Patient-Centered Cancer Treatment Planning: Improving the Quality of Oncology Care – Summary of a Workshop – Institute of Medicine – 13 June 2011

Posted on June 14, 2011. Filed under: Oncology | Tags: |

Patient-Centered Cancer Treatment Planning: Improving the Quality of Oncology Care – Summary of a Workshop – Institute of Medicine – 13 June 2011

Full text

“The life-threatening nature of cancer and the complexity of cancer treatment options, each with its own set of potential risks and benefits, make it difficult for people with cancer to make decisions about their care. In addition, cancer care usually involves multiple specialties, impeding the coordination of care and development of comprehensive treatment plans. A cancer treatment plan can provide a roadmap to help patients navigate their uncertain path. A treatment plan is a written document that informs everyone—the patient, his or her family, and other treating physicians—about the path of care and who is responsible for each portion of that care. However, most providers lack the tools, time, and resources needed to efficiently and effectively prepare such plans with their patients.

The IOM’s National Cancer Policy Forum held a workshop February 28-March 1, 2011, to discuss ways to create a more coordinated, patient-centered cancer treatment planning process. Speakers and participants representing patients, providers, nonprofits, and other groups identified a number of obstacles to achieving patient-centered care planning in practice, including poor communication between patients and providers, and a lack of adequate reimbursement for the time needed to develop, discuss, and document a treatment plan.  Workshop participants also suggested a variety of approaches for addressing these challenges. This document summarizes the workshop.”

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

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

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

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

 

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Digital Infrastructure for the Learning Health System: The Foundation for Continuous Improvement in Health and Health Care – Workshop Series Summary – Institute of Medicine – 23 May 2011

Posted on May 25, 2011. Filed under: Health Informatics, Patient Participation | Tags: |

Digital Infrastructure for the Learning Health System: The Foundation for Continuous Improvement in Health and Health Care – Workshop Series Summary – Institute of Medicine – 23 May 2011
Full text online

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

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

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Generating Evidence for Genomic Diagnostic Test Development – IoM Workshop Summary – 6 May 2011

Posted on May 9, 2011. Filed under: Diagnostics, Genomics | Tags: |

Generating Evidence for Genomic Diagnostic Test Development – IoM Workshop Summary – 6 May 2011

Full text online

“Ten years after the sequencing of the human genome, scientists have developed genetic tests that can predict a person’s response to certain drugs, estimate the risk of developing Alzheimer’s disease, and make other predictions based on known links between genes and diseases. However, most clinical practitioners do not use these tests regularly, and genetic testing has yet to become part of routine medical care. One barrier is the lack of evidence for their effectiveness—there is little to show that using these tests improves patients’ health.

The IOM’s Roundtable on Translating Genomic-Based Research for Health held a workshop on November 17, 2010, to explore barriers and solutions to generating evidence for genetic tests. Participants discussed stakeholder views on the use of evidence in decision-making processes such as clearance, reimbursement, clinical practice adoption, and patient utility; innovative methods to generate high-quality evidence more efficiently; and potential ways to overcome current limitations in generating evidence of clinical utility. This document summarizes the workshop.”

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Child and Adolescent Health and Health Care Quality: Measuring What Matters – Institute of Medicine – 25 April 2011

Posted on April 27, 2011. Filed under: Child Health / Paediatrics, Research | Tags: |

Child and Adolescent Health and Health Care Quality: Measuring What Matters – Institute of Medicine – 25 April 2011

Full text online 

“Type: Consensus Report

Health and health care quality measures can provide valuable information about the health status of children and adolescents, as well as the outcomes associated with medical care, policy, and social programs. Despite the fact that the U.S. government currently supports hundreds of data sets and measures through federal surveys and administrative data systems, the United States lacks robust national- and state-level information about the health status or health care quality of children and adolescents, particularly in areas that could provide guidance to policy makers and health care providers.

In the Children’s Health Insurance Program Reauthorization Act of 2009, Congress directed the IOM and the National Research Council (NRC) to evaluate the state of efforts to measure child and adolescent health and the quality of their health care services. The IOM found that the lack of standardization between data sets, as well as the lack of information on physical and social environments, limits researchers’ ability to accurately assess the data. To help overcome these barriers, the IOM recommends that HHS provide leadership on standardization in key data areas and guide other improvements to measurement. In addition, the IOM recommends a stepwise approach (see Figure) for improving data sources and measures of health and health care quality for children and adolescents. The approach is designed to stimulate and support collaborative efforts among federal and state agencies and key stakeholder groups.”

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Finding What Works in Health Care: Standards for Systematic Reviews – Institute of Medicine – 2011

Posted on March 24, 2011. Filed under: Clin Governance / Risk Mgmt / Quality, Evidence Based Practice, Health Systems Improvement | Tags: , |

Finding What Works in Health Care: Standards for Systematic Reviews – Institute of Medicine – 2011

Authors:  Jill Eden, Laura Levit, Alfred Berg, and Sally Morton, Editors; Committee on Standards for Systematic Reviews of Comparative Effectiveness Research; Institute of Medicine

“Healthcare decision makers-including doctors-increasingly turn to systematic reviews for reliable, evidence-based comparisons of health interventions. Systematic reviews identify, select, assess, and syn thesize the findings of similar but separate studies. In this report, the IOM recommends stan dards for systematic reviews of the comparative effectiveness of medical or surgical interventions.”

ISBN-10: 0-309-21053-4
ISBN-13: 978-0-309-21053-9

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Clinical Practice Guidelines We Can Trust – Institute of Medicine – 2011

Posted on March 24, 2011. Filed under: Clin Governance / Risk Mgmt / Quality | Tags: , |

Clinical Practice Guidelines We Can Trust

Authors: Robin Graham, Michelle Mancher, Dianne Miller Wolman, Sheldon Greenfield, and Earl Steinberg, Editors; Committee on Standards for Developing Trustworthy Clinical Practice Guidelines; Institute of Medicine

“Healthcare providers may rely on clinical practice guidelines, in addition to their knowledge, skills, experience, and patient preferences, when faced with difficult decisions when treating patients. 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. At the request of the U.S. Congress, the IOM developed eight standards for developing rigorous, trustworthy clinical practice guidelines.”

ISBN-10: 0-309-21049-6
ISBN-13: 978-0-309-21049-2

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Toward an Integrated Science of Families – Workshop Report – Institute of Medicine – 18 March 2011

Posted on March 21, 2011. Filed under: Child Health / Paediatrics, Research | Tags: |

Toward an Integrated Science of Families – Workshop Report – Institute of Medicine – 18 March 2011

“How do you conduct research on the impact of family environments and relationships on children and adolescents?  In the United States, the growing diversity of what constitutes “family” presents an increasing variety of answers. The majority of families with children still consist of two married biological parents, but a growing number consist of two unmarried biological parents, single mothers or fathers, stepparents, adoptive parents, or same-sex parents. In addition, children may live with siblings, half siblings, or stepsiblings, and have extended family members that play an important part in their daily lives. These complexities of family life are challenging the methods of researchers who frequently use approaches that are designed to best assess traditional family structures.   By modifying their surveys and field work, researchers may be better able to understand the influence of family environments on children.

The IOM held a workshop July 13-14, 2010, to examine the methodologies used to conduct research on families. Participants discussed recent research that contributes to understanding how families affect children; methods of researching families; and opportunities to improve family research. This document summarizes the workshop.”

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Hunger and Obesity: Understanding a Food Insecurity Paradigm – Workshop Summary – Institute of Medicine – 17 March 2011

Posted on March 18, 2011. Filed under: Dietetics, Health Status, Public Hlth & Hlth Promotion | Tags: , |

Hunger and Obesity: Understanding a Food Insecurity Paradigm – Workshop Summary – Institute of Medicine – 17 March 2011

“Researchers have long observed a relationship between food insecurity—difficulty providing food for all one’s family members, known as hunger in its most severe form—and obesity. The relationship is complicated. Food insecurity and obesity often coincide, occurring in the same communities, families, and individuals. But does food insecurity directly cause excess weight gain, or do these two problems occur together for other reasons? More information is needed to improve our understanding and move closer to eliminating food insecurity and obesity.

The IOM held a workshop November 16-18, 2010, to explore the relationship between food insecurity and obesity, the current state of the research, and the data and analyses needed to better understand their relationship. Participants explored the occurrence of food insecurity and obesity in a variety of groups, including children, immigrants, Native Americans, and rural populations, in addition to the U.S. population as a whole. This document summarizes the workshop.”

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HIV Screening and Access to Care: Health Care System Capacity for Increased HIV Testing and Provision of Care – Institute of Medicine – 17 March 2011

Posted on March 18, 2011. Filed under: Infectious Diseases | Tags: |

HIV Screening and Access to Care: Health Care System Capacity for Increased HIV Testing and Provision of Care – Institute of Medicine – 17 March 2011

“More than 200,000 people living with HIV/AIDS in the United States do not know they are infected. Increased HIV testing may help identify these individuals, reducing the chance that they will spread HIV to others and improving their health outcomes. But many may not receive the care they need because the health care system may not have the capacity to care for them.

The IOM Committee on HIV Screening and Access to Care held its third workshop September 29-30, 2010, to explore the health care system’s capacity to administer more HIV tests and care for those newly diagnosed with HIV. Based on workshop presentations and a review of the literature, the committee concludes that budget constraints at state and local health departments pose a barrier to more widespread HIV testing. In addition, fewer practitioners are specializing in HIV/AIDS care and the number of specialists entering the workforce is not replacing the number retiring. To meet the growing demand for care, the committee concludes that more practitioners need training in HIV/AIDS treatment and care; and their hospitals, clinics, and health departments must receive sufficient funding to maintain their staff and support screening efforts. This report summarizes the workshop and reviewed literature and contains the committee’s conclusions.”

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Leading Health Indicators for Healthy People 2020 – Institute of Medicine [US] – 15 March 2011

Posted on March 16, 2011. Filed under: Health Status, Public Hlth & Hlth Promotion | Tags: , |

Leading Health Indicators for Healthy People 2020 – Institute of Medicine [US] – 15 March 2011

“For the past three decades, the Department of Health and Human Services (HHS) has issued a national agenda aimed at improving the health of all Americans over each 10-year span. Under each of these Healthy People initiatives, HHS established health benchmarks and monitored how well people were reaching them over time. HHS asked the IOM to review the Healthy People 2020 objectives and recommend leading health indicators that could sharpen the focus of the agenda. In particular, the IOM was asked to identify 12 key topics and 24 key objectives, and to identify 24 leading indicators that are critical to the nation’s health needs.

With this basis, the IOM identified a set of basic principles for Healthy People 2020 and developed a conceptual framework within which the topics, indicators, and objectives would be developed or selected. The IOM concludes that the indicators for Healthy People 2020 should prove valuable in eliciting interest and awareness among the general population; motivating diverse population groups to engage in activities that will exert a positive impact on specific indicators and, in turn, improve the overall health of the nation; and providing feedback on progress toward improving the status of specific indicators.”

…continues on the site

full text of the report

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Innovations in Health Literacy – Workshop Summary – IOM – 10 March 2011

Posted on March 11, 2011. Filed under: Patient Participation | Tags: , |

Innovations in Health Literacy – Workshop Summary – IOM – 10 March 2011

“Nearly nine out of 10 adults have difficulty using everyday health information to make good health decisions. Minority and lower socioeconomic groups disproportionately lack health literacy—the degree to which a person can obtain, process, and understand basic health information and services needed to make appropriate health decisions. But are there proven ways to improve health literacy? How can research help illuminate pathways to improved health literacy and better health?

The IOM Roundtable on Health Literacy held a meeting on May 27, 2010, to explore areas for research in health literacy, the relationship between health literacy and health disparities, and ways to apply information technology to improve health literacy. Leaders from three government agencies presented the new National Action Plan to Improve Health Literacy (NAP), and participants examined the role research can play in achieving the goals the NAP sets forth. This document summarizes the workshop.”

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National Cancer Policy Summit – Summary of a Meeting of the National Cancer Policy Forum – 28 February 2011

Posted on March 1, 2011. Filed under: Oncology | Tags: |

National Cancer Policy Summit – Summary of a Meeting of the National Cancer Policy Forum – 28 February 2011
Institute of Medicine (IOM)

“Technological advances are altering the way cancer research is conducted and care is delivered to cancer patients. Many targeted therapies are being developed to match the unique molecular changes in patients’ tumors.  In addition, cancer research increasingly is an international endeavor involving patients, researchers, and practitioners worldwide. At the same time, cancer research budgets are shrinking, and the cost of care is growing.

The National Cancer Policy Forum brought together leaders in the cancer community at the National Cancer Policy Summit on October 25, 2010, to identify and discuss these and other changes in research and care. The Summit featured presentations and discussions that explored emerging policy issues in cancer research, health care reform, cancer care delivery, public health needs, and cancer control. Participants suggested many potential actions to improve information technologies in health care; define new and financially sustainable models for cancer care; provide more patient-centered cancer care; and foster greater precompetitive collaboration. This document summarizes the workshop.”

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Nanotechnology and Oncology – Workshop Summary – Institute of Medicine – 25 February 2011

Posted on February 28, 2011. Filed under: Oncology | Tags: , |

Nanotechnology and Oncology – Workshop Summary – Institute of Medicine – 25 February 2011

“One of the challenges in treating cancer is the disease’s complexity. Cancer emerges and behaves differently in each patient, and the same treatment may be effective in one patient and ineffective in another. Nanotechnology in medicine—also known as nanomedicine—has the potential to overcome these and other challenges in cancer care. Nanotechnology could improve diagnostic imaging to detect cancer earlier and locate it more accurately; direct treatments more accurately to cancer cells and avoid causing harm to healthy ones; and create new tools for cancer prevention.

The National Cancer Policy Forum held a workshop July 12-13, 2010, to explore what nanomedicine is, what it can do, its potential risks and benefits, and how it should be regulated. Discussions focused on the use of nanotechnology in oncology and cancer research; research and development of new cancer nanomedicine; risk management; and nanontechnology and the public. This document summarizes the workshop.”

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Preparedness and Response to a Rural Mass Casualty Incident: Workshop Summary – Institute of Medicine – 2011

Posted on February 24, 2011. Filed under: Disaster Management, Rural Remote Health | Tags: |

Preparedness and Response to a Rural Mass Casualty Incident: Workshop Summary – Institute of Medicine – 2011

“Problems contacting emergency services and delayed assistance are not unusual when incidents occur in rural areas, and the consequences can be devastating, particularly with mass casualty incidents. The IOM’s Forum on Medical and Public Health Preparedness for Catastrophic Events held a workshop to examine the current capabilities of emergency response systems and the future opportunities to improve mass casualty response in rural communities.”

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

Posted on February 23, 2011. Filed under: Public Hlth & Hlth Promotion | Tags: , , , |

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

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

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

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Clinical Data as the Basic Staple for Health Learning – Workshop Summary – Institute of Medicine – 3 February 2011

Posted on February 4, 2011. Filed under: Health Informatics, Research | Tags: , |

Clinical Data as the Basic Staple for Health Learning – Workshop Summary – Institute of Medicine – 3 February 2011

“The successful development of clinical data as an engine for real-time knowledge generation has the potential to transform health and health care in America. Nurturing clinical data as a resource for continuous learning can allow patients, health professionals, and health care researchers to have the best information on which to base care decisions, health strategies, and scientific recommendations. However, broader access to and use of health care data requires not only fostering reliable and accessible data systems, but also addressing the issues such as individual data ownership and patient and public perception of clinical data as a carefully stewarded public good.

As part of its Learning Health System Series, the Roundtable on Value & Science-Driven Health Care hosted a workshop to consider the issues surrounding clinical data as a foundation for care improvement. Workshop participants explored the transformational prospects for large, interoperable clinical and administrative datasets to allow real-time discoveries in areas such as disease risk and personalized diagnosis and treatment. In addition, participants shared their views on the priorities for data stewardship if clinical data are to become a reliable resource for broad, systematic, and continuous improvement in health and health care.”

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

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

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

Full text online

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Medical Countermeasures Dispensing: Emergency Use Authorization and the Postal Model – Workshop Summary – Institute of Medicine – 22 October 2010

Posted on October 25, 2010. Filed under: Disaster Management, Public Hlth & Hlth Promotion | Tags: |

Medical Countermeasures Dispensing: Emergency Use Authorization and the Postal Model – Workshop Summary – Institute of Medicine – 22 October 2010
Full text online

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

During public health emergencies such as terrorist attacks or influenza outbreaks, the public health system’s ability to save lives could depend on dispensing medical countermeasures such as antibiotics, antiviral medications, and vaccines to a large number of people in a short amount of time. For example, if aerosolized anthrax were released over a large, highly-populated area, millions of people could need prophylactic antibiotics within 48 hours to survive. This is only one of many threats, and the United States needs many different medical countermeasures to be prepared for potential chemical, biological, radiological, and nuclear public health threats. However, in an emergency, the best available medical countermeasure may not already be approved by the Food and Drug Administration (FDA), or it may only be approved for other uses.

The IOM’s Forum on Medical and Public Health Preparedness for Catastrophic Events held a workshop on November 18, 2009, to discuss current threats, progress made in the public health system regarding the distribution and dispensing of countermeasures, and remaining vulnerabilities. Presentations and discussions focused on two areas in which important advances recently have been made: Emergency Use Authorization (EUA), which permits the FDA Commissioner to authorize the use of unapproved medical products or the unapproved use of approved products during an emergency, and a pilot program of the Postal Model, which uses postal carriers to deliver countermeasures. This document summarizes the workshop.”

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Examination of Front-of-Package Nutrition Rating Systems and Symbols: Phase 1 Report – Institute of Medicine – 13 October 2010

Posted on October 14, 2010. Filed under: Dietetics | Tags: , , |

Examination of Front-of-Package Nutrition Rating Systems and Symbols: Phase 1 Report – Institute of Medicine – 13 October 2010

full text online

“The federal government requires that most packaged foods carry a standardized label—the Nutrition Facts panel—that provides nutrition information intended to help consumers make healthful choices. In recent years, manufacturers have begun to include additional nutrition messages on their food packages. These messages are commonly referred to as “front-of-package” (FOP) labeling. As FOP labeling has multiplied, it has become easy for consumers to be confused about critical nutrition information. In considering how FOP labeling should be used as a nutrition education tool in the future, Congress directed the Centers for Disease Control and Prevention to undertake a two-phase study with the IOM on FOP nutrition rating systems and nutrition-related symbols. The Food and Drug Administration is also a sponsor.

In Phase 1 of its study, the IOM reviewed current systems and examined the strength and limitations of the nutrition criteria that underlie them. The IOM concludes that it would be useful for FOP labeling to display calorie information and serving sizes in familiar household measures. In addition, as FOP systems may have the greatest benefit if the nutrients displayed are limited to those most closely related to prominent health conditions, FOP labeling should provide information on saturated fats, trans fats, and sodium.”

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The Future of Nursing: Leading Change, Advancing Health – US report – 5 October 2010

Posted on October 6, 2010. Filed under: Nursing, Workforce | Tags: , |

The Future of Nursing: Leading Change, Advancing Health
Released: October 5, 2010
Type: Consensus Report
Topics: Health Care Workforce, Quality and Patient Safety, Health Services, Coverage, and Access
Activity: Robert Wood Johnson Foundation Initiative on the Future of Nursing, at the Institute of Medicine
Board: Studies under the IOM Executive Office

full text online

“With more than 3 million members, the nursing profession is the largest segment of the nation’s health care workforce. Working on the front lines of patient care, nurses can play a vital role in helping realize the objectives set forth in the 2010 Affordable Care Act, legislation that represents the broadest health care overhaul since the 1965 creation of the Medicare and Medicaid programs. A number of barriers prevent nurses from being able to respond effectively to rapidly changing health care settings and an evolving health care system. These barriers need to be overcome to ensure that nurses are well- positioned to lead change and advance health.

In 2008, The Robert Wood Johnson Foundation (RWJF) and the IOM launched a two-year initiative to respond to the need to assess and transform the nursing profession. The IOM appointed the Committee on the RWJF Initiative on the Future of Nursing, at the IOM, with the purpose of producing a report that would make recommendations for an action-oriented blueprint for the future of nursing. Through its deliberations, the committee developed four key messages:”

…continues on the site

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Redesigning the Clinical Effectiveness Research Paradigm: Innovation and Practice-Based Approaches: Workshop Summary – 2010

Posted on October 5, 2010. Filed under: Comparative Effectiveness Research, Evidence Based Practice, Research | Tags: |

Redesigning the Clinical Effectiveness Research Paradigm: Innovation and Practice-Based Approaches: Workshop Summary – 2010

LeighAnne Olsen and J. Michael McGinnis; Roundtable on Value & Science-Driven Health Care; Institute of Medicine

ISBN-10: 0-309-11988-X
ISBN-13: 978-0-309-11988-7

Extract from the description:

“The Institute of Medicine Roundtable on Value & Science-Driven Health Care’s vision for a learning healthcare system, in which evidence is applied and generated as a natural course of care, is premised on the development of a research capacity that is structured to provide timely and accurate evidence relevant to the clinical decisions faced by patients and providers. As part of the Roundtable’s Learning Healthcare System series of workshops, clinical researchers, academics, and policy makers gathered for the workshop Redesigning the Clinical Effectiveness Research Paradigm: Innovation and Practice-Based Approaches. Participants explored cutting-edge research designs and methods and discussed strategies for development of a research paradigm to better accommodate the diverse array of emerging data resources, study designs, tools, and techniques. Presentations and discussions are summarized in this volume.”

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Rare Diseases and Orphan Products: Accelerating Research and Development – Institute of Medicine – 4 October 2010

Posted on October 5, 2010. Filed under: Health Systems Improvement, Pharmacy, Research | Tags: , |

Rare Diseases and Orphan Products: Accelerating Research and Development – Institute of Medicine – 4 October 2010

Type: Consensus Report

full text online

“Rare diseases collectively affect millions of Americans of all ages. They often are serious and life-altering; many are life-threatening or fatal. But because each rare disease affects a relatively small population, it can be challenging to develop drugs and medical devices to prevent, diagnose, and treat these conditions. We still lack even a basic understanding of the cause or underlying molecular mechanisms of many rare diseases. To help in accelerating rare diseases research and product development, the National Institutes of Health (NIH), with support from the Food and Drug Administration (FDA), asked the IOM to examine the opportunities for and obstacles in developing drugs and medical devices for treating rare diseases.

To guide policymakers, the IOM sets forth the elements of an integrated national strategy to promote rare diseases research and product development. Among other recommendations, the IOM calls for NIH to work with industry, academia, and voluntary organizations to develop a comprehensive system of shared resources for discovery research on rare diseases and to facilitate communication and cooperation for such research. In addition, the IOM calls for the Secretary of the Department of Health and Human Services to establish a national task force on accelerating rare diseases research and product development. Overall, the effort and investment needed to move further toward a collaborative, coordinated, open, and sustained approach to rare diseases will be substantial, but not making the investment will also be costly. The potential benefits justify a renewed commitment to accelerating rare diseases research and product development.”

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Patient Safety and Health Information Technology – Institute of Medicine new area of activity – 29 September 2010

Posted on October 4, 2010. Filed under: Health Informatics, Patient Safety | Tags: , |

Patient Safety and Health Information Technology – Institute of Medicine new area of activity – 29 September 2010

“The IOM will review the available evidence and the experience from the field on how the use of health information technology (HIT) affects the safety of patient care and make recommendations on how public and private actors can maximize the safety of HIT-assisted health care services. The IOM’s final report will be both comprehensive and specific in terms of recommended options and opportunities for public and private interventions that may improve the safety of care that incorporates the use EHRs and other forms of HIT.”

Extract fom the ONC press release:

“The Institute of Medicine (IOM) will conduct a 1-year study aimed at ensuring that health information technology (HIT) will achieve its full potential for improving patient safety in health care.  The study will be carried out under a $989,000 contract announced today by the Office of the National Coordinator for Health Information Technology (ONC), which is charged with coordinating federal efforts regarding HIT adoption and meaningful use.

            “Since 1999, when the IOM published its ground-breaking study To Err Is Human, the Institute has been a leader in the movement to improve patient safety,” said David Blumenthal, M.D., national coordinator for health information technology.  “This study will draw on IOM’s depth of knowledge in this area to help all of us ensure that HIT reaches the goals we are seeking for patient safety improvement.” “

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Women’s Health Research: Progress, Pitfalls, and Promise – Committee on Women s Health Research; Institute of Medicine – September 2010

Posted on September 24, 2010. Filed under: Research | Tags: |

Women’s Health Research: Progress, Pitfalls, and Promise – Committee on Women s Health Research; Institute of Medicine – September 2010

“Even though slightly over half of the U.S. population is female, medical research historically has neglected the health needs of women. However, over the past two decades, there have been major changes in government support of women’s health research–in policies, regulations, and the organization of research efforts. To assess the impact of these changes, Congress directed the Department of Health and Human Services (HHS) to ask the IOM to examine what has been learned from that research and how well it has been put into practice as well as communicated to both providers and women.

Women’s Health Research finds that women’s health research has contributed to significant progress over the past 20 years in lessening the burden of disease and reducing deaths from some conditions, while other conditions have seen only moderate change or even little or no change. Gaps remain, both in research areas and in the application of results to benefit women in general and across multiple population groups. Given the many and significant roles women play in our society, maintaining support for women’s health research and enhancing its impact are not only in the interest of women, they are in the interest of us all.”

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

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

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

Full text online

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

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

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

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

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

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

Full text online

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

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

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

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A Summary of the February 2010 Forum on the Future of Nursing: Education – Robert Wood Johnson Foundation Initiative on the Future of Nursing, at the Institute of Medicine – released 31 August 2010

Posted on September 6, 2010. Filed under: Educ for Hlth Professions, Nursing, Workforce | Tags: , |

A Summary of the February 2010 Forum on the Future of Nursing: Education
Released: August 31, 2010

full text of the report

Activity: Robert Wood Johnson Foundation Initiative on the Future of Nursing, at the Institute of Medicine
Note: Workshop Summaries contain the opinion of the presenters, but do NOT reflect the conclusions of the IOM. Learn more about the differences between Workshop Summaries and Consensus Reports.

“Nurses are the largest segment of the health care workforce and patients’ primary professional caregivers. Their education and training directly affect the safety and quality of patient care. However, the American health care system is evolving, and patients’ needs are changing. The population is growing older and becoming more diverse, and health needs are becoming more complex; increasingly, nurses work in teams of providers from different areas of expertise; and health care technology is advancing rapidly. To ensure that nurses are prepared to meet these challenges, the education system needs to adapt. The education system needs to provide high-quality education from basic to advanced levels. It needs to ensure that there is adequate capacity to educate the right number of nurses across all levels with the right competencies and skills. And it needs to enable seamless progression to higher levels of education.

The Robert Wood Johnson Foundation Initiative on the Future of Nursing, at the IOM, seeks to build a blueprint for the future of nursing as part of larger efforts to reform the health care system. The Initiative held three public forums to explore challenges and opportunities in the nursing profession. The third forum, which took place on February 22, 2010 in Houston, examined nursing education. During the forum, experts considered innovations and strategies in three areas: what to teach, how to teach, and where to teach. The information and perspectives discussed at this forum will inform a final report on the future of nursing, expected to release in October 2010.”

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

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

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

Type: Workshop Summary – online version

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

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

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Assessing the Effects of the Gulf of Mexico Oil Spill on Human Health – IOM – 10 August 2010

Posted on August 13, 2010. Filed under: Public Hlth & Hlth Promotion | Tags: |

Assessing the Effects of the Gulf of Mexico Oil Spill on Human Health – Institute of Medicine
Released: August 10, 2010

Report freely available online

Type: Workshop Summary

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

On April 20, 2010, the Deepwater Horizon drilling rig in the Gulf of Mexico exploded, causing an oil leak one mile beneath the ocean’s surface. The explosion killed 11 workers and unleashed one of the largest offshore oil spills in history. The oil well was plugged in mid-July, but the effects of the spill on the short- and long-term health of individuals—including workers, volunteers, residents and visitors—remain uncertain.  

At the request of the U.S. Department of Health and Human Services, the IOM convened a public workshop June 22-23 to begin planning for the surveillance of the Gulf oil spill’s effects on human health. Speakers explored the potential adverse health effects for at-risk populations living in the Gulf region or assisting with clean-up activities. Participants also discussed current monitoring activities, the types of research methods and data sources currently available, and options to consider when developing short- and long-term surveillance plans. Additionally, participants considered effective ways to communicate potential health risks to the public and to engage them in research on the spill’s effects. This document summarizes the workshop.

Presentations from the meeting as well as full video and transcripts are available online.”

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Transforming Clinical Research in the United States – Institute of Medicine Workshop Summary – 2 August 2010

Posted on August 3, 2010. Filed under: Research | Tags: |

Transforming Clinical Research in the United States – Institute of Medicine Workshop Summary – 2 August 2010
Released: August 2, 2010

full text 

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

“Scientists and medical researchers conduct clinical trials to test whether a new product works as expected and is effective at treating disease. Clinical trials with patients suffering from a specific condition represent the crucial link between scientific discovery and medical utility. However, many barriers impede the effectiveness of clinical research in the United States. Planning and executing a clinical trial can take years and cost hundreds of millions of dollars. Our nation’s clinical trial infrastructure is not well developed; clinical trials must be conducted in a “one-off” manner, in which substantial resources—such as funding, investigators, administrators, and patients—are used for only a finite period of time and then disbanded. Also, clinical trial sponsors, investigators, and research institutions face significant regulatory and administrative hurdles. Finally, patients and providers often do not participate in clinical research in sufficient numbers to support the science, and this problem is compounded by the general lack of public understanding of the value of clinical research and its direct link to improvements in health care.

The IOM held a public workshop October 7-8, 2009, to evaluate the state of clinical research in the U.S. and to identify strategies for improving clinical trials’ efficiency and effectiveness.  Clinical trial experts discussed their successes, failures, and challenges in conducting clinical research.  This document summarizes the workshop.”

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Extending the Spectrum of Precompetitive Collaboration in Oncology Research – Institute of Medicine – released 22 July 2010

Posted on July 23, 2010. Filed under: Oncology, Pharmacy | Tags: |

Extending the Spectrum of Precompetitive Collaboration in Oncology Research – Institute of Medicine – released 22 July 2010

Full text online 

Workshop Summary
Activity: National Cancer Policy Forum

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

“Although the cost of research and development for new drugs has increased 50-fold since 1970, the success rate for developing new drugs has not improved. In fields such as oncology, in which patients’ survival may depend on new treatments, there is an urgent need to find a more productive way to develop drugs through cooperation among industry, academia, government, and philanthropic organizations. One solution may be increased precompetitive collaboration, or the collaboration among competitors to achieve goals with the potential to benefit everyone, in oncology drug development. Such collaboration would allow institutions to pool resources and expertise for the multidisciplinary research necessary for drug development. In addition, groups working toward similar objectives could learn from one another’s successes and failures, furthering progress toward a shared goal.

The IOM’s National Cancer Policy Forum held a workshop February 9-10, 2010, to explore the benefits and challenges of precompetitive collaboration. Speakers offered lessons learned and best practices as well as steps to increase collaboration in oncology drug development. This document summarizes the workshop.:

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

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

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

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

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

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

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

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

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

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

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

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

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

Read in full text

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

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Leadership Commitments to Improve Value in Healthcare: Finding Common Ground – workshop Summary from the Institute of Medicine – 14 June 2010

Posted on June 15, 2010. Filed under: Health Mgmt Policy Planning | Tags: , , |

Leadership Commitments to Improve Value in Healthcare: Finding Common Ground – workshop Summary from the Institute of Medicine – 14 June 2010

Full text online of the workshop summary

Released: June 14, 2010
Type: Workshop Summary

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

“The U.S. health care system is large, dynamic, complex, and multifaceted. It consists of many participants—including doctors, patients, hospital administrators, insurers, health product companies, and regulators—who have vital roles. Although each of these groups seeks to improve patient health and well-being, they often work in unassociated or fragmented ways that compromise the quality and value of care. The IOM hosted a workshop that brought together stakeholders to discuss opportunities and cooperative strategies to improve the efficiency and effectiveness of care throughout the nation.”

Table of contents

PART ONE: Finding Value in Common Ground (37-38)
1 Guiding Perspective: The Learning Healthcare System (39-58)
2 Foundation Stones in the Common Ground (59-66)
3 Transformational Opportunities (67-78)
4 Moving Forward (79-94)
PART TWO: Leadership Commitments to Improve Health Care (95-96)
5 Patients (97-116)
6 Healthcare Professionals (117-148)
7 Healthcare Delivery Organizations (149-186)
8 Healthcare Product Developers (187-216)
9 Clinical Investigators and Evaluators (217-236)
10 Regulators (237-268)
11 Insurers (269-296)
12 Employers and Employees (297-308)
13 Information Technology (309-320)

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A Summary of the December 2009 Forum on the Future of Nursing: Care in the Community – 3 June 2010

Posted on June 4, 2010. Filed under: Community Services, Nursing | Tags: , |

A Summary of the December 2009 Forum on the Future of Nursing: Care in the Community – 3 June 2010

http://www.iom.edu/Reports/2010/A-Summary-of-the-December-2009-Forum-on-the-Future-of-Nursing-Care-in-the-Community.aspx

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

The American health care system is evolving; care is becoming more focused on wellness, disease prevention, health promotion, and chronic illness management. In addition, health care reform will provide many people with access to health care that they did not have previously. As a result, there will be a continuing increase in the demand for everyday care through community health centers; professional home health care services; long-term care facilities; primary care providers’ offices; and non-emergency settings that are close to home. In these settings, nurses are essential to ensuring access to needed care, and their knowledge and skills directly affect the quality of care that patients receive.  

The Robert Wood Johnson Foundation Initiative on the Future of Nursing, at the IOM, seeks to build a blueprint for the future of nursing as part of larger efforts to reform the health care system. The Initiative held three public forums to explore challenges and opportunities in nursing. The second forum, which took place December 3, 2009, examined care in the community, focusing on community health, public health, primary care, and long-term care. Presenters described examples of best practices in the community that shed light on what is needed to meet the country’s changing health needs. The perspectives and ideas presented at this forum will inform a final report on the future of nursing, expected to release in fall 2010.”

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

full text

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

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

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

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

Strategies to Reduce Sodium Intake in the United States

Full text

Released: April 20, 2010
Type: Consensus Report

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

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

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

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

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

full text online

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

…continues

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

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

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

full text online

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

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

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

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

…continues

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

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

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

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

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

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

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

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

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

Type: Workshop Summary
full text

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

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

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

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

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

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

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Know Hepatitis – new CDC website – February 2010

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

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

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

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

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

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

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A Population-Based Policy and Systems Change Approach to Prevent and Control Hypertension – IOM – 22 February 2010

Posted on February 25, 2010. Filed under: Public Hlth & Hlth Promotion | Tags: , , |

A Population-Based Policy and Systems Change Approach to Prevent and Control Hypertension
Released: February 22, 2010
Type: Consensus Report 
Full text of the report       Press release         Report brief     

Activity: Public Health Priorities to Reduce and Control Hypertension in the U.S. Population
Board(s): Board on Population Health and Public Health Practice

“Hypertension, also known as high blood pressure, is one of the nation’s leading causes of death, responsible for roughly one in six deaths among adults annually. Nearly one in three adults has hypertension, which places huge economic demands on the health care system, estimated at $73.4 billion in direct and indirect costs in 2009 alone.  The Centers for Disease Control and Prevention (CDC), which leads the federal government’s efforts to reduce the impact of hypertension, asked the IOM to identify high-priority areas on which public health organizations and professionals should focus in order to accelerate progress in hypertension reduction and control.

In this report, the IOM recommends that the CDC as well as state and local health jurisdictions focus on population-based strategies that can reach large numbers of people and improve the well-being of entire communities. Behavioral and lifestyle interventions–reducing sodium intake, increasing consumption of fruits and vegetables, and increasing physical activity–are among the best examples. The report also highlights the need to improve providers’ adherence to the treatment guidelines for hypertension, especially in the elderly population, and to encourage patients to take medication consistently by reducing or eliminating the cost of antihypertensive medication.”

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Redesigning Continuing Education in the Health Professions – US – February 2010

Posted on February 22, 2010. Filed under: Educ for Hlth Professions, Health Professions, Workforce | Tags: |

Redesigning Continuing Education in the Health Professions 

Authors: Committee on Planning a Continuing Health Professional Education Institute; Institute of Medicine
Published by The National Academies Press
ISBN-10: 0-309-14078-1
ISBN-13: 978-0-309-14078-2

“Description

Today in the United States, the professional health workforce is not consistently prepared to provide high quality health care and assure patient safety, even as the nation spends more per capita on health care than any other country. The absence of a comprehensive and well-integrated system of continuing education (CE) in the health professions is an important contributing factor to knowledge and performance deficiencies at the individual and system levels.

To be most effective, health professionals at every stage of their careers must continue learning about advances in research and treatment in their fields (and related fields) in order to obtain and maintain up-to-date knowledge and skills in caring for their patients. Many health professionals regularly undertake a variety of efforts to stay up to date, but on a larger scale, the nation’s approach to CE for health professionals fails to support the professions in their efforts to achieve and maintain proficiency.

Redesigning Continuing Education in the Health Professions illustrates a vision for a better system through a comprehensive approach of continuing professional development, and posits a framework upon which to develop a new, more effective system. The book also offers principles to guide the creation of a national continuing education institute.”

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

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

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

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

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

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

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Medical Surge Capacity. Workshop Summary – Institute of Medicine of the National Academies [US] – released 27 January 2010

Posted on January 28, 2010. Filed under: Disaster Management, Public Hlth & Hlth Promotion | Tags: |

Medical Surge Capacity. Workshop Summary – Institute of Medicine of the National Academies [US] – released 27 January 2010
Type: Workshop Summary
Topic(s): Biomedical and Health Research, Public Health
Activity: Forum on Medical and Public Health Preparedness for Catastrophic Events
Board(s): Board on Health Sciences Policy

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

During natural disasters, disease pandemics, terrorist attacks, and other public health emergencies, the health system must be prepared to accommodate a surge in the number of individuals seeking medical help. For the health community, a primary concern is how to provide care to individuals during such high demand, when the health system’s resources are exhausted and there are more patients than the system can accommodate.

The IOM’s Forum on Medical and Public Health Preparedness for Catastrophic Events held a workshop June 10-11, 2009, to assess the capability of and tools available to federal, state, and local governments to respond to a medical surge. In addition, participants discussed strategies for the public and private sectors to improve preparedness for such a surge. The workshop brought together leaders in the medical and public health preparedness fields, including policy makers from federal agencies and state and local public health departments; providers from the health care community; and health care and hospital administrators. This document summarizes the workshop.”

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Hepatitis and Liver Cancer: A National Strategy for Prevention and Control of Hepatitis B and C – US – 2010

Posted on January 12, 2010. Filed under: Infectious Diseases | Tags: , |

Hepatitis and Liver Cancer: A National Strategy for Prevention and Control of Hepatitis B and C
Authors: Heather M. Colvin and Abigail E. Mitchell, Editors; Committee on the Prevention and Control of Viral Hepatitis Infections; Institute of Medicine

ISBN-10: 0-309-14628-3
ISBN-13: 978-0-309-14628-9

“The global epidemic of hepatitis B and C is a serious public health problem. Hepatitis B and C are the major causes of chronic liver disease and liver cancer in the world. In the next 10 years, 150,000 people in the United States will die from liver disease or liver cancer associated with chronic hepatitis B virus (HBV) or hepatitis C virus (HCV) infections. Today, between 800,000 and 1.4 million people in the United States have chronic hepatitis B and between 2.7 and 3.9 million have chronic hepatitis C. People most at risk for hepatitis B and C often are the least likely to have access to medical services. Reducing the rates of illness and death associated with these diseases will require greater awareness and knowledge among health care workers, improved identification of at-risk people, and improved access to medical care.

Hepatitis B is a vaccine-preventable disease. Although federal public health officials recommend that all newborns, children, and at-risk adults receive the vaccine, about 46,000 new acute cases of the HBV infection emerge each year, including 1,000 in infants who acquire the infection during birth from their HBV-positive mothers. Unfortunately, there is no vaccine for hepatitis C, which is transmitted by direct exposure to infectious blood.

Hepatitis and Liver Cancer identifies missed opportunities related to the prevention and control of HBV and HCV infections. The book presents ways to reduce the numbers of new HBV and HCV infections and the morbidity and mortality related to chronic viral hepatitis. It identifies priorities for research, policy, and action geared toward federal, state, and local public health officials, stakeholder, and advocacy groups and professional organizations.”

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

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

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

Full text online

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

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

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

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

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

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

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

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

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

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

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

ABSTRACT

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Full text of the report from National Academies Press

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

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

2 articles on this from the NEJM – 30 June 2009

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

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

2 articles from the Annals of Internal Medicine

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

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

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Combating Tobacco Use in Military and Veteran Populations – US – 2009

Posted on June 29, 2009. Filed under: Public Hlth & Hlth Promotion | Tags: , , |

Combating Tobacco Use in Military and Veteran Populations – US – 2009
Authors: Stuart Bondurant and Roberta Wedge, Editors; Committee on Smoking Cessation in Military and Veteran Populations; Institute of Medicine.  National Academies Press   ISBN-10: 0-309-13767-5    ISBN-13: 978-0-309-13767-6

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Full text of the guidelines

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

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

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

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

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

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

Released On:       May 14, 2009

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

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

Full text

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

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

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

Released On:       May 14, 2009

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

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

Full text online

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

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

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

Released On:       April 29, 2009

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

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

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

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

Conflict of Interest in Medical Research, Education, and Practice

Released On:       April 28, 2009   Full text available

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

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

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

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

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

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

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

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

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

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

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Beyond the HIPAA Privacy Rule: Enhancing Privacy, Improving Health Through Research – US Institute of Medicine

Posted on April 8, 2009. Filed under: Health Informatics, Medical Records, Research | Tags: |

US IOM Report published 4 February 2009

“Our modern electronic world has many benefits and conveniences, but the free flow of information also creates privacy concerns. In the realm of health care, privacy protections are needed to preserve patients’ dignity and prevent harms such as discrimination. But such protections can also have unintended consequences for health care, and the health research that is vital for making medical advances. More than 10 years ago Congress called for a set of federal standards, now known as the HIPAA Privacy Rule, to protect the privacy of personally identifiable health information while still allowing the flow of information needed to promote high-quality health care.

In its 2009 report, Beyond the HIPAA Privacy Rule: Enhancing Privacy, Improving Health Through Research, the Institute of Medicine’s Committee on Health Research and the Privacy of Health Information concludes that the HIPAA Privacy Rule does not protect privacy as well as it should, and that, as currently implemented, it impedes important health research. The committee recommends an entirely new approach to protecting privacy in health research. However, if national policy makers choose to continue to rely on the HIPAA Privacy Rule rather than adopt the new approach, the committee recommends a series of changes to improve the rule and the guidance that the HHS provides on how to comply with it. More specific recommendations related to these approaches are available in the report brief.

Privacy protec­tions and ethically-conducted health research provide valuable, interrelated benefits to society, and society should strive to support both to the extent possible. In order to preserve patients’ dignity and ensure continued progress in improving our nation’s health and health care, Congress and HHS must implement more effective privacy protections in health research. “

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