patient Safety and Quality
Patient Safety and Quality

Author: Ronda Hughes

Publisher: Department of Health and Human Services

Published: 2008

Total Pages: 592

ISBN-13:

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"Nurses play a vital role in improving the safety and quality of patient car -- not only in the hospital or ambulatory treatment facility, but also of community-based care and the care performed by family members. Nurses need know what proven techniques and interventions they can use to enhance patient outcomes. To address this need, the Agency for Healthcare Research and Quality (AHRQ), with additional funding from the Robert Wood Johnson Foundation, has prepared this comprehensive, 1,400-page, handbook for nurses on patient safety and quality -- Patient Safety and Quality: An Evidence-Based Handbook for Nurses. (AHRQ Publication No. 08-0043)." - online AHRQ blurb, http://www.ahrq.gov/qual/nurseshdbk/