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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Health Literacy and Numeracy: Workshop Summary (2014) – National Research Council

Posted on April 4, 2014. Filed under: Patient Participation | Tags: , , |

Health Literacy and Numeracy: Workshop Summary (2014) – National Research Council

National Research Council. Health Literacy and Numeracy: Workshop Summary. Washington, DC: The National Academies Press, 2014.

“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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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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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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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

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“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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The Role of Telehealth in an Evolving Health Care Environment: Workshop Summary – Institute of Medicine – November 2012

Posted on November 28, 2012. Filed under: Telehealth | Tags: |

The Role of Telehealth in an Evolving Health Care Environment: Workshop Summary – Institute of Medicine – November 2012

ISBN-10: 0-309-26201-1   ISBN-13: 978-0-309-26201-9

“In 1996, the Institute of Medicine (IOM) released its report Telemedicine: A Guide to Assessing Telecommunications for Health Care. In that report, the IOM Committee on Evaluating Clinical Applications of Telemedicine found telemedicine is similar in most respects to other technologies for which better evidence of effectiveness is also being demanded. Telemedicine, however, has some special characteristics-shared with information technologies generally-that warrant particular notice from evaluators and decision makers.

Since that time, attention to telehealth has continued to grow in both the public and private sectors. Peer-reviewed journals and professional societies are devoted to telehealth, the federal government provides grant funding to promote the use of telehealth, and the private technology industry continues to develop new applications for telehealth. However, barriers remain to the use of telehealth modalities, including issues related to reimbursement, licensure, workforce, and costs. Also, some areas of telehealth have developed a stronger evidence base than others.

The Health Resources and Service Administration (HRSA) sponsored the IOM in holding a workshop in Washington, DC, on August 8-9 2012, to examine how the use of telehealth technology can fit into the U.S. health care system. HRSA asked the IOM to focus on the potential for telehealth to serve geographically isolated individuals and extend the reach of scarce resources while also emphasizing the quality and value in the delivery of health care services. This workshop summary discusses the evolution of telehealth since 1996, including the increasing role of the private sector, policies that have promoted or delayed the use of telehealth, and consumer acceptance of telehealth. The Role of Telehealth in an Evolving Health Care Environment: Workshop Summary discusses the current evidence base for telehealth, including available data and gaps in data; discuss how technological developments, including mobile telehealth, electronic intensive care units, remote monitoring, social networking, and wearable devices, in conjunction with the push for electronic health records, is changing the delivery of health care in rural and urban environments. This report also summarizes actions that the U.S. Department of Health and Human Services (HHS) can undertake to further the use of telehealth to improve health care outcomes while controlling costs in the current health care environment.”

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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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Contagion of Violence – Workshop Summary – Institute of Medicine – 3 October 2012

Posted on October 4, 2012. Filed under: Violence | Tags: |

Contagion of Violence – Workshop Summary – Institute of Medicine – 3 October 2012

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“In the past 25 years, there has been a shift in the field of violence prevention, from the assumption that violence is inevitable to the recognition that violence is preventable. In exploring the occurrence of violence, researchers have recognized the tendency for violent acts to cluster, to spread from place to place, and to mutate from one type to another – similar to the infectious disease model, in which an agent or vector initiates a specific biological pathway leading to symptoms of disease and infectivity.

On April 30 – May 1, 2012, the IOM Forum on Global Violence Prevention held a workshop to explore the contagious nature of violence. The workshop focused on the epidemiology of the contagion, possible processes and mechanisms by which violence is transmitted, how contextual factors mitigate or exacerbate the issue, and ways in which the contagion of violence might be interrupted. 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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Best Care at Lower Cost: The Path to Continuously Learning Health Care in America – Institute of Medicine – 6 September 2012

Posted on September 7, 2012. Filed under: Clin Governance / Risk Mgmt / Quality, Educ for Hlth Professions, Health Informatics, Patient Participation | Tags: |

Best Care at Lower Cost: The Path to Continuously Learning Health Care in America – Institute of Medicine – 6 September 2012

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“… IOM convened the Committee on the Learning Health Care System in America to explore these central challenges to health care today. The product of the committee’s deliberations, Best Care at Lower Cost, identifies three major imperatives for change: the rising complexity of modern health care, unsustainable cost increases, and outcomes below the system’s potential. But it also points out that emerging tools like computing power, connectivity, team-based care, and systems engineering techniques—tools that were previously unavailable—make the envisioned transition possible, and are already being put to successful use in pioneering health care organizations. Applying these new strategies can support the transition to a continuously learning health system, one that aligns science and informatics, patient-clinician partnerships, incentives, and a culture of continuous improvement to produce the best care at lower cost. The report’s recommendations speak to the many stakeholders in the health care system and outline the concerted actions necessary across all sectors to achieve the needed transformation.”

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How Can Health Care Organizations Become More Health Literate? – Workshop Summary – Institute of Medicine – 18 July 2012

Posted on July 19, 2012. Filed under: Patient Participation | Tags: , |

How Can Health Care Organizations Become More Health Literate? – Workshop Summary – Institute of Medicine – 18 July 2012

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“Approximately 80 million adults in the United States have low health literacy – an individual’s ability to obtain, process, and understand basic health information. Low health literacy creates difficulties in communicating with clinicians, poses barriers in managing chronic illness, lessens the likelihood of receiving preventive care, heightens the possibility of experiencing serious medication errors, increased risk of hospitalization, and results in poorer quality of life.

It is important for health care organizations to develop strategies that can improve their health literacy, yet organizations often find it difficult to determine exactly what it means to be health literate. The IOM Roundtable on Health Literacy commissioned a paper that defined a health literate health care organization as “an organization that makes it easier for people to navigate, understand, and use information and services to take care of their health.” In November 2011, the roundtable held a workshop to discuss the growing recognition that health literacy depends not only on individual skills and abilities but also on the demands and complexities of the health care system. 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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The Mental Health and Substance Use Workforce for Older Adults: In Whose Hands? – Institute of Medicine – 10 July 2012

Posted on July 16, 2012. Filed under: Aged Care / Geriatrics, Alcohol & Drug Dep., Mental Health Psychi Psychol, Workforce | Tags: |

The Mental Health and Substance Use Workforce for Older Adults: In Whose Hands? – Institute of Medicine – 10 July 2012

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“At least 5.6 million to 8 million – nearly one in five – older adults in America have one or more mental health and substance use conditions, which present unique challenges for their care. With the number of adults age 65 and older projected to soar from 40.3 million in 2010 to 72.1 million by 2030, the aging of America holds profound consequences for the nation.

For decades, policymakers have been warned that the nation’s health care workforce is ill-equipped to care for a rapidly growing and increasingly diverse population. In the specific disciplines of mental health and substance use, there have been similar warnings about serious workforce shortages, insufficient workforce diversity, and lack of basic competence and core knowledge in key areas.

Following its 2008 report highlighting the urgency of expanding and strengthening the geriatric health care workforce, the IOM was asked by the Department of Health and Human Services to undertake a complementary study on the geriatric mental health and substance use workforce. An expert committee assessed the needs of this population and the workforce that serves it. The breadth and magnitude of inadequate workforce training and personnel shortages have grown to such proportions, says the committee, that no single approach, nor a few isolated changes in disparate federal agencies or programs, can adequately address the issue. Overcoming these challenges will require focused and coordinated action by all.”

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Ten Attributes of Health Literate Health Care Organizations – Institute of Medicine – June 2012

Posted on July 3, 2012. Filed under: Patient Participation | Tags: , |

Ten Attributes of Health Literate Health Care Organizations – Institute of Medicine – June 2012

Cindy Brach, Debra Keller, Lyla M. Hernandez, Cynthia Baur, Ruth Parker, Benard Dreyer, Paul Schyve, Andrew J. Lemerise, and Dean Schillinger,  Participants in the activities of the IOM Roundtable on Health Literacy.

“This paper describes 10 attributes of health literate health care organizations, that is, health care organizations that make it easier for people to navigate, understand, and use information and services to take care of their health. Having health literate health care organizations benefits not only the 77 million Americans who have limited health litera-cy, but also the majority of Americans who have difficulty understanding and using cur-rently available health information and health services (ODPHP, 2008).

Although health literacy is commonly defined as an individual trait—the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions (Ratzan and Parker, 2000)—there is a growing appreciation that health literacy does not depend on the skills of individuals alone (IOM, 2003). Health literacy is the product of individuals’ capacities and the health literacy–related demands and complexities of the health care system (Baker, 2006; Rudd 2003). System changes are needed to align health care demands better with the public’s skills and abilities (Parker, 2009; Rudd, 2007).  Health literacy has been identified as a priority area for national action, first by the Department of Health and Human Services as an objective for Healthy People 2010 (HHS, 2000), and again in the 2003 Institute of Medicine report Health Literacy: A Pre-scription to End Confusion (IOM, 2004). The following decade saw the achievement of many milestones that marked health literacy’s ascendency in both the public and private sectors (Parker and Ratzan, 2010), including a National Action Plan to Improve Health Literacy (ODPHP, 2010). Health literacy has now reached a possible tipping point, the place where paying attention to it could quickly become the norm for health care organi-zations (Koh et al., 2012).”

… continues

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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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Communications and Technology for Violence Prevention – Workshop Summary – Institute of Medicine – 13 June 2012

Posted on June 18, 2012. Filed under: Violence | Tags: |

Communications and Technology for Violence Prevention – Workshop Summary – Institute of Medicine – 13 June 2012

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“In the last 25 years, a major shift has occurred in the field of violence prevention, from the assumption that violence is inevitable to the realization that violence is preventable. As we learn more about what works to reduce violence, the challenge facing those who work in the field is how to use all of this new information to rapidly deploy or enhance new programs. At the same time, new communications technologies and distribution channels have altered traditional means of communications, and have made community-based efforts to prevent violence possible by making information readily available. How can these new technologies be successfully applied to the field of violence prevention?

On December 8-9, 2011, the IOM’s Forum on Global Violence Prevention held a workshop to explore the intersection of violence prevention and information and communications technology. The workshop – called “mPreventViolence” – provided an opportunity for practitioners to engage in new and innovative thinking concerning these two fields with the goal of bridging gaps in language, processes, and mechanisms. The workshop focused on exploring the potential applications of technology to violence prevention, drawing on experience in development, health, and the social sector as well as from industry and the private sector. This document summarizes the workshop.”

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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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Facing the Reality of Drug-Resistant Tuberculosis: Challenges and Potential Solutions in India – Summary of a Joint Workshop by the Institute of Medicine, the Indian National Science Academy, and the Indian Council of Medical Research – IOM – 27 April 2012

Posted on April 30, 2012. Filed under: Infectious Diseases, Pharmacy | Tags: |

Facing the Reality of Drug-Resistant Tuberculosis: Challenges and Potential Solutions in India – Summary of a Joint Workshop by the Institute of Medicine, the Indian National Science Academy, and the Indian Council of Medical Research – IOM – 27 April 2012

“An estimated 8.8 million people fell ill with tuberculosis (TB) in 2010 and 1.4 million died from the disease. Although antibiotics to treat TB were developed in the 1950s and are effective against a majority of TB cases, resistance to these antibiotics has emerged over the years, resulting in the growing spread of multidrug-resistant (MDR) TB. Due to challenges in timely and accurate diagnosis of drug-resistant TB, length and tolerability of treatment regimens, and expense of second-line anti-TB drugs, effectively controlling the disease requires complex public health interventions.

The IOM Forum on Drug Discovery, Development, and Translation held three international workshops to gather information from local experts around the world on the threat of drug resistant TB and how the challenges it presents can be met. Workshops were held in South Africa and Russia in 2010. The third workshop was held April 18-19, 2011, in New Delhi, India, in collaboration with the Indian National Science Academy and the Indian Council of Medical Research. The aim of the workshop was to highlight key challenges to controlling the spread of drug-resistant strains of TB in India and to discuss strategies for advancing and integrating local and international efforts to prevent and treat drug-resistant TB. This document summarizes the workshop.”

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Envisioning a Transformed Clinical Trials Enterprise in the United States: Establishing an Agenda for 2020 – Workshop Summary – Institute of Medicine – 13 April 2012

Posted on April 16, 2012. Filed under: Pharmacy, Research | Tags: |

Envisioning a Transformed Clinical Trials Enterprise in the United States: Establishing an Agenda for 2020 – Workshop Summary – Institute of Medicine – 13 April 2012

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“There is growing recognition that the United States’ clinical trials enterprise (CTE) faces great challenges. There is a gap between what is desired – where medical care is provided solely based on high quality evidence – and the reality – where there is limited capacity to generate timely and practical evidence for drug development and to support medical treatment decisions.

With the need for transforming the CTE in the U.S. becoming more pressing, the IOM Forum on Drug Discovery, Development, and Translation held a two-day workshop in November 2011, bringing together leaders in research and health care. The workshop focused on how to transform the CTE, and discussed a vision to make the enterprise more efficient, effective, and fully integrated into the health care system. Key issue areas addressed at the workshop included: the development of a robust clinical trials workforce, the alignment of cultural and financial incentives for clinical trials, and the creation of a sustainable infrastructure to support a transformed CTE. This document summarizes the workshop.”

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For the Public’s Health: Investing in a Healthier Future – Institute of Medicine – 10 April 2012

Posted on April 12, 2012. Filed under: Health Economics, Public Hlth & Hlth Promotion | Tags: |

For the Public’s Health: Investing in a Healthier Future – Institute of Medicine – 10 April 2012

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Briefing slides

Press release

Report brief

“The poor performance of the United States in life expectancy and other major health outcomes, as compared with its global peers reflects what the nation prioritizes in its health investments. It spends extravagantly on clinical care but meagerly on other types of population-based actions that influence health more profoundly than medical services. The health system’s failure to develop and deliver effective preventive strategies continues to take a growing toll on the economy and society.

In 2009, the IOM formed a committee to consider three topics related to population health: data and measurement, law and policy, and funding. In this final report, the IOM assesses both the sources and adequacy of current government public health funding and identifies approaches to building a sustainable and sufficient public health presence going forward, while recognizing the importance of the other actors in the health system, including clinical care, governmental public health, and others. In order for health outcomes to improve in the U.S., we will need to transform the way the nation invests in health to pay more attention to population-based prevention efforts; remedy the dysfunctional manner in which public health funding is allocated, structured and used; and ensure stable funding for public health departments.”

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Child Maltreatment Research, Policy, and Practice for the Next Decade – Workshop Summary – Institute of Medicine – 5 April 2012

Posted on April 10, 2012. Filed under: Child Health / Paediatrics | Tags: , |

Child Maltreatment Research, Policy, and Practice for the Next Decade – Workshop Summary – Institute of Medicine – 5 April 2012

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“In 1993, the National Research Council (NRC) released Understanding Child Abuse and Neglect, which highlighted child maltreatment as a devastating social problem in America. The report noted that abuse and neglect were the cause of thousands of child deaths each year, and research in the field of child maltreatment was relatively undeveloped. The services required for children who had been abused or neglected cost millions of dollars annually. To reduce the physical and emotional tolls of child maltreatment, the report called for a wide-ranging research program.

Nearly 20 years later, child maltreatment research has greatly expanded, however, many critical gaps in knowledge remain. On January 30-31, 2012, the IOM and NRC’s Board on Children, Youth, and Families held a workshop to review the accomplishments of the past two decades of research related to child maltreatment, identify remaining gaps, and consider potential research priorities. This document summarizes the workshop.”

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Building a Resilient Workforce: Opportunities for the Department of Homeland Security – Workshop Summary – Institute of Medicine – 9 April 2012

Posted on April 10, 2012. Filed under: Workforce | Tags: , |

Building a Resilient Workforce: Opportunities for the Department of Homeland Security – Workshop Summary – Institute of Medicine – 9 April 2012

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“Every job can lead to stress for a variety of reasons. How a person responds to stress in the workplace can be determined by the workplace environment. The Department of Homeland Security (DHS) has raised concerns that long-term exposures to stressors may reduce individual resilience and negatively affect employee’s physical and mental well-being. DHS employs a diverse staff that includes emergency responders, border patrol agents, federal airs marshals, and policy analysts.  These employees may be exposed to traumatic and disturbing information as part of their jobs. Additionally, many positions within DHS require employees to have a security clearance, which can make it difficult to seek assistance.

To explore DHS workforce resiliency, the IOM hosted two workshops in September and November 2011. The September workshop focused on DHS’s operational and law enforcement personnel, while the November workshop concentrated on DHS policy and program personnel with top secret security clearances. The workshop brought together an array of experts from various fields including resiliency research, occupation health psychology, and emergency response. This document summarizes the workshops.”

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Ensuring Safe Foods and Medical Products Through Stronger Regulatory Systems Abroad – Institute of Medicine – 4 April 2012

Posted on April 5, 2012. Filed under: Dietetics, Health Technology Assessment | Tags: |

Ensuring Safe Foods and Medical Products Through Stronger Regulatory Systems Abroad – Institute of Medicine – 4 April 2012

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“Whether it’s suspect scallions from Mexico or contaminated ingredients from China used in the blood thinner heparin, the FDA is intimately familiar with the daunting task of policing the safety of food and medical products faced by regulators abroad. The FDA is responsible for protecting American consumers from unsafe food, medicines, biologics, and medical products that originate from many different countries and are transported through complex supply chains. Almost 40 percent of the fruits and nuts and 85 percent of the seafood that Americans purchase come from aboard. More than 80 percent of active pharmaceutical ingredients are imported, and 40 percent of medicines are imported as finished products.

U.S. law requires drug manufactures to prove safety before the FDA permits sale of their products, however many regulatory agencies abroad lack the legal framework, funding, training, and oversight that have helped to transform the FDA into one of the world’s top-notch regulatory agencies. At the request of the FDA, the IOM formed a committee to identify the core elements of food, medicine, medical product, and biologics regulatory systems in developing countries; to pin-point the main gaps in these systems; and to design a strategy to leverage the expertise of the FDA and other stakeholders to strengthen regulatory systems abroad.”

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Country-Level Decision Making for Control of Chronic Diseases – Workshop Summary – Institute of Medicine – 2 April 2012

Posted on April 3, 2012. Filed under: Chronic Disease Mgmt, Health Policy, Preventive Healthcare | Tags: |

Country-Level Decision Making for Control of Chronic Diseases – Workshop Summary – Institute of Medicine – 2 April 2012

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“A 2010 IOM report, Promoting Cardiovascular Health in the Developing World, found that not only is it possible to reduce the burden of cardiovascular disease and related chronic diseases in developing countries, but also that such a reduction will be critical to achieving global health and development goals. One key step to achieving this outcome is to identify practical ways to assist low- and middle-income countries in improving control of chronic diseases through the approaches that are led by a country’s decision makers and stakeholders and that will be most appropriate, effective, and feasible based on a country’s circumstances.

As part a series of follow-up activities to the 2010 report, the IOM planned a workshop to explore ideas and opportunities for supporting country-specific assessment of resource needs and planning of resource allocation for chronic diseases as part of the broader process of priority setting, decision making, and planning. The workshop, held in July 2011, aimed to identify what is needed to create tools for country-led planning of effective, efficient, and equitable provision of programs to prevent and reduce the burden of chronic diseases. This document summarizes the workshop.”

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Epilepsy Across the Spectrum: Promoting Health and Understanding – Institute of Medicine – 30 March 2012

Posted on April 2, 2012. Filed under: Neurology | Tags: , |

Epilepsy Across the Spectrum: Promoting Health and Understanding – Institute of Medicine – 30 March 2012

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“Although epilepsy is one of the nation’s most common neurological disorders, public understanding of it is limited. Many people do not know the causes of epilepsy or what they should do if they see someone having a seizure. Epilepsy is a complex spectrum of disorders that affects an estimated 2.2 million Americans in a variety of ways, and is characterized by unpredictable seizures that differ in type, cause, and severity. Yet living with epilepsy is about much more than just seizures; the disorder is often defined in practical terms, such as challenges in school, uncertainties about social situations and employment, limitations on driving, and questions about independent living.

The IOM was asked to examine the public health dimensions of the epilepsies, focusing on public health surveillance and data collection; population and public health research; health policy, health care, and human services; and education for people with the disorder and their families, health care providers, and the public. The IOM makes recommendations ranging from the expansion of collaborative epilepsy surveillance efforts, to the coordination of public awareness efforts, to the engagement of people with epilepsy and their families in education, dissemination, and advocacy for improved care and services. Taking action across multiple dimensions will improve the lives of people with epilepsy and their families. The realistic, feasible, and action-oriented recommendations in this report can help enable short- and long-term improvements for people with epilepsy.”

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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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Safe and Effective Medicines for Children: Pediatric Studies Conducted Under BPCA and PREA – IOM – 29 February 2012

Posted on March 1, 2012. Filed under: Child Health / Paediatrics, Pharmacy | Tags: |

Safe and Effective Medicines for Children: Pediatric Studies Conducted Under BPCA and PREA – IOM – 29 February 2012

full text   Institute of Medicine

“Until 1997, most drugs used to treat children were tested for safety and effectiveness only in adults. It was then that Congress and the FDA created policies – including what are now the Best Pharmaceuticals for Children Act (BPCA) and the Pediatric Research Equity Act (PREA) – to encourage more pediatric studies of drugs used for children. The FDA asked the IOM to review aspects of pediatric studies and changes in product labeling that resulted from BPCA and PREA and their predecessor policies, as well as to assess the incentives for pediatric studies of biologics – drugs derived from human or animal sources, or microorganisms – and the extent to which biologics have been studied in children.

The IOM committee concludes that policies included in BPCA and PREA have helped provide clinicians who care for children with better information about the efficacy, safety, and appropriate prescribing of drugs. The IOM suggests that more can be done to increase knowledge about drugs used by children and thereby improve the clinical care, health, and well-being of the nation’s children.”

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Measuring Progress in Obesity Prevention – Workshop Report – Institute of Medicine – 23 February 2012

Posted on February 27, 2012. Filed under: Preventive Healthcare, Public Hlth & Hlth Promotion | Tags: , |

Measuring Progress in Obesity Prevention – Workshop Report – Institute of Medicine – 23 February 2012

Full text

“Nearly 69 percent of U.S. adults and 32 percent of children are either overweight or obese, creating an annual medical cost burden that may reach $147 billion. The physical environments and the kinds of foods available where people live and work, the marketing and media messages they receive, and the public policies that govern their lives all play a major role in their diets and physical activity levels. Researchers and policy makers are eager to identify improved measures of environmental and policy factors that contribute to obesity prevention.

The IOM formed the Committee on Accelerating Progress in Obesity Prevention to review the IOM’s past obesity-related recommendations, identify a set of recommendations for future action, and recommend indicators of progress in implementing these actions. The committee held a workshop in March 2011 about how to improve measurement of progress in obesity prevention. The workshop was an opportunity for the committee to discuss opportunities and challenges related to measurement and to hear from experts in relevant fields, including public health, economics, nutrition, media studies and communication, marketing, and public policy. This document summarizes the workshop.”

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Alzheimer’s Diagnostic Guideline Validation: Exploration of Next Steps – Workshop Summary – Institute of Medicine – 16 February 201

Posted on February 17, 2012. Filed under: Aged Care / Geriatrics | Tags: , |

Alzheimer’s Diagnostic Guideline Validation: Exploration of Next Steps – Workshop Summary – Institute of Medicine – 16 February 2012

full text

“The diagnostic guidelines for Alzheimer’s disease most widely used today were proposed more than 25 years ago. At the time, there was a sense that Alzheimer’s disease was a binary condition. However, scientific advances over the last decade now indicate that Alzheimer’s is a continuous, progressive cognitive disease, most likely beginning asymptomatically many years before dementia is apparent. To reflect this change, revisions to the diagnostic guidelines were proposed in 2007 by the International Working Group and in 2011 by working groups convened by the National Institute on Aging and the Alzheimer’s Association.

On July 18, 2011, the IOM Forum on Neuroscience and Nervous System Disorders hosted a public workshop session at the Alzheimer’s Association International Conference. The session brought together stakeholders to discuss next steps in the validation of these new diagnostic guidelines for Alzheimer’s disease. This document summarizes the workshop.”

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Living Well with Chronic Illness: A Call for Public Health Action – Institute of Medicine – 31 January 2012

Posted on February 3, 2012. Filed under: Chronic Disease Mgmt, Public Hlth & Hlth Promotion | Tags: |

Living Well with Chronic Illness: A Call for Public Health Action – Institute of Medicine – 31 January 2012

full text
media report 

“The epidemic of chronic illness – which represents 75 percent of the $2 trillion in annual U.S. health care spending – is steadily moving toward crisis proportions, yet maintaining or enhancing quality of life for individuals living with these illnesses has not been given the attention it deserves. Longevity is no longer the only goal as more focus is placed on living a long and healthy life.

The CDC and the nonprofit Arthritis Foundation asked the IOM to help identify ways to reduce disability and improve the function and quality of life for people living with chronic illness. The report lays out a comprehensive framework intended as a guide to develop and implement cross-cutting strategies that reduce the individual and societal burdens of chronic illness by helping people with chronic illnesses live well. The IOM makes recommendations to the CDC as well as HHS on the development and support of programs to meet the health and social needs of people living with chronic illnesses.”

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Barriers to Integrating Crisis Standards of Care Principles into International Disaster Response Plans – Workshop Summary – Institute of Medicine – 23 January 2012

Posted on January 27, 2012. Filed under: Disaster Management | Tags: |

Barriers to Integrating Crisis Standards of Care Principles into International Disaster Response Plans – Workshop Summary – Institute of Medicine – 23 January 2012

“When a nation or region prepares for public health emergencies such as a pandemic influenza, a large-scale earthquake, or any major disaster scenario in which the health system may be destroyed or stressed to its limits, it is important to describe how standards of care would change due to shortages of critical resources. Crisis standards of care can be defined as the level of health and medical care capable of being delivered during a catastrophic event. Nations and regions need a robust system to provide information to those who are involved in catastrophic events.

At the 17th World Congress on Disaster and Emergency Medicine, held May 31-June 3, 2011, in Beijing, the IOM Forum on Medical and Public Health Preparedness sponsored a session that focused on the promise of and challenges to integrating crisis standards of care principles into international disaster response plans. This document summarizes the workshop.”

 

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IOM Partners in ‘The Weight of the Nation,’ A New National Initiative to Engage Individuals, Communities in Confronting Obesity Crisis – 2012

Posted on January 18, 2012. Filed under: Preventive Healthcare | Tags: , |

IOM Partners in ‘The Weight of the Nation,’ A New National Initiative to Engage Individuals, Communities in Confronting Obesity Crisis

Text taken from an email alert from the Institute of Medicine

“As obesity continues to diminish the quality of people’s lives and raise health care costs, the Institute of Medicine is pleased to join HBO, the Centers for Disease Control and Prevention (CDC), the National Institutes of Health (NIH), the Michael & Susan Dell Foundation, and Kaiser Permanente in developing “The Weight of the Nation,” a new national campaign tackling the obesity crisis.

The Weight of the Nation will shed new light on the facts and myths of this urgent public health issue and explore how obesity is impacting our nation and the health care system. This multipronged project will feature a series of four documentary films, a three-part HBO Family series, 14 bonus short films, a social media campaign, a companion book, and a nationwide community-based outreach campaign. The four-part documentary series — which HBO announced will air May 14 and 15 — and other facets of the initiative were developed with expert input from IOM as well as CDC and NIH.”

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Sex-Specific Reporting of Scientific Research – Workshop Summary – Institute of Medicine – 13 January 2012

Posted on January 16, 2012. Filed under: Research | Tags: |

Sex-Specific Reporting of Scientific Research – Workshop Summary – Institute of Medicine – 13 January 2012

Full text online 

“In 2010, the IOM released a report that found that, among other things, data not being reported by sex had slowed progress in women’s health. The number of women participating in clinical trials has increased over the last two decades, though they are still underrepresented. Even when women are included in these trials, however, the results are often not analyzed separately by sex.

On August 30, 2011, the IOM’s Board on Population Health and Public Health Practice hosted a workshop to address the recommendation in Women’s Health Research: Progress, Pitfalls, and Promise that journals should adopt a guideline that, where appropriate, articles report the outcomes of clinical trials report on men and women separately. The workshop focus went beyond clinical trials, to look at sex-specific reporting in all types of scientific research. Speakers at the workshop discussed the need for sex-specific reporting, potential barriers to such reporting, as well as what must be done to report sex-specific results. This document summarizes the workshop.”

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Strengthening a Workforce for Innovative Regulatory Science in Therapeutics Development – Workshop Summary – Institute of Medicine – 21 December 2011

Posted on January 3, 2012. Filed under: Health Technology Assessment, Workforce | Tags: |

Strengthening a Workforce for Innovative Regulatory Science in Therapeutics Development – Workshop Summary – Institute of Medicine – 21 December 2011

Full text 

“The development and application of regulatory science – which FDA has defined as the science of developing new tools, standards, and approaches to assess the safety, efficacy, quality, and performance of FDA-regulated products – calls for a well-trained, scientifically engaged, and motivated workforce. FDA faces challenges in retaining these regulatory scientists and providing them with opportunities for professional development. In the private sector, advancement of innovative regulatory science in drug development has not always been clearly defined, well coordinated, or connected to the needs of the agency. Moreover, resource constraints and an increasingly complex workload make it difficult for FDA scientists to interact with other scientists and enhance their scientific knowledge base. Several barriers to the advancement of regulatory science have been identified – including workforce and resource constraints in all sectors, systemic barriers to collaboration and scientific exchange, and deficiencies in the regulatory science infrastructure.

In 2010, the IOM’s Forum on Drug Discovery, Development, and Translation held a workshop that examined the state of regulatory science and considered approaches to enhance it. As a follow-up to that workshop, the Forum held a workshop on September 20-21, 2011, to provide a format for establishing a specific agenda to implement the vision and principles relating to a regulatory science workforce and infrastructure as discussed in the 2010 workshop. At the workshop, speakers considered opportunities and needs for advancing innovation in the discipline of regulatory science for therapeutics development through an interdisciplinary regulatory science workforce and examined specific strategies for developing a discipline of innovative regulatory science through the development of a robust workforce within academia and industry and at FDA. This document summarizes the workshop.”

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Scientific Standards for Studies on Modified Risk Tobacco Products – Institute of Medicine – 14 December 2011

Posted on December 15, 2011. Filed under: Public Hlth & Hlth Promotion | Tags: , |

Scientific Standards for Studies on Modified Risk Tobacco Products – Institute of Medicine – 14 December 2011

Full text of the report

“Tobacco use is the leading cause of preventable death and disease in the U.S. Smoking leads to approximately 443,000 premature deaths each year, and smoking-related diseases kill more Americans than alcohol, illegal drugs, murder, and suicide combined. The passage of the Family Smoking Prevention and Tobacco Control Act of 2009 (FSPTCA) granted the FDA broad authority to regulate the manufacturing, distribution, and marketing of tobacco products. It also gave the FDA authority to regulate “modified risk tobacco products” (MRTPs), tobacco products that are either designed or advertised to reduce harm or the risk of tobacco-related disease. In order to market an MRTP, manufacturers must submit to the FDA scientific evidence to demonstrate the product has the potential to reduce tobacco related harms as compared to conventional tobacco products.

At the request of the FDA, the IOM formed a committee to identify minimum standards for scientific studies that an applicant would need to complete to obtain an order to market the product from the FDA. It concludes that the public health standard in the FSPTCA will require a wide range of scientific evidence including the composition and performance of the MRTP, perceptions about the risks and benefits of the MRTP, the addictive potential of the MRTP, and its human health effects. The FDA will need to issue guidance and regulation on the types, design, conduct, analysis, reporting, and governance of studies about MRTPs. The IOM’s recommendations are designed to help the FDA ensure that its evaluation of MRTPs is systematic and founded on evidence, resulting in products that not only reduce risk compared with conventional tobacco products, but also reduce the rates of tobacco-related harm across the country.”

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Allied Health Workforce and Services – Workshop Summary – Institute of Medicine [US] – 8 December 2011

Posted on December 9, 2011. Filed under: Allied Health, Workforce | Tags: |

Allied Health Workforce and Services – Workshop Summary – Institute of Medicine [US] – 8 December 2011 

Full text 

“The demand for health care is growing as the nation ages and seeks to provide coverage for the millions of Americans who lack health insurance. At the same time, escalating costs have led to a variety of initiatives to make the delivery of health care more effective and efficient. The allied health workforce is critical to the success of these efforts. The allied health workforce includes thousands of professionals employed in many different professions with different job duties and different amounts of education and training, but there is no single definition for allied health or list of allied health occupations.

Given the importance of allied health, particularly in light of health care reform, the IOM held a workshop May 9-10, 2011, to examine the current allied health care workforce and consider how it can contribute to improving health care access, quality, and effectiveness. Among other topics, speakers at the workshop examined the following questions:

What is allied health, and who is part of that workforce?
What workforce strategies could improve access to select allied health services?
How can policy makers, state and federal government, and allied health care providers improve the regulations and structure?

This document summarizes the workshop.”

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Breast Cancer and the Environment: A Life Course Approach – Institute of Medicine – 7 December 2011

Posted on December 8, 2011. Filed under: Oncology | Tags: |

Breast Cancer and the Environment: A Life Course Approach – Institute of Medicine – 7 December 2011

full text of the report 

“With more than 230,000 new cases of breast cancer expected to be diagnosed in the United States in 2011, many wonder about the role that environmental exposures may be playing. Susan G. Komen for the Cure® asked the IOM to review the current evidence on breast cancer and the environment, consider gene–environment interactions, review the research challenges, explore evidence-based actions that women might take to reduce their risk, and recommend directions for future research. Overall, the IOM finds that major advances have been made in understanding breast cancer and its risk factors, but more needs to be learned about its causes and how to prevent it. The report urges a life-course approach to studying breast cancer because new information suggests that women and girls might be more susceptible to some risk factors during certain life stages.

The committee defined “environment” broadly, and reviewed evidence on a range of factors women encounter in their daily lives. Of the environmental factors reviewed, those with the most consistent evidence of a link with increased breast cancer risk included ionizing radiation, combination estrogen-progestin hormone therapy, and greater postmenopausal weight. More physical activity was linked to reduced risk. But for many other factors, the evidence from human studies is more limited, contradictory, or absent.

The IOM concludes that women may have some opportunities to reduce their risk of breast cancer through personal actions, such as avoiding unnecessary medical radiation throughout life, avoiding use of estrogen –progestin hormone therapy, avoiding smoking, limiting alcohol consumption, increasing physical activity, and, for postmenopausal breast cancer, minimizing weight gain. In addition to applying a life-course approach to studies of breast cancer, research recommendations include developing improved tools for epidemiologic research and testing of chemicals and other substances, developing effective preventive interventions, developing better approaches to modeling breast cancer risks, and improving communication about breast cancer risks. Questions about the topics addressed in the report are explored in the Questions and Answers booklet.”

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Information Sharing and Collaboration: Applications to Integrated Biosurveillance – Workshop Summary – Institute of Medicine – 30 November 2011

Posted on December 1, 2011. Filed under: Disaster Management, Health Informatics | Tags: , |

Information Sharing and Collaboration: Applications to Integrated Biosurveillance – Workshop Summary – Institute of Medicine – 30 November 2011

full text 

“After the September 11, 2001, terrorist attacks and subsequent anthrax mailings, the U.S. government prioritized a biosurveillance strategy aimed at detecting, monitoring, and characterizing national security health threats in human and animal populations, food, water, agriculture, and the environment. A variety of agencies share biosurveillance responsibilities, and efforts have been made to improve national biosurveillance through data exchanges and collaboration. However, gaps and challenges in biosurveillance efforts and integration of biosurveillance activities remain.

September 8-9, 2011, the IOM held a workshop to explore the information-sharing and collaboration processes needed for the nation’s integrated biosurveillance strategy. Presenters at the workshop

examined the strengths and limitations of different models of information analysis, control, and distribution;
considered examples and lessons learned from other similar information sharing collaborations;
explored approaches to developing an effective and sustainable concept of operations that includes join rules, procedures, and performance measures; and
illustrated the value added in collaboration through scenarios and real-life examples.

This document summarizes the workshop.”

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Integrating Large-Scale Genomic Information into Clinical Practice: Workshop Summary – Institute of Medicine – 2011

Posted on November 15, 2011. Filed under: Genomics | Tags: |

Integrating Large-Scale Genomic Information into Clinical Practice: Workshop Summary – Institute of Medicine – 2011

ISBN-10: 0-309-22034-3     ISBN-13: 978-0-309-22034-7

“The initial sequencing of the human genome, carried out by an international group of experts, took 13 years and $2.7 billion to complete. In the decade since that achievement, sequencing technology has evolved at such a rapid pace that today a consumer can have his or her entire genome sequenced by a single company in a matter of days for less than $10,000, though the addition of interpretation may extend this timeframe. Given the rapid technological advances, the potential effect on the lives of patients, and the increasing use of genomic information in clinical care, it is important to address how genomics data can be integrated into the clinical setting. Genetic tests are already used to assess the risk of breast and ovarian cancers, to diagnose recessive diseases such as cystic fibrosis, to determine drug dosages based on individual patient metabolism, and to identify therapeutic options for treating lung and breast tumors, melanoma, and leukemia.

With these issues in mind and considering the potential impact that genomics information can have on the prevention, diagnosis, and treatment of disease, the Roundtable on Translating Genomic-Based Research for Health hosted a workshop on July 19, 2011, to highlight and identify the challenges and opportunities in integrating large-scale genomic information into clinical practice.

Integrating Large-Scale Genomic Information into Clinical Practice summarizes the speaker presentations and the discussions that followed them. This report focuses on several key topics, including the analysis, interpretation, and delivery of genomic information plus workforce, ethical, and legal issues.”

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Improving Health Literacy Within a State – Workshop Summary – Institute of Medicine – 14 November 2011

Posted on November 15, 2011. Filed under: Patient Participation | Tags: , |

Improving Health Literacy Within a State – Workshop Summary – Institute of Medicine – 14 November 2011

“Nearly half of all American adults lack health literacy – an individual’s ability to obtain, process, and understand basic health information.

In order to improve knowledge among these 90 million people, the IOM’s Roundtable on Health Literacy, along with the UCLA Anderson School of Management, held a workshop on November 30, 2010, to explore ways in which state-based organizations and individuals can work to improve health literacy. At the workshop, speakers discussed the clinical effects of health literacy improvement efforts, the economic outcomes of health literacy implementation, and the impact that various stakeholders can have on health literacy.

The roundtable brings together leaders from the federal government, foundations, health plans, associations, and private companies to discuss challenges related to health literacy and to identify approaches to promote health literacy in both the public and private sectors. This document summarizes the workshop.”

Full text

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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

full text 

“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 Common Rule and Continuous Improvement in Health Care: A Learning Health System Perspective – Institute of Medicine Discussion Paper – October 2011

Posted on November 1, 2011. Filed under: Clin Governance / Risk Mgmt / Quality | Tags: , , , |

The Common Rule and Continuous Improvement in Health Care: A Learning Health System Perspective – Institute of Medicine Discussion Paper – October 2011

Harry Selker, Claudia Grossmann, Alyce Adams, Donald Goldmann, Christopher Dezii, Gregg Meyer, Veronique Roger, Lucy Savitz and Richard Platt

Working Group participants drawn from the Clinical Effectiveness Research Innovation Collaborative of the IOM Roundtable on Value & Science-Driven Health Care

“Abstract

To generate needed improvements in healthcare, its delivery, and its outcomes, organized and sustained efforts at continuous improvement are needed. The Institute of Medicine’s Roundtable on Value & Science-Driven Health Care has developed the vision of a healthcare system that gets the right care to the right people when they need it, and captures the results for making improvements: a learning health system. The Roundtable sees the creation of generalizable new knowledge as a necessary, routine aspect of the delivery of healthcare. Activities that involve measurement, comparison, evaluation, systematic introduction of accepted therapies, sharing of experience and information, and coordination of these activities among organizations, either are, or should become, normal expected activities of such organizations.”  … continues on the site

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Social and Economic Costs of Violence: Workshop Summary – Institute of Medicine – October 2011

Posted on October 26, 2011. Filed under: Violence | Tags: |

Social and Economic Costs of Violence: Workshop Summary – Institute of Medicine – October 2011
ISBN-10: 0-309-22024-6     ISBN-13: 978-0-309-22024-8

“Measuring the social and economic costs of violence can be difficult, and most estimates only consider direct economic effects, such as productivity loss or the use of healthcare services. Communities and societies feel the effects of violence through loss of social cohesion, financial divestment, and the increased burden on the healthcare and justice systems. Initial estimates show that early violence prevention intervention has economic benefits. The IOM Forum on Global Violence Prevention held a workshop to examine the successes and challenges of calculating direct and indirect costs of violence, as well as the potential cost-effectiveness of intervention.”

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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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Patients Charting the Course: Citizen Engagement in the Learning Health System – Workshop Summary – Institute of Medicine – 3 October 2011

Posted on October 4, 2011. Filed under: Patient Participation | Tags: |

Patients Charting the Course: Citizen Engagement in the Learning Health System – Workshop Summary – Institute of Medicine – 3 October 2011

“As past, current, or future patients, the public should be the health care system’s unwavering focus and serve as change agents in its care. Taking this into account, the quality of health care should be judged not only by whether clinical decisions are informed by the best available scientific evidence, but also by whether care is tailored to a patient’s individual needs and perspectives. However, too often it is provider preference and convenience, rather than those of the patient, that drive what care is delivered.

As part of its Learning Health System series of workshops, the Roundtable on Value & Science-Driven Health Care hosted a workshop to assess the prospects for improving health and lowering costs by advancing patient involvement in the elements of a learning health system. This publication of the discussions, Patients Charting the Course: Citizen Engagement and the Learning Health System, underscores the centrality of communication strategies that account for and engage individual perspectives, needs, preferences, understanding, and support necessary to mobilize change.”

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Prepositioning Antibiotics for Anthrax – Institute of Medicine – 30 September 2011

Posted on October 3, 2011. Filed under: Disaster Management, Infection Control, Infectious Diseases | Tags: , |

Prepositioning Antibiotics for Anthrax – Institute of Medicine – 30 September 2011

“If terrorists released Bacillus anthracis over a large city, hundreds of thousands of people could be at risk of the deadly disease anthrax – caused by the B anthracis spores – unless they had rapid access to antibiotic medical countermeasures (MCM). The spores can be inhaled, be ingested, or come into contact with the skin. Inhalational anthrax is considered the most severe bioterrorism threat because the spores can travel significant distances through the air, and it has the highest mortality rate – approaching 100 percent if untreated. Although plans for rapidly delivering MCM to a large number of people following an anthrax attack have been significantly enhanced over the last decade, many public health authorities and policy experts fear that the nation’s current systems and plans are insufficient to respond to the most challenging scenarios, such as a very large-scale anthrax attack or an attack on multiple cities.

The U.S. Department of Health and Human Services’ Office of the Assistant Secretary for Preparedness and Response commissioned the IOM to examine the potential uses, benefits, and disadvantages of strategies for prepositioning antibiotics. This involves storing antibiotics close to or in the possession of the people who would need rapid access to them should an attack occur. The IOM defined and evaluated three categories of prepositioning strategies that could complement existing, centralized stockpiling strategies, including the Strategic National Stockpile maintained by the Centers for Disease Control and Prevention:

Forward-Deployed MCM: MCM stored near the locations from which they will be dispensed
Cached MCM: MCM stored at the locations from which they will be dispensed, such as workplaces and health care facilities
Predispensed MCM: MCM stored by the intended users

While prepositioning strategies have the potential to reduce the time between an anthrax attack and when an individual receives antibiotics, this potential benefit should be weighed against increased costs of associated with prepositioning strategies, a lower degree of flexibility to change plans following an attack if needed, and possible health risks involved with home antibiotic storage. The IOM committee developed a decision-aiding framework to help state, local, and tribal health officials determine which prepositioning strategies—if any—would benefit their communities.”

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Incorporating Occupational Information in Electronic Health Records: Letter Report – Institute of Medicine – 30 September 2011

Posted on October 3, 2011. Filed under: Health Informatics, Medical Records, Occupational Hlth Safety | Tags: , |

Incorporating Occupational Information in Electronic Health Records: Letter Report – Institute of Medicine – 30 September 2011

“Each year in the United States, more than 4,000 occupational fatalities and more than 3 million occupational injuries occur along with more than 160,000 cases of occupational illnesses. The use of electronic health records (EHRs) has increased rapidly since the passage of the 2009 Health Information Technology for Economic and Clinical Health (HITECH) Act. Incorporating patients’ occupational information into EHRs could lead to more informed clinical diagnosis and treatment plans as well as more effective policies, interventions, and prevention strategies to improve the overall health of the working population.

At the request of the National Institute for Occupational Safety and Health, the IOM appointed a committee to examine the rationale and feasibility of incorporating occupational information in patients’ EHRs. The committee focused on the potential benefits of the inclusion of occupational information to individual and public health, current systems that use this information, and technical barriers to incorporating occupational information into the EHR. The IOM concluded that three data elements – occupation, industry, and work-relatedness – were ready for immediate focus. To incorporate these data into EHRs, recommendations were made that include assessment of data collection and incorporation, requirements for storing and communicating occupational information, development of metrics and performance measures, and assessment of privacy concerns, among others.”

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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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Fungal Diseases: An Emerging Threat To Human, Animal, and Plant Health – Institute of Medicine Workshop Summary – Released 9 September 2011

Posted on September 12, 2011. Filed under: Infectious Diseases | Tags: |

Fungal Diseases: An Emerging Threat To Human, Animal, and Plant Health – Institute of Medicine Workshop Summary – Released 9 September 2011
Full text on National Academies Press 

“Fungal organisms are indispensible members of virtually all ecosystems and the “invisible” shapers of the world around us. They comprise one of the most diverse kingdoms in the Tree of Life, yet fewer than 10 percent of fungal organisms have been formally classified. Fungal diseases have contributed to death and disability in humans, triggered global wildlife extinctions and population declines, devastated agricultural crops, and altered forest ecosystem dynamics. Despite the extensive influence of fungi on health and economic well-being, the threats posed by emerging fungal pathogens to life on Earth are often underappreciated and poorly understood.

On December 14 and 15, 2010, the IOM’s Forum on Microbial Threats hosted a public workshop to explore the scientific and policy dimensions associated with the causes and consequences of emerging fungal diseases. Participants discussed factors influencing the emergence, establishment, and spread of fungal pathogens; the effects of these diseases on human and animal health, agriculture, and biodiversity; and opportunities to improve surveillance, detection, and response strategies for these diseases.”

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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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Leveraging Food Technology for Obesity Prevention and Reduction Effort – Institute of Medicine Workshop Summary – 27 July 2011

Posted on August 1, 2011. Filed under: Dietetics, Preventive Healthcare, Public Hlth & Hlth Promotion | Tags: , |

Leveraging Food Technology for Obesity Prevention and Reduction Effort – Institute of Medicine Workshop Summary – 27 July 2011

Full text

 “We make over 200 food-related decisions each day, and our complex eating behaviors  have multiple layers of influence. Eating is affected by the physiological responses that occur when we are in the presence of food as well as societal norms and values around portion size and eating behaviors. With more than one-third of the U.S. adult population considered obese, behavioral scientists have emphasized building an evidence base for understanding what drives the energy imbalance – particularly with regard to portion size, energy density, and satiety – in overweight and obese individuals. Food scientists have been using this evidence base to improve existing technologies and create new technologies that can enhance the healthfulness of the food supply. For example, scientists have created fat- and sugar-reducing technologies, multiple baking technologies, and fat replacement technologies through the incorporation of fiber to reduce the energy density of foods. Other technologies, such as portion-controlled frozen meals or snacks and  technologies that increase fruit and vegetable intake, also have been developed in an effort to reduce and prevent obesity.

The IOM’s Food Forum held a public workshop November 2 -3, 2010, in Washington, DC, to examine the complexity of human eating behavior and explore ways in which the food industry can continue to leverage modern and innovative food processing technologies to influence energy intake as one method to reduce and prevent obesity. Speakers discussed the associations between certain eating behaviors and weight gain as well as the opportunities and challenges of altering the food in homes and restaurants in order to reduce overeating. This document summarizes the workshop.”

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Medical Devices and the Public’s Health: The FDA 510(k) Clearance Process at 35 Years – 29 July 2011

Posted on August 1, 2011. Filed under: Health Technology Assessment | Tags: , |

Medical Devices and the Public’s Health: The FDA 510(k) Clearance Process at 35 Years – 29 July 2011

Full text

“Medical devices play a critical role in the health care of Americans. They can range from simple tools, such as tongue depressors and bandages, to complex or life-saving equipment, such as pacemakers, magnetic resonance imaging machines, and heart–lung machines. The Federal Food, Drug, and Cosmetic Act (FFDCA) requires a “reasonable assurance of safety and effectiveness” before a device can be marketed, and the U.S. Food and Drug Administration (FDA) is responsible for enforcing this requirement. Devices that are deemed to have a moderate risk to patients generally cannot go on the market until they are cleared through the 510(k) process, named for Section 510(k) of the FFDCA.  Some policymakers and patients have expressed concern about the ability of the 510(k) process to ensure that medical devices on the market are safe and effective. Other policymakers and patients, as well as the medical-device industry, have asserted that the process has become too burdensome and time-consuming and that it is delaying important new medical devices from entering the market.

The FDA turned to the IOM to review the 510(k) process and answer two questions:

Does the current 510(k) process protect patients optimally and promote innovation in support of public health?
If not, what legislative, regulatory, or administrative changes are recommended to achieve the goals of the 510(k) process optimally
The IOM finds that the current 510(k) process is flawed based on its legislative foundation. Rather than continuing to modify the 35-year-old 510(k) process, the IOM concludes that the FDA’s finite resources would be better invested in developing an integrated premarket and postmarket regulatory framework that provides a reasonable assurance of safety and effectiveness throughout the device life cycle. The IOM outlines its criteria for this framework in the report.”

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Learning What Works: Infrastructure Required for Comparative Effectiveness Research – Institute of Medicine Workshop Summary – 25 July 2011

Posted on July 26, 2011. Filed under: Evidence Based Practice | Tags: , , |

Learning What Works: Infrastructure Required for Comparative Effectiveness Research – Institute of Medicine Workshop Summary – 25 July 2011

Full text

“Evidence is the cornerstone of a high-performing healthcare system. It is essential for patients and clinicians to know which treatments work best for whom if they are to make informed, collaborative care decisions. Despite this need, only a small fraction of health-related expenditures in the U.S. have been devoted to comparative effectiveness research. Recent activities—such as the creation of the Patient-Centered Outcomes Research Institute—are beginning to address this shortfall, bringing the importance of clinical research and evidence development to the forefront of health policy discussions.

As part of its Learning Health System series of workshops, the IOM’s Roundtable on Value & Science-Driven Health Care hosted a workshop to discuss capacity priorities to build the evidence base necessary for care that is more effective and delivers higher value for patients. Participants explored issues such as; data linkage and improvement; study coordination and results dissemination; research methods innovation; and the training and size of the workforce, all as they relate to improved medical decision making.”

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A Nationwide Framework for Surveillance of Cardiovascular and Chronic Lung Diseases – Institute of Medicine – released 22 July 2011

Posted on July 25, 2011. Filed under: Cardiol / Cardiothor Surg, Chronic Disease Mgmt, Health Status, Public Hlth & Hlth Promotion, Respiratory Medicine | Tags: |

A Nationwide Framework for Surveillance of Cardiovascular and Chronic Lung Diseases – Institute of Medicine – released 22 July 2011
full text

“Chronic diseases, such as cardiovascular disease and chronic lung disease, are common and costly, yet they also are among the most preventable health problems. Surveillance systems focused on chronic diseases have a potentially key role in reducing this health toll. Currently, surveillance data are collected from a variety of sources, often with beneficial results. But a critical link is missing: There is no surveillance system that operates on a national basis and in a coordinated manner to integrate current and emerging data on chronic diseases and generate timely guidance for stakeholders at the local, state, regional, and national levels. To help close this gap, two federal health agencies—the National Heart, Lung, and Blood Institute of the National Institutes of Health, and the Division for Heart Disease and Stroke Prevention of the Centers for Disease Control and Prevention—asked the IOM to develop a framework for building a national chronic disease surveillance system focused primarily on cardiovascular and chronic lung disease.

In this report, the IOM presents a conceptual framework for national surveillance of cardiovascular and chronic lung disease and calls on the Department of Health and Human Services (HHS) to adopt it. The IOM recommends that HHS take the lead in overseeing and coordinating development and implementation efforts of a national surveillance system using this framework. In its design, HHS should work to develop a system that can provide various types of data that individually and collectively can be used to understand the continuum of disease prevention, progression, treatment, and outcomes. Without a national surveillance system, the gaps in current monitoring approaches will continue to exist, making it more difficult to track the nation’s health status despite advances in technology and data collection. The framework put forth by the IOM not only could help with tracking and monitoring cardiovascular and chronic lung disease but might well become a building block for an integrated surveillance system for the broad spectrum of chronic diseases.”

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Implementing a National Cancer Clinical Trials System for the 21st Century – Institute of Medicine Workshop Summary – released 22 July 2011

Posted on July 25, 2011. Filed under: Oncology, Research | Tags: |

Implementing a National Cancer Clinical Trials System for the 21st Century – Institute of Medicine Workshop Summary – released 22 July 2011
Full text

“The Clinical Trials Cooperative Group Program, supported by the National Cancer Institute (NCI), works to advance patient care and research through studies of new cancer treatments, methods of cancer prevention and early detection, and rehabilitation during and after treatment. According to the 2010 IOM report A National Clinical Trials System for the 21st Century: Reinvigorating the NCI Cooperative Group Program, the Cooperative Groups’ research has significantly improved cancer prevention and treatment measures. Currently, the Group involves more than 3,100 institutions and 14,000 investigators who enroll more than 25,000 patients in clinical trials each year. Despite such broad participation, the Cooperative Group Program’s ability to undertake medical practice-changing clinical trials is threatened by declining funding, inefficient processes, and extensive government oversight.

The IOM’s National Cancer Policy Forum and the American Society of Clinical Oncology held a workshop on March 21, 2011, in Washington, DC, to pursue ways to achieve the goals and implement the recommendations from the 2010 IOM report. Speakers discussed how to work toward the report’s goal of increasing the efficiency and productivity of the clinical trials system. The workshop included panels on a variety of topics, such as efforts to consolidate the existing Cooperative Groups, public-private collaboration, funding, and ensuring broad involvement of patients and healthcare providers in the clinical trials system. This document summarizes the workshop.”

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Clinical Preventive Services for Women: Closing the Gaps – Institute of Medicine – 19 July 2011

Posted on July 20, 2011. Filed under: Preventive Healthcare, Public Hlth & Hlth Promotion | Tags: |

Clinical Preventive Services for Women: Closing the Gaps – Institute of Medicine – 19 July 2011
Full text

“As a centerpiece of the Patient Protection and Affordable Care Act (ACA) of 2010, the focus on preventive services is a profound shift from a reactive system that primarily responds to acute problems and urgent needs to one that helps foster optimal health and well-being. The ACA addresses preventive services for both men and women of all ages, and women in particular stand to benefit from additional preventive health services. The inclusion of evidence-based screenings, counseling and procedures that address women’s greater need for services over the course of a lifetime may have a profound impact for individuals and the nation as a whole.

Given the magnitude of change, the U.S. Department of Health and Human Services charged the IOM with reviewing what preventive services are important to women’s health and well-being and then recommending which of these should be considered in the development of comprehensive guidelines. The IOM defined preventive health services as measures—including medications, procedures, devices, tests, education and counseling—shown to improve well-being, and/or decrease the likelihood or delay the onset of a targeted disease or condition. The IOM recommends that women’s preventive services include:”   … continues on the site

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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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Engineering a Learning Healthcare System: A Look at the Future – Workshop Summary – Institute of Medicine – 8 July 2011

Posted on July 11, 2011. Filed under: Health Systems Improvement | Tags: , |

Engineering a Learning Healthcare System: A Look at the Future – Workshop Summary – Institute of Medicine – 8 July 2011

full text 

“Lessons from engineering have the potential to improve both the efficiency and quality of healthcare delivery.  The fundamental notion of a high-performing healthcare system—one that increasingly is more effective, more efficient, safer, and higher quality—is rooted in continuous improvement principles that medicine shares with engineering. As technological advances and new insights into disease and individual variation increase the complexity of medicine, progress will depend on the ability to design healthcare delivery systems in which all of the components are coordinated, streamlined, efficient, and seamlessly interfaced.

As part of its Learning Health System series of workshops, the IOM’s Roundtable on Value & Science-Driven Health Care hosted a workshop, jointly with the National Academy of Engineering, on lessons from systems and operations engineering that could be applied to the organization, structure, and function of health care delivery, monitoring, and change processes. Participant discussions on the promise of, and actions necessary to implement, engineering approaches to healthcare systems improvement are summarized in this report.”

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Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research – Institute of Medicine – 29 June 2011

Posted on June 30, 2011. Filed under: Anaesthesiology, Chronic Disease Mgmt | Tags: , |

Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research – Institute of Medicine – 29 June 2011

full text 

“Chronic pain affects an estimated 116 million American adults—more than the total affected by heart disease, cancer, and diabetes combined. Pain also costs the nation up to $635 billion each year in medical treatment and lost productivity. The 2010 Patient Protection and Affordable Care Act required the Department of Health and Human Services (HHS) to enlist the IOM in examining pain as a public health problem.

In this report, the IOM offers a blueprint for action in transforming prevention, care, education, and research, with the goal of providing relief for people with pain in America. To reach the vast multitude of people with various types of pain, the nation must adopt a population-level prevention and management strategy. The IOM recommends that HHS develop a comprehensive plan with specific goals, actions, and timeframes. Better data are needed to help shape efforts, especially on the groups of people currently underdiagnosed and undertreated, and the IOM encourages federal and state agencies and private organizations to accelerate the collection of data on pain incidence, prevalence, and treatments. Because pain varies from patient to patient, healthcare providers should increasingly aim at tailoring pain care to each person’s experience, and self-management of pain should be promoted. In addition, because there are major gaps in knowledge about pain across health care and society alike, the IOM recommends that federal agencies and other stakeholders redesign education programs to bridge these gaps. Pain is a major driver for visits to physicians, a major reason for taking medications, a major cause of disability, and a key factor in quality of life and productivity. Given the burden of pain in human lives, dollars, and social consequences, relieving pain should be a national priority.”

 

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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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Early Childhood Obesity Prevention Policies – Institute of Medicine – 23 June 2011

Posted on June 24, 2011. Filed under: Child Health / Paediatrics, Preventive Healthcare | Tags: , |

Early Childhood Obesity Prevention Policies – Institute of Medicine – 23 June 2011
Full text  
 
“Even the youngest children in the United States are at risk of becoming obese. Today, almost 10 percent of infants and toddlers carry excess weight for their length, and slightly more than 20 percent of children between the ages of two and five are already overweight or obese. Because early obesity can track into adulthood, efforts to prevent obesity should begin long before a child enters school.

The IOM reviewed factors related to overweight and obesity from birth to age five, with a focus on nutrition, physical activity, and sedentary behavior. In this report, the IOM recommends actions that healthcare professionals, caregivers, and policymakers can take to prevent obesity in children five and younger. Pediatricians and other healthcare professionals have an important opportunity to make parents aware of their child’s excess weight early on, and the IOM recommends that healthcare professionals measure weight and height or length in a standardized way, as well as pay attention to obesity risk factors, such as rate of weight gain and parental weight, at routine pediatric visits. In addition, the IOM recommends that parents and child care providers keep children active throughout the day and provide them with diets rich in fruits, vegetables, and whole grains, and low in energy-dense, nutrient-poor foods. Caregivers also should limit young children’s screen time and ensure that children sleep an adequate amount each day. What happens to children during the first years of life is important to their current and future health and well-being.”

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