Harvard Pilgrim Health Care’s Post

I love the discussion in this week’s Health:Further podcast with Marcus Whitney and Vic Gatto about the question of the impact of the annual physical exam. Thank you gentlemen, for turning the conversation in exactly the right direction – that our system, not our clinicians, are at blame for the irrelevance of the annual physical exam (eg. the annual wellness visit, the annual PCP check-in) that does little to truly help guide a patient’s health and well-being. But let’s be clear and not confuse two different concepts: the lack of evidence around the annual ADULT physical exam does not in any way negate the importance of primary care. It’s not the annual nature of a primary care visit that actually makes a real impact on health. It’s the continuity and coordination that #primarycare provides that actually prevents longer term disease. It’s the anticipatory guidance and real focus on prevention and management that the pediatric framework supplies in the well child visit. I find it interesting that this JAMA article is from 2021 compares our annual physical exam to that of the national health service in England and the Netherlands - both also having larger systems surrounding #publichealth and prevention that our #healthcare system is clearly not in a place to support. Our primary care teams need a broader transformation throughout the system. When we discuss real #transformation in healthcare, let’s be sure to acknowledge how our system as a whole needs to incentivize real change in an upstream manner, and not single out what is really more of a vestige of the checklist approach to financial payment on which our healthcare system continues to rely. #healthcareonlinkedin

Many of us have been reflecting on the pervasive issue of prior authorizations in both commercial and Medicare Advantage insurance products. Our recent publication in JAMA Ophthalmology, led by Sabin Dang alongside Charles Wykoff and Ankoor Shah from Retina Consultants of Texas, and Monica Horton and Allison Madson at the ASRS – American Society of Retina Specialists, delves into the impact of this practice on patient care. Our findings are striking: while over 96% of prior authorization requests for crucial anti-VEGF injections are eventually approved, nearly 60% of these approvals take more than 24 hours. This delay forces patients to make additional trips to the office, adding unnecessary stress and burden, particularly for those with retinal conditions such as #maculardegeneration and #diabeticretinopathy. This study highlights a critical area for improvement in our healthcare delivery system. We need to strive for a system where patients face fewer obstacles to receiving timely care. Eliminating cumbersome prior authorizations is a key part of that solution. Let's continue pushing for a more efficient and patient-centered healthcare system. Additional authors: David Eichenbaum, D Wilkin Parke III, Guneet Sodhi, Jared Nielsen, MD, MBA, Carl Danzig, Geeta Lalwani, Nader Moinfar, MD, MPH, FACS, FASRS, Nikolas London, Alan Kimura, J. Michael Jumper, Dante Pieramici, Anton Orlin, Jill Blim, Jessica A. Cao, John Thompson, Saira Khanna.

Nobody plans to fail but we may fail to plan. Long-term care planning is more focused on putting contingencies in place so we can avoid those high medical bills not covered by Provincial Health care. The older we get the more at risk we become for chronic illnesses and terminal illnesses. We can significantly navigate our way so we can age gracefully and more importantly less costly with Long-Term Care Planning in place. This video is dedicated to Long-Term Care Planning!

We have compiled some tips on how home health agencies can avoid using Questionable Encounter codes or codes that do not fall into any of the clinical groups under PDGM.

Empower Yourself with Information. Information is the key to patient empowerment. As you gather information about your condition you will become more informed about treatment options. This will allow you to manage your condition more effectively and increase your sense of wellbeing. Research suggests that patients who take a more active role in visits with their physician may have a greater sense of control and better health outcomes. Increased participation with your health care team will also lead to more meaningful discussions and thoughtful decisions about your medical care. #patientempowerment #patientexperience #patientengagement

If you want to take a deeper look into Ontario's health care system from the perspective of hospital leaders, Santis Health has a new podcast out that does just that. A discussion with hospital leaders as to how they are tackling the challenges that we see in the news everyday - staff shortages, infrastructure issues - all while trying to provide high-quality care for patients. Listen below! https://lnkd.in/gb2dSnZU

Saturday Statistics: Overcrowding in the hospital can lead to an admission extension by minimum of 1 day. What is that costing the health care system? Seems like an endless cycle ➡ Over capacity protocols in place ➡ Under staffed and over worked health care professionals ➡ Improper care of patients ➡ longer than needed admissions OR sending people home before they are ready. What can you do about it? Advocate for yourself and loved ones. Ensure that you have the appropriate tools to maintain dignity and safety. Ask for P-Stik when you need to provide a urine sample!

🌟 Enhancing Your Care: We're taking a step beyond the usual questions during admission to truly understand and cater to your unique needs. Our commitment to personalized care now includes Social Determinants of Health (SDOH) questions. These help us gather crucial information about your circumstances, allowing us to craft tailored care plans that go beyond the medical aspects. Your well-being is our priority! Learn more at www.mgmc.org/SDOH #PatientCare #SDOH #PersonalizedHealthcare

In order to integrate primary care into public health, we need to not only change the training regimen but we must also change the way that primary care functions within the entirety of the system. How do you think we can better integrate primary care into public health? Listen to the rest of the conversation here:👨🏼⚕️🎙️🩺 https://lnkd.in/ddGJBVGb #DoctorsOfLinkedIn #DoctorPatientRelationship #healthylifestyle #futuredoctor #medlife #Medicine #medical #PrimaryCare #primarycaredoctor

In home health care, when a patient is considered homebound – meaning they cannot leave the home without considerable and taxing effort – they require care and education specific to their condition in order to reach their health care goals and achieve better outcomes. #specialtyprograms #homehealthcare #optimaloutcomes