Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Redefining an Illness – Institute of Medicine – 10 February 2015

Posted on February 13, 2015. Filed under: Chronic Disease Mgmt | Tags: , |

Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Redefining an Illness – Institute of Medicine – 10 February 2015
The guidelines come with a new moniker: systemic exertion intolerance disease (SEID).

US panel redefines chronic fatigue syndrome – Nature News 11 February 2015
Recommendation to change name to systemic exertion intolerance disease ignites controversy.

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Shared Decision-Making Strategies for Best Care: Patient Decision Aids – Institute of Medicine discussion paper – 18 September 2014

Posted on October 1, 2014. Filed under: Patient Participation | Tags: , |

Shared Decision-Making Strategies for Best Care: Patient Decision Aids – Institute of Medicine discussion paper – 18 September 2014

“In Shared Decision-Making Strategies for Best Care: Patient Decision Aids, the authors suggest concrete steps to fully integrate the ideals and practices of shared decision making (SDM) into routine clinical practice. The discussion paper, published by the Institute of Medicine (IOM), is a product of participants in the IOM’s Evidence Communication Innovation Collaborative. The authors identify key steps to shift expectations and behaviors of patients and clinicians: certifying decision aids, establishing measurement standards for SDM, using health information technology to facilitate information exchange, and expanding the role of employers and payers in supporting certified decision aids. In support of these steps, the authors summarize their views of the compelling case for implementing SDM, and underscore the potential benefits.”

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Graduate Medical Education That Meets the Nation’s Health Needs – Institute of Medicine – 29 July 2014

Posted on July 31, 2014. Filed under: Educ for Hlth Professions, Medicine | Tags: , |

Graduate Medical Education That Meets the Nation’s Health Needs – Institute of Medicine – 29 July 2014

“Since the creation of the Medicare and Medicaid programs in 1965, the public has provided tens of billions of dollars to fund graduate medical education (GME), the period of residency and fellowship that is provided to physicians after they receive a medical degree. Although the scale of govern­ment support for physician training far exceeds that for any other profession, there is a striking absence of transparency and accountability in the GME financing system for producing the types of physicians that the nation needs.

The IOM formed an expert committee to conduct an independent review of the governance and financing of the GME system. The 21-member IOM committee concludes that there is an unquestionable imperative to assess and optimize the effectiveness of the public’s investment in GME. In its report, Graduate Medical Education That Meets the Nation’s Health Needs, the committee recommends significant changes to GME financ­ing and governance to address current deficiencies and better shape the phy­sician workforce for the future. The IOM report provides an initial road­map for reforming the Medicare GME payment system and building an infrastructure that can drive more strategic investment in the nation’s physician workforce.”

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Assessing Genomic Sequencing Information for Health Care Decision Making – Institute of Medicine – 2014

Posted on July 24, 2014. Filed under: Genomics | Tags: , |

Assessing Genomic Sequencing Information for Health Care Decision Making – Institute of Medicine – 2014

Institute of Medicine. Assessing Genomic Sequencing Information for Health Care Decision Making: Workshop Summary. Washington, DC: The National Academies Press, 2014.

“Description

Rapid advances in technology have lowered the cost of sequencing an individual’s genome from the several billion dollars that it cost a decade ago to just a few thousand dollars today and have correspondingly greatly expanded the use of genomic information in medicine. Because of the lack of evidence available for assessing variants, evaluation bodies have made only a few recommendations for the use of genetic tests in health care. For example, organizations, such as the Evaluation of Genomic Applications in Practice and Prevention working group, have sought to set standards for the kinds of evaluations needed to make population-level health decisions. However, due to insufficient evidence, it has been challenging to recommend the use of a genetic test. An additional challenge to using large-scale sequencing in the clinic is that it may uncover “secondary,” or “incidental,” findings – genetic variants that have been associated with a disease but that are not necessarily related to the conditions that led to the decision to use genomic testing. Furthermore, as more genetic variants are associated with diseases, new information becomes available about genomic tests performed previously, which raises issues about how and whether to return this information to physicians and patients and also about who is responsible for the information.

To help develop a better understanding of how genomic information is used for healthcare decision making, the Roundtable on Translating Genomic-Based Research for Health of the Institute of Medicine held a workshop in Washington,DC in February 2014. Stakeholders, including clinicians, researchers, patients, and government officials, discussed the issues related to the use of genomic information in medical practice. Assessing Genomic Sequencing Information for Health Care Decision Making is the summary of that workshop. This report compares and contrasts evidence evaluation processes for different clinical indications and discusses key challenges in the evidence evaluation process.”

 

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Institute of Medicine. Health Literacy and Numeracy: Workshop Summary. Washington, DC: The National Academies Press, 2014

Posted on July 22, 2014. Filed under: Patient Participation | Tags: , , |

Institute of Medicine. Health Literacy and Numeracy: Workshop Summary. Washington, DC: The National Academies Press, 2014.

ISBN 978-0-309-29980-0

“Description

Although health literacy is commonly defined as an individual trait, it does not depend on the skills of individuals alone. Health literacy is the product of the interaction between individuals’ capacities and the health literacy-related demands and complexities of the health care system. Specifically, the ability to understand, evaluate, and use numbers is important to making informed health care choices.

Health Literacy and Numeracy is the summary of a workshop convened by The Institute of Medicine Roundtable on Health Literacy in July 2013 to discuss topics related to numeracy, including the effects of ill health on cognitive capacity, issues with communication of health information to the public, and communicating numeric information for decision making. This report includes a paper commissioned by the Roundtable, “Numeracy and the Affordable Care Act: Opportunities and Challenges,” that discusses research findings about people’s numeracy skill levels; the kinds of numeracy skills that are needed to select a health plan, choose treatments, and understand medication instructions; and how providers should communicate with those with low numeracy skills. The paper was featured in the workshop and served as the basis of discussion.”

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Contemporary Issues for Protecting Patients in Cancer Research: Workshop Summary – Institute of Medicine – 2014

Posted on July 8, 2014. Filed under: Oncology, Research | Tags: , |

Contemporary Issues for Protecting Patients in Cancer Research: Workshop Summary – Institute of Medicine – 2014

Institute of Medicine. Contemporary Issues for Protecting Patients in Cancer Research: Workshop Summary. Washington, DC: The National Academies Press, 2014.

“Description

In the nearly 40 years since implementation of federal regulations governing the protection of human participants in research, the number of clinical studies has grown exponentially. These studies have become more complex, with multisite trials now common, and there is increasing use of archived biospecimens and related data, including genomics data. In addition, growing emphasis on targeted cancer therapies requires greater collaboration and sharing of research data to ensure that rare patient subsets are adequately represented. Electronic records enable more extensive data collection and mining, but also raise concerns about the potential for inappropriate or unauthorized use of data, bringing patient protections into a new landscape. There are also long-standing concerns about the processes and forms used to obtain informed consent from patients participating in clinical studies. These changes and challenges raise new ethical and practical questions for the oversight of clinical studies, and for protecting patients and their health information in an efficient manner that does not compromise the progress of biomedical research.

Contemporary Issues for Protecting Patients in Cancer Research is the summary of a workshop convened by the National Cancer Policy Forum of the Institute of Medicine in February 2014 to explore contemporary issues in human subjects protections as they pertain to cancer research, with the goal of identifying potential relevant policy actions. Clinical researchers, government officials, members of Institutional Review Boards, and patient advocates met to discuss clinical cancer research and oversight. This report examines current regulatory provisions that may not adequately protect patients or may be hindering research, and discusses potential strategies and actions to address those challenges.”

 

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Supporting a Movement for Health and Health Equity: Workshop Summary – Institute of Medicine – 2014

Posted on June 19, 2014. Filed under: Public Hlth & Hlth Promotion | Tags: , , |

Supporting a Movement for Health and Health Equity: Workshop Summary – Institute of Medicine – 2014

Institute of Medicine. Supporting a Movement for Health and Health Equity: Workshop Summary. Washington, DC: The National Academies Press, 2014

“Description

Supporting a Movement for Health and Health Equity is the summary of a workshop convened in December 2013 by the Institute of Medicine Roundtable on the Promotion of Health Equity and the Elimination of Health Disparities and the Roundtable on Population Health Improvement to explore the lessons that may be gleaned from social movements, both those that are health-related and those that are not primarily focused on health. Participants and presenters focused on elements identified from the history and sociology of social change movements and how such elements can be applied to present-day efforts nationally and across communities to improve the chances for long, healthy lives for all.

The idea of movements and movement building is inextricably linked with the history of public health. Historically, most movements – including, for example, those for safer working conditions, for clean water, and for safe food – have emerged from the sustained efforts of many different groups of individuals, which were often organized in order to protest and advocate for changes in the name of such values as fairness and human rights. The purpose of the workshop was to have a conversation about how to support the fragments of health movements that roundtable members believed they could see occurring in society and in the health field. Recent reports from the National Academies have highlighted evidence that the United States gets poor value on its extraordinary investments in health – in particular, on its investments in health care – as American life expectancy lags behind that of other wealthy nations. As a result, many individuals and organizations, including the Healthy People 2020 initiative, have called for better health and longer lives.”

 

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Institute of Medicine and National Research Council. The National Children’s Study 2014: An Assessment. Washington, DC: The National Academies Press, 2014

Posted on June 17, 2014. Filed under: Child Health / Paediatrics | Tags: , |

Institute of Medicine and National Research Council. The National Children’s Study 2014: An Assessment. Washington, DC: The National Academies Press, 2014

“Description

The National Children s Study (NCS) was authorized by the Children s Health Act of 2000 and is being implemented by a dedicated Program Office in the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD). The NCS is planned to be a longitudinal observational birth cohort study to evaluate the effects of chronic and intermittent exposures on child health and development in the U.S.. The NCS would be the first study to collect a broad range of environmental exposure measures for a national probability sample of about 100,000 children, followed from birth or before birth to age 21.

Detailed plans for the NCS were developed by 2007 and reviewed by a National Research Council / Institute of Medicine panel. At that time, sample recruitment for the NCS Main Study was scheduled to begin in 2009 and to be completed within about 5 years. However, results from the initial seven pilot locations, which recruited sample cases in 2009-2010, indicated that the proposed household-based recruitment approach would be more costly and time consuming than planned. In response, the Program Office implemented a number of pilot tests in 2011 to evaluate alternative recruitment methods and pilot testing continues to date.

At the request of Congress, The National Children s Study 2014 reviews the revised study design and proposed methodologies for the NCS Main Study. This report assesses the study s plan to determine whether it is likely to produce scientifically sound results that are generalizable to the United States population and appropriate subpopulations. The report makes recommendations about the overall study framework, sample design, timing, content and need for scientific expertise and oversight.

The National Children s Study has the potential to add immeasurably to scientific knowledge about the impact of environmental exposures, broadly defined, on children s health and development in the United States. The recommendations of this report will help the NCS will achieve its intended objective to examine the effects of environmental influences on the health and development of American children.”

 

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Institute of Medicine. The Current State of Obesity Solutions in the United States: Workshop Summary. Washington, DC: The National Academies Press, 2014

Posted on June 16, 2014. Filed under: Public Hlth & Hlth Promotion | Tags: , , |

Institute of Medicine. The Current State of Obesity Solutions in the United States: Workshop Summary. Washington, DC: The National Academies Press, 2014

“Description

For the first time in decades, promising news has emerged regarding efforts to curb the obesity crisis in the United States. Obesity rates have fallen among low-income children in 18 states, the prevalence of obesity has plateaued among girls, regardless of ethnicity, and targeted efforts in states such as Massachusetts have demonstrably reduced the prevalence of obesity among children. Although the reasons for this turnaround are as complex and multifaceted as the reasons for the dramatic rise in obesity rates in recent decades, interventions to improve nutrition and increase physical activity are almost certainly major contributors. Yet major problems remain. Diseases associated with obesity continue to incur substantial costs and cause widespread human suffering. Moreover, substantial disparities in obesity rates exist among population groups, and in some cases these disparities are widening. Some groups and regions are continuing to experience increases in obesity rates, and the prevalence of severe obesity is continuing to rise.

The Current State of Obesity Solutions in the United States is the summary of a workshop convened in January 2014 by the Institute of Medicine Roundtable on Obesity Solutions to foster an ongoing dialogue on critical and emerging implementation, policy, and research issues to accelerate progress in obesity prevention and care. Representatives of public health, health care, government, the food industry, education, philanthropy, the nonprofit sector, and academia met to discuss interventions designed to prevent and treat obesity. The workshop focused on early care and education, schools, worksites, health care institutions, communities and states, the federal government, and business and industry. For each of these groups, this report provides an overview of current efforts to improve nutrition, increase physical activity, and reduce disparities among populations.”

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Assessing Health Professional Education: Workshop Summary – Institute of Medicine – Washington, DC: The National Academies Press, 2014

Posted on May 1, 2014. Filed under: Educ for Hlth Professions | Tags: , , |

Assessing Health Professional Education: Workshop Summary – Institute of Medicine – Washington, DC: The National Academies Press, 2014

“Description

Assessing Health Professional Education is the summary of a workshop hosted by the Institute of Medicine’s Global Forum on Innovation in Health Professional Education to explore assessment of health professional education. At the event, Forum members shared personal experiences and learned from patients, students, educators, and practicing health care and prevention professionals about the role each could play in assessing the knowledge, skills, and attitudes of all learners and educators across the education to practice continuum. The workshop focused on assessing both individuals as well as team performance. This report discusses assessment challenges and opportunities for interprofessional education, team-based care, and other forms of health professional collaborations that emphasize the health and social needs of communities.”

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New Directions in Child Abuse and Neglect Research – Institute of Medicine; National Research Council – 25 March 2014

Posted on April 28, 2014. Filed under: Child Health / Paediatrics | Tags: , , |

New Directions in Child Abuse and Neglect Research – Institute of Medicine; National Research Council – 25 March 2014

Edited by Anne C. Petersen, Joshua Joseph, and Monica Feit. Committee on Child Maltreatment Research, Policy, and Practice for the Next Decade: Phase II; Board on Children, Youth, and Families; Committee on Law and Justice; Institute of Medicine; National Research Council.
Washington (DC): National Academies Press (US); 2014 Mar 25.
ISBN-13: 978-0-309-28512-4ISBN-10: 0-309-28512-7

“Each year, child protective services receive reports of child abuse and neglect involving six million children, and many more go unreported. The long-term human and fiscal consequences of child abuse and neglect are not relegated to the victims themselves — they also impact their families, future relationships, and society. In 1993, the National Research Council (NRC) issued the report, Under-standing Child Abuse and Neglect, which provided an overview of the research on child abuse and neglect. New Directions in Child Abuse and Neglect Research updates the 1993 report and provides new recommendations to respond to this public health challenge. According to this report, while there has been great progress in child abuse and neglect research, a coordinated, national research infrastructure with high-level federal support needs to be established and implemented immediately.

New Directions in Child Abuse and Neglect Research recommends an actionable framework to guide and support future child abuse and neglect research. This report calls for a comprehensive, multidisciplinary approach to child abuse and neglect research that examines factors related to both children and adults across physical, mental, and behavioral health domains–including those in child welfare, economic support, criminal justice, education, and health care systems–and assesses the needs of a variety of subpopulations. It should also clarify the causal pathways related to child abuse and neglect and, more importantly, assess efforts to interrupt these pathways. New Directions in Child Abuse and Neglect Research identifies four areas to look to in developing a coordinated research enterprise: a national strategic plan, a national surveillance system, a new generation of researchers, and changes in the federal and state programmatic and policy response.”

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Capturing Social and Behavioral Domains in Electronic Health Records Phase 1 – Committee on the Recommended Social and Behavioral Domains and Measures for Electronic Health Records; Board on Population Health and Public Health Practice; Institute of Medicine (US) – 2014

Posted on April 28, 2014. Filed under: Health Informatics, Public Hlth & Hlth Promotion | Tags: , , |

Capturing Social and Behavioral Domains in Electronic Health Records Phase 1 – Committee on the Recommended Social and Behavioral Domains and Measures for Electronic Health Records; Board on Population Health and Public Health Practice; Institute of Medicine (US) – 2014

“Description

Substantial empirical evidence of the contribution of social and behavioral factors to functional status and the onset and progression of disease has accumulated over the past few decades. Electronic health records (EHRs) provide crucial information to providers treating individual patients, to health systems, including public health officials, about the health of populations, and to researchers about the determinants of health and the effectiveness of treatment. Inclusion of social and behavioral health domains in EHRs is vital to all three uses. The Health Information Technology for Economic and Clinical Health Act and the Patient Protection and Affordable Care Act place new importance on the widespread adoption and meaningful use of EHRs. “Meaningful use” in a health information technology context refers to the use of EHRs and related technology within a health care organization to achieve specified objectives. Achieving meaningful use also helps determine whether an organization can receive payments from the Medicare EHR Incentive Program or the Medicaid EHR Incentive Program.

Capturing Social and Behavioral Domains in Electronic Health Records is the first phase of a two-phase study to identify domains and measures that capture the social determinants of health to inform the development of recommendations for meaningful use of EHRs. This report identifies specific domains to be considered by the Office of the National Coordinator, specifies criteria that should be used in deciding which domains should be included, identifies core social and behavioral domains to be included in all EHRs, and identifies any domains that should be included for specific populations or settings defined by age, socioeconomic status, race/ethnicity, disease, or other characteristics.”

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Including Health in Global Frameworks for Development, Wealth, and Climate Change: Workshop Summary – Institute of Medicine, Washington, DC: The National Academies Press, 2014

Posted on April 24, 2014. Filed under: Climate Change, Public Hlth & Hlth Promotion | Tags: , , , |

Including Health in Global Frameworks for Development, Wealth, and Climate Change: Workshop Summary – Institute of Medicine, Washington, DC: The National Academies Press, 2014

“Description

Including Health in Global Frameworks for Development, Wealth, and Climate Change is the summary of a three-part public webinar convened by the Institute of Medicine Roundtable on Environmental Health Sciences, Research, and Medicine and its collaborative on Global Environmental Health and Sustainable Development. Presenters and participants discussed the role of health in measuring a country’s wealth (going beyond gross domestic product), health scenario communication, and international health goals and indicators. The workshop focused on fostering discussion across academic, government, business, and civil society sectors to make use of existing data and information that can be adapted to track progress of global sustainable development and human health. This report examines frameworks for global development goals and connections to health indicators, the role for health in the context of novel sustainable economic frameworks that go beyond gross domestic product, and scenarios to project climate change impacts.”

 

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Identifying and Addressing the Needs of Adolescents and Young Adults with Cancer: Workshop Summary – Institute of Medicine – 10 January 2014

Posted on January 30, 2014. Filed under: Child Health / Paediatrics, Oncology | Tags: , |

Identifying and Addressing the Needs of Adolescents and Young Adults with Cancer: Workshop Summary – Institute of Medicine – 10 January 2014

National Cancer Policy Forum; Board on Health Care Services; A Livestrong and Institute of Medicine Workshop; Institute of Medicine.

“Identifying and Addressing the Needs of Adolescents and Young Adults with Cancer is the summary of a workshop convened by the Institute of Medicine’s National Cancer Policy Forum in July 2013 to facilitate discussion about gaps and challenges in caring for adolescent and young adult cancer patients and potential strategies and actions to improve the quality of their care. The workshop featured invited presentations from clinicians and other advocates working to improve the care and outcomes for the adolescent and young adult population with cancer.

Cancer is the leading disease-related cause of death in adolescents and young adults. Each year nearly 70,000 people between the ages of 15 and 39 are diagnosed with cancer, approximately 8 times more than children under age 15. This population faces a variety of unique short- and long-term health and psychosocial issues, such as difficulty reentering school, the workforce, or the dating scene; problems with infertility; cardiac, pulmonary, or other treatment repercussions; and secondary malignancies. Survivors are also at increased risk for psychiatric conditions such as anxiety, depression, substance abuse, and suicide and may have difficulty acquiring health insurance and paying for needed care. Identifying and Addressing the Needs of Adolescents and Young Adults with Cancer discusses a variety of topics important to adolescent and young adult patients with cancer, including the ways in which cancers affecting this group differ from cancers in other age groups and what that implies about the best treatments for these cancer patients. This report identifies gaps and challenges in providing optimal care to adolescent and young adult patients with cancer and to discuss potential strategies and actions to address them.”

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Financing Long-Term Services and Supports for Individuals with Disabilities and Older Adults: Workshop Summary – Institute of Medicine – 2013

Posted on October 23, 2013. Filed under: Chronic Disease Mgmt, Health Economics | Tags: , |

Financing Long-Term Services and Supports for Individuals with Disabilities and Older Adults: Workshop Summary – Institute of Medicine – 2013

ISBN 978-0-309-29406-5

“Description

Financing Long-Term Services and Supports for Individuals with Disabilities and Older Adults is the summary of a workshop convened in June 2013 by the Forum on Aging, Disability, and Independence of the Institute of Medicine and the National Research Council to examine the financing of long-term services and supports for working-age individuals with disabilities and among individuals who are developing disabilities as they age. The workshop covered both older adults who acquire disabilities and younger adults with disabilities who may acquire additional impairments as they age, the target population of the Forum’s work. The challenges associated with financing long-term services and supports for people with disabilities impacts all age groups. While there are important differences between the characteristics of programs developed for different age groups, and specific populations may have different needs, this workshop addressed the financing sources for long-term services and supports in general, noting specific differences as appropriate.

The financing of long-term services and supports has become a major issue in the United States. These are the services and supports that individuals with disabilities, chronic conditions, and functional impairments need in order to live independently, such as assistance with eating, bathing, and dressing. Long-term services and supports do not include the medical or nursing services required to manage health conditions that may be responsible for a disabling condition. At least 11 million adults ages 18 and over receive long-term services and supports. Only a little more than half of them – 57 percent – are ages 65 or older. One study found that about 6 percent of people turning 65 in 2005 could expect to have expenses of more than $100,000 for long-term services and supports. Financing Long-Term Services and Supports for Individuals with Disabilities and Older Adults discusses the scope and trends of current sources of financing for long-term services and supports for working-age individuals with disabilities and older adults aging into disability, including income supports and personal savings. This report considers the role of families, business, and government in financing long-term services and supports and discusses implications of and opportunities for current and innovative approaches.”

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Elder Abuse and Its Prevention: Workshop Summary – Institute of Medicine – 2013

Posted on October 22, 2013. Filed under: Aged Care / Geriatrics, Violence | Tags: , |

Elder Abuse and Its Prevention: Workshop Summary – Institute of Medicine – 2013

ISBN 978-0-309-29351-8

“Description

Elder Abuse and Its Prevention is the summary of a workshop convened in April 2013 by the Institute of Medicine’s Forum on Global Violence Prevention. Using an ecological framework, this workshop explored the burden of elder abuse around the world, focusing on its impacts on individuals, families, communities, and societies. Additionally, the workshop addressed occurrences and co-occurrences of different types of abuse, including physical, sexual, emotional, and financial, as well as neglect. The ultimate objective was to illuminate promising global and multisectoral evidence-based approaches to the prevention of elder maltreatment. While the workshop covered scope and prevalence and unique characteristics of abuse, the intention was to move beyond what is known about elder abuse to foster discussions about how to improve prevention, intervention, and mitigation of the victims’ needs, particularly through collaborative efforts. The workshop discussions included innovative intervention models and opportunities for prevention across sectors and settings.

Violence and related forms of abuse against elders is a global public health and human rights problem with far-reaching consequences, resulting in increased death, disability, and exploitation with collateral effects on well-being. Data suggest that at least 10 percent of elders in the United States are victims of elder maltreatment every year. In low- and middle-income countries, where the burden of violence is the greatest, the figure is likely even higher. In addition, elders experiencing risk factors such as diminishing cognitive function, caregiver dependence, and social isolation are more vulnerable to maltreatment and underreporting. As the world population of adults aged 65 and older continues to grow, the implications of elder maltreatment for health care, social welfare, justice, and financial systems are great. However, despite the magnitude of global elder maltreatment, it has been an underappreciated public health problem. Elder Abuse and Its Prevention discusses the prevalence and characteristics of elder abuse around the world, risk factors for abuse and potential adverse health outcomes, and contextually specific factors, such as culture and the role of the community.”

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Organizational Change to Improve Health Literacy: Workshop Summary – Institute of Medicine – 2013

Posted on October 18, 2013. Filed under: Patient Participation | Tags: , , |

Organizational Change to Improve Health Literacy: Workshop Summary – Institute of Medicine – 2013

ISBN 978-0-309-28805-7

“Organizational Change to Improve Health Literacy is the summary of a workshop convened in April 2013 by the Institute of Medicine Board on Population Health and Public Health Practice Roundtable on Health Literacy. As a follow up to the 2012 discussion paper Ten Attributes of a Health Literate Health Care Organization, participants met to examine what is known about implementation of the attributes of a health literate health care organization and to create a network of health literacy implementers who can share information about health literacy innovations and problem solving. This report discusses implementation approaches and shares tools that could be used in implementing specific literacy strategies.

Although health literacy is commonly defined as an individual trait, there is a growing appreciation that health literacy does not depend on the skills of individuals alone. Health literacy is the product of the interaction between individuals’ capacities and the health literacy-related demands and complexities of the health care system. System changes are needed to better align health care demands with the public’s skills and abilities. Organizational Change to Improve Health Literacy focuses on changes that could be made to achieve this goal.”

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Establishing Transdisciplinary Professionalism for Improving Health Outcomes: Workshop summary – Institute of Medicine – 2013

Posted on October 9, 2013. Filed under: Educ for Hlth Professions, Health Professions | Tags: |

Establishing Transdisciplinary Professionalism for Improving Health Outcomes: Workshop summary – Institute of Medicine – 2013

ISBN 978-0-309-28901-6

Authors

Patricia A. Cuff, Rapporteur; Global Forum on Innovation in Health Professional Education; Board on Global Health; Institute of Medicine

“Description

Establishing Transdisciplinary Professionalism for Improving Health Outcomes is a summary of a workshop convened by the Institute of Medicine Global Forum on Innovation in Health Professional Education to explore the possibility of whether different professions can come together and whether a dialogue with society on professionalism is possible. Most of the 59 members making up the Global Forum were present at the workshop and engaged with outside participants in active dialogue around issues related to professionalism and how the different professions might work effectively together and with society in creating a social contract. The structure of the workshop involved large plenary discussions, facilitated table conversations, and small-group breakout sessions. In this way, the members – representing multiple sectors, countries, health professions, and educational associations – had numerous opportunities to share their own perspectives on transdisciplinary professionalism as well as hear the opinions of subject matter experts and the general public.

Efforts to improve patient care and population health are traditional tenets of all the health professions, as is a focus on professionalism. But in a time of rapidly changing environments and evolving technologies, health professionals and those who train them are being challenged to work beyond their traditional comfort zones, often in teams. A new professionalism might be a mechanism for achieving improved health outcomes by applying a transdisciplinary professionalism throughout health care and wellness that emphasizes crossdisciplinary responsibilities and accountability. Establishing Transdisciplinary Professionalism for Improving Health Outcomes discusses how shared understanding can be integrated into education and practice, ethical implications of and barriers to transdisciplinary professionalism, and the impact of an evolving professional context on patients, students, and others working within the health care system.”

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Delivering High-Quality Cancer Care: Charting a New Course for a System in Crisis – Institute of Medicine – 10 September 2013

Posted on September 12, 2013. Filed under: Clin Governance / Risk Mgmt / Quality, Oncology | Tags: , |

Delivering High-Quality Cancer Care: Charting a New Course for a System in Crisis – Institute of Medicine – 10 September 2013

“In the United States, approximately 14 million people have had cancer and more than 1.6 million new cases are diagnosed each year. By 2022, it is projected that there will be 18 million cancer survivors and, by 2030, cancer incidence is expected to rise to 2.3 million new diagnoses per year. However, more than a decade after the IOM first studied the quality of cancer care, the barriers to achieving excellent care for all cancer patients remain daunting. Therefore, the IOM convened a committee of experts to examine the quality of cancer care in the United States and formulate recommendations for improvement. Delivering High-Quality Cancer Care: Charting a New Course for a System in Crisis presents the committee’s findings and recommendations.

The committee concluded that the cancer care delivery system is in crisis due to a growing demand for cancer care, increasing complexity of treatment, a shrinking workforce, and rising costs. Changes across the board are urgently needed to improve the quality of cancer care. All stakeholders – including cancer care teams, patients and their families, researchers, quality metrics developers, and payers, as well as HHS, other federal agencies, and industries – must reevaluate their current roles and responsibilities in cancer care and work together to develop a higher quality cancer care delivery system. Working toward the recommendations outlined in this report, the cancer care community can improve the quality of life and outcomes for people facing a cancer diagnosis.”

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Health Impact Assessment of Shale Gas Extraction: Workshop Summary – Institute of Medicine – 2013

Posted on September 2, 2013. Filed under: Environmental Health | Tags: , |

Health Impact Assessment of Shale Gas Extraction: Workshop Summary – Institute of Medicine – 2013

ISBN 978-0-309-28791-3

“Description

Natural gas extraction from shale formations, which includes hydraulic fracturing, is increasingly in the news as the use of extraction technologies has expanded, rural communities have been transformed seemingly overnight, public awareness has increased, and regulations have been developed. The governmental public health system, which retains primary responsibility for health, was not an early participant in discussions about shale gas extraction; thus public health is lacking critical information about environmental health impacts of these technologies and is limited in its ability to address concerns raised by regulators at the federal and state levels, communities, and workers employed in the shale gas extraction industry.

Health Impact Assessment of Shale Gas Extraction is the summary of a workshop convened in 2012 by the Institute of Medicine (IOM) Roundtable on Environmental Health Sciences, Research, and Medicine to discuss the human health impact of shale gas extraction through the lens of a health impact assessment. Eminent scientists, physicians, public health experts, and representatives from government agencies at federal and state levels, from nongovernment organizations, from the business sector, and from interest groups representing the interests of the citizens met to exchange ideas and to inform on hydraulic fracturing as a means of extraction of natural gas. This report examines the state of the science regarding shale gas extraction, the direct and indirect environmental health impacts of shale gas extraction, and the use of health impact assessment as a tool that can help decision makers identify the public health consequences of shale gas extraction.”

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Health Literacy: Improving Health, Health Systems, and Health Policy Around the World – Workshop Summary – released 12 July 2013

Posted on August 26, 2013. Filed under: Health Policy, Public Hlth & Hlth Promotion | Tags: , , |

Health Literacy: Improving Health, Health Systems, and Health Policy Around the World – Workshop Summary – released 12 July 2013

“From the first use of the term health literacy in 1974 – described as “health education meeting minimal standards for all school grade levels” – the definition of health literacy has evolved into a common idea that involves both the need for people to understand information that helps them maintain good health and the need for health systems to reduce their complexity . Since the 1990s, health literacy has taken two different approaches; one oriented to clinical care and the other to public health. The public health approach is more prominent in developing nations, where organizations not only work to improve health for large groups of people but also provide educational opportunities. There are many opportunities for international research collaboration between the United States, European countries, and developing nations.

In September 2012, the IOM Roundtable on Health Literacy hosted a workshop focused on international health literacy efforts. The workshop featured presentations and discussions about health literacy interventions from various countries as well as other topics related to international health literacy. This document summarizes the workshop.”

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Partnering with Patients to Drive Shared Decisions, Better Value, and Care Improvement: Workshop Proceedings – Institute of Medicine – 2013

Posted on August 16, 2013. Filed under: Patient Participation | Tags: , |

Partnering with Patients to Drive Shared Decisions, Better Value, and Care Improvement: Workshop Proceedings – Institute of Medicine – 2013

“The Institute of Medicine’s Roundtable on Value & Science-Driven Health Care held a workshop, titled Partnering with Patients to Drive Shared Decisions, Better Value, and Care Improvement, on February 25 and 26, 2013. The workshop, supported by the Gordon and Betty Moore Foundation and the Blue Shield of California Foundation, focused on identifying and exploring issues, attitudes, and approaches to increasing patient engagement in and demand for the following: shared decision making and better communication about the evidence in support of testing and treatment options; the best value from the health care they receive; and the use of data generated in the course of their care experience for care improvement.

The workshop hoped to build awareness and demand from patients and families for better care at lower costs and to create a health care system that continuously learns and improves. Participants included members of the medical, clinical research, health care services research, regulatory, health care economics, behavioral economics, health care delivery, payer, and patient communities. Partnering with Patients to Drive Shared Decisions, Better Value, and Care Improvement Workshop Proceedings offers a summary of the 2-day workshop including the workshop agenda and biographies of speakers.”

 

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Inclusion Criteria [for clinical practice guidelines to be included in the US National Guideline Clearinghouse] – June 2013 Agency for Healthcare Research and Qualit

Posted on June 11, 2013. Filed under: Clin Governance / Risk Mgmt / Quality | Tags: , , , , |

Inclusion Criteria [for clinical practice guidelines to be included in the US National Guideline Clearinghouse] – June 2013  Agency for Healthcare Research and Quality

“Effective June 2014, NGC will employ the 2011 definition of clinical practice guideline developed by the Institute of Medicine (IOM).1

Clinical practice guidelines are statements that include recommendations intended to optimize patient care that are informed by a systematic review of evidence and an assessment of the benefits and harms of alternative care options.

For more information, please refer to the Frequently Asked Questions. We invite you to send your comments to info@guideline.gov.

Revised Criteria for Inclusion of Clinical Practice Guidelines in NGC

Effective June 2014: In order for NGC to accept a submitted clinical practice guideline, the guideline must meet all the criteria below. In addition to the guideline, developers must provide NGC with documentation of the underlying systematic review*.”

… continues on the site

 

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Interprofessional Education for Collaboration: Learning How to Improve Health from Interprofessional Models Across the Continuum of Education to Practice: Workshop Summary – Institute of Medicine – 2013

Posted on May 15, 2013. Filed under: Educ for Hlth Professions | Tags: , |

Interprofessional Education for Collaboration: Learning How to Improve Health from Interprofessional Models Across the Continuum of Education to Practice: Workshop Summary – Institute of Medicine – 2013

“Every year, the Global Forum undertakes two workshops whose topics are selected by the more than 55 members of the Forum. It was decided in this first year of the Forum’s existence that the workshops should lay the foundation for future work of the Forum and the topic that could best provide this base of understanding was “interprofessional education.” The first workshop took place August 29-30, 2012, and the second was on November 29-30, 2012. Both workshops focused on linkages between interprofessional education (IPE) and collaborative practice. The difference between them was that Workshop 1 set the stage for defining and understanding IPE while Workshop 2 brought in speakers from around the world to provide living histories of their experience working in and between interprofessional education and interprofessional or collaborative practice.

A committee of health professional education experts planned, organized, and conducted a 2-day, interactive public workshop exploring issues related to innovations in health professions education (HPE). The committee involved educators and other innovators of curriculum development and pedagogy and will be drawn from at least four health disciplines. The workshop followed a high-level framework and established an orientation for the future work of the Global Forum on Innovations in Health Professional Education. Interprofessional Education for Collaboration: Learning How to Improve Health from Interprofessional Models Across the Continuum of Education to Practice summarizes the presentations and small group discussions that focused on innovations in five areas of HPE:

1. Curricular innovations – Concentrates on what is being taught to health professions’ learners to meet evolving domestic and international needs;
2. Pedagogic innovations – Looks at how the information can be better taught to students and WHERE education can takes place;
3. Cultural elements – Addresses who is being taught by whom as a means of enhancing the effectiveness of the design, development and implementation of interprofessional HPE;
4. Human resources for health – Focuses on how capacity can be innovatively expanded to better ensure an adequate supply and mix of educated health workers based on local needs; and
5. Metrics – Addresses how one measures whether learner assessment and evaluation of educational impact and care delivery systems influence individual and population health.”

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Best Care at Lower Cost: The Path to Continuously Learning Health Care in America – Committee on the Learning Health Care System in America, Institute of Medicine – 2013

Posted on May 14, 2013. Filed under: Evidence Based Practice, Health Economics, Health Informatics, Health Mgmt Policy Planning | Tags: , |

Best Care at Lower Cost: The Path to Continuously Learning Health Care in America – Committee on the Learning Health Care System in America, Institute of Medicine – 2013

ISBN-10: 0-309-26073-6    ISBN-13: 978-0-309-26073-2

“America’s health care system has become too complex and costly to continue business as usual. Best Care at Lower Cost explains that inefficiencies, an overwhelming amount of data, and other economic and quality barriers hinder progress in improving health and threaten the nation’s economic stability and global competitiveness. According to this report, the knowledge and tools exist to put the health system on the right course to achieve continuous improvement and better quality care at a lower cost.

The costs of the system’s current inefficiency underscore the urgent need for a systemwide transformation. About 30 percent of health spending in 2009–roughly $750 billion–was wasted on unnecessary services, excessive administrative costs, fraud, and other problems. Moreover, inefficiencies cause needless suffering. By one estimate, roughly 75,000 deaths might have been averted in 2005 if every state had delivered care at the quality level of the best performing state. This report states that the way health care providers currently train, practice, and learn new information cannot keep pace with the flood of research discoveries and technological advances.

About 75 million Americans have more than one chronic condition, requiring coordination among multiple specialists and therapies, which can increase the potential for miscommunication, misdiagnosis, potentially conflicting interventions, and dangerous drug interactions. Best Care at Lower Cost emphasizes that a better use of data is a critical element of a continuously improving health system, such as mobile technologies and electronic health records that offer significant potential to capture and share health data better. In order for this to occur, the National Coordinator for Health Information Technology, IT developers, and standard-setting organizations should ensure that these systems are robust and interoperable. Clinicians and care organizations should fully adopt these technologies, and patients should be encouraged to use tools, such as personal health information portals, to actively engage in their care.

This book is a call to action that will guide health care providers; administrators; caregivers; policy makers; health professionals; federal, state, and local government agencies; private and public health organizations; and educational institutions.”

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Perspectives on Research with H5N1 Avian Influenza: Scientific Inquiry, Communication, Controversy: Summary of a Workshop – Institute of Medicine – 2013

Posted on April 9, 2013. Filed under: Infectious Diseases, Influenza A(H1N1) / Swine Flu, Research | Tags: , |

Perspectives on Research with H5N1 Avian Influenza: Scientific Inquiry, Communication, Controversy: Summary of a Workshop – Institute of Medicine – 2013

“When, in late 2011, it became public knowledge that two research groups had submitted for publication manuscripts that reported on their work on mammalian transmissibility of a lethal H5N1 avian influenza strain, the information caused an international debate about the appropriateness and communication of the researchers’ work, the risks associated with the work, partial or complete censorship of scientific publications, and dual-use research of concern in general.

Recognizing that the H5N1 research is only the most recent scientific activity subject to widespread attention due to safety and security concerns, on May 1, 2012, the National Research Council’s Committee on Science, Technology and Law, in conjunction with the Board on Life Sciences and the Institute of Medicine’s Forum on Microbial Threats, convened a one-day public workshop for the purposes of 1) discussing the H5N1 controversy; 2) considering responses by the National Institute of Allergy and Infectious Diseases (NIAID), which had funded this research, the World Health Organization, the U.S. National Science Advisory Board for Biosecurity (NSABB), scientific publishers, and members of the international research community; and 3) providing a forum wherein the concerns and interests of the broader community of stakeholders, including policy makers, biosafety and biosecurity experts, non-governmental organizations, international organizations, and the general public might be articulated.
Perspectives on Research with H5N1 Avian Influenza: Scientific Enquiry, Communication, Controversy summarizes the proceedings of the workshop.”

ISBN-10: 0-309-26775-7
ISBN-13: 978-0-309-26775-5

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Sharing Clinical Research Data – Institute of Medicine Workshop Summary – 29 March 2013

Posted on April 2, 2013. Filed under: Research | Tags: , |

Sharing Clinical Research Data – Institute of Medicine Workshop Summary – 29 March 2013

“Pharmaceutical companies, academic researchers, and government agencies compile large quantities of clinical research data, which, if shared more widely both within and across sectors, could improve public health, enhance patient safety, and spur drug development. Data sharing also can increase public trust in clinical trials and the conclusions derived from them by lending transparency to the clinical research process.

Despite several barriers to data sharing – such as concerns about data mining, erroneous secondary analyses of data, and unwarranted litigation – there is increasing acknowledgement among researchers of the importance and potential benefits to sharing clinical research data at various stages of the research, discovery, and development pipeline.

On October 4-5, 2012, four groups within the IOM – the Forum on Drug Discovery, Development, and Translation; the Forum on Neuroscience and Nervous System Disorders; the National Cancer Policy Forum; and the Roundtable on Translating Genomic-Based Research for Health – hosted a workshop to explore the benefits of sharing clinical research data, the barriers to such sharing, and strategies to address these barriers to facilitate the development of safe, effective therapeutics and diagnostics. This document summarizes the workshop.

As follow up to this workshop the IOM is in the process of developing a consensus study that will focus on the open availability and use of clinical trial data.”

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Cognitive Rehabilitation Therapy for Traumatic Brain Injury: Model Study Protocols and Frameworks to Advance the State of the Science – Institute of Medicine Workshop Summary – 29 March 2013

Posted on April 2, 2013. Filed under: Mental Health Psychi Psychol, Neurology | Tags: , , , |

Cognitive Rehabilitation Therapy for Traumatic Brain Injury: Model Study Protocols and Frameworks to Advance the State of the Science – Institute of Medicine Workshop Summary – 29 March 2013

“The 2011 IOM report, Cognitive Rehabilitation Therapy for Traumatic Brain Injury: Evaluating the Evidence, assessed the evidence for the effectiveness of using cognitive rehabilitation therapy (CRT) to treat people with traumatic brain injury (TBI). As the signature wound of the American military conflicts in Iraq and Afghanistan, TBI has increasingly gained attention over the past 15 years. As one form of treatment for TBI, CRT is a systematic, goal-oriented approach to helping patients overcome cognitive impairments. The 2011 IOM report’s conclusions revolved around the fact that there is little continuity among research studies of the effectiveness of different types of CRT, and there exist only small amounts of evidence demonstrating the effectiveness of using CRT to treat TBI, though the small amount of evidence generally indicates that CRT interventions have some effectiveness.

In October 2012, the IOM held a workshop to discuss the barriers for evaluating the effectiveness of CRT care and for identifying suggested taxonomy, terminology, timing, and ways forward for CRT research. This document summarizes the workshop.”

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Challenges and Opportunities for Change in Food Marketing to Children and Youth – Workshop Summary – Institute of Medicine – 4 March 2013

Posted on March 5, 2013. Filed under: Child Health / Paediatrics, Preventive Healthcare, Public Hlth & Hlth Promotion | Tags: , , , |

Challenges and Opportunities for Change in Food Marketing to Children and Youth – Workshop Summary – Institute of Medicine – 4 March 2013

Full text
“The childhood obesity epidemic is an urgent public health problem, and it will continue to take a substantial toll on the health of Americans. The most recent data show that almost a third of U.S. children and adolescents are overweight or obese. Children are exposed to an enormous amount of commercial advertising and marketing for food. In 2009, children age 2-11 saw and average of more than 10 television food ads per day. Internet-based advergames, cell phones, and social network marketing create even more avenues for children to be exposed to food advertisements. The marketing of high-calorie, low-nutrient foods and beverages is linked to overweight and obesity. A 2006 IOM report provided evidence that television advertising influences the food and beverage preferences, requests, and short-term consumption of children.

To review progress and explore opportunities for action on food and beverage marketing that targets children and youth, the IOM’s Standing Committee on Childhood Obesity Prevention hosted a workshop on November 5, 2012. The workshop featured presentations and discussion on contemporary trends in marketing of foods and beverages to children and youth and the implications of those trends for obesity prevention. This document summarizes the workshop.”

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Delivering Affordable Cancer Care in the 21st Century – Workshop Summary – Institute of Medicine – 11 February 2013

Posted on February 14, 2013. Filed under: Health Economics, Oncology | Tags: , |

Delivering Affordable Cancer Care in the 21st Century – Workshop Summary – Institute of Medicine – 11 February 2013

“Spending on health care currently accounts for 18 percent of the United States’ GDP. By 2037, that percentage is expected to increase to 25 percent of GDP. This growth in health care spending is unsustainable, jeopardizes international economic competitiveness, and negatively impacts many national priorities, including investments in research, education, and infrastructure. Individuals are also burdened by rising healthcare costs, both in terms of medical expenses and stagnant wages. Despite these high expenditures for health care, health outcomes in the U.S. are not considerably better than other high-income countries.

Spending on cancer care in the U.S. is expected to increase because of the rapid influx of new cancer diagnoses as the population ages. In addition, as more expensive therapies and technologies become the standard of care, there are concerns that the costs of cancer treatment could begin to outpace health care inflation as a whole.

On October 8-9, 2012, the IOM’s National Cancer Policy Forum held a workshop to examine the drivers of current and projected cancer care costs, as well as potential ways to curb these costs while maintaining or improving the quality of care. This document summarizes the workshop.”

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Posted on February 14, 2013. Filed under: Patient Safety, Pharmacy | Tags: , |

Countering the Problem of Falsified and Substandard Drugs – Institute of Medicine – 13 February 2013

“Falsified and substandard medicines provide little protection from disease and, worse, can expose consumers to major harm. Bad drugs pose potential threats around the world, but the nature of the risk varies by country, with higher risk in countries with minimal or non-existent regulatory oversight. While developed countries are not immune, – negligent production at a Massachusetts compounding pharmacy killed 44 people from September 2012 to January 2013 – the vast majority of problems occur in developing countries where underpowered and unsafe medicines affect millions.

It is difficult to measure the public health burden of falsified and substandard drugs, the number of deaths they cause, or the amount of time and money wasted using them. The FDA asked the IOM to assess the global public health implications of falsified, substandard, and counterfeit pharmaceuticals to help jumpstart international discourse about this problem. At the international level, productive discussion relies on cooperation and mutual trust. This report lays out a plan to invest in quality to improve public health.”

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Childhood Immunization Schedule and Safety: Stakeholder Concerns, Scientific Evidence, and Future Studies – Institute of Medicine – 16 January 2013

Posted on January 17, 2013. Filed under: Child Health / Paediatrics, Infectious Diseases | Tags: , , , , |

Childhood Immunization Schedule and Safety: Stakeholder Concerns, Scientific Evidence, and Future Studies – Institute of Medicine – 16 January 2013

“Vaccines are among the most safe and effective public health interventions to prevent serious disease and death. Because of the success of vaccines, most Americans today have no firsthand experience with such devastating illnesses as polio or diphtheria. Health care providers who vaccinate young children follow a schedule prepared by the U.S. Advisory Committee on Immunization Practices. Under the current schedule, children younger than six may receive as many as 24 immunizations by their second birthday. New vaccines undergo rigorous testing prior to receiving FDA approval; however, like all medicines and medical interventions, vaccines carry some risk.

Driven largely by concerns about potential side effects, there has been a shift in some parents’ attitudes toward the child immunization schedule. HHS asked the IOM to identify research approaches, methodologies, and study designs that could address questions about the safety of the current schedule.

This report is the most comprehensive examination of the immunization schedule to date. The IOM committee uncovered no evidence of major safety concerns associated with adherence to the childhood immunization schedule. Should signals arise that there may be need for investigation, however, the report offers a framework for conducting safety research using existing or new data collection systems.”

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U.S. Health in International Perspective: Shorter Lives, Poorer Health – Institute of Medicine – 9 January 2013

Posted on January 10, 2013. Filed under: Health Status | Tags: , |

U.S. Health in International Perspective: Shorter Lives, Poorer Health – Institute of Medicine – 9 January 2013

“The United States is among the wealthiest nations in the world, but it is far from the healthiest. For many years, Americans have been dying at younger ages than people in almost all other high-income countries. This health disadvantage prevails even though the U.S. spends far more per person on health care than any other nation. To gain a better understanding of this problem, the NIH asked the National Research Council and the IOM to investigate potential reasons for the U.S. health disadvantage and to assess its larger implications.

No single factor can fully explain the U.S. health disadvantage. It likely has multiple causes and involves some combination of inadequate health care, unhealthy behaviors, adverse economic and social conditions, and environmental factors, as well as public policies and social values that shape those conditions. Without action to reverse current trends, the health of Americans will probably continue to fall behind that of people in other high-income countries. The tragedy is not that the U.S. is losing a contest with other countries, but that Americans are dying and suffering from illness and injury at rates that are demonstrably unnecessary.”

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An Integrated Framework for Assessing the Value of Community-Based Prevention – Institute of Medicine – 2 November 2012

Posted on November 20, 2012. Filed under: Preventive Healthcare, Public Hlth & Hlth Promotion | Tags: , , |

An Integrated Framework for Assessing the Value of Community-Based Prevention – Institute of Medicine – 2 November 2012

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“Over the last century, the major causes of disease and death among Americans have changed, shifting from predominantly communicable diseases spread by germs to chronic ailments. This shift has been accompanied by a deeper understanding about what keeps people healthy or leaves them vulnerable to becoming ill. To get at the heart of the challenges to living a healthy life, we must increasingly emphasize factors that affect today’s causes of morbidity and mortality.

Despite their importance to preventing illness, determining the value of community-based interventions has proven difficult. Preventing illness requires immediate investments with benefits that might not be realized for many years.

This report proposes a framework to assess the value of community-based, non-clinical prevention policies and wellness strategies. The framework represents a valuable step toward realizing the elusive goal of appropriately and comprehensively valuing community-based prevention.”

 

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An Integrated Framework for Assessing the Value of Community-Based Prevention – Institute of Medicine – 2 November 2012

Posted on November 5, 2012. Filed under: Community Services, Preventive Healthcare | Tags: , |

An Integrated Framework for Assessing the Value of Community-Based Prevention – Institute of Medicine – 2 November 2012

Full text

“Over the last century, the major causes of disease and death among Americans have changed, shifting from predominantly communicable diseases spread by germs to chronic ailments. This shift has been accompanied by a deeper understanding about what keeps people healthy or leaves them vulnerable to becoming ill. To get at the heart of the challenges to living a healthy life, we must increasingly emphasize factors that affect today’s causes of morbidity and mortality.

Despite their importance to preventing illness, determining the value of community-based interventions has proven difficult. Preventing illness requires immediate investments with benefits that might not be realized for many years.

This report proposes a framework to assess the value of community-based, non-clinical prevention policies and wellness strategies. The framework represents a valuable step toward realizing the elusive goal of appropriately and comprehensively valuing community-based prevention.”

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Reducing Tobacco-Related Cancer Incidence and Mortality – Workshop Summary – Institute of Medicine – 1 November 2012

Posted on November 2, 2012. Filed under: Alcohol & Drug Dep., Oncology | Tags: , , |

Reducing Tobacco-Related Cancer Incidence and Mortality – Workshop Summary – Institute of Medicine – 1 November 2012

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“Tobacco use is the leading cause of preventable death in the United States, causing more than 440,000 deaths and resulting in $193 billion in health-related economic losses every year. In addition to causing cardiovascular and respiratory diseases, tobacco use is linked to the development of 18 different types of cancer and accounts for at least 30 percent of all cancer deaths and 80 percent of lung cancer deaths. Despite the widespread agreement on the dangers of tobacco use and considerable success in reducing the smoking rate by half since the first U.S. Surgeon General’s report on smoking in 1964, progress in reducing tobacco use has slowed in recent years. Today, nearly 19 percent of U.S. adults smoke, many of whom began smoking as adolescents or young adults. In addition, the use of new tobacco and nicotine products is on the rise, with unclear health consequences.

Recognizing that progress in combating cancer will not be fully achieved without addressing the tobacco problem, the IOM’s National Cancer Policy Forum held a workshop June 11-12, 2012. The workshop examined current challenges in tobacco control and explored potential policy, outreach, and treatment strategies that could overcome these challenges and reduce tobacco-related cancer incidence and death. This document summarizes the workshop.”

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The Human Microbiome, Diet, and Health – Workshop Summary – Institute of Medicine – 24 October 2012

Posted on October 25, 2012. Filed under: Dietetics, Gastroenterology | Tags: , , |

The Human Microbiome, Diet, and Health – Workshop Summary – Institute of Medicine – 24 October 2012

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“One of the most intimate relationships that our body has with the outside world is through our gut. Our gastrointestinal tracts harbor a vast and still largely unexplored microbial world known as the human microbiome that scientists are only just beginning to understand. Researchers are recognizing the integral role of the microbiome in human physiology, health, and disease — with microbes playing critical roles in many host metabolic pathways — and the intimate nature of the relationships between the microbiome and both host physiology and host diet. While there is still a great deal to learn, the newfound knowledge already is being used to develop dietary interventions aimed at preventing and modifying disease risk by leveraging the microbiome.

The IOM’s Food Forum held a public workshop on February 22-23, 2012, to explore current and emerging knowledge on the human microbiome, its role in human health, its interaction with the diet, and the translation of new research findings into tools and products that improve the healthfulness of the food supply. This document summarizes the workshop.”

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Improving Food Safety Through a One Health Approach – Workshop Summary – Institute of Medicine – 10 September 2012

Posted on September 11, 2012. Filed under: Dietetics, Infectious Diseases | Tags: , , |

Improving Food Safety Through a One Health Approach – Workshop Summary – Institute of Medicine – 10 September 2012

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“Globalization of the food supply has created conditions favorable for the emergence, reemergence, and spread of food-borne pathogens—compounding the challenge of anticipating, detecting, and effectively responding to food-borne threats to health. In the United States, food-borne agents affect 1 out of 6 individuals and cause approximately 48 million illnesses, 128,000 hospitalizations, and 3,000 deaths each year. This figure likely represents just the tip of the iceberg, because it fails to account for the broad array of food-borne illnesses or for their wide-ranging repercussions for consumers, government, and the food industry—both domestically and internationally. A One Health approach to food safety may hold the promise of harnessing and integrating the expertise and resources from across the spectrum of multiple health domains including the human and veterinary medical and plant pathology communities with those of the wildlife and aquatic health and ecology communities.

The IOM’s Forum on Microbial Threats hosted a public workshop on December 13 and 14, 2011 that examined issues critical to the protection of the nation’s food supply. The workshop explored existing knowledge and unanswered questions on the nature and extent of food-borne threats to health. Participants discussed the globalization of the U.S. food supply and the burden of illness associated with foodborne threats to health; considered the spectrum of food-borne threats as well as illustrative case studies; reviewed existing research, policies, and practices to prevent and mitigate foodborne threats; and, identified opportunities to reduce future threats to the nation’s food supply through the use of a “One Health” approach to food safety. This document summarizes the workshop.”

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Informatics Needs and Challenges in Cancer Research – Workshop Summary – Institute of Medicine – 16 July 2012

Posted on July 17, 2012. Filed under: Health Informatics, Oncology, Research | Tags: , |

Informatics Needs and Challenges in Cancer Research – Workshop Summary – Institute of Medicine – 16 July 2012

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“As information technology becomes an integral part of health care, it is important to collect and analyze data in a way that makes the information understandable and useful. Informatics tools – which help collect, organize, and analyze data – are essential to biomedical and health research and development.  The field of cancer research is facing an overwhelming deluge of data, heightening the national urgency to find solutions to support and sustain the cancer informatics ecosystem. There is a particular need to integrate research and clinical data to facilitate personalized medicine approaches to cancer prevention and treatment – for example, tailoring treatment based on an individual patient’s genetic makeup as well as that of the tumor – and to allow for more rapid learning from patient experiences.

To further examine informatics needs and challenges for 21st century biomedical research, the IOM’s National Cancer Policy Forum held a workshop February 27-28, 2012. The workshop was designed to raise awareness of the critical and urgent importance of the challenges, gaps and opportunities in informatics; to frame the issues surrounding the development of an integrated system of cancer informatics for acceleration of research; and to discuss solutions for transformation of the cancer informatics enterprise. This document summarizes the workshop.”

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A CEO Checklist for High-Value Health Care – prepared by Participants in the IOM Roundtable on Value & Science-Driven Health Care – June 2012

Posted on June 19, 2012. Filed under: Health Mgmt Policy Planning, Health Policy | Tags: , |

A CEO Checklist for High-Value Health Care – prepared by Participants in the IOM Roundtable on Value & Science-Driven Health Care – June 2012

Institute of Medicine
Delos Cosgrove, Michael Fisher, Patricia Gabow, Gary Gottlieb, George Halvorson, Brent James, Gary Kaplan, Jonathan Perlin, Robert Petzel, Glenn Steele, and John Toussaint

“As leaders of health care organizations, we are acutely aware of the pressures that rising health care costs place on individuals, employers, and the government, as we are of unacceptable shortfalls in the quality and effi ciency of care. But we have also learned, through experiences in our own institutions and through communication and collaboration with colleagues in others, that better outcomes at lower costs can be achieved through care transformation initiatives that yield improved results, more satisfi ed patients, and cultures of continuous learning. These transformation efforts have generated certain foundational lessons relevant to every CEO and Board member, and the health care delivery organizations they lead. We have assembled these lessons here as a A CEO Checklist for High-Value Health Care to describe touchstone principles, illustrated with case examples, central not only to our work to date, but to sustaining and reinforcing the system-wide transformation necessary for continuous improvement in the face of rapidly increasing pressures, demands, and market changes.

“This Checklist is intended to be a living and dynamic document, and we invite both suggestions to improve its utility and reach, and co-signing by our CEO colleagues who wish to support these strategies for effective, efficient, and continuously improving health care for all Americans.”

“Foundational elements
• Governance priority—visible and determined leadership by CEO and Board
• Culture of continuous improvement—commitment to ongoing, real-time learning

Infrastructure fundamentals
• IT best practices—automated, reliable information to and from the point of care
• Evidence protocols—effective, efficient, and consistent care
• Resource utilization—optimized use of personnel, physical space, and other resources

Care delivery priorities
• Integrated care—right care, right setting, right providers, right teamwork
• Shared decision making—patient–clinician collaboration on care plans
• Targeted services—tailored community and clinic interventions for resource-intensive patients

Reliability and feedback
• Embedded safeguards—supports and prompts to reduce injury and infection
• Internal transparency—visible progress in performance, outcomes, and costs”

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Public Engagement on Facilitating Access to Antiviral Medications and Information in an Influenza Pandemic – Workshop Series Summary – Institute of Medicine – 17 May 2012

Posted on May 18, 2012. Filed under: Infectious Diseases | Tags: , , , |

Public Engagement on Facilitating Access to Antiviral Medications and Information in an Influenza Pandemic – Workshop Series Summary – Institute of Medicine – 17 May 2012

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“Influenza pandemics overwhelm health care systems with thousands or hundreds of thousands of sick patients, as well as those worried they may be sick. In order to ensure a successful response to the patient swell caused by a pandemic, robust planning is essential to prepare for challenges public health officials may face. This includes the need to quickly distribute and dispense antiviral medications that can reduce the severity and duration of disease to large numbers of people.

In response to a request from the CDC, the IOM’s Forum on Medical and Public Health Preparedness for Catastrophic Events held a series of workshops that explored the public’s perception of how to facilitate access to antiviral medications and treatment during an influenza pandemic. To help inform potential strategies still in the development stages at the CDC, workshops were held in Fort Benton, Montana; Chattanooga, Tennessee; and Los Angeles, California; during February and March 2012 to consider the usefulness of several alternative strategies of delivering antiviral medication to the public. Participants considered how the normal systems for prescribing and dispensing antiviral medications could be adjusted to ensure that the public has quick, safe, and equitable access to both potentially life-saving drugs and information about the pandemic and treatment options. This document summarizes the workshops.”

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Alliances for Obesity Prevention: Finding Common Ground – Workshop Summary – Institute of Medicine – 11 May 2012

Posted on May 14, 2012. Filed under: Child Health / Paediatrics, Preventive Healthcare, Public Hlth & Hlth Promotion | Tags: , , |

Alliances for Obesity Prevention: Finding Common Ground – Workshop Summary – Institute of Medicine – 11 May 2012

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“What do obesity prevention groups have in common with the Federal Reserve and the National Gardening Association? In October 2011, the Institute of Medicine’s Standing Committee on Childhood Obesity Prevention hosted a workshop in order to hear from organizations, movements, and sectors with the potential to be allies for obesity prevention, and to identify common ground and engender dialogue among them. The workshop speakers discussed how to develop innovative alliances that can bring synergies to efforts and resources, accelerate progress, and sustain efforts toward obesity prevention. They explored common ground for joint activities and mutual successes, and lessons learned from efforts at aligning diverse groups with goals in common. This document summarizes the workshop.”

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Ranking Vaccines: A Prioritization Framework – Phase I: Demonstration of Concept and a Software Blueprint – Institute of Medicine – 10 May 2012

Posted on May 11, 2012. Filed under: Infectious Diseases | Tags: , , |

Ranking Vaccines: A Prioritization Framework – Phase I: Demonstration of Concept and a Software Blueprint – Institute of Medicine – 10 May 2012

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“As a number of diseases emerge or reemerge, thus stimulating new vaccine development opportunities to help prevent those diseases, it can be especially difficult for decision makers to know where to invest their limited resources. Therefore, it is increasingly important for decision makers to have the tools that can assist and inform their vaccine prioritization efforts.

In this first phase report, the IOM offers a framework and proof of concept to account for various factors influencing vaccine prioritization—demographic, economic, health, scientific, business, programmatic, social, policy factors and public concerns. Ranking Vaccines: A Prioritization Framework describes a decision-support model and the blueprint of software—called Strategic Multi-Attribute Ranking Tool for Vaccines or SMART Vaccines. SMART Vaccines should be of help to decision makers. SMART Vaccines Beta is not available for public use, but SMART Vaccines 1.0 is expected to be released at the end of the second phase of this study, when it will be fully operational and capable of guiding discussions about prioritizing the development and introduction of new vaccines.”

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Primary Care and Public Health: Exploring Integration to Improve Population Health – Institute of Medicine – 28 March 2012

Posted on March 29, 2012. Filed under: Primary Hlth Care, Public Hlth & Hlth Promotion | Tags: , |

Primary Care and Public Health: Exploring Integration to Improve Population Health – Institute of Medicine – 28 March 2012

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“Primary care and public health have critical roles in providing for the health and well-being of communities across the nation. Although they each share a common goal, historically they have operated independently of each other. However, new opportunities are emerging that could bring the two sectors together in ways that will yield substantial and lasting improvements in the health of individuals, communities, and populations. Because of this potential, the Centers for Disease Control and Prevention and the Health Resources and Services Administration asked the IOM to examine the integration of primary care and public health.

The interactions between the two sectors are so varied that it is not possible to prescribe a specific model or template for how integration should look. Instead, the IOM identifies a set of core principles derived from successful integration efforts – including a common goal of improving population health, as well as involving the community in defining and addressing its needs. The time is right for action, and the principles provided in this report can serve as a roadmap to move the nation toward a more efficient health system. The challenges in integrating primary care and public health are great – but so are the opportunities and rewards.”

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Evolution of Translational Omics: Lessons Learned and the Path Forward – Institute of Medicine – 23 March 2012

Posted on March 26, 2012. Filed under: Genomics, Health Technology Assessment, Pathology | Tags: , , |

Evolution of Translational Omics: Lessons Learned and the Path Forward – Institute of Medicine – 23 March 2012

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“Technologies that are collectively called omics have made it feasible to measure an enormous number of molecules within a tissue or cell; for example, genomics investigates thousands of DNA sequences, and proteomics examines large numbers of proteins. Patients look to the scientific community to develop innovative omics-based tests to more reliably detect disease and to predict their likelihood of responding to specific drugs. However, the translation of these new technologies into clinical laboratory tests that can help patients directly has happened more slowly than anticipated.

Following a recent case involving premature use of omics-based tests in cancer clinical trials at Duke University, the National Cancer Institute requested that the IOM establish a committee to recommend ways to strengthen omics-based test development and evaluation. The IOM’s recommendations speak to the many parties responsible for discovery and development of omics-based tests, including investigators, their institutions, sponsors of research, the FDA, and journals. The report identifies best practices to enhance development, evaluation, and translation of omics-based tests while simultaneously reinforcing steps to ensure that these tests are appropriately assessed for scientific validity before they are used to guide patient treatment in clinical trials. The IOM’s recommendations aim to ensure that progress in omics test development is grounded in sound scientific practice and is reproducible, resulting not only in improved health care but also in continued public trust.”

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Crisis Standards of Care: A Systems Framework for Catastrophic Disaster Response – Institute of Medicine – 21 March 2012

Posted on March 22, 2012. Filed under: Clin Governance / Risk Mgmt / Quality, Disaster Management | Tags: , |

Crisis Standards of Care: A Systems Framework for Catastrophic Disaster Response – Institute of Medicine – 21 March 2012

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“In 2011 alone, a tornado devastated Joplin, Missouri, and earthquakes rocked New Zealand and Japan, underscoring how quickly and completely health systems can be overwhelmed. Disasters can stress health care systems to the breaking point and disrupt delivery of vital medical services.

At the request of the HHS, the IOM formed a committee in 2009, which developed guidance that health officials could use to establish and implement standards of care during disasters. In its first report, the committee defined “crisis standards of care” (CSC) as a state of being that indicates a substantial change in health care operations and the level of care that can be delivered in a public health emergency, justified by specific circumstances. During disasters, medical care must promote the use of limited resources to benefit the population as a whole.

In this report, the IOM examines the effect of its 2009 report, and develops vital templates to guide the efforts of professionals and organizations responsible for CSC planning and implementations. Integrated planning for a coordinated response by state and local governments, EMS, health care organizations, and health care providers in the community is critical to successfully responding to disasters. The report provides a foundation of underlying principles, steps needed to achieve implementation, and the pillars of the emergency response system, each separate and yet together upholding the jurisdictions that have the overarching authority for ensuring that CSC planning and response occurs.”

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Monitoring HIV Care in the United States: Indicators and Data Systems – Institute of Medicine – 15 March 2012

Posted on March 20, 2012. Filed under: Infectious Diseases | Tags: , , |

Monitoring HIV Care in the United States: Indicators and Data Systems – Institute of Medicine – 15 March 2012

“Advances in medical treatment have made it possible for people infected with HIV to live longer, healthier lives. The CDC estimates that 1.2 million people live with HIV in the United States, with approximately 50,000 people newly infected each year. People with HIV require continuous access to quality care and treatment for HIV as well as for their other health conditions. Access to and consistent use of medicines helps to improve health outcomes for people with HIV, reduces the risk of infected individuals transmitting the virus to others, among other benefits.

In July 2010, the White House Office of National AIDS Policy (ONAP) released its National HIV/AIDS Strategy (NHAS), which includes goals to increase access to care and optimize health outcomes for people with HIV, and to reduce HIV-related health disparities. At the same time, the Patient Protection and Affordable Care Act (ACA) is poised to bring millions of uninsured people – including many with HIV – into the health care system when it is implemented in 2014.

ONAP asked the IOM to identify core indicators related to continuous HIV clinical care and access to supportive services, and to monitor the effect of both the NHAS and ACA on improving HIV care. The IOM committee also was asked to identify the best sources of data to calculate the core indicators, as well as to describe potential barriers to data collection and the role of health IT in data collection. This report outlines a number of obstacles that prevent people with HIV from experiencing optimal health, identifies core indicators for use by the HHS to gauge the effects of the NHAS and ACA on improvements in HIV care and access to supportive services for people with HIV, and highlights 12 data collection systems that could be used to monitor the impact of the NHAS and ACA.”

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Health IT and Patient Safety: Building Safer Systems for Better Care – Institute of Medicine [US] – 8 November 2011

Posted on February 14, 2012. Filed under: Health Informatics, Patient Safety | Tags: |

Health IT and Patient Safety: Building Safer Systems for Better Care – Institute of Medicine [US] – 8 November 2011

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“If implemented appropriately, health IT can help improve health care providers’ performance, better communication between patients and providers, and enhance patient safety, which ultimately may lead to better care for Americans. Health IT is designed to help improve the performance of health professionals, reduce costs, and enhance patient safety. For example, the number of patients who receive the correct medication in hospitals increases when these hospitals implement well-planned, robust computerized prescribing mechanisms and use barcoding systems. However, poorly designed health IT can create new hazards in the already complex delivery of care.

In the wake of more widespread use of health IT, the Department of Health and Human Services asked the IOM to evaluate health IT safety concerns and to recommend ways that both government and the private sector can make patient care safer using health IT. The IOM finds that safe use of health IT relies on several factors, clinicians and patients among them. Safety analyses should not look for a single cause of problems but should consider the system as a whole when looking for ways to make a safer system. Vendors, users, government, and the private sector all have roles to play. The IOM’s recommendations include improving transparency in the reporting of health IT safety incidents and enhancing monitoring of health IT products.”

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Health IT and Patient Safety: Building Safer Systems for Better Care – Institute of Medicine, Committee on Patient Safety and Health Information Technology – 8 November 2011

Posted on November 10, 2011. Filed under: Health Informatics, Patient Safety | Tags: , |

Health IT and Patient Safety: Building Safer Systems for Better Care – Institute of Medicine, Committee on Patient Safety and Health Information Technology – 8 November 2011

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“If implemented appropriately, health IT can help improve health care providers’ performance, better communication between patients and providers, and enhance patient safety, which ultimately may lead to better care for Americans. Health IT is designed to help improve the performance of health professionals, reduce costs, and enhance patient safety. For example, the number of patients who receive the correct medication in hospitals increases when these hospitals implement well-planned, robust computerized prescribing mechanisms and use barcoding systems. However, poorly designed health IT can create new hazards in the already complex delivery of care.

In the wake of more widespread use of health IT, the Department of Health and Human Services asked the IOM to evaluate health IT safety concerns and to recommend ways that both government and the private sector can make patient care safer using health IT. The IOM finds that safe use of health IT relies on several factors, clinicians and patients among them. Safety analyses should not look for a single cause of problems but should consider the system as a whole when looking for ways to make a safer system. Vendors, users, government, and the private sector all have roles to play. The IOM’s recommendations include improving transparency in the reporting of health IT safety incidents and enhancing monitoring of health IT products.”

ISBN-10: 0-309-22202-8    ISBN-13: 978-0-309-22202-0

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Promoting Health Literacy to Encourage Prevention and Wellness: Workshop Summary – Institute of Medicine – November 2011

Posted on November 4, 2011. Filed under: Preventive Healthcare, Public Hlth & Hlth Promotion | Tags: , , |

Promoting Health Literacy to Encourage Prevention and Wellness: Workshop Summary – Institute of Medicine – November 2011
Authors: Lyla Hernandez and Suzanne Landi, Rapporteurs; Roundtable on Health Literacy; Institute of Medicine

ISBN-10: 0-309-21577-3    ISBN-13: 978-0-309-21577-0

“Health literacy has been shown to affect health outcomes. The use of preventive services improves health and prevents costly health care expenditures. Several studies have found that health literacy makes a difference in the extent to which populations use preventive services. On September 15, 2009, the Institute of Medicine Roundtable on Health Literacy held a workshop to explore approaches to integrate health literacy into primary and secondary prevention.

Promoting Health Literacy to Encourage Prevention and Wellness serves as a factual account of the discussion that took place at the workshop. The report describes the inclusion of health literacy into public health prevention programs at the national, state and local levels, reviews how insurance companies factor health literacy into their prevention programs, and discusses industry contributions to providing health literate primary and secondary prevention.”

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The Richard and Hinda Rosenthal Lecture 2011: New Fontiers in Patient Safety – Institute of Medicine – 5 October 2011

Posted on October 17, 2011. Filed under: Clin Governance / Risk Mgmt / Quality, Patient Safety | Tags: , |

The Richard and Hinda Rosenthal Lecture 2011: New Fontiers in Patient Safety – Institute of Medicine – 5 October 2011

“Through the generosity of the Richard and Hinda Rosenthal Foundation, a lecture series was established in 1988 at the Institute of Medicine to bring to greater attention some of the critical health policy issues facing our country today. Each year a topic of special policy relevance is selected and addressed during an evening lecture.

More than 10 years ago, the IOM released its landmark report on patient safety, To Err is Human: Building a Safer Health System. The 2011 Rosenthal Lecture featured the Honorable Kathleen G. Sebelius, Secretary of the U.S. Department of Health and Human Services, who presented the new steps that HHS is taking to improve patient safety. A panel of leaders in patient safety followed to discuss patient safety progress and opportunities. The panel members were: Donald M. Berwick, Administrator, Centers for Medicare and Medicaid Services; Carolyn M. Clancy, Director, Agency for Healthcare Research and Quality; Brent C. James, Chief Quality Officer, Intermountain Healthcare; and Paul H. O’Neill, Former Secretary, U.S. Department of the Treasury.”

Full text

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Public Engagement and Clinical Trials: New Models and Disruptive Technologies – Workshop Summary – Institute of Medicine – 14 October 2011

Posted on October 17, 2011. Filed under: Pharmacy, Research | Tags: , , |

Public Engagement and Clinical Trials: New Models and Disruptive Technologies – Workshop Summary – Institute of Medicine – 14 October 2011

“Clinical trials provide essential information needed to turn basic medical research findings into patient treatments. New treatments must be studied in large numbers of humans to determine whether they are effective and to assess any harm that may arise from treatment. There is growing recognition, however, that the U.S. clinical trials enterprise is unable to keep pace with the national demand for research results. Many clinical trials never meet their recruitment goals and others accrue patients far too slowly. The divide between clinical research and clinical care is growing wider, with many patients and their physicians far removed from the clinical trials that are needed to create the data necessary to bring scientific discoveries into clinical practice.

To further examine the current challenges to U.S. clinical trials, the IOM Forum on Drug Discovery, Development, and Translation, in collaboration with the Mount Sinai School of Medicine, held a workshop June 27-28, 2011 to engage stakeholders and experts in a discussion about possible solutions to improve public engagement in clinical trials. The workshop covered topics such as recruiting and retaining trial participants, increasing practicing clinicians’ participation in and referrals to trials, and strengthening public understanding of clinical trials. This document is a summary of the workshop.”

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The Learning Health System and its Innovation Collaboratives – Update Report – Institute of Medicine Roundtable on Value & Science-Driven Health Care – 2011

Posted on September 22, 2011. Filed under: Clin Governance / Risk Mgmt / Quality, Evidence Based Practice | Tags: , , |

The Learning Health System and its Innovation Collaboratives – Update ReportInstitute of Medicine Roundtable on Value & Science-Driven Health Care – 2011

“By the year 2020, ninety percent of clinical decisions will be supported by accurate, timely, and up-to-date clinical information, and will reflect the best available evidence.”  Charter  IOM Roundtable on Value & Science-Driven Health Care

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Updating the USDA National Breastfeeding Campaign – Workshop Summary – Institute of Medicine – 21 September 2011

Posted on September 22, 2011. Filed under: Obstetrics | Tags: , , |

Updating the USDA National Breastfeeding Campaign – Workshop Summary – Institute of Medicine – 21 September 2011

“Support for breastfeeding has been a priority of the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) – which provides 9.2 million Americans with nutritious food, nutrition education, support, and healthcare referrals – since the program began in the 1970s. The Loving Support Makes Breastfeeding Work campaign, which the U.S. Department of Agriculture’s (USDA) Food and Nutrition Services (FNS) launched in 1997, emphasizes that the support of family and friends, the healthcare system, and the community are essential for a breastfeeding mother to be successful. More than a decade after the campaign began, USDA is seeking to update it using an evidence-based social marketing strategy, taking into account the socioeconomic and demographic changes among WIC participants, changes in the WIC program, and the appearance of interactive, democratized communication created by new technology.

As one of the first steps in the campaign’s update, FNS asked the IOM to host a workshop on April 26, 2011 to convene experts for a discussion on what has changed since Loving Support began in 1997. Speakers examined changes in today’s millennial moms, laws and the emergence of new technologies, evaluated lessons learned from other public health campaigns, and provided thoughts on where to take the campaign in the future. Suggestions for the future included updating the market research, the use of modern communications tools, strategic community-based partnerships, and the use of ongoing evaluation tools. This document summarizes the workshop.”

Full text of the summary

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Preventing Violence Against Women and Children – Institute of Medicine Workshop Summary – 15 September 2011

Posted on September 16, 2011. Filed under: Violence | Tags: , |

Preventing Violence Against Women and Children – Institute of Medicine Workshop Summary – 15 September 2011

full text online 

“Across the world, violence against women and children poses a high burden on global health. Women and children are particularly susceptible to violence because often they have fewer rights or lack legal protection. Many women and children victims of violence know their perpetrators – often as family members or intimate partners – and are sometimes hesitant to report the crimes. Sometimes, a “cycle of violence” occurs, in which the victim eventually becomes a perpetrator. Over the last decade, researchers have gathered data on the growing magnitude of this violence, but many knowledge gaps still remain.

The IOM Forum on Global Violence Prevention held its first workshop January 27-28, 2011 to explore the prevention of violence against women and children. The workshop was designed to examine approaches to violence prevention from multiple perspectives and diverse levels of society. The workshop brought together stakeholders to discuss intervention strategies to prevent violence before it starts, prevent the recurrence of violence, prevent violence-related trauma, and stop the spread of violence to the next generation or social level. Speakers suggested a need to advance research on the co-occurrence of abuse on both child and partner, changing social norms, and the state of violence prevention research in low- and middle-income countries. This document is a summary of the workshop.”

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Adverse Effects of Vaccines: Evidence and Causality – Institute of Medicine – report to be released 25 August 2011

Posted on August 24, 2011. Filed under: Infectious Diseases | Tags: , , , |

Adverse Effects of Vaccines: Evidence and Causality – Institute of Medicine – to be released 25 August 2011

The Institute of Medicine will release the report Adverse Effects of Vaccines: Evidence and Causality on Thursday, August 25, 2011 at 11:00 am EDT. Committee chair, Ellen Wright Clayton, and two members of the committee, S. Claiborne Johnston and Douglas Barrett, will host an audio webcast at 1:00 pm EDT on August 25th.

A link to the webcast will be available shortly before the 1:00 pm start at http://www.iom.edu/vaccineadverseeffects or http://www.nationalacademies.org . Listeners will be able to email questions to the committee during the audio webcast via a link on the same webpage.

The report and summary material will be available for free download at 11:00 am at http://www.iom.edu/vaccineadverseeffects .

Please use the registration link ( HERE). Registered participants will receive an email reminder 15 minutes prior to the start of the audio webcast on August 25th.

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Improving Access to Oral Health Care for Vulnerable and Underserved Populations – Institute of Medicine – 13 July 2011

Posted on July 14, 2011. Filed under: Dental Health | Tags: , |

Improving Access to Oral Health Care for Vulnerable and Underserved Populations – Institute of Medicine – 13 July 2011

“Good health requires good oral health, yet millions of Americans lack access to basic oral health care. Various factors create barriers, preventing access to care for vulnerable and underserved populations, such as children and Medicaid beneficiaries. The Health Resources and Services Administration and the California HealthCare Foundation asked the IOM and the National Research Council to assess the current oral health care system, to develop a vision for how to improve oral health care for these populations, and to recommend ways to achieve this vision.

Access to oral health care across the life cycle is critical to overall health, and it will take flexibility and ingenuity among multiple stakeholders—including government leaders, oral health professionals, and others—to make this access available. To improve provider participation in public programs, states should increase Medicaid and Children’s Health Insurance Program reimbursement rates. With proper training, nondental health care professionals can acquire the skills to perform oral disease screenings and provide other preventive services. Dental schools should expand opportunities for dental students to care for patients with complex oral health care needs in community-based settings in order to improve the students’ comfort levels in caring for vulnerable and underserved populations.  Finally, states should examine and amend state practice laws to allow healthcare professionals to practice to their highest level of competence. The IOM’s recommendations provide a roadmap for the important and necessary next steps to improve access to oral health care, reduce oral health disparities, and improve the oral health of the nation’s vulnerable and underserved populations.”

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For the Public’s Health: Revitalizing Law and Policy to Meet New Challenges – Committee on Public Health Strategies to Improve Health; Institute of Medicine – June 2011

Posted on June 29, 2011. Filed under: Public Hlth & Hlth Promotion | Tags: , |

For the Public’s Health: Revitalizing Law and Policy to Meet New Challenges – Committee on Public Health Strategies to Improve Health; Institute of Medicine – June 2011

“Public policy can be one of the most effective approaches to protecting and improving the health of the population. At the request of the Robert Wood Johnson Foundation, the Institute of Medicine (IOM) reviewed how statutes and regulations prevent injury and disease, save lives, and improve the health of the population. The IOM recommends that the government update public health statutes to ensure that public health agencies are equipped to combat contemporary challenges. In addition, the IOM recommends that the government and private sector consider health in all policies and evaluate the health effects and costs of major legislation.”

ISBN-10: 0-309-21648-6
ISBN-13: 978-0-309-21648-7

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The Causes and Impacts of Neglected Tropical and Zoonotic Diseases: Opportunities for Integrated Intervention Strategies – Institute of Medicine – 1 June 2011

Posted on June 3, 2011. Filed under: Infectious Diseases | Tags: , |

The Causes and Impacts of Neglected Tropical and Zoonotic Diseases: Opportunities for Integrated Intervention Strategies – Workshop Summary – Institute of Medicine – 1 June 2011
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“Neglected tropical diseases (NTDs) afflict more than 1.4 billion people, many of whom live on less than $1.25 a day. NTDs are a symptom of poverty and neglect; those who are most affected are also the poorest of the poor, living in remote rural areas, pockets of poverty in Appalachia, urban slums, or conflict zones. While there are effective ways to control NTDs—including drugs, vaccines, and infrastructure improvements—policy-makers and funding agencies have only recently begun to recognize the public health and economic importance of increased, sustained support for programs to control and manage the impacts of these diseases.

The IOM’s Forum on Microbial Threats held a workshop September 21-22, 2010, to consider the science and policy implications of NTDs. Participants discussed the origins and impact of these diseases; the influence of NTDs on human and animal health and economic productivity; and opportunities to engage the global community in combating neglected diseases.”

 

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Preventing Transmission of Pandemic Influenza and Other Viral Respiratory Diseases: Personal Protective Equipment for Healthcare Personnel Update 2010 – Institute of Medicine [US] – Released: 27 January 2011

Posted on January 28, 2011. Filed under: Infection Control, Infectious Diseases, Influenza A(H1N1) / Swine Flu, Workforce | Tags: , , |

Preventing Transmission of Pandemic Influenza and Other Viral Respiratory Diseases: Personal Protective Equipment for Healthcare Personnel Update 2010 – Institute of Medicine [US] – Released: 27 January 2011

Full text online

“In light of the unanswered research questions following the 2009 H1N1 influenza pandemic, the National Personal Protective Technology Laboratory at the National Institute for Occupational Safety and Health (NIOSH) asked the IOM to assess the progress of PPE research and to identify future directions for PPE for healthcare personnel. While the IOM finds that there are gaps and deficiencies in the research about PPE use in health care, there is sufficient knowledge to recommend a four-pronged strategy for effective PPE use:

Deliberate planning and preparation at the leadership and organizational levels
Comprehensive training for all personnel, including supervisors and managers
Widespread and convenient availability of appropriate PPE devices
Accountability at all levels of the organization

The IOM also offers several recommendations for continuing the momentum of PPE research that are detailed in the report and the report brief. The more scientists and researchers know about how to maximize the effectiveness of PPE and its use, the more prepared we will be for the next influenza pandemic.”

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The Digital Infrastructure for a Learning Health System: Foundation for Continuous Improvement in Health and Health Care – Institute of Medicine Workshop Summary – 20 December 2010

Posted on January 19, 2011. Filed under: Health Informatics | Tags: , |

The Digital Infrastructure for a Learning Health System: Foundation for Continuous Improvement in Health and Health Care – Institute of Medicine Workshop Summary – 20 December 2010

“Like many other industries, health care increasingly is turning to digital information and the use of electronic resources. The next generation digital health infrastructure could shape health and health care in fundamental ways. Electronic patient records, digital communication between patients and clinicians, accessible web-based health information, and even remote site diagnosis and treatment are examples of rapidly emerging technologies with great potential. With access to timely, comprehensive digital health information, patients and clinicians will be able to make collaborative and informed decisions grounded in a sound and up-to-date evidence base. At the same time, the availability of large repositories of health data will transform the breadth, depth, and pace of clinical research and analysis to inform future decisions. 

As part of its Learning Health System Series, the IOM’s Roundtable on Value & Science-Driven Health Care hosted three workshops, sponsored by the Office of the National Coordinator for Health IT, to explore current efforts and opportunities to accelerate progress in improving health and health care with information technology systems. Participants’ discussions and presentations focused on four important cross-cutting dimensions: promoting technical advances and innovation, generating and using information, engaging patients and the public, and fostering stewardship and governance. This report summarizes workshop discussions on these issues and the context for their engagement.”

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For the Public’s Health: The Role of Measurement in Action and Accountability – Institute of Medicine Consensus Report – 8 December 2010

Posted on January 19, 2011. Filed under: Public Hlth & Hlth Promotion | Tags: , , |

For the Public’s Health: The Role of Measurement in Action and Accountability – Institute of Medicine Consensus Report – 8 December 2010

“Despite having the costliest medical care delivery system in the world, Americans are not particularly healthy. Recent international comparisons show that life expectancy in the U.S. ranks 49th among all nations, and infant mortality rates are higher in the U.S. than in many far less affluent nations. While these statistics are alarming, the bigger problem is that we do not know how to reverse this trend. Our lack of knowledge is due in large part to significant inadequacies in the system for gathering, analyzing, and communicating health information about the population.

To inform the public health community and all other sectors that contribute to population health, the Robert Wood Johnson Foundation commis¬sioned the IOM to examine three major topics that influence the health of the public—measurement, laws, and funding. In this, the first of three reports, the IOM reviews current approaches for measuring the health of individuals and communities and suggests changes in the processes, tools, and approaches used to gather information about health outcomes and their determinants. The IOM recommends developing an integrated and coordinated system in which all parties—including governmental and private sector partners at all levels—have access to timely and meaningful data to help foster individual and community awareness and action.”

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Redesigning the Clinical Effectiveness Research Paradigm: Innovation and Practice-Based Approaches – Workshop Summary – Institute of Medicine – 6 December 2010

Posted on January 19, 2011. Filed under: Comparative Effectiveness Research, Research | Tags: , |

Redesigning the Clinical Effectiveness Research Paradigm: Innovation and Practice-Based Approaches – Workshop Summary – Institute of Medicine – 6 December 2010

“Currently, a substantial gap exists between the knowledge needed and that available for medical care decisions—and that gap is growing larger. Approaches to clinical research are being substantially outpaced by the rapid growth in new health care diagnostic and treatment options and an explosion of new genetics insights that hold real implications for the potential – and the need – to personalize individual interventions. Advances in informatics, large scale data sets, and clinical research methods to assess those data sets hold promise for considerably accelerating the pace, reliability, and applicability of clinical effectiveness research. 

To help consider these issues, the IOM Roundtable on Value & Science-Driven Health Care sponsored a meeting to explore the methods, data resources, tools, and techniques that are emerging in the new generation of accelerated clinical research approaches.  This publication of the discussions, Redesigning the Clinical Effectiveness Research Paradigm: Innovation and Practice-Based Approaches, summarizes issues related to the magnitude of the need for better information, the opportunities to align research and practice, and the potential for emerging research and data networks, innovative approaches to study design, analysis, and modeling.  This publication is the most recent in the Roundtable’s Learning Health System Series in which each volume represents a basic element in the movement towards a system in which progress in science, informatics, and care culture align to generate new knowledge as an ongoing and natural by-product of the care experience, and to seamlessly refine and deliver best practices for continuous improvement in health and health care.”

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Perspectives on Biomarker and Surrogate Endpoint Evaluation – Workshop Summary from the Institute of Medicine

Posted on January 19, 2011. Filed under: Chronic Disease Mgmt, Pathology | Tags: , , |

Perspectives on Biomarker and Surrogate Endpoint Evaluation – Workshop Summary from the Institute of Medicine
18 January 2011

“Doctors, scientists, and other health professionals use biomarkers as tools to obtain information about a person’s health status or response to interventions. Defined as characteristics that indicate biological processes, biomarkers are essential for monitoring the health of both individuals and communities. In 2008, the Food and Drug Administration (FDA) asked the IOM to conduct a study on the evaluation process for biomark¬ers, focusing on biomarkers and surrogate endpoints in chronic disease. In its report Evaluation of Biomarkers and Surrogate Endpoints in Chronic Disease, the IOM recommends that the FDA adopt a consistent scientific framework to evaluate biomarkers, consisting of three steps: analytical validation, evidentiary qualification, and utilization analysis.

The IOM held a workshop June 21-22, 2010, to provide stakeholders with an opportunity to learn about, react to, and discuss the report. Presenters provided perspectives on the report from the point of view of participants from the FDA, the National Institutes of Health, and from a diverse group of industry stakeholders. This document summarizes the workshop.”

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Challenges and Opportunities in Using Residual Newborn Screening Samples for Translational Research – IOM – released 8 September 2010

Posted on September 9, 2010. Filed under: Obstetrics, Research | Tags: , , |

Challenges and Opportunities in Using Residual Newborn Screening Samples for Translational Research – IOM – released 8 September 2010

Full text online

Type: Workshop Summary
 
Note: Workshop Summaries contain the opinion of the presenters, but do NOT reflect the conclusions of the IOM. Learn more about the differences between Workshop Summaries and Consensus Reports.

“Newborn screening programs test blood samples from more than 4 million infants each year for life-threatening disorders, such as phenylketonuria and sickle-cell disease, that are treatable if identified at birth. The blood that remains after screening can be an invaluable resource for public health and biomedical research and has been used previously to study childhood leukemia, the prevalence of HIV infection, and exposure to environmental toxins. However, recent legal challenges have brought to light that most parents are unaware that samples can be stored for years afterward and that they can be used for purposes other than screening.

On May 24, 2010, the IOM held a workshop to examine the issues surrounding the use of newborn screening samples for translational research, including autonomy, confidentiality, privacy, informed consent, and consent to future use of samples originally taken for a different purpose. Participants discussed the benefits of making samples available for research; ways to ensure the privacy of individuals while allowing scientists to make use of samples; and strategies for making samples available for additional uses without compromising the main function of the newborn screening program. This document summarizes the workshop.”

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Antibiotic Resistance: Implications for Global Health and Novel Intervention Strategies – Institute of Medicine – 7 September 2010

Posted on September 8, 2010. Filed under: Infectious Diseases | Tags: , , |

Antibiotic Resistance: Implications for Global Health and Novel Intervention Strategies – Institute of Medicine – 7 September 2010

Full text online

Type: Workshop Summary
Note: Workshop Summaries contain the opinion of the presenters, but do NOT reflect the conclusions of the IOM. Learn more about the differences between Workshop Summaries and Consensus Reports.

“For decades it seemed as if modern medicine had conquered many of the infectious diseases that once threatened human and animal health. But years of using, misusing, and overusing antibiotics and other antimicrobial drugs have led to the emergence of multidrug-resistant “superbugs.” Some strains of bacteria and viruses are now resistant to all but a single drug, while others have no effective treatments at all.

The IOM’s Forum on Microbial Threats held a public workshop April 6-7 to discuss the nature and sources of drug-resistant bacteria and viruses and their implications for global health. Speakers explored the evolutionary, genetic, and ecological origins of antimicrobial drug resistance and its effects on human and animal health worldwide. Participants discussed the causes of drug resistance; strategies for extending the life of antimicrobial drugs; alternative approaches for treating infections; incentives and disincentives for prudent antimicrobial drug use; and prospects for the next generation of antimicrobial treatments. This document summarizes the workshop.”

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The Value of Genetic and Genomic Technologies – Institute of Medicine – 23 August 2010

Posted on August 24, 2010. Filed under: Genomics | Tags: , |

The Value of Genetic and Genomic Technologies – Institute of Medicine – 23 August 2010

Type: Workshop Summary – online version

“Each and every human being shares the same genes—and yet, slight alterations in those genes can contribute to great differences among us, ranging from eye color variance and baldness to increasing the risk of developing breast cancer and diabetes. Knowing one’s genetic disposition to a variety of diseases, including common chronic diseases, can benefit both the individual and society at large. In fact, genetic testing in the laboratory is relatively common today; it can help physicians diagnose genetic disorders even before symptoms appear, confirm a disease after symptoms develop, screen for markers of increased risk of disease, or determine whether someone is a carrier for a recessive disease. The knowledge that can be gained from genetic testing or profiling allows for care that is personalized to an individual, ranging from medication that is tailored to a person’s unique genetic makeup, to the ability to identify an individual’s risk of developing certain diseases over a lifetime. Still, the question remains: how should any or all of these advances be used in the health care setting?

The IOM’s Roundtable on Translating Genomic-Based Research for Health held a workshop on March 22, 2010, to bring together diverse perspectives on the value of genetic testing, and to discuss its use in clinical practice. Three case examples were used to facilitate discussion: correlation between Lynch Syndrome and colon cancer; pharmacogenomic testing for warfarin dosing; and genomic profiling. This document summarizes the workshop.”

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Microbial Evolution and Co-Adaptation: A Tribute to the Life and Scientific Legacies of Joshua Lederberg – 28 June 2010

Posted on July 2, 2010. Filed under: Infectious Diseases | Tags: , |

Microbial Evolution and Co-Adaptation: A Tribute to the Life and Scientific Legacies of Joshua Lederberg
Institute of Medicine (US) Forum on Microbial Threats
Created: June 28, 2010

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Infectious Disease Movement in a Borderless World: Workshop Summary – 28 June 2010

Posted on July 2, 2010. Filed under: Infectious Diseases | Tags: , |

Infectious Disease Movement in a Borderless World: Workshop Summary
Institute of Medicine (US) Forum on Microbial Threats
nap12758
Created: June 28, 2010.

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The Domestic and International Impacts of the 2009-H1N1 Influenza A Pandemic: Global Challenges, Global Solutions: Workshop Summary – 28 June 2010

Posted on July 2, 2010. Filed under: Infectious Diseases, Influenza A(H1N1) / Swine Flu | Tags: , , |

The Domestic and International Impacts of the 2009-H1N1 Influenza A Pandemic: Global Challenges, Global Solutions: Workshop  Summary
Institute of Medicine (US) Forum on Microbial Threats
nap12799
Created: June 28, 2010.

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A Foundation for Evidence-Driven Practice: A Rapid Learning System for Cancer Care: Workshop Summary – Institute of Medicine – 2010

Posted on June 16, 2010. Filed under: Oncology | Tags: , |

A Foundation for Evidence-Driven Practice: A Rapid Learning System for Cancer Care: Workshop Summary – Institute of Medicine – 2010

ISBN-10: 0-309-15126-0
ISBN-13: 978-0-309-15126-9

Read in full text

“The IOM’s National Cancer Policy Forum held a workshop October 5-6, 2009, to examine how to apply the concept of a ‘rapid learning health system’ to the problem of cancer. This document summarizes the workshop.”

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Crisis Standards of Care – Summary of a Workshop Series – Institute of Medicine (US) Forum on Medical and Public Health Preparedness for Catastrophic Events – May 2010

Posted on May 18, 2010. Filed under: Disaster Management, Emergency Medicine, Public Hlth & Hlth Promotion | Tags: , , , |

Crisis Standards of Care – Summary of a Workshop Series – Institute of Medicine (US) Forum on Medical and Public Health Preparedness for Catastrophic Events – May 2010

IOM (Institute of Medicine). 2010. Crisis standards of care: Summary of a workshop series. Washington, DC: The National Academies Press.  (pdf full text)

“In recent years, a number of federal, state, and local efforts have taken place to develop crisis standards of care protocols and policies for use in conditions of overwhelming resource scarcity. Those involved in these efforts have begun to carefully consider these difficult issues and to develop plans that are ethical, consistent with the community’s values, and implementable during a crisis. These planning efforts are essential because, absent careful planning, there is enormous potential for confusion, chaos, and flawed decision making in a catastrophic public health emergency or disaster.

However, although these efforts have accomplished a tremendous amount in just a few years, a great deal remains to be done in even the most advanced plan. Furthermore, the efforts have mainly been taking place independently, leading to a lack of consistency across neighboring jurisdictions and unnecessary duplication of effort. Lastly, many states have not yet substantially begun to develop policies and protocols for crisis standards of care during a mass casualty event.

These issues prompted the Institute of Medicine’s (IOM’s) Forum on Medical and Public Health Preparedness for Catastrophic Events (Preparedness Forum) to organize a series of regional workshops on this topic. These workshops were held in Irvine, CA; Orlando, FL; New York, NY; and Chicago, IL, between March and May of 2009.”

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Evaluation of Biomarkers and Surrogate Endpoints in Chronic Disease – Institute of Medicine – 12 May 2010

Posted on May 13, 2010. Filed under: Chronic Disease Mgmt | Tags: , |

Evaluation of Biomarkers and Surrogate Endpoints in Chronic Disease – Institute of Medicine – 12 May 2010
Type: Consensus Report
Full text

“Doctors, scientists, and other health professionals use biomarkers as tools to obtain information about a person’s health status or response to interventions. Biomarkers, defined as characteristics that indicate biological processes, are essential for monitoring the health of both individuals and communities. Some biomarkers, called surrogate endpoints, are used as sub­stitutes for actual clinical endpoints such as incidence of disease or death. Surrogate endpoints are intended to predict benefit or harm based on scien­tific evidence, and they are used in practice when it is difficult to collect data based on clinical endpoints.

In 2008, the Food and Drug Administration (FDA) asked the IOM to conduct a study on the evaluation process for biomark­ers, focusing on biomarkers and surrogate endpoints in chronic disease. The FDA’s Center for Food Safety and Applied Nutrition initiated this study at a time when it was faced with hundreds of applications for review of food health claims based on stated effects on biomarkers.

In this report, the IOM recommends that the FDA adopt a consistent scientific framework for biomarker evaluation in order to achieve a rigorous and transparent process.”  … continues

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Bridging the Evidence Gap in Obesity Prevention: A Framework to Inform Decision Making – 23 April 2010

Posted on April 30, 2010. Filed under: Health Status, Public Hlth & Hlth Promotion | Tags: , , , |

Bridging the Evidence Gap in Obesity Prevention: A Framework to Inform Decision Making
Released: April 23, 2010
Type: Consensus Report

full text

“About 68 percent of adults in the United States aged 20 years or older are overweight or obese. Among children, the rate is nearly 32 percent. The obesity epidemic poses major challenges for policy makers, public health professionals, and other decision makers who need to act decisively to respond to this complex, population-based health problem. To inform their decisions, they need relevant and useful evidence on promising obesity prevention actions for the populations they serve.

In 2008, Kaiser Permanente asked the IOM to develop a practical, action-oriented framework to guide the use of evidence in decision making about obesity prevention policies and programs and to guide the generation of new and relevant evidence. With these questions in mind, the IOM developed the L.E.A.D. framework, short for Locate evidence, Evaluate it, Assemble it, and Inform Decisions. Decision makers, their intermediaries, and researchers can apply the L.E.A.D. framework and its innovative process for generating, identifying, evaluating, and assembling evidence to inform the decisions that must be made about obesity prevention. If they are able to collect and use the best available evidence and work with researchers to generate additional useful evidence, decision makers will be armed with the most appropriate and relevant knowledge to help turn around this overwhelming national health crisis.”

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Strategies to Reduce Sodium Intake in the United States – Institute of Medicine – 20 April 2010

Posted on April 21, 2010. Filed under: Dietetics, Public Hlth & Hlth Promotion | Tags: , , , |

Strategies to Reduce Sodium Intake in the United States

Full text

Released: April 20, 2010
Type: Consensus Report

“Americans consume unhealthy amounts of sodium in their food, far exceeding public health recommendations. Consuming too much sodium increases the risk for high blood pressure, a serious health condition that is avoidable and can lead to a variety of diseases. Analysts estimate that population-wide reductions in sodium could prevent more than 100,000 deaths annually. While numerous stakeholders have initiated voluntary efforts to reduce sodium consumption in the United States during the past 40 years, they have not succeeded. Without major change, hypertension and cardiovascular disease rates will continue to rise, and consumers will pay the price for inaction.

In 2008, Congress asked the IOM to recommend strategies for reducing sodium intake to levels recommended in the Dietary Guidelines for Americans. In this report, the IOM concludes that reducing sodium content in food requires new government standards for the accept­able level of sodium. Manufacturers and restaurants need to meet these standards so that all sources in the food supply are involved. The goal is to slowly, over time, reduce the sodium content of the food supply in a way that goes unnoticed by most consumers as individuals’ taste sensors adjust to the lower levels of sodium.”

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A National Cancer Clinical Trials System for the 21st Century: Reinvigorating the NCI Cooperative Group Program – 15 April 2010

Posted on April 16, 2010. Filed under: Oncology, Research | Tags: , , , |

A National Cancer Clinical Trials System for the 21st Century: Reinvigorating the NCI Cooperative Group Program
Released: April 15, 2010
Type: Consensus Report

full text online

“Advances in biomedical research continue to create significant opportunities for improving cancer detection, treatment, and prevention. Clinical trials that test the safety and therapeutic benefit of promising treatments are essential in translating new knowledge into tangible benefits for patients with cancer. For the past 50 years, the National Cancer Institute’s (NCI) Clinical Trials Cooperative Group Program has played a key role in developing new and improved cancer therapies. More than 25,000 patients and thousands of clinical investigators participate in the program’s clinical trials annually. In recent years, however, many stakeholders have expressed concerns that the program is falling short of its potential to conduct the timely, large-scale, innovative clinical trials needed to improve patient care. As a result, NCI asked the IOM to assess the state of cancer clinical trials, review the Cooperative Group Program, and provide advice on improvements.”

…continues

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Future Directions for the National [US] Healthcare Quality and Disparities Reports – 14 April 2010

Posted on April 15, 2010. Filed under: Clin Governance / Risk Mgmt / Quality, Health Systems Improvement | Tags: , , |

Future Directions for the National Healthcare Quality and Disparities Reports
Released: April 14, 2010
Type: Consensus Report

full text online

Activity: Future Directions for the National Healthcare Quality and Disparities Reports
Board: Board on Health Care Services

“As the United States devotes extensive resources to health care, evalu­ating how successfully the U.S. system delivers high-quality, high-value care in an equitable manner is essential. At the request of Congress, the Agency for Healthcare Research and Quality (AHRQ) annually produces the National Healthcare Quality Report (NHQR) and the National Healthcare Disparities Report (NHDR). The reports have revealed areas in which health care perfor­mance has improved over time, but they also have identified major shortcom­ings. After five years of producing the NHQR and NHDR, AHRQ asked the IOM for guidance on how to improve the next generation of reports.

The IOM concludes that the NHQR and NHDR can be improved in ways that would make them more influential in promoting change in the health care system. In addition to being sources of data on past trends, the national healthcare reports can provide more detailed insights into current performance, establish the value of closing gaps in quality and equity, and project the time required to bridge those gaps at the current pace of improvement. The IOM deter­mined that AHRQ should:

Align the NHQR and NHDR with nationally recognized priority areas.
Select measures that reflect health care attri­butes or processes that are deemed to have the greatest impact on population health.
Affirm that achieving equity is an essential part of quality improvement.
Increase the reach and usefulness of AHRQ’s family of report-related products.
Analyze and present data in ways that will inform policy and promote best-in-class achievement for all actors.
Identify measure and data needs to set a research and data collection agenda.”

…continues

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A Summary of the October 2009 Forum on the Future of Nursing: Acute Care – US – 14 April 2010

Posted on April 15, 2010. Filed under: Nursing | Tags: , , |

A Summary of the October 2009 Forum on the Future of Nursing: Acute Care
Released: April 14, 2010
Type: Workshop Summary
full text online

Activity: Robert Wood Johnson Foundation Initiative on the Future of Nursing, at the Institute of Medicine
Board: Studies under the IOM Executive Office
Note: Workshop Summaries contain the opinion of the presenters, but do NOT reflect the conclusions of the IOM.

“Overcoming the challenges in nursing is essential to overcoming the challenges in the health care system as a whole. Nurses are the largest segment of the health care workforce, and their skills and availability can directly affect quality, safety, and efficiency. Most nurses work in hospitals or other acute care settings, where they are patients’ primary, professional caregivers and the individuals most likely to intercept medical errors. However, because hospital systems and acute care settings are often complex and chaotic, many nurses spend unnecessary time hunting for supplies, filling out paperwork, and coordinating staff time and patient care, reducing the time they are able to spend with patients and delivering care.

The Robert Wood Johnson Foundation Initiative on the Future of Nursing, at the IOM, seeks to transform nursing as part of larger efforts to reform the health care system. As part of this Initiative, three forums were held to explore challenges and opportunities in nursing. The first forum, on October 19, 2009, focused on quality and safety, technology, and interdisciplinary collaboration in acute care; and speakers offered new strategies to allow nurses to provide higher-quality care. The IOM will use the perspectives and ideas summarized in this document to inform a final report on the future of nursing, expected to release in fall 2010.”

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Perspectives from United Kingdom and United States Policy Makers on Obesity Prevention. Workshop Summary – Institute of Medicine – 25 March 2010

Posted on April 7, 2010. Filed under: Public Hlth & Hlth Promotion | Tags: , , |

Perspectives from United Kingdom and United States Policy Makers on Obesity Prevention. Workshop Summary – Institute of Medicine – 25 March 2010

Type: Workshop Summary
full text

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Regionalizing Emergency Care. Workshop Summary – Institute of Medicine – released 22 March 2010

Posted on March 23, 2010. Filed under: Disaster Management, Emergency Medicine | Tags: , |

Regionalizing Emergency Care. Workshop Summary
Released: March 22, 2010
Full text of the workshop summary

“Note: Workshop Summaries contain the opinion of the presenters, but do NOT reflect the conclusions of the IOM. Learn more about the differences between Workshop Summaries and Consensus Reports.

During medical emergencies, hospital staff and emergency medical services (EMS) providers, can face barriers in delivering the fastest and best possible care. Overcrowded emergency rooms cannot care for patients as quickly as necessary, and some may divert ambulances and turn away new patients outright. In many states, ambulance staff lacks the means to determine which hospitals can provide the best care to a patient. Given this absence of knowledge, they bring patients to the closest hospital. In addition, because emergency service providers from different companies compete with each other for patients, and emergency care legislation varies from state to state, it is difficult to establish the necessary local, interstate, and national communication and collaboration to create a more efficient system.

In 2006, the IOM recommended that the federal government implement a regionalized emergency care system to improve cooperation and overcome these challenges. In a regionalized system, local hospitals and EMS providers would coordinate their efforts so that patients would be brought to hospitals based on the hospitals’ capacity and expertise to best meet patients’ needs. In September 2009, three years after making these recommendations, the IOM held a workshop sponsored by the federal Emergency Care Coordination Center to assess the nation’s progress toward regionalizing emergency care. The workshop brought together policymakers and stakeholders, including nurses, EMS personnel, hospital administrators, and others involved in emergency care. Participants identified successes and shortcomings in previous regionalization efforts; examined the many factors involved in successfully implementing regionalization; and discussed future challenges to regionalizing emergency care. This document summarizes the workshop.”

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Know Hepatitis – new CDC website – February 2010

Posted on March 23, 2010. Filed under: Infectious Diseases | Tags: , , , , |

“In the report Hepatitis and Liver Cancer: A National Strategy for Prevention and Control of Hepatitis B and C , the IOM warned that lack of knowledge and awareness about hepatitis B and C can contribute to continued transmission, missed opportunities for early diagnosis and medical care, and poor health outcomes in infected people. This February, in response to the IOM’s recommendation to improve knowledge and awareness through educational programs, the CDC launched Know Hepatitis.org. This website targets community-based health care providers and social service providers on the front lines of hepatitis prevention and provides basic information about the problem of chronic viral hepatitis.”

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Infectious Disease Movement in a Borderless World. Workshop Summary – Institute of Medicine – 12 March 2010

Posted on March 15, 2010. Filed under: Infectious Diseases | Tags: , , |

Infectious Disease Movement in a Borderless World. Workshop Summary – Institute of Medicine – 12 March 2010

Full text at National Academies Press
 
“Type: Workshop Summary
Topics: Diseases, Global Health, Public Health
Activity: Forum on Microbial Threats
Board: Board on Global Health
Note: Workshop Summaries contain the opinion of the presenters, but do NOT reflect the conclusions of the IOM. Learn more about the differences between Workshop Summaries and Consensus Reports.
 
Modern transportation allows people, animals, and plants—and the pathogens they carry—to travel more easily than ever before. The ease and speed of travel, tourism, and international trade connect once-remote areas with one another, eliminating many of the geographic and cultural barriers that once limited the spread of disease. Because of our global interconnectedness through transportation, tourism and trade, infectious diseases emerge more frequently; spread greater distances; pass more easily between humans and animals; and evolve into new and more virulent strains.
 
The IOM’s Forum on Microbial Threats hosted the workshop “Globalization, Movement of Pathogens (and Their Hosts) and the Revised International Health Regulations” December 16-17, 2008 in order to explore issues related to infectious disease spread in a “borderless” world. Participants discussed the global emergence, establishment, and surveillance of infectious diseases; the complex relationship between travel, trade, tourism, and the spread of infectious diseases; national and international policies for mitigating disease movement locally and globally; and obstacles and opportunities for detecting and containing these potentially wide-reaching and devastating.”

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Policy Issues in the Development of Personalized Medicine in Oncology: Workshop Summary – Institute of Medicine – 2010

Posted on February 10, 2010. Filed under: Oncology | Tags: , |

Policy Issues in the Development of Personalized Medicine in Oncology: Workshop Summary – Institute of Medicine – 2010
Authors:  Margie Patlak and Laura Levit, Rapporteurs; Institute of Medicine

ISBN-10: 0-309-14575-9
ISBN-13: 978-0-309-14575-6

“One of the challenges in treating cancer is the disease’s complexity and variation among patients. Cancer manifests differently in each patient, so treatments that are effective in one patient may not be effective in another. As cancer care becomes more personalized, subpopulations of individuals will be given preventive or therapeutic interventions based on their susceptibility to a particular disease or their predicted response to a specific treatment. However, before the use of personalized cancer care can reach its full potential, the health care system must resolve a number of technological, regulatory, and reimbursement issues.

To explore these policy challenges, the National Cancer Policy Forum held the workshop Policy Issues in the Development of Personalized Medicine in Oncology in June 2009. Experts provided presentations on the current state of personalized medicine technology, as well as issues in the validation of, regulation of, and reimbursement for the predictive tests that underpin personalized medicine. Participants discussed the obstacles and possible solutions to further developing and using personalized medicine technologies. This document summarizes the workshop.”

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The Domestic and International Impacts of the 2009-H1N1 Influenza A Pandemic: Global Challenges, Global Solutions – Institute of Medicine – 29 December 2009

Posted on January 6, 2010. Filed under: Influenza A(H1N1) / Swine Flu | Tags: , |

The Domestic and International Impacts of the 2009-H1N1 Influenza A Pandemic: Global Challenges, Global Solutions – Institute of Medicine     Released: December 29, 2009
Type: Workshop Summary

Full text online

“Note: Workshop Summaries contain the opinion of the presenters, but do NOT reflect the conclusions of the IOM. Learn more about the differences between Workshop Summaries and Consensus Reports.

In March 2009, a new H1N1 influenza A virus emerged in Mexico and the United States. On June 11, 2009, the World Health Organization declared a pandemic in response to the sustained global spread of the virus. President Obama, on October 24, 2009, signed an official proclamation declaring the 2009-H1N1 influenza A swine flu outbreak a national emergency in the United States. While the 2009 H1N1 pandemic appears to be the mildest pandemic of the past century, many scientific and policy questions related to this virus remain unanswered.

On September 15-16, 2009, the IOM’s Forum on Microbial Threats held a public workshop to discuss the domestic and international impacts of the 2009 H1N1 influenza A pandemic. Participants explored the origins, evolution, and epidemiology of the 2009 H1N1 influenza A virus as well as prospects for development and distribution of vaccines and other mitigation measures. In addition, participants discussed the value of disease detection and surveillance in understanding the epidemiology of the virus and in evaluating the success of various interventions to reduce the virus’s spread. This report summarizes the workshop’s discussions.”

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Redesigning Continuing Education in the Health Professions – US Institute of Medicine consensus report – 4 December 2009

Posted on December 29, 2009. Filed under: Clinical Education, Educ for Hlth Professions | Tags: , , |

US Institute of Medicine consensus report 4 December 2009
Redesigning Continuing Education in the Health Professions

“A workforce of knowledgeable health professionals is critical to the discovery and application of health care practices to prevent disease and promote wellbeing. Yet today’s professional health workforce is not consistently prepared to provide high quality health care and assure patient safety. One contributing factor to this problem is the absence of a comprehensive and well-integrated system of continuing education in the health professions.

At the request of the Josiah Macy, Jr. Foundation, the IOM convened a committee to consider the establishment of a national interprofessional continuing education institute dedicated to the improvement of continuing education for the health care workforce. The committee’s report, Redesigning Continuing Education in the Health Professions, examines continuing education for all health professionals, explores development of a national continuing education institute, and offers guidance on the establishment and operation of an institute to develop a coordinated continuing professional development system.”

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Patient Safety At Ten: Unmistakable Progress, Troubling Gaps – Health Affairs article – 2010

Posted on December 2, 2009. Filed under: Patient Safety | Tags: , , , |

Patient Safety At Ten: Unmistakable Progress, Troubling Gaps / Robert M. Wachter
Health Affairs  v.29,  no. 1 (2010)
doi: 10.1377/hlthaff.2009.0785
http://dx.doi.org/10.1377/hlthaff.2009.0785

ABSTRACT

“December 1, 2009, marks the tenth anniversary of the Institute of Medicine report on medical errors, To Err Is Human, which arguably launched the modern patient-safety movement. Over the past decade, a variety of pressures (such as more robust accreditation standards and increasing error-reporting requirements) have created a stronger business case for hospitals to focus on patient safety. Relatively few health care systems have fully implemented information technology, and we are finally grappling with balancing “no blame” and accountability. The research pipeline is maturing, but funding remains inadequate. Our limited ability to measure progress in safety is a substantial impediment. Overall, I give our safety efforts a grade of B−, a modest improvement since 2004.”

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Addressing the Threat of Drug-Resistant Tuberculosis: A Realistic Assessment of the Challenge. Workshop Summary – IOM – 26 August 2009

Posted on August 28, 2009. Filed under: Infectious Diseases | Tags: , , , |

Addressing the Threat of Drug-Resistant Tuberculosis: A Realistic Assessment of the Challenge. Workshop Summary
Institute of Medicine (US)  Released On:   August 26, 2009
ISBN-10: 0-309-13044-1
ISBN-13: 978-0-309-13044-8

“Tuberculosis is one of the leading causes of death in the world today, with 4,500 people dying from the disease every day. Although antibiotic treatment for TB was discovered more than half a century ago, an estimated one-third of the world’s population is currently infected with TB, and 9.2 million new cases occur each year. Many cases of TB can be cured by available antibiotics, but some TB is resistant to multiple drugs–a major and growing threat worldwide.

The Institute of Medicine’s Forum on Drug Discovery, Development, and Translation hosted a workshop on November 5, 2008, to address the mounting concern of drug-resistant TB. The session brought together a wide range of international experts to discuss what is known and not known about this growing threat, and to explore possible solutions.”

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A Review of the HHS Family Planning Program: Mission, Management, and Measurement of Results – US – August 2009

Posted on August 11, 2009. Filed under: Health Mgmt Policy Planning | Tags: , , , |

A Review of the HHS Family Planning Program: Mission, Management, and Measurement of Results
Adrienne Stith Butler and Ellen Wright Clayton, Editors; Committee on a Comprehensive Review of the HHS Office of Family Planning Title X Program; Institute of Medicine
ISBN-10: 0-309-13117-0
ISBN-13: 978-0-309-13117-9

“A Review of the HHS Family Planning Program provides a broad evaluation of the Title X family planning program since its establishment in 1970. The program successfully provides family planning services to its target audience of low-income individuals, but there is room for improvement. While the program’s core goals are apparent, a secondary set of changing priorities has emerged without a clear, evidence-based strategic process. Also, funding for the program has increased in actual dollars, but has not kept pace with inflation or increased costs. Several aspects of the program’s structure could be improved to increase the ability of Title X to meet the needs of its target population. At the same time, the extent to which the program meets those needs cannot be assessed without a greater capacity for long-term data collection.

A Review of the HHS Family Planning Program recommends several specific steps to enhance the management and improve the quality of the program, as well as to demonstrate its direct contribution to important end results, such as reducing rates of unintended pregnancy, cervical cancer, and infertility. The book will guide the Office of Family Planning toward improving the effectiveness of the program. Other parties who will find the research and recommendations valuable include programs receiving Title X funding from the Office of Family Planning, policy makers, researchers, and professional organizations.”

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The U.S. Oral Health Workforce in the Coming Decade: – Workshop Summary Institute of Medicine August 2009

Posted on August 7, 2009. Filed under: Dental Health, Workforce | Tags: , |

The U.S. Oral Health Workforce in the Coming Decade:  – Workshop Summary Institute of Medicine August 2009

Authors:  Tracy A. Harris, Rapporteur; Planning Committee for a Workshop on the Sufficiency of the U.S. Oral Health Workforce in the Coming Decade; Institute of Medicine
ISBN-10: 0-309-13904-X
ISBN-13: 978-0-309-13904-5

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Initial National Priorities for Comparative Effectiveness Research – Institute of Medicine (US) – 30 June 2009

Posted on July 1, 2009. Filed under: Health Systems Improvement, Research | Tags: , , , , , |

Initial National Priorities for Comparative Effectiveness Research – Institute of Medicine (US) – 30 June 2009

Full text of the report from National Academies Press

“Clinical research presents health care providers with information on the natural history and clinical presentations of disease as well as diagnostic and treatment options. Consumers, patients, and caregivers also require this information to decide how to evaluate and treat their conditions. All too often, the information necessary to inform these medical decisions is incomplete or unavailable, resulting in more than half of the treatments delivered today lacking clear evidence of effectiveness.

Comparative effectiveness research (CER) identifies what works best for which patients under what circumstances. Congress, in the American Recovery and Reinvestment Act (ARRA) of 2009, tasked the Institute of Medicine (IOM) to recommend national priorities for research questions to be addressed by CER and supported by ARRA funds. In its 2009 report, Initial National Priorities for Comparative Effectiveness Research, the authoring committee establishes a working definition of CER, develops a priority list of research topics to be undertaken with ARRA funding using broad stakeholder input, and identifies the necessary requirements to support a robust and sustainable CER enterprise. The full list of priorities and recommendations can be found in the below report brief.”

2 articles on this from the NEJM – 30 June 2009

Prioritizing Comparative-Effectiveness Research — IOM Recommendations
J.K. Iglehart

Comparative-Effectiveness Research — Implications of the Federal Coordinating Council’s Report
P.H. Conway and C. Clancy

2 articles from the Annals of Internal Medicine

Comparative Effectiveness Research: A Report From the Institute of Medicine
Harold C. Sox, MD, Editor, and Sheldon Greenfield, MD
4 August 2009  Volume 151 Issue 3  Annals of Internal Medicine

Rethinking Randomized Clinical Trials for Comparative Effectiveness Research: The Need for Transformational Change
Bryan R. Luce, PhD, MBA; Judith M. Kramer, MD, MS; Steven N. Goodman, MD, MHS, PhD; Jason Connor, PhD; Sean Tunis, MD, MSc; Danielle Whicher, MHS; and J. Sanford Schwartz, MD
4 August 2009  Volume 151 Issue 3    Annals of Internal Medicine

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Depression in Parents, Parenting, and Children: Opportunities to Improve Identification, Treatment, and Prevention – US IoM – 10 June 2009

Posted on June 15, 2009. Filed under: Mental Health Psychi Psychol | Tags: , , |

Depression in Parents, Parenting, and Children: Opportunities to Improve Identification, Treatment, and Prevention
Institute of Medicine report   Released On:  June 10, 2009
Full text online

“Depression is a widespread condition affecting approximately 7.5 million parents in the U.S. each year and may be putting at least 15 million children at risk for adverse health outcomes. Based on evidentiary studies, major depression in either parent can interfere with parenting quality and increase the risk of children developing mental, behavioral and social problems. Depression in Parents, Parenting, and Children highlights disparities in the prevalence, identification, treatment, and prevention of parental depression among different sociodemographic populations. It also outlines strategies for effective intervention and identifies the need for a more interdisciplinary approach that takes biological, psychological, behavioral, interpersonal, and social contexts into consideration.

A major challenge to the effective management of parental depression is developing a treatment and prevention strategy that can be introduced within a two-generation framework, conducive for parents and their children. Thus far, both the federal and state response to the problem has been fragmented, poorly funded, and lacking proper oversight. This study examines options for widespread implementation of best practices as well as strategies that can be effective in diverse service settings for diverse populations of children and their families.

The delivery of adequate screening and successful detection and treatment of a depressive illness and prevention of its effects on parenting and the health of children is a formidable challenge to modern health care systems. This study offers seven solid recommendations designed to increase awareness about and remove barriers to care for both the depressed adult and prevention of effects in the child. The report will be of particular interest to federal health officers, mental and behavioral health providers in diverse parts of health care delivery systems, health policy staff, state legislators, and the general public. “

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Weight Gain During Pregnancy: Reexamining the Guidelines – Institute of Medicine – June 2009

Posted on June 10, 2009. Filed under: Obstetrics | Tags: , , |

Weight Gain During Pregnancy: Reexamining the Guidelines
Authors:  Kathleen M. Rasmussen and Ann L. Yaktine, Editors; Committee to Reexamine IOM Pregnancy Weight Guidelines; Institute of Medicine; National Research Council,  June 2009
ISBN-10: 0-309-13109-X
ISBN-13: 978-0-309-13109-4

“As women of childbearing age have become heavier, the trade-off between maternal and child health created by variation in gestational weight gain has become more difficult to reconcile. Weight Gain During Pregnancy responds to the need for a reexamination of the 1990 Institute of Medicine guidelines for weight gain during pregnancy. It builds on the conceptual framework that underscored the 1990 weight gain guidelines and addresses the need to update them through a comprehensive review of the literature and independent analyses of existing databases. The book explores relationships between weight gain during pregnancy and a variety of factors (e.g., the mother’s weight and height before pregnancy) and places this in the context of the health of the infant and the mother, presenting specific, updated target ranges for weight gain during pregnancy and guidelines for proper measurement. New features of this book include a specific range of recommended gain for obese women.

Weight Gain During Pregnancy is intended to assist practitioners who care for women of childbearing age, policy makers, educators, researchers, and the pregnant women themselves to understand the role of gestational weight gain and to provide them with the tools needed to promote optimal pregnancy outcomes.”

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Weight Gain During Pregnancy: Reexamining the Guidelines – Institute of Medicine (US) – 28 May 2009

Posted on May 29, 2009. Filed under: Obstetrics | Tags: , |

Weight Gain During Pregnancy: Reexamining the Guidelines – Institute of Medicine (US)   Released On:  May 28, 2009

Full text of the guidelines

“It has been nearly two decades since guidelines for how much weight a woman should gain during pregnancy were issued by the Institute of Medicine (IOM). In that time, more research has been conducted on the effects of weight gain in pregnancy on the health of both mother and baby. There have also been dramatic changes in the population of women having babies. American women are now a more diverse group; they are having more twin and triplet pregnancies, and they tend to be older when they become pregnant. Women today are also heavier; a greater percentage of them are entering pregnancy overweight or obese, and many are gaining too much weight during pregnancy. Many of these changes carry the added burden of chronic disease, which can put the mother and her baby’s health at risk.

Given these changes, the IOM’s 2009 report Weight Gain During Pregnancy: Reexamining the Guidelines examines weight gain during pregnancy from the perspective that factors that af­fect pregnancy begin before conception and continue through the first year after de­livery.

The new weight gain guidelines are based on revised Body Mass Index (BMI) categories and now have a recommendation for obese women. To meet the recommendations of the report, women need to gain within the weight gain ranges for their BMI category. Achieving the recommended gain will require individualized attention and support from a woman’s care providers as well as her family and community.”

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Managing Food Safety Practices from Farm to Table. Workshop Summary from the Institute of Medicine (US) – published 14 May 2009

Posted on May 18, 2009. Filed under: Public Hlth & Hlth Promotion | Tags: , |

Managing Food Safety Practices from Farm to Table. Workshop Summary from the Institute of Medicine (US)

Released On:       May 14, 2009

“After hearing news reports of tainted milk, spinach contaminated with E. coli, outbreaks of salmonella and other incidents, the public is more aware than ever of the risk of food contamination. Legal regulations and manufacturers’ monitoring practices have not been enough to prevent contamination of the national food supply and protect consumers from serious harm. In addressing food safety risks, regulators could perhaps better ensure the quality and safety of food by monitoring food production not just at a single point in production but all along the way, from farm to table.

Recognizing the troubled state of food safety, the Institute of Medicine’s (IOM) Food Forum met in Washington, DC, on September 9, 2008, to explore the management of food safety practices from the beginning of the supply chain to the marketplace. Experts in various disciplines discussed ways to develop systematic, risk-based strategies for preventing microbial contamination in foods at every stage of production, not just processing and packaging. They addressed approaches, technologies, and institutional strategies to manage the food safety risks that continue to emerge in our ever- developing global marketplace. ”

Full text

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Innovations in Service Delivery in the Age of Genomics. Workshop Summary from the Institute of Medicine (US) published 14 May 2009

Posted on May 18, 2009. Filed under: Genomics | Tags: , |

Innovations in Service Delivery in the Age of Genomics. Workshop Summary from the Institute of Medicine (US)

Released On:       May 14, 2009

“New discoveries in genomics—that is, the study of the entire human genome—are changing how we diagnose and treat diseases. Whereas previously, genetic testing could only screen for rare genetic disorders, increasingly, patients and their physicians are able to use genetic information to predict the risk of common diseases such as diabetes and breast cancer and to help determine prevention and treatment options. Genetic specialists have long been the main providers of genetic services, offering intensive counseling for rare genetic disorders. However, as the trend shifts from genetic testing largely being undertaken for rare genetic disorders to, increasingly, individuals being screened for common diseases, general practitioners, pediatricians, obstetricians/gynecologists, and other providers need to be knowledgeable about and comfortable using genetic information to improve their patients’ health.

The Roundtable on Translating Genomic-Based Research for Health held the public workshop “Innovations in Service Delivery in the Age of Genomics” on July 27, 2008. The workshop set out to examine the current system of genetic service delivery, learn about some pioneering current practice models, and propose new models for integrating genetic and genomic innovations into education, training, and clinical practice. Participants discussed the strengths and challenges of the current system and considered a vision for the future of genetic and genomic services, which may not be so distant after all.”

Full text online

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Ensuring Quality Cancer Care through the Oncology Workforce: Sustaining Care in the 21st Century. Workshop Summary – US Institute of Medicine

Posted on May 1, 2009. Filed under: Oncology, Workforce | Tags: , |

Ensuring Quality Cancer Care through the Oncology Workforce: Sustaining Care in the 21st Century. Workshop Summary – US Institute of Medicine Full text of the report

Released On:       April 29, 2009

The American Society of Clinical Oncology (ASCO) predicts that by 2020, there will be an 81 percent increase in people living with or surviving cancer but only a 14 percent increase in the number of practicing oncologists. As a result, there may be too few oncologists to meet the population’s need for cancer care. This shortage will be compounded by a predicted lack of primary care physicians, who are responsible for a majority of cancer care, as well as a predicted lack of nurses, allied health care professionals, physician assistants, social workers, public health workers, and cancer registrars. There is a real danger that patients with cancer, whose successful recovery often depends on early detection and swift treatment, may not have access to the care essential to their survival and future health.

To help address the challenges in overcoming this potential crisis of cancer care, the National Cancer Policy Forum of the Institute of Medicine (IOM) convened the workshop “Ensuring Quality Cancer Care through the Oncology Workforce: Sustaining Care in the 21st Century” in Washington, DC on October 20 and 21, 2008. Workshop participants discussed how to address both the shortage in the oncology workforce as well as the health care workforce as a whole, to ensure the workforce does not become overburdened and is prepared to meet the growing number of patients in need of cancer care.

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Conflict of Interest in Medical Research, Education, and Practice – Institute of Medicine report 28 April 2009

Posted on April 29, 2009. Filed under: Research | Tags: , |

Conflict of Interest in Medical Research, Education, and Practice

Released On:       April 28, 2009   Full text available

New England Journal of Medicine ‘Perspective’ commentary on the report 29 April 2009

Collaborations between physicians or medical researchers and pharmaceutical, medical device, and biotechnology companies can benefit society—most notably by promoting the discovery and development of new medications and medical devices that improve individual and public health. However, relationships between medicine and industry may create conflicts of interest, potentially resulting in undue influence on professional judgments.

In 2007, the Institute of Medicine (IOM) appointed the Committee on Conflict of Interest in Medical Research, Education, and Practice to examine conflicts of interest in medicine and to recommend steps to identify, limit, and manage conflicts of inter­est without negatively affecting constructive collaborations.

The committee’s report stresses the importance of preventing bias and mistrust rather than trying to remedy damage after it is discovered. It focuses specifically on financial conflicts of interest involving pharmaceutical, medical device, and biotechnology companies.

The committee recommends the implementation of policies and procedures that will reduce the risk of conflicts that can jeopardize the integrity of sci­entific investigations, the objectivity of medical education, the quality of patient care, and the public’s trust in medicine.

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Institute of Medicine President releases free electronic edition of The Swine Flu Affair, offering lessons from the 1976 swine flu scare

Posted on April 29, 2009. Filed under: Infectious Diseases, Influenza A(H1N1) / Swine Flu | Tags: , , |

Institute of Medicine President releases free electronic edition of The Swine Flu Affair, offering lessons from the 1976 swine flu scare

In 1976, a small group of soldiers at Fort Dix were infected with a swine flu virus that was deemed similar to the virus responsible for the great 1918-19 world-wide flu pandemic. The U.S. government initiated an unprecedented effort to immunize every American against the disease. While a qualified success in terms of numbers reached-more than 40 million Americans received the vaccine-the disease never reappeared. The program was marked by controversy, delay, administrative troubles, legal complications, unforeseen side effects and a progressive loss of credibility for public health authorities. In the waning days of the flu season, the incoming Secretary of what was then the Department of Health, Education and Welfare, Joseph Califano, asked Richard Neustadt and Harvey Fineberg to examine what happened and to extract lessons to help cope with similar situations in the future. The result was their report, The Swine Flu Affair: Decision-Making on a Slippery Disease.

In response to the recent outbreak of swine flu in North America, Dr. Fineberg has released a new electronic edition of this report, The Swine Flu Affair, dedicated to the memory of Richard Neustadt, and available for download by the public. Dr. Fineberg is president of the Institute of Medicine of the National Academies.   28 April 2009

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Toward Health Equity and Patient-Centeredness: Integrating Health Literacy, Disparities Reduction, and Quality Improvement

Posted on April 16, 2009. Filed under: Clin Governance / Risk Mgmt / Quality, Health Systems Improvement, Patient Journey, Patient Participation, Patient Safety | Tags: |

Toward Health Equity and Patient-Centeredness: Integrating Health Literacy, Disparities Reduction, and Quality Improvement. Workshop Summary

Released On:       February 27, 2009

During a time of economic uncertainty, the national discussion of health reform understandably focuses on insurance coverage and cost. To receive the greatest value for health care, it is important to focus on issues of quality and disparity, and the ability of individuals to make appropriate decisions based on basic health knowledge and services, or health literacy. As health care practitioners often see patients from diverse cultures who speak different languages and have a wide range of individual needs, practitioners must ensure all patients receive the same quality of care.

Three IOM bodies (the Forum on the Science of Health Care Quality Improvement and Implementation, the Roundtable on Health Disparities, and the Roundtable on Health Literacy) jointly convened a workshop to discuss these concerns. The workshop, “Toward Health Equity and Patient-Centeredness: Integrating Health Literacy, Disparities Reduction, and Quality Improvement,” was held on May 12, 2008. During this workshop, speakers and participants explored how equity in care delivered and a focus on patients could be improved through concentration on eliminating health disparities and addressing issues of health literacy. For example, providing patients with appropriate medications in their primary languages and offering translation services can vastly improve the health care patients receive. Integrating these seemingly separate areas at the practitioner level was discussed, yielding discussions around resource management, the business case for addressing health literacy and reducing health disparities, cultural competency in the workforce, data collection, and communication. Participants also addressed national-level policy issues of integration, including data collection and measurement.

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