Podcasts about clinical effectiveness

JCO PO author Dr. Dean A. Regier at the Academy of Translational Medicine, University of British Columbia (UBC), and the School of Population and Public Health, BC Cancer Research Institute shares insights into his JCO PO article, “Clinical Effectiveness and Cost-Effectiveness of Multigene Panel Sequencing in Advanced Melanoma: A Population-Level Real-World Target Trial Emulation.” Host Dr. Rafeh Naqash and Dr. Regier discuss the real-world clinical effectiveness and cost-effectiveness of multigene panels compared with single-gene BRAF testing to guide therapeutic decisions in advanced melanoma. Transcript Dr. Rafeh Naqash:Hello and welcome to JCO Precision Oncology Conversations, where we bring you engaging conversations with authors of clinically relevant and highly significant JCO PO articles. I'm your host, Dr. Rafeh Naqash, Podcast Editor for JCO Precision Oncology and Assistant Professor at the OU Health Stephenson Cancer Center in the University of Oklahoma. Today, we are excited to be joined by Dr. Dean A. Regier, Director at the Academy of Translational Medicine, Associate Professor at the School of Population and Public Health, UBC Senior Scientist at the British Columbia Cancer Research Institute, and also the senior author of the JCO Precision Oncology article entitled "Clinical Effectiveness and Cost-Effectiveness of Multigene Panel Sequencing in Advanced Melanoma: A Population-Level Real-World Target Trial Emulation." At the time of this recording, our guest's disclosures will be linked in the transcript. Dean, welcome to our podcast and thank you for joining us today. Dr. Dean Regier:Thank you. I'm delighted to be here. Dr. Rafeh Naqash:So, obviously, you are from Canada, and medicine, or approvals of drugs to some extent, and in fact approvals of gene testing to some extent is slightly different, which we'll come to learn about more today, compared to what we do in the US—and in fact, similarly, Europe versus North America to a large extent as well. Most of the time, we end up talking about gene testing in lung cancer. There is a lot of data, a lot of papers around single-gene panel testing in non-small cell lung cancer versus multigene testing. In fact, a couple of those papers have been published in JCO PO, and it has shown significant cost-effectiveness and benefit and outcomes benefit in terms of multigene testing. So this is slightly, you know, on a similar approach, but in a different tumor type. So, could you tell us first why you wanted to investigate this question? What was the background to investigating this question? And given your expertise in health economics and policy, what are some of the aspects that one tends or should tend to understand in terms of cost-effectiveness before we go into the results for this very interesting manuscript? Dr. Dean Regier:Yeah, of course, delighted to. So, one of the reasons why we're deeply interested in looking at comparative outcomes with respect to single- versus multigene testing— whether that's in a public payer system like Canada or an insurer system, a private system in the United States— is that the question around does multigene versus single-gene testing work, has not typically tested in randomized controlled trials. You don't have people randomized to multigene versus single-gene testing. And what that does, it makes the resulting evidence base, whether it's efficacy, safety, or comparative cost-effectiveness, highly uncertain. So, the consequence of that has been uneven uptake around the world of next-generation sequencing panels. And so if we believe that next-gen sequencing panels are indeed effective for our patients, we really need to generate that comparative evidence around effectiveness and cost-effectiveness. So we can go to payers, whether it be single payer or a private insurer, to say, "Here are the comparative outcomes." And when I say that uptake has been uneven, uptake there's been actually plenty, as you know, publications around that uneven uptake, whether it be in Europe, in the United States, in Canada. And so we're really interested in trying to produce that evidence to create the type of deliberations that are needed to have these types of technologies accessible to patients. And part of those deliberations, of course, is the clinical, but also in some contexts, cost-effectiveness. And so, we really start from the perspective of, can we use our healthcare system data, our learning healthcare system, to generate that evidence in a way that emulates a randomized controlled trial? We won't be able to do these randomized controlled trials for various, like really important and and reasons that make sense, quite frankly. So how can we mimic or emulate randomized controlled trials in a way that allows us to make inference around those outcomes? And for my research lab, we usually think through how do we do causal inference to address some of those biases that are inherent in observational data. So in terms of advanced melanoma, we were really interested in this question because first of all, there have been no randomized controlled trials around next-gen sequencing versus single-gene testing. And secondly, these products, these ICIs, immune checkpoint inhibitors, and BRAF and MEK inhibitors, they are quite expensive. And so the question really becomes: are they effective? And if so, to what extent are they cost-effective? Do they provide a good reason to have information around value for money? Dr. Rafeh Naqash:So now going to the biology of melanoma, so we know that BRAF is one of the tumor-agnostic therapies, it has approvals for melanoma as well as several other tumor types. And in fact, I do trials with different RAF-RAS kinase inhibitors. Now, one of the things that I do know is, and I'm sure some of the listeners know, is the DREAMseq trial, which was a melanoma study that was an NCI Cooperative Group trial that was led by Dr. Mike Atkins from Georgetown a couple of years back, that did show survival benefit of first-line immunotherapy sequencing. It was a sequencing study of whether to do first-line BRAF in BRAF-mutant melanoma followed by checkpoint inhibitors, or vice versa. And the immune checkpoint inhibitors followed by BRAF was actually the one that showed benefit, and the trial had to stop early, was stopped early because of the significant benefit seen. So in that context, before we approach the question of single-gene versus multigene testing in melanoma, one would imagine that it's already established that upfront nivolumab plus ipilimumab, for that matter, doublet checkpoint inhibitor therapy is better for BRAF-mutant melanoma. And then there's no significant other approvals for melanoma for NRAS or KIT, you know, mucosal melanomas tend to have KIT mutations, for example, or uveal melanomas, for that matter, have GNAQ, and there's no targeted therapies. So, what is the actual need of doing a broader testing versus just testing for BRAF? So just trying to understand when you started looking into this question, I'm sure you kind of thought about some of these concepts before you delved into that. Dr. Dean Regier:I think that is an excellent question, and it is a question that we asked ourselves: did we really expect any differences in outcomes between the testing strategies? And what did the real-world implementation, physician-guided, physician-led implementation look like? And so, that was kind of one of the other reasons that we really were interested is, why would we go to expanded multigene panel sequencing at all? We didn't really expect or I didn't expect an overall survival a priori. But what we saw in our healthcare system, what happened in our healthcare system was the implementation in 2016 of this multigene panel. And this panel covered advanced melanoma, and this panel cost quite a bit more than what they were doing in terms of the single-gene BRAF testing. And so when you're a healthcare system, you have to ask yourself those questions of what is the additional value associated with that? And indeed, I think in a healthcare system, we have to be really aware that we do not actually follow to the ideal extent randomized controlled trials or trial settings. And so that's the other thing that we have to keep in mind is when these, whether it's an ICI or a BRAF MEK inhibitor, when these are implemented, they do not look like randomized controlled trials. And so, we really wanted to emulate not just a randomized controlled trial, but a pragmatic randomized controlled trial to really answer those real-world questions around implementation that are so important to decision making. Dr. Rafeh Naqash:Sure. And just to understand this a little better: for us in the United States, when we talk about multigene testing, we generally refer to, these days, whole-exome sequencing with whole-transcriptome sequencing, which is like the nuclear option of of the testings, which is not necessarily cheap. So, when you talk about multigene testing in your healthcare system, what does that look like? Is it a 16-gene panel? Is it a 52-gene panel? What is the actual makeup of that platform? Dr. Dean Regier:Excellent question. Yeah, so at the time that this study is looking at, it was 2016, when we, as BC Cancer—so British Columbia is a population right now of 5.7 million people, and we have data on all those individuals. We are one healthcare system providing health care to 5.7 million people. In 2016, we had what I call our "home-brew" multigene panel, which was a 53-gene panel that was reimbursed as standard of care across advanced cancers, one of them being advanced melanoma. We have evolved since then. I believe in 2022, we are using one of the Illumina panels, the Focus panel. And so things have changed; it's an evolving landscape. But we're specifically focused on the 53-gene panel. It was called OncoPanel. And that was produced in British Columbia through the Genome Sciences Centre, and it was validated in a single-arm trial mostly around validity, etc. Dr. Rafeh Naqash:Thank you for explaining that. So now, onto the actual meat and the science of this project. So, what are some of the metrics from a health economy standpoint that you did look at? And then, methodology-wise, I understand, in the United States, we have a fragmented healthcare system. I have data only from my institution, for that matter. So we have to reach out to outside collaborators and email them to get the data. And that is different for you where you have access to all the data under one umbrella. So could you speak to that a little bit and how that's an advantage for this kind of research especially? Dr. Dean Regier:Yeah. In health economics, we look at the comparative incremental costs against the incremental effectiveness. And when we think about incremental costs, we think not just about systemic therapy or whether you see a physician, but also about hospitalizations, about all the healthcare interactions related to oncology or not that a patient might experience during their time or interactions with the healthcare system. You can imagine with oncology, there are multiple interactions over a prolonged time period depending on survival. And so what we try to do is we try to—and the benefit of the single-payer healthcare system is what we do is we link all those resource utilization patterns that each patient encounters, and we know the price of that encounter. And we compare those incremental costs of, in this case, it's the multigene panel versus the single-gene panel. So it's not just the cost of the panel, not just the cost of systemic therapy, but hospitalizations, physician encounters, etc. And then similarly, we look at, in this case, we looked at overall survival - we can also look at progression-free survival - and ask the simple question, you know, what is the incremental cost per life-year gained? And in that way, we get a metric or an understanding of value for money. And how we evaluate that within a deliberative priority setting context is we look at safety and efficacy first. So a regulatory package that you might get from, in our case, Health Canada or the FDA, so we look at that package, and we deliberate on, okay, is it safe and is it effective? How many patients are affected, etc. And then separately, what is the cost-effectiveness? And at what price, if it's not cost-effective, at what price would it be cost-effective? Okay, so for example, we have this metric called the incremental cost-effectiveness ratio, which is incremental cost in the numerator, and in this case, life-years gained in the denominator. And if it is around $50,000 or $100,000 per life-year gained—so if it's in that range, this ratio—then we might say it's cost-effective. If it's above this range, which is common in oncology, especially when we talk about ICIs, etc., then you might want to negotiate a price. And indeed, when we negotiate that price, we use the economic evaluation, that incremental cost-effectiveness ratio, as a way to understand at what price should we negotiate to in order to get value for money for the healthcare system. Dr. Rafeh Naqash:Thank you for explaining those very interesting terminologies. Now, one question I have in the context of what you just mentioned is, you know, like the drug development space, you talked about efficacy and safety, but then on the safety side, we talk about all-grade adverse events or treatment-related adverse events—two different terminologies. From a healthcare utilization perspective, how do you untangle if a patient on a BRAF therapy got admitted for a hypoxic respiratory failure due to COPD, resulting in a hospitalization from the cost, overall cost utilization, or does it not matter? Dr. Dean Regier:We try to do as much digging into those questions as possible. And so, this is real-world data, right? Real-world data is not exactly as clean as you'd get from a well-conducted clinical trial. And so what we do is we look at potential adverse event, whether it's hospitalization, and the types of therapies around that hospitalization to try- and then engage with clinicians to try to understand or tease out the different grades of the adverse event. Whether it's successful or not, I think that is a real question that we grapple with in terms of are we accurate in delineating different levels of adverse events? But we try to take the data around the event to try to understand the context in which it happens. Dr. Rafeh Naqash:Thank you for explaining that, Dean. So, again to the results of this manuscript, could you go into the methodology briefly? Believe you had 147 patients, 147 patients in one arm, 147 in the other. How did you split that cohort, and what were some of the characteristics of this cohort? Dr. Dean Regier:So, the idea, of course, is that we have selection criteria, study inclusion criteria, which included in our case 364 patients. And these were patients who had advanced melanoma within our study time period. So that was 2016 to 2018. And we had one additional year follow. So we had three total years. And what we did is that we linked our data, our healthcare system data. During this time, because the policy change was in 2016, we had patients both go on the multigene panel and on the single-gene BRAF testing. So, the idea was to emulate a pragmatic randomized controlled trial where we looked at contemporaneous patients who had multigene panel testing versus single-gene BRAF testing. And then we did a matching procedure—we call it genetic matching. And that is a type of matching that allows us to balance covariates across the patient groups, across the multigene versus BRAF testing cohorts. The idea again is, as you get in a randomized controlled trial, you have these baseline characteristics that look the same. And then the hope is that you address any source selection or confounding biases that prohibit you to have a clean answer to the question: Is it effective or cost-effective? So you address all those biases that may prohibit you to find a signal if indeed a signal is there. And so, what we did is we created—we did this genetic matching to balance covariates across the two cohorts, and we matched them one-to-one. And so what we were able to do is we were able to find, of those 364 patients in our pool, 147 in the multigene versus 147 in the single-gene BRAF testing that were very, very similar. In fact, we created what's called a directed acyclic graph or a DAG, together with clinicians to say, “Hey, what biases would you expect to have in these two cohorts that might limit our ability to find a signal of effectiveness?” And so we worked with clinicians, with health economists, with epidemiologists to really understand those different biases at play. And the genetic matching was able to match the cohorts on the covariates of interest. Dr. Rafeh Naqash:And then could you speak on some of the highlights from the results? I know you did survival analysis, cost-effectiveness, could you explain that in terms of what you found? Dr. Dean Regier:We did two analyses. The intention-to-treat analysis is meant to emulate the pragmatic randomized controlled trial. And what that does is it answers the question, for all those eligible for multigene or single-gene testing: What is the cost-effectiveness in terms of incremental life-years gained and incremental cost per life-years gained? And the second one was around a protocol analysis, which really answered the question of: For those patients who were actually treated, what was the incremental effectiveness and cost-effectiveness? Now, they're different in two very important ways. For the intention-to-treat, it's around population questions. If we gave single-gene or multigene to the entire population of advanced melanoma patients, what is the cost-effectiveness? The per-protocol is really around that clinical question of those who actually received treatment, what was the incremental cost and effectiveness? So very different questions in terms of population versus clinical cost and effectiveness. So, for the intention-to-treat, what we found is that in terms of life-years gained is around 0.22, which is around 2.5 months of additional life that is afforded to patients who went through the multigene panel testing versus the single-gene testing. That was non-statistically significant from zero at the 5% level. But on average, you would expect this additional 2.5 months of life. The incremental costs were again non-statistically significant, but they're around $20,000. And so when we look at incremental cost-effectiveness, we can also look at the uncertainty around that question, meaning what percentage of incremental cost-effectiveness estimates are likely to be cost-effective at different willingness-to-pay thresholds? Okay? So if you are willing to pay $100,000 to get one gain of life-years, around 52.8% of our estimates, in terms of when we looked at the entire uncertainty, would be cost-effective. So actually that meets the threshold of implementation in our healthcare system. So it's quite uncertain, just over 50%. But what we see is that decision-makers actually have a high tolerance for uncertainty around cost-effectiveness. And so, while it is uncertain, we would say that, well, the cost-effectiveness is finely balanced. Now, when we looked at the population, the per-protocol population, those folks who just got treatment, we actually have a different story. We have all of a sudden around 4.5 or just under 5 months of life gained that is statistically significantly different from zero, meaning that this is a strong signal of benefit in terms of life-years gained. In terms of the changes in costs or the incremental costs, they are larger again, but statistically insignificant. So the question now is, to what extent is it cost-effective? What is the probability of it being cost-effective? And at the $100,000 per life-year gained willingness-to-pay, there was a 73% chance that multigene panel testing versus single-gene testing is cost-effective. Dr. Rafeh Naqash:So one of the questions I have here, this is a clarification both for myself and maybe the listeners also. So protocol treatment is basically if you had gene testing and you have a BRAF in the multigene panel, then the patient went on a BRAF treatment. Is that correct? Dr. Dean Regier:It's still physician choice. And I think that's important to say that. So typically what we saw in both in our pre- and post-matching data is that we saw around 50% of patients, irrespective of BRAF status, get an ICI, which is appropriate, right? And so the idea here is that you get physician-guided care, but if the patient no longer performs on the ICI, then it gives them a little bit more information on what to do next. Even during that time when we thought it wasn't going to be common to do an ICI, but it was actually quite common. Dr. Rafeh Naqash:Now, did you have any patients in this study who had the multigene testing done and had an NRAS or a KIT mutation and then went on to those therapies, which were not captured obviously in the single-gene testing, which would have just tried to look at BRAF? Dr. Dean Regier:So I did look at the data this morning because I thought that might come up in terms of my own questions that I had. I couldn't find it, but what we did see is that some patients went on to clinical trials. So, meaning that this multigene panel testing allowed, as you would hope in a learning healthcare system, patients to move on to clinical trials to have a better chance at more appropriate care if a target therapy was available. Dr. Rafeh Naqash:And the other question in that context, which is not necessarily related to the gene platform, but more on the variant allele frequency, so if you had a multigene panel that captured something that was present at a high VAF, with suspicion that this could be germline, did you have any of those patients? I'm guessing if you did, probably very low number, but I'm just thinking from a cost-effective standpoint, if you identify somebody with germline, their, you know, first-degree relative gets tested, that ends up, you know, prevention, etc. rather than somebody actually developing cancer subsequently. That's a lot of financial gains to the system if you capture something early. So did you look at that or maybe you're planning to look at that? Dr. Dean Regier:We did not look at that, but that is a really important question that typically goes unanswered in economic evaluations. And so, the short answer is yes, that result, if there was a germline finding, would be returned to the patient, and then the family would be able to be eligible for screening in the appropriate context. What we have found in economic evaluations, and we've recently published this research, is that that scope of analysis is rarely incorporated into the economic evaluation. So those downstream costs and those downstream benefits are ignored. And when you- especially also when you think about things like secondary or incidental findings, right? So it could be a germline finding for cancer, but what about all those other findings that we might have if you go with an exome or if you go with a genome, which by the way, we do have in British Columbia—we do whole-genome and transcriptome sequencing through something called the Personalized OncoGenomics program. That scope of evaluation, because it's very hard to get the right types of data, because it requires a decision model over the lifetime of both the patients and potentially their family, it becomes very complicated or complex to model over patients' and families' lifetime. That doesn't mean that we should not do it, however. Dr. Rafeh Naqash:So, in summary Dean, could you summarize some of the known and unknowns of what you learned and what you're planning in subsequent steps to this project? Dr. Dean Regier:Our North Star, if you will, is to really understand the entire system effect of next-generation sequencing panels, exome sequencing, whole genomes, or whole genomes and transcriptome analysis, which we think should be the future of precision oncology. The next steps in our research is to provide a nice base around multigene panels in terms of multigene versus single-gene testing, whether that be colorectal cancer, lung cancer, melanoma, etc., and to map out the entire system implications of implementing next-generation sequencing panels. And then we want to answer the questions around, “Well, what if we do exomes for all patients? What if we do whole genomes and transcriptomes for all patients? What are the comparative outcomes for a true tumor-agnostic precision oncology approach, accounting for, as you say, things like return of results with respect to hereditary cancers?” I think the challenge that's going to be encountered is really around the persistent high costs of something like a whole-genome and transcriptome sequencing approach. Although we do see the technology prices going down—the "$1,000 genome" or “$6,000 genome" on whatever Illumina machine you might have—that bioinformatics is continuing to be expensive. And so, there are pipelines that are automated, of course, and you can create a targeted gene report really rapidly within a reasonable turnaround time. But of course, for secondary or what I call level two analysis, that bioinformatics is going to continue to be expensive. And so, we're just continually asking that question is: In our healthcare system and in other healthcare systems, if you want to take a precision oncology approach, how do you create the pipelines? And what types of technologies really lend themselves to benefits over and above next-generation sequencing or multigene panels, allowing for access to off-label therapies? What does that look like? Does that actually improve patients? I think some of the challenges, of course, is because of heterogeneity, small benefiting populations, finding a signal if a signal is indeed there is really challenging. And so, what we are thinking through is, with respect to real-world evidence methods and emulating randomized controlled trials, what types of evidence methods actually allow us to find those signals if indeed those signals are there in the context of small benefiting populations? Dr. Rafeh Naqash:Thank you so much, Dean. Sounds like a very exciting field, especially in the current day and age where cost-effectiveness, financial toxicity is an important aspect of how we improve upon what is existing in oncology. And then lots more to be explored, as you mentioned. The last minute and a half I want to ask about you as an individual, as a researcher. There's very few people who have expertise in oncology, biomarkers, and health economics. So could you tell us for the sake of our trainees and early career physicians who might be listening, what was your trajectory briefly? How did you end up doing what you're doing? And maybe some advice for people who are interested in the cost of care, the cost of oncology drugs - what would your advice be for them very briefly? Dr. Dean Regier:Sure. So I'm an economist by training, and indeed I knew very little about the healthcare system and how it works. But I was recruited at one point to BC Cancer, to British Columbia, to really try to understand some of those questions around costs, and then I learned also around cost-effectiveness. And so, I did training in Scotland to understand patient preferences and patient values around quality of care, not just quantity of life, but also their quality of life and how that care was provided to them. And then after that, I was at Oxford University at the Nuffield Department of Population Health to understand how that can be incorporated into randomized control trials in children. And so, I did a little bit of learning about RCTs. Of course, during the way I picked up some epidemiology with deep understanding of what I call econometrics, what others might call biostatistics or just statistics. And from there, it was about working with clinicians, working with epidemiologists, working with clinical trialists, working with economists to understand the different approaches or ways of thinking of how to estimate efficacy, effectiveness, safety, and cost-effectiveness. I think this is really important to think through is that we have clinical trialists, we have people with deep understanding of biostatistics, we have genome scientists, we have clinicians, and then you add economists into the mix. What I've really benefited from is that interdisciplinary experience, meaning that when I talk to some of the world's leading genome scientists, I understand where they're coming from, what their hope and vision is. And they start to understand where I'm coming from and some of the tools that I use to understand comparative effectiveness and cost-effectiveness. And then we work together to actually change our methods in order to answer those questions that we're passionate about and curious about better for the benefit of patients. So, the short answer is it's been actually quite a trajectory between Canada, the UK. I spent some time at the University of Washington looking at the Fred Hutch Cancer Research Center, looking at precision oncology. And along the way, it's been an experience about interdisciplinary research approaches to evaluating comparative outcomes. And also really thinking through not just at one point in time on-off decisions—is this effective? Is it safe? Is it cost-effective?—not those on-off decisions, but those decisions across the lifecycle of a health product. What do those look like at each point in time? Because we gain new evidence, new information at each point in time as patients have more and more experience around it. And so what really is kind of driving our research is really thinking about interdisciplinary approaches to lifecycle evaluation of promising new drugs with the goal of having these promising technologies to patients sooner in a way that is sustainable for the healthcare system. Dr. Rafeh Naqash:Awesome. Thank you so much for those insights and also giving us a sneak peek of your very successful career. Thank you for listening to JCO Precision Oncology Conversations. Don't forget to give us a rating or review, and be sure to subscribe so you never miss an episode. You can find all ASCO shows at asco.org/podcast. Thank you. The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement.      

In this episode of the Becker's Healthcare Podcast, Erika Spicer Mason speaks with Yaw Fellin, Vice President of Product and Solutions for Clinical Effectiveness at Wolters Kluwer Health, about how healthcare organizations can better leverage data and digital tools to drive improved patient outcomes. Yaw shares strategies for integrating data into meaningful clinical workflows, highlights the importance of harmonized patient education, and discusses the exciting role of AI and predictive analytics in advancing care efficiency and quality. Tune in to hear how leaders can navigate the evolving intersection of technology, decision support, and patient engagement.This episode is sponsored by Wolters Kluwer.

In this conversation, Yaw Fellin, Vice President of Product and Solutions for Clinical Effectiveness at Wolters Kluwer Health, discusses the integration of AI in healthcare, focusing on clinical decision support, partnerships, and the importance of responsible AI practices. He shares insights from the HLTH 2024 conference, highlighting the enthusiasm for AI technologies and the need for improvements in provider workflows. The discussion also covers significant partnerships aimed at enhancing clinical care and the evolving role of AI in reducing provider burden.In this episode they discuss:The focus is on helping clinicians make the best decisions.Small time increments in workflows can lead to significant improvements.There's genuine enthusiasm for AI's tangible benefits in healthcare.Responsible approaches to AI are crucial to eliminate bias.Partnerships are essential for advancing healthcare technology.AI can significantly reduce provider burnout and improve workflows.The integration of AI in clinical settings is a powerful opportunity.Investing in responsible AI practices is a priority for healthcare organizations.Collaboration across care teams can enhance patient care.The future of AI in healthcare is promising but requires careful navigation.A little bit about Yaw : Yaw Fellin brings more than 20 years of experience as a healthcare executive, with proven results leading cross-functional teams, generating value and revenue growth.Prior to joining Wolters Kluwer Health, Yaw spent 3 years at Optum, a global healthcare IT company. Before that, Yaw spent over 15 years at the Advisory Board, a leading healthcare research, consulting and technology firm, where he led multiple high growth SaaS business lines. He received a BS in Healthcare Administration from Penn State University.

TopMedTalk at The American Society of Anesthesiologists (ASA)'s annual general meeting; Anesthesiology 2024. We're bringing you a series of podcasts from the conference. Make sure you check our podcast feed and are subscribed to TopMedTalk, as we are currently releasing episodes more often than usual to accommodate high demand. This piece provides much needed focus on the topic of pediatrics and hemodynamics. Is it true to say that children are completely different to adults? What information do we need and what should the considerations around this topic really be? Presented by Desiree Chappell and Mike Grocott with their guests Dwight Bailey, Chief, Division of Pediatric Critical Care Medicine at Atrium Health, Levine Children's Hospital and Jonathan Tan, Vice Chair of Analytics and Clinical Effectiveness, Department of Anesthesiology Critical Care Medicine, Assistant Professor of Clinical Anesthesiology and Spatial Sciences, Children's Hospital Los Angeles, Keck School of Medicine of the University of Southern California, Spatial Sciences Institute of the University of Southern California

Welcome to the (delayed) 10th & SUMMER BOTOX SPECIAL EPISODE of BSCOS Paediatric Orthopaedic Digest (POD)cast with Caroline Edwards, Head of Childrens Surgery  at Plymouth hospital who started her consultant career at Southampton Childrens Hospital, she set up and developed the neuromuscular service. She proposes a "hub and spoke" model for learning at busy tertiary centres and shared her research on the surgical vulnerability score, a tool to assess the likelihood of early death in patients with neuromuscular disorders. Caroline highlights the challenges faced by young adults transitioning from clinic care for cerebral palsy and suggested district general hospitals could provide dedicated clinics. Listen in to the episode to learn more!   We scoured 35 journals & highlighted the most impactful studies that we feel can change practice or improve outcomes in Paediatric Orthopaedics.  Follow Updates on @BSCOS_UK  REFERENCES: 1.     Skeletal Muscle in Cerebral Palsy: From Belly to Myofibril. Howard JJ &  Herzog W. Front Neurol. Feb 2021. PMID: 33679586 2.     Virtual Reality Distraction Is No Better Than Simple Distraction Techniques for Reducing Pain and Anxiety During Pediatric Orthopaedic Outpatient Procedures: A Randomized Controlled Trial. Fabricant PD et al. Clin Orthop Relat Res. May 2024. PMID: 37939199   3.     Effect of parental touch on relieving acute procedural pain in neonates and parental anxiety (Petal): a multicentre, randomised controlled trial in the UK. Hauck AGV et al. Lancet Child Adolesc Health. April 2024. PMID: 38373429.   4.     REM Sleep Preserves Affective Response to Social Stress-Experimental Study. Halonen et al. eNeuro. June 2024. PMID: 38802242   5.     Functional electrical stimulation during walking in children with unilateral spastic cerebral palsy: A randomized cross-over trial. Moll et al. Dev Med Child Neurol. May 2024. PMID: 37823431.   6.     Clinical Effectiveness of Newborn Screening for Spinal Muscular Atrophy: A Nonrandomized Controlled Trial. Schwartz et al. JAMA Pediatr. June 2024. PMID: 38587854   7.     Surgical management of proximal femoral unicameral bone cyst in children. Maximen et al + SOFOP. Bone Joint J. May 2024. PMID: 38688504   8.     Treatment of Hip Displacement in Children With Cerebral Palsy: A 5-year Comparison of Proximal Femoral Osteotomy and Combined Femoral-Pelvic Osteotomy in 163 Children. Kiapekos N et al. J Pediatr Orthop. July 2024. PMID: 38477355    9.     Impact of Pavlik Harness treatment on motor skills acquisition: A case-control study. Jesus AR et al. J Child Orthop. March 2024. PMID: 39100978   10.  Deep Learning Analysis of Surgical Video Recordings to Assess Nontechnical Skills. Harari RE et al. JAMA Netw Open. July 2024. PMID: 39083274   11.  Single versus double retrograde intramedullary nail technique for treatment of displaced proximal humeral fractures in children: A retrospective cohort study. Samara E et al. J Child Orthop. March 2024. PMID: 38831859   12.  Can the Achilles tendon regenerate completely following percutaneous tenotomy in older children with clubfoot? Aroojis A et al. Int Orthop. June 2024. PMID: 38340143.   13.  Guided Growth With Minifragment Plates for Angular Deformities in the Distal Radius in Skeletally Immature Patients. Preliminary Results. Soler-Jimenez A et al. J Pediatr Orthop. September 2024. PMID: 38767293.   14.  Robot-assisted Temporary Hemiepiphysiodesis With Eight-plates for Lower Extremity Deformities in Children. Liang M et al. J Pediatr Orthop. April 2024. PMID: 38312109    Follow Hosts: @AnishPSangh @AlpsKothari @Pranai_B See as many of you as possible at the BSCOS sessions at the BOA in Birmingham!

This recording features audio versions of July 2024 Journal of Vascular and Interventional Radiology (JVIR) abstracts:Comparison of Clinical Effectiveness and Safety of Drug-Coated Balloons versus Percutaneous Transluminal Angioplasty in Arteriovenous Fistulae: A Review of Systematic Reviews and Updated Meta-Analysis ReadStent-Graft Placement for Hepatic Arterial Hemorrhage after Pancreaticobiliary Surgery: Long-Term Clinical Outcomes ReadThe Natural History of Splenic Artery Aneurysms: Factors That Predict Aneurysm Growth ReadModified Radiation Lobectomy Strategy of Radioembolization for Right-Sided Unresectable Primary Liver Tumors ReadImage-Guided Transbronchial Pulmonary Cryoablation with a Flexible Cryoprobe in Swine: Performance and Radiology-Pathology Correlation ReadIntegration of Ethanol and the Immune Modulator Curcumin for Immunoablation of Hepatocellular Carcinoma ReadDouble-Balloon Catheter–Mediated Transarterial Chemotherapy Delivery in a Swine Model: A Mechanism Recruiting the Vasa Vasorum for Localized Therapies ReadThe Prevalence of Financial Conflict of Interest Disclosures by Endovascular Specialists on X (Twitter) ReadJVIR and SIR thank all those who helped record this episode:Host:Manbir Singh Sandhu, University of California Riverside School of MedicineAudio editor:Hannah Curtis, Loma Linda University School of MedicineAbstract readers:Daniel Roh, Loma Linda University School of MedicineEric Chang, MS, University of Illinois College of MedicineAndrew Brandser, Frank H. Netter MD School of Medicine at Quinnipiac UniversityAnna Hu, George Washington University School of Medicine and Health SciencesBridget Kowalczyk, MD, UT Health HoustonMelissa Millett, MD, Southeast Health, DothanMark Oliinik,  Loma Linda University School of MedicineErin Moore, Northeast Ohio Medical University ©  Society of Interventional RadiologySupport the Show.

This piece is part of our coverage of The International Anesthesia Research Society (IARS) annual meeting. Here our guest discusses his dual roles in patient safety and quality improvement and his research in spatial sciences; focusing on how environmental and social factors impact health. Can the integration of environmental data into electronic health records allow us to better understand and address health determinants like air quality? What are the practical applications for healthcare providers? Presented by Desiree Chappell, TopMedTalk co-editor in Chief and Monty Mythen, TopMedTalk's founder, with their guest Jonathan Tan, Vice Chair of Analytics and Clinical Effectiveness, Department of Anesthesiology Critical Care Medicine, Assistant Professor of Clinical Anesthesiology and Spatial Sciences, Keck School of Medicine of USC.

For episode 16 of the Clinical Audit and Improvement Podcast, Madeeha Rahim-Rasool and Angela Ward join Suzanne Henderson to discuss data triangulation and the benefits it can have as well as the challenges involved.This episode's guests:Madeeha Rahim-Rasool is the Deputy Head of Clinical Effectiveness at Birmingham and Solihull Mental Health NHS Foundation Trust. She has worked in both Acute and Mental Health NHS trusts, and her experience in Clinical Effectiveness has required her to oversee Trust-wide Clinical Audit planners, support senior directors with strategic work, and support the review of NICE guidelines.Angela Ward is a Clinical Audit and NICE lead at Oxford Health NHS Foundation Trust. She's worked in both Acute and Community NHS Trusts and has helped engage staff with using clinical audit for quality improvement. She's coordinated local audit plans, managed national project participation, promoted audit for accreditation and managed NICE compliance evidence.Suzanne Henderson is the Programme Manager for AMaT. She was previously the project manager in the Clinical Audit and Effectiveness team at Lancashire Teaching Hospitals Trust. Suzanne had sixteen years' Clinical Audit experience before joining AMaT in 2020 and is a member of the Q Community. Hosted on Acast. See acast.com/privacy for more information.

In a busy outpatient practice, timely access to up-to-date clinical resources is crucial to delivering evidence-based care. In the olden days, books and journal articles were the go-to method. Today, technology creates a more user-friendly method of receiving the most recent information. Say goodbye to having to order the latest edition of a book and hello to automatic updates. Our Children's Hospital Colorado antimicrobial stewardship team, clinical effectiveness and pathways teams, along with other local and state partners have partnered with Firstline, a health technology company, to design a mobile version of our infectious disease guidance. “It is another way to bring clinical decision support directly into somebody's hand if they are not sitting at a computer, which a lot of times you are not,” Leigh Anne Bakel, MD, says. A technology like this can change the future of treating patients. With new information comes new treatment choices, and this app is a way to put all of that content in the palm of a provider's hand. “It's really about judicious use, so using the right antibiotic for the right length of time but also only in the right patient and then the right dose; I think we understand overtime that antibiotics have a lot more side effects than we previously appreciated,” Sarah Parker, MD, says. Joining us to talk about this innovative technology are Drs. Sarah Parker and Leigh Anne Bakel. Dr. Parker is the Medical Director of the Antimicrobial Stewardship Program here at Children's Colorado, as well as a professor of pediatrics in the Division of Infectious Diseases at the University of Colorado School of Medicine. Dr. Bakel is the Medical Director of Clinical Effectiveness here at Children's Colorado, as well as a practicing pediatric hospitalist. She is also an associate professor of pediatrics. Some highlights from this episode include:   How the Firstline app works Why Firstline is beneficial for providers everywhere How Firstline will enhance rural healthcare The future of technology for treating patients  For more information on how to download the app visit https://firstline.org/colorado/. Drs. Parker and Bakel would like to acknowledge the brains behind this operation.   With Children's Colorado:  Sarah Parker, MD Leigh Anne Bakel, MD, MSc Michael J Bozzella, DO, MS Joana Dimo, DO Matthew Weber, Research Assistant, MPH Christine MacBrayne, PharmD, MSCS Matt Miller, PharmD With Denver Health:  Tim Jenkins, MD Katie Shihadeh, PharmD Maggie Cooper, PharmD With CDPHE:  Chris Czaja, MD, DrPH Lauren Biehle, PharmD Rachel Schaefer, MPH Other:  Local and regional providers, infection preventionists and pharmacists who gave feedback Firstline Pfizer Global Bridges Grant Daniel Dodson, MD, MS For more information on Children's Colorado, visit: childrenscolorado.org     

Dr. Nilesh Dave is a pulmonologist and sleep and critical care specialist. In addition to his medical training, he obtained his Master of Public Health at Johns Hopkins University, Bloomberg School of Public Health, and Master of Business Administration at Northwestern University, Kellogg School of Management. He first appeared on the podcast 4 years ago. At the time he was practicing and serving as a medical director for one of the regional Blue Cross/Blue Shield subsidiaries. Since then, his career has continued to flourish, and he is now Vice-President for Clinical Effectiveness and Chief Medical Officer for a large hospital system. In today's interview, we discuss how his career as a hospital senior executive developed. Nilesh shares advice for others who wish to pursue a similar career path, including his opinion about obtaining advanced certifications and degrees. You will find all of the links mentioned in the episode at https://nonclinicalphysicians.com/health-system-chief-medical-officer/                                                               =============== You can support this podcast by making a small monthly or annual donation. To learn more, go to nonclinicalphysicians.com/donate Get the FREE GUIDE to 10 Nonclinical Careers at nonclinicalphysicians.com/freeguide. Get a list of 70 nontraditional jobs at nonclinicalphysicians.com/70jobs.

Clinical decision support is needed to handle the avalanche of data and to advance value-based care, says Yaw Fellin, VP of Products and Solutions for Wolters Kluwer Health's Clinical Effectiveness team.

Respiratory Syncytial Virus (RSV) is a potentially deadly virus that tragically causes an estimated 100 to 300 deaths each year among children younger than age 5. Children from families with low-income status, children of color and children with compromised immune systems are at particular risk. Join us for a discussion about the recent progress in making mAbs available for the upcoming RSV season and next steps that are needed to ensure that all children are covered. Moderator Adjoa Kyerematen, MS Vice President of Public Affairs & Communications National Minority Quality Forum Adjoa Kyerematen is Vice President of Public Affairs and Communications at the National Minority Quality Forum (NMQF), the leading research national nonprofit focused on health equity and advancing minority health. Adjoa co-chairs the Cancer Stage Shifting Initiative, NMQF's initiative aligned with President Biden's Cancer Moonshot 2.0 program, and leads strategic campaigns that shape policy, execute community interventions, and drives awareness to advance cancer equity. Adjoa was named to PRWeek's 40 under 40 top PR Professionals and a Capitol Hill/federal government agency veteran, Adjoa is a strategic communications expert with an award-winning record and health equity expertise. Prior to this, Adjoa worked at CMS' Center for Innovation (CMMI) as a Senior Advisor in the center's leadership office where she crafted messaging, advised on communication efforts and stakeholder engagement among payers, pharmaceutical companies, health systems and other federal agencies. She currently serves on the Patient-Centered Outcomes Research Institute (PCORI) Advisory Panel on Clinical Effectiveness and Decision Science (CEDS) which analyzes critical knowledge gaps in health communication particularly in vulnerable communities. Panelists Erin E. Jones, JD Director, Legislative and Strategy Counsel March of Dimes Office of Government Affairs Erin Jones currently serves as the Director, Legislative and Strategy Counsel within March of Dimes Office of Government Affairs. Erin has been with the organization for 17 years. With more than 28 years of experience in health care, behavioral health, advocacy, and public policy, Erin has held various positions within March of Dimes and as Interim Director of Behavioral Health at Eastern CT Health Network, Medicaid Outreach and Advocacy Director for MAXIMUS and the State of Connecticut, Counselor and Case Manager at Easter Seals of Connecticut. Erin earned her Bachelor's degree in Sociology from Saint Joseph's College, her Master's degree of science in Clinical and Counseling Psychology at Central Connecticut State University and Juris Doctorate at Yale University School of Law. William V. La Via, M.D., FAAP Medical Director, Medical Affairs, RSV Prevention Sanofi I completed pediatric residency training as well as pediatric infectious diseases fellowship training at the University of California, Irvine medical center and the affiliated Miller Children's Hospital in Long Beach, CA. After training I spent 14 years in practice mostly in academic infectious diseases but 3 years were spent in private practice. In 2005 I moved to Medical affairs at MedImmune, which became a specialty division of AstraZeneca after its acquisition. I supported their infectious disease biologic portfolio, vaccines and respiratory biologics. During the pandemic, I transitioned to work at Karius, a pioneer in the detection of microbial cell-free DNA (mcfDNA) for serious, deep-seated infections, as a medical director in Medical Affairs. I have been interested in RSV since first conducting a clinical study during residency and am passionate about finding a solution to mitigate the impact on infants and young children each winter season. This led me to Sanofi where I joined Medical Affairs to work as a medical director focused on RSV disease prevention in 2020.

PCORI's Dr. Chue brings to light the complexities & challenges of conducting research, engaging stakeholders, and implementing findings in real-world settings. About the Show Welcome to Health Hats, learning on the journey toward best health. I am Danny van Leeuwen, a two-legged, old, cisgender, white man with privilege, living in a food oasis, who can afford many hats and knows a little about a lot of healthcare and a lot about very little. Most people wear hats one at a time, but I wear them all at once.  I'm the Rosetta Stone of Healthcare. We will listen and learn about what it takes to adjust to life's realities in the awesome circus of healthcare.  Let's make some sense of all this. We respect Listeners, Watchers, and Readers. Show Notes at the end. Watch on YouTube Read Newsletter The same content as the podcast but not a verbatim transcript. Could be a book chapter with images. download the printable transcript here Contents Executive Summary. 1 Proem.. 2 Introducing Dr. Amanda Chue 01:37. 2 Podcast intro 02:22. 2 Health is fragile 03:14. 2 Path to young adult mental health research 03:48. 3 Evidence gaps 05:22. 3 Do comparators exist? 08:17. 4 Efficacy versus efficiency 11:29. 4 Dynamic tension - Parent engagement in research 12:52. 4 A word from our sponsor, Abridge 13:38. 5  Call to action 14:41. 5 Dissemination to those with lived experience 15:51. 5 Research results impacting clinical work or decisions 19:07. 6 Dynamic tension – CER and innovation 20:04. 6 Dissemination – sharing results 21:36. 6 Community implementation 22:51. 7 Stakeholder Advisory Panels 27:06. 7 Dynamic tensions in public engagement, dissemination, and implementation 30:09. 8 PCORI and public engagement 30:53. 8 Policy making 34:17. 9 Reflection 37:18. 10 Podcast Outro 39:26. 10 Episode Executive Summary PCORI's Dr. Chue brings to light the complexities and challenges involved in conducting research, engaging stakeholders, and implementing findings in real-world settings. It emphasizes the need for long-term partnerships with community organizations and the importance of addressing disparities in research representation. The dynamic tensions in various research and implementation aspects underscore the need for thoughtful and creative approaches to address complex healthcare issues effectively. Proem Image created in DALL.E I treasure the dynamic tensions in life—for example, privacy and community, pathological optimism and catastrophizing, early adopter and skeptic. While not a researcher, I am personally and professionally neck-deep in research. Yet, despite my commitment to research, I'm a skeptic. Who's it for? How can it aid decision-making? Who's included in the research question, process, analysis, and dissemination? Where are the vested interests? Do we already have evidence yet have little will to implement, or does the bureaucracy or culture impede action? I will step in and highlight some dynamic tensions as the conversation flows. What about research funding sources? What's their perspective? What are the dynamic tensions? I asked my cronies at PCORI (Patient-Centered Outcomes Research Institute) to introduce me to a staff scientist specializing in comparative effectiveness research funding for emerging adults with mental illness. Dr. Amanda Chue kindly agreed to speak with us. Image created on DALL.E Introducing Dr. Amanda Chue Dr. Amanda Chue received a BS in human development from Cornell University and a Ph.D. in clinical psychology from American University. She is a Program Officer for the Clinical Effectiveness and Decision Science program at the Patient-Centered Outcomes Research Institute (PCORI). In this role, she manages a portfolio of comparative clinical effectiveness research awards focused on meaningful outcomes for patients. Her portfolio includes several studies on clinical strategies for managing and reducing lo...

Chris Holcombe is Consultant Breast Surgeon in Liverpool and currently Associate Medical Director for Clinical Effectiveness and President of the Association of Breast Surgery. He has done various leadership roles locally, regionally, and nationally over the years and spent three years working in Africa. His passion is to 'take his ordinary life - his sleeping, eating, going to work, and walking around life - and place it before God (Romans 12.1, Message) and to ask for God's wisdom and grace while doing it, with the aim of embedding Kingdom values in the workplace, and hopefully making things a little better and a little more Godly for his passing. For more information about CHLN, visit: https://cmf.li/CHLNWhat it means to be salt and light in NHS leadership &​ management​ PPT.https://bit.ly/3mkFUVgSupport the show

Norton Healthcare's Plugged in to Nursing is the podcast that celebrates and informs the profession of nursing.   This Episode: Back to Baseline: Enhanced Recovery After Surgery (ERAS)   Summary: Getting back to baseline is an important part of the post-operative recovery process. In this month's episode of Plugged In to Nursing listen to Kirsten McCoy Dietrich, RN, and Amanda Murray, MSN, APRN, AGCNS-BC, CMSRN, director with Clinical Effectiveness, discuss enhanced recovery after surgery (ERAS) and why mobility is key to better patient outcomes. As Amanda shares, it's all about “education and empowerment!”   Speakers: Kirsten McCoy Dietrich, RN Norton Audubon Hospital   Amanda Murray, MSN, APRN, AGCNS-BC, CMSRN Director, Clinical Effectiveness     About Norton Healthcare's Center for Nursing Practice Norton Healthcare's Center for Nursing Practice is responsible for readying student nurses for practice and transitioning new graduate nurses into practice.  Our team is committed to serving the profession of nursing, meeting people where they are and taking them to where they want to be.   Contact Information:  PluggedInToNursing@nortonhealthcare.org

There are new tools that can guide healthcare stakeholders to deliver high-quality care. In this episode, Yaw Fellin talks about the new solutions they are launching for virtual care providers and payers in Microsoft's cloud platform, a content-as-service education suite, and an engagement guide. Wolters Kluwer is working with care providers and payers by delivering educational content so that they can improve virtual healthcare experiences and patient engagement. Tune in to learn more about Wolters Kluwer Health and the innovations they are excited to share with the industry!  Click this link to the show notes, transcript, and resources: outcomesrocket.health

Dr. Andrea Wolf is Director of the New York Mesothelioma Program at the Mount Sinai Health System, which provides comprehensive, multidisciplinary clinical care for patients with suspected or diagnosed malignant pleural mesothelioma. She has expertise in surgery for pleural mesothelioma and VATS lobectomy, and research interests in mesothelioma, health care disparities, and lung cancer. Dr. Wolf graduated Cum Laude from Princeton University and earned highest honors and her medical degree at Harvard Medical School. She trained in General Surgery and served as Chief Resident at Massachusetts General Hospital in Boston. Dr. Wolf earned a Master in Public Health with a focus on Clinical Effectiveness at Harvard University School of Public Health while researching malignant pleural mesothelioma and early stage lung cancer as a Thoracic Oncology Research Fellow at Brigham and Women's Hospital, also in Boston. She completed her training in Cardiothoracic Surgery after serving as Chief Resident in Thoracic Surgery at Brigham and Women's Hospital. Dr. Wolf is interviewed by Shannon Sinclair, RN, BSN, OCN, who serves as the patient services director at the Mesothelioma Applied Research Foundation. www.curemeso.org.

Norton Healthcare's Plugged in to Nursing is the podcast that celebrates and informs the profession of nursing.     This Episode: Lightening the Load of Nursing Documentation   Summary: Nursing documentation is integral to positive patient outcomes and interdisciplinary teamwork, but documentation does take time. In this month's episode of Plugged In to Nursing, listen to Kristen McCoy Dietrich, nurse at Norton Healthcare, and Danette Culver, director of Clinical Effectiveness, discuss what Norton Healthcare is doing to help nurses improve efficiency of patient care by Lightening the Load of Nursing Documentation.   Speakers Kirsten McCoy Dietrich, RN Norton Audubon Hospital   Danette Culver MSN, APRN, ACNS-BC, CCRN-K, RN-BC Director, Clinical Effectiveness   Show Notes: American Nursing Informatics Association- The Six Domains of Burden: A Conceptual Framework to Address the Burden of Documentation in the Electronic Health Record ehrBurdenPosition.pdf (ania.org)     About Norton Healthcare's Center for Nursing Practice Norton Healthcare's Center for Nursing Practice is responsible for readying student nurses for practice and transitioning new graduate nurses into practice.  Our team is committed to serving the profession of nursing, meeting people where they are and taking them to where they want to be.   Contact Information:  PluggedInToNursing@nortonhealthcare.org  

About Yaw Fellin:Yaw J. Fellin, is the VP of Product and Solutions and Clinical Effectiveness for Wolters Kluwer HealthYaw Fellin brings more than 15 years of experience as a healthcare executive, with proven results leading cross-functional teams, generating value and revenue growth, most recently at Optum, a global healthcare IT company. Prior to that, Yaw spent over 12 years at the Advisory Board, a leading healthcare research firm, where he ultimately led its highest-growth SaaS business line. He received a BS in Healthcare Administration from Penn State University. Things You'll Learn:Wolters Kluwer is an integrated resource into EMRs to provide clinicians with mission-critical information as they make decisions to deliver high-quality care.In the Virtual Care Space, there is a need to amplify the quality and experience for both clinicians and patients.Virtual Care is here to stay as it's proven to increase access to patients and improve their experiences with support throughout their journeys.The Digital Health Architect Consumer Education Suite provides patients, consumers, and members access to evidence-based content to improve their digital health experiences.The EmmiGuide brings incremental benefits to payers by helping them with care management, particularly scaling member engagement. Resources:Connect with and follow Yaw Fellin on LinkedIn.Follow Wolters Kluwer Health on LinkedIn.Discover the Wolters Kluwer Health Website!Find Wolters Kluwer's Digital Health Architect Consumer Education Suite here!Find Wolters Kluwer's EmmiGuide in the Microsoft Commercial Marketplace here!

Dr. Munish Khaneja is the Chief Strategy Officer of CareAbout. Prior to joining CareAbout, Dr. Khaneja served as the Chief Medical Officer of Altruista Health, Inc., where he oversaw clinical strategy and regulatory innovation across all products and services. Prior to Altruista, Dr. Khaneja served as Vice President of Clinical Effectiveness and Pharmacy at EmblemHealth, where he was also the Corporate Clinical Lead for Population Health and Value-Based Purchasing. Dr. Khaneja has served as the Senior Vice President and Chief Medical Officer of Affinity Health Plan and the Greater Hudson Valley Health Center. He was also a Hospitalist at Kings County Health Center in Brooklyn, New York. Dr. Khaneja presently maintains academic affiliation as an Assistant Professor of Medicine and Pediatrics at SUNY Downstate College of Medicine. He is a board member and advisor to numerous national organizations and corporations and is a Fellow of the American College of Physicians.Dr. Khaneja graduated Summa Cum Laude with a B.S. in Chemistry from Brooklyn College. He holds his M.D. from the SUNY Downstate College of Medicine. In addition, Dr. Khaneja holds his M.S. in Public Health from the Mailman School of Public Health at Columbia University. He is trained in Internal Medicine and General Pediatrics, is a board-certified internist, and is certified in Medical and Healthcare Informatics. Please subscribe to our podcast on apple or amazon and give us a great review. You can make suggestions for guests and topics on our website below. Thanks for listening. Follow us on social media YouTube, Instagram, WebPage The Pediatric Lounge - A Podcast taking you behind the door of the Physician's Lounge to get a deeper insight into what docs are talking about today, from the clinically profound to the wonderfully routine...and everything in between. The conversations are not intended as medical advice and the opinions expressed are solely those of the host and guest.

For episode 10 of the Clinical Audit and Improvement Podcast, Diane Lynch and Zoe Lowe discuss how roles within clinical audit have changed over the years.This episode's guests:Diane Lynch is the Head of Clinical Effectiveness at The Dudley Group NHS Foundation Trust. She began her career in 1998 as a junior, collecting notes in her first clinical audit department. She aims to make the department she works in as productive as possible, which involves a passion for moving clinical audit from paper-based to digital systems.Zoe Lowe is the the Deputy Head of Clinical Effectiveness at Barnsley NHS Foundation Trust. She has been heavily involved in the redesign of the governance processes around Clinical Audit, NICE, and NCEPOD and has spoken at NQICAN meetings regarding improvements which include the introduction of a locally developed assurance assessment. Hosted on Acast. See acast.com/privacy for more information.

In this episode, we will learn about an occupational therapist who utilizes equine movement & animal-assisted therapy in her OT practice. Nicole Raftis, Registered Occupational Therapist, Manager for the Pathways Ponies Occupational Therapy program, ( graduated from Queen's University's School of Rehabilitation Science's Occupational Therapy Program and is a Registered OT in Guelph, Ontario, Canada. For the first 3 years of practice Nicole traveled and worked as an OT in 7 locations throughout the U.S.A and provided volunteer OT services in Guyana, Nepal, Thailand and India, taking in knowledge about the wide variety of roles OT's play in various settings as well as culturally sensitive and environmentally appropriate ways to support clients. Upon her return to Canada, Nicole has spent the majority of her 27 years of practice in pediatrics, initially working at Vancouver's Sunny Hill Health Center for Childern, on their Brain injury program, Autism Assessment Team and their Substance exposure team. Family brought Nicole to Ottawa where she provided school care services for a few years before taking her dream job at the Children's Hospital of Eastern Ontario, on the child and adolescent mental health units, gaining experience with psychotherapy and mental health practice. It was during her time in Ottawa that she got to experience the magic of pet therapy for the first time, helping to facilitate the sessions for kids experiencing significant emotional, sensory and behavior dysregulation. Aging parents inspired another move to Guelph, ON where Nicole has been working in private practice for the last 12 years. She continues to support children and teens to reach their full potential at home and school. The pandemic presented a unique opportunity for Nicole to become involved with a physical therapist who uses Equine movement and pet therapy to assist clients to reach their goals. Nicole was invited to develop an Occupational Therapy program at the barn and she has been thrilled to be a part of this initiative, integrating her mental health, sensory, motor and pet therapy experience to create a very holistic therapy program in a beautiful outdoor setting. Nicole has recently completed her American Hippotherapy Association Level 1 course and feels this latest adventure is a testament to the excitement and versatility that has been available over a 27-year career in Occupational Therapy. Nicole also mentors a number of younger OTs and supervises students from McMaster University. Her desire to share information and resources has led her to partner with other OTs in Guelph to create TREEO Occupational Therapy, an online library of courses and resources meant to support parents, teachers and OT's looking for pediatric resources. Their online platform launched in 2021 with their first course titled “Pandemic Parenting: Meaningful Tools for Health & Hope”. Their courses can be found at https://treeo-ot.thinkific.com My sincere apologies to my Canadian friends for my poor pronunciation of your provinces! Show Key Points:· Nicole gives us a glimpse of her background and interests· She describes her Uncommon OT work and whom she serves· She describes what inspired her to do this work and her path to entrepreneurship · She explains her holistic service and how it can benefit children· She provides OT practitioners an example of a typical session· She provides resources and her contact information RESOURCES: Email nicoleraftis@gmail.com IG @nicoleraftis.ot Check out my website www.nicoleraftis.ca https://treeo-ot.thinkific.com/courses/pandemic-parenting-burnout-meaningful-tools-for-health-hope Mims,D. & Waddell, R. (2016) Animal Assisted Therapy and Trauma Survivors. Evid Inf Soc Work. Sept-Oct 2016 13 (5). Young, C. & Horton, J. (2019). Canine and Equine Therapy for Mental Health: A Review of Clinical Effectiveness. Ottawa (ON): Canadian Agency for Drug & Technologies in Health 2019 August.As always, I welcome any feedback & ideas from all of you or if you are interested in being a guest on future episodes, please do not hesitate to contact Patricia Motus at transitionsot@gmail.com or DM via Instagram @transitionsot THANK YOU for LISTENING, FOLLOWING, DOWNLOADING, RATING, REVIEWING & SHARING “The Uncommon OT Series” Podcast with all your OTP friends and colleagues! Full Episodes and Q & A only available at: https://www.wholistic-transitions.com/the-uncommon-ot-seriesSign Up NOW for the Transitions OT Email List to Receive the FREE Updated List of Uncommon OT Practice Settingshttps://www.wholistic-transitions.com/transitionsot For Non-Traditional OT Practice Mentorship w/ Patricia: https://docs.google.com/forms/d/e/1FAIpQLSeC3vI5OnK3mLrCXACEex-5ReO8uUVPo1EUXIi8FKO-FCfoEg/viewformHappy Listening Friends!Big OT Love!All views are mine and guests own.Be a Patron to support The Uncommon OT Series Podcast project via Patreon.

Drs Michael Saag and Constance Benson discuss antiretroviral therapy, maintenance, and switching. Relevant disclosures can be found with the episode show notes on Medscape.com (https://www.medscape.com/viewarticle/963238). The topics and discussions are planned, produced, and reviewed independently of our advertiser. This podcast is intended only for US healthcare professionals. Resources Preexposure Prophylaxis for the Prevention of HIV Infection in the United States – 2021 Update https://www.cdc.gov/hiv/pdf/risk/prep/cdc-hiv-prep-guidelines-2021.pdf AIDS Clinical Trials Group https://actgnetwork.org/ Clarithromycin Therapy for Bacteremic Mycobacterium Avium Complex Disease https://www.acpjournals.org/doi/10.7326/0003-4819-121-12-199412150-00001?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed UC San Diego Medical Center https://healthlocations.ucsd.edu/san-diego/200-w.-arbor-drive-hospital Highlights from the Ryan White Clinical Conference https://www.hiv.gov/blog/long-acting-injectables-hold-promise-maintaining-viral-suppression-and-preventing-hiv Clinical Effectiveness of Integrase Strand Transfer Inhibitor–Based Antiretroviral Regimens Among Adults With Human Immunodeficiency Virus: A Collaboration of Cohort Studies in the United States and Canada https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8492356/ Key Considerations and Recommendations for Early (Acute and Recent) HIV Infection https://clinicalinfo.hiv.gov/en/guidelines/hiv-clinical-guidelines-adult-and-adolescent-arv/early-acute-and-recent-hiv-infection?view=full Rising Rates of Recent Preexposure Prophylaxis Exposure Among Men Having Sex with Men Newly Diagnosed With HIV: Antiviral Resistance Patterns and Treatment Outcomes https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8876422/ Long-acting Cabotegravir Plus Rilpivirine for Treatment in Adults With HIV-1 Infection: 96-week Results of the Randomised, Open-Label, Phase 3 FLAIR Study https://linkinghub.elsevier.com/retrieve/pii/S2352-3018(20)30340-4

Host Matt Fisher's guest is Jason Burum, GM, Healthcare Provider Segment, Clinical Effectiveness at Wolters Kluwer. Discussion topics include, addressing and filling in the knowledge gap between clinicians and consumers; translating knowledge to action points in a way that does not play just to a score; challenge of sorting information and knowledge to pragmatic perspectives; benefits of digitization; and stabilization of virtual care options and aligning interests. To stream our Station live 24/7 visit www.HealthcareNOWRadio.com or ask your Smart Device to “….Play HealthcareNOW Radio”. Find all of our network podcasts on your favorite podcast platforms and be sure to subscribe and like us. Learn more at www.healthcarenowradio.com/listen

Norton Healthcare's Plugged in to Nursing is the podcast that celebrates and informs the profession of nursing. This Episode - Be Sepsis Aware September is Sepsis Awareness Month, a time to educate health care professionals and the public about this life-threatening condition. Sepsis occurs when the body's response to an infection damages its own tissues. Almost any infection, including COVID-19, can lead to sepsis. In the latest “Plugged In to Nursing” podcast episode, Danette Culver, director, Clinical Effectiveness, and system lead for sepsis at Norton Healthcare, explains what sepsis is, why it is important for nurses to understand it and the amazing work Norton Healthcare is doing to help patients survive sepsis. Content Note: The speaker acknowledges a correction regarding Systemic Inflammatory Response Syndrome (SIRS): respiratory rate >20 is considered abnormal and a positive SIRS criteria.   About Norton Healthcare's Center for Nursing Practice Norton Healthcare's Center for Nursing Practice is responsible for readying student nurses for practice and transitioning new graduate nurses into practice.  Our team is committed to serving the profession of nursing, meeting people where they are and taking them to where they want to be. Contact Information:  PluggedInToNursing@nortonhealthcare.org  

Can you have less pain, less opioids, and faster and better recovery after surgery? Absolutely! ERAS, Enhanced Recovery After Surgery optimizes care before, during and after surgery in terms. Learn about ERAS from the President of ERAS USA. Dr Mike Scott  MB ChB FRCP FRCA FFICM Professor of Anesthesiology and Critical Care Medicine at the Hospital of the University of PennsylvaniaDivision Chief Surgical & Neuroscience Critical Care Medicine Medical Director, PENN E-LERT Telemedicine ICU Program University of Pennsylvania Biography Dr. Mike Scott undertook his undergraduate medical training in the UK and Postgraduate training in the UK and Australia. He trained in internal medicine before doing anesthesiology and critical care medicine and has Fellowships with the Royal College of Physician's, Royal College of Anaesthetists and Faculty for Intensive Care Medicine. He was one of the first clinicians to adopt Enhanced Recovery after Surgery (ERAS) principles in 2001 at the Royal Surrey County Hospital in Guildford UK and has championed it ever since. He was appointed a National Clinical Advisor in Enhanced Recovery for NHS Improvement in 2012. Mike has a keen research interest and has been investigator / Chief Investigator for multiple studies in analgesia, haemodynamic monitoring, fluid therapy and the stress response for surgery within an ERAS Protocol. He advocates opioid sparing analgesia and hemodynamic monitoring including bedside ultrasound as a standard of care. He was lead author of the Perioperative Quality Initiative for opioid sparing analgesia and recently co-author of the international multidisciplinary consensus statement on the prevention of opioid-related harm in adult surgical patients. Dr. Scott is President of ERAS USA and co-author for some of the ERAS Society Consensus Guidelines, Chair of the ERAS Education Committee and is on the ERAS Society Executive Committee. Mike has lectured extensively around the world and has published clinical trials, editorials and review papers. He is Senior Editor for Anesthesia and Analgesia. Dr. Scott moved to the USA from the UK at the end of 2016 to take up the position of Medical Director for Clinical Effectiveness and Division Chief of Critical Care medicine at Virginia Commonwealth University Health System, Richmond, Virginia. He moved to take up the position of Division Chief at the University of Pennsylvania at the beginning of 2020 just in time for the COVID pandemic! ERAS Resources Enhanced Recovery After Surgery Statement on prevention of opioid-related harm in surgery from international multidisciplinary healthcare professionals.

Being a doctor can be very gratifying when a life is saved or a patient is cured. However, the number of jobs and skills physicians need to master is increasing with the advancement of technology and science. This makes the medical environment increasingly stressful, also because at the moment, many IT solutions are burdensome and add the bureaucratic workload to the schedules of doctors. Today's topic is how to doctors approach and manage medication prescribing. I spoke with David W. Bates, Patient Safety Expert and Harvard MD, who is an internationally renowned expert in patient safety, using information technology to improve care, quality-of-care, cost-effectiveness, and outcomes assessment in medical practice. He is a Professor of Medicine at Harvard Medical School, and a Professor of Health Policy and Management at the Harvard School of Public Health, where he co-directs the Program in Clinical Effectiveness. He directs the Center for Patient Safety Research and Practice at Brigham and Women's Hospital, and serves as external program lead for research in the World Health Organization's Global Alliance for Patient Safety. He has published over 700 peer-reviewed papers.  We discussed:  How is patient care changing and impacting medication management, Why doctors ignore alerts of decision support systems, What are healthcare IT systems missing in the UX design,  What do doctors hope to see from IT in the near future, And how should organisations approach patient safety culture improvements? Enjoy the discussion, go to www.facesofdigitalhealth,com This discussion was part of a series of discussions recorded for the movie (OVER)DOSE - How can we prevent medication errors?  Opportunity: HRSA Announces New Loan Repayment Program for Behavioral Health Providers. Learn more and apply here: https://bhw.hrsa.gov/funding/apply-loan-repayment/star-lrp

Dr. Andrea Smith-Brooks, DNP, MBA, FNP-BC, ENP-C, received her Doctor of Nursing Practice and Master of Science degrees from University of Maryland School of Nursing in Baltimore, Maryland. She completed her Masters of Business Administration from R. H. Smith School of Business at the University of Maryland, College Park. She is certified by the American Nurses Credentialing Center as a Family Nurse Practitioner and the American Academy of Nurse Practitioners Certification Board as an Emergency Nurse Practitioner. Andrea has over 14 years of experience in emergency health care including emergency department and urgent care settings.  Dr. Andrea Smith-Brooks is the board president of the American Academy of Emergency Nurse Practitioners Dr. Smith-Brooks currently works as the Director of Clinical Effectiveness at the University of Maryland Medical Center, Division of Quality and Safety. Andrea maintains clinical practice in UMMC's Adult Emergency Department, UMMC Urgent Care and University of Maryland's Midtown Campus Emergency Department.  Link to claim CME credit: https://www.surveymonkey.com/r/3DXCFW3 (https://www.surveymonkey.com/r/3DXCFW3) CME credit is available for up to 3 years after the stated release date Contact CEOD@bmhcc.org if you have any questions about claiming credit.

Returning guest Pam Foster, VP Care Coordination, joins colleague Allison Rose, Network Director of Clinical Effectiveness, to share with host Gavin Ward and our audience about their initiatives at their muti-hospital system serving Scottsdale and Phoenix that end up leading to great outcomes for the patients that they ssrvice.

Celia Ingham-Clark is the Medical Director for Clinical Effectiveness at NHS England. Ms Ingham-Clark started off her career as a general surgeon before moving into leadership roles initially as Medical Director at trust level before going on to have a series of national roles at NHS England. Recently she has been heavily involved in important work tackling sepsis and saving lives. In 2013 She was awarded an MBE for services to the NHS. In this episode we ask her about: Her career Surgery Leadership Advice for medical students and young doctors   For comments, collaboration or feedback, contact us via email or Twitter. Email: medspirepodcast@gmail.com Twitter: @medspirepodcast  

In this week’s episode of Tuning Into the C-Suite, Managed Healthcare Executive Associate Editor Briana Contreras spoke with Denise Basow, president and CEO of Clinical Effectiveness at Wolters Kluwer. Briana and Basow discussed the importance of uniting prescribers and pharmacists at the point of care and how this form of care can create more efficient and effective operations within health systems.

2020 has been a tough year for healthcare personnel, for reasons including COVID-19. Many healthcare workers around the world, from the United States to China, have been reporting symptoms of anxiety and distress. In this episode, Professor Ciaran O'Boyle, Director of the RCSI Centre for Positive Psychology and Health in Ireland, reveals coping strategies for healthcare personnel and healthcare leadership, the type of authentic leadership that is required in current times, and how the very nature of healthcare itself needs to change in a rapidly changing and complex world. This episode was recorded in partnership with OBIX Middle East. Register for Webinar: Compassion, Clinical Effectiveness & Burnout: Essential Strategies for Nurse Leadership on 12 October: https://event.on24.com/wcc/r/2623884/1BCB07AE1444BDD9826A67F5CD19578F?partnerref=pdcst (https://event.on24.com/wcc/r/2623884/1BCB07AE1444BDD9826A67F5CD19578F?partnerref=pdcst)

Clinical effectiveness seeks to answer the question “What works?” in healthcare; what are the best ways to prevent, diagnose and treat diseases in children? Today we are going to talk with Lalit Bajaj, MD, MPH/MPSH and dive in to clinical effectiveness and look at how those practices are be applied here at Children’s Colorado and beyond and the impact of this work to the primary care setting. Dr. Bajaj is a Pediatric Emergency Medicine Physician, Professor of Pediatrics and Emergency Medicine at the University of Colorado School of Medicine, and Director of Clinical Effectiveness at Children’s Hospital Colorado. Pediatric Clinical Pathways Do you have thoughts about today's episode or suggestions for a future topic? Write to us, chartingpediatrics@childrenscolorado.org This episode was recorded prior to COVID-19.

Health care leaders are rightfully focused on solving immediate supply chain issues—like shoring up enough PPE and supplies to keep up with testing and begin restarting elective procedures. While the near term focus on supply chain is focused on operations—the long term outlook for supply chain is about to get far more strategic in nature. This episode addresses how Covid-19 could fundamentally change a provider’s approach to supply chain moving forward. More resources: Covid-19 Update: Supplies, equipment, and testing—the keys to reopening the economy Our take: Can online 'swap meets' fill hospitals' needs for PPE?

Paper for discussion: Clinical Effectiveness of the Elder-Friendly Approaches to the Surgical Environment Initiative in Emergency General Surgery Teaching topic: Hypothesis Testing Our tune is"Inspiring Optimistic Upbeat Energetic Guitar Rhythm" by Free Music | https://soundcloud.com/fm_freemusic Music promoted by https://www.free-stock-music.com Creative Commons Attribution 3.0 Unported License https://creativecommons.org/licenses/by/3.0/deed.en_US

Show notes at pharmacyjoe.com/episode499. In this episode, I ll discuss an article about using prothrombin complex concentrates for the treatment of factor Xa inhibitor-related intracranial hemorrhage. The post 499: What is the Clinical Effectiveness of PCC in Factor Xa Inhibitor-Related Intracranial Hemorrhage? appeared first on Pharmacy Joe.

Dr. Philip Hykin discusses the LEAVO trial which was a large prospective trial comparing the efficacy of three main anti-VEGF intravitreal injections (bevacizumab, ranibizumab and aflibercept) for treating macular edema secondary to Central Retinal Vein Occlusion. The discussed article: Clinical Effectiveness of Intravitreal Therapy With Ranibizumab vs Aflibercept vs Bevacizumab for Macular Edema Secondary to Central Retinal Vein Occlusion: A Randomized Clinical Trial. Hykin P, Prevost AT, Vasconcelos JC, Murphy C, Kelly J, Ramu J, Hounsome B, Yang Y, Harding SP, Lotery A, Chakravarthy U, Sivaprasad S; LEAVO Study Group. JAMA Ophthalmol. 2019 Aug 29. doi:10.1001/jamaophthalmol.2019.3305.

Nearly 75% of Americans will consider healthcare a main factor when they vote in the 2020 presidential election, according to a survey published by Wolters Kluwer late last year. The survey, called Mending HealthCare in America 2020: Consumers & Cost, showed alignment and deep divisions among patients and providers, with issues around transparency, cost, and care variability causing concern. On this episode of the podcast, we speak with Peter Bonis, MD, chief medical officer, Clinical Effectiveness, Wolters Kluwer, Health.

In this episode of the PILL podcast, we interview Dr. Ken Wilson, an Executive Consultant for Norton Healthcare in Louisville, KY.  Dr. Wilson has years of experience leading complex implementation efforts. He provides unique insight from a strategic perspective of change in a large health system within a competitive marketplace.He is also a leader in the enterprise-wide adoption of the Patient-Centered Medical Home model at Norton Healthcare. He previously served as the System Vice President for Clinical Effectiveness & Quality. During his years in this position, Dr. Wilson had oversight over Norton's quality program. In his spare time, he travels internationally to help improve medical care. He has traveled to Rwanda, Uganda, Kenya, and other countries. If you need assistance with quality improvement call the Kentucky REC at 859-323-3090 or check out our website at www.kentuckyrec.com. For specific Quality Payment Program assistance, check out our online resource center at www.qppresourcecenter.orgRoyalty Free Music from Bensound 

Bridget Gaglio PhD, MPH is a Senior Program Officer for the Clinical Effectiveness and Decision Science program at the Patient-Centered Outcomes Research Institute (PCORI). She works to improve communication and dissemination of evidence-based information among patients and their healthcare providers. Gaglio has published papers on patient-centered communication, health literacy, and dissemination and implementation of health interventions. […]

Bridget Gaglio PhD, MPH is a Senior Program Officer for the Clinical Effectiveness and Decision Science program at the Patient-Centered Outcomes Research Institute (PCORI). She works to improve communication and dissemination of evidence-based information among patients and their healthcare providers. Gaglio has published papers on patient-centered communication, health literacy, and dissemination and implementation of health interventions. […]

Dr. Austin Chiang is a triple board-certified, dual ivy-league (Harvard, Columbia) educated and trained gastroenterologist and advanced endoscopist. Dr. Chiang's interests include novel endoscopic weight loss treatments as well as the complex interventional endoscopic procedures including the diagnosis and treatment of various gastrointestinal conditions and their complications. Dr. Chiang is currently an Assistant Professor of Medicine at Jefferson Health (Thomas Jefferson University Hospitals) in Philadelphia, PA, and serves as the Director of the Endoscopic Weight Loss Program and Chief Medical Social Media Officer for the health system. Passionate about empowering patients with accurate medical information online, he pursued a Masters In Public Health with a field of study in Clinical Effectiveness and a concentration in Public Health Leadership. Consistently one of the most influential voices in the field of gastroenterology online, Dr. Chiang has conducted extensive research in social media and is champion of physician presence on social media and is the Chief Medical Social Media Officer of Jefferson Health and Founding President of the Association for Healthcare Social Media (AHSM), the first 501(c)(3) professional society for health professional social media use. In this episode, we talk about: How prioritizing has helped him in work and life Medical beginnings How to choose a speciality Good days and bad days in medicine Leadership Best practices for healthcare professionals using social media How to overcome your fear when starting a healthcare social media account Connect with Austin: Website: http://www.austinchiang.com/ YouTube: https://www.youtube.com/austinchiangmd Instagram: https://www.instagram.com/austinchiangmd/ Joy Energy Time Club Waitlist: https://joyenergytime.mykajabi.com/joyenergytimeclub Join the Joy Energy Time Collective, our bi-weekly wellness newsletter for healthcare professionals: https://www.joyenergytime.com/the-thriving-collective/ Our Instagram: www.instagram.com/burntouttolitup/ www.instagram.com/joy.energy.time/ Facebook: www.facebook.com/burntouttolitup Free Guides for Occupational Therapists + All Healthcare Professionals: https://www.joyenergytime.com/resources/ Support the Podcast! patreon.com/burntouttolitup Our website: joyenergytime.com/podcast

Interview with Adrian F. Hernandez, MD, MHS, author of Clinical Effectiveness of Direct Oral Anticoagulants vs Warfarin in Older Patients With Atrial Fibrillation and Ischemic Stroke: Findings From the Patient-Centered Research Into Outcomes Stroke Patients Prefer and Effectiveness Research (PROSPER) Study

Interview with Adrian F. Hernandez, MD, MHS, author of Clinical Effectiveness of Direct Oral Anticoagulants vs Warfarin in Older Patients With Atrial Fibrillation and Ischemic Stroke: Findings From the Patient-Centered Research Into Outcomes Stroke Patients Prefer and Effectiveness Research (PROSPER) Study

As providers, the safety of our patients is paramount. In recent years, increased attention has been given to diagnostic error in medicine, specifically those that arise through error in cognitive perception, failed heuristics and biases. In today’s episode, we are talking with Joe Grubenhoff, MD about error in diagnosis and strategies for reducing cognitive bias. Dr. Grubenhoff is the Associate Medical Director of Clinical Effectiveness and is a pediatric emergency medicine physician at Children’s Colorado. He is also an Associate Professor of Pediatrics at the University of Colorado School of Medicine. Resources mentioned in today's episode: How Doctor's Think by Jerome Groopman, MD Thinking Fast and Slow by Daniel Kahneman What did you think of today's episode? Send Dr. Brumbaugh a tweet @DBrumbaughMD.

They say that civilization advances by extending the number of important things we can do without thinking about them. To me, that's the promise of technology and it's particularly true when it comes to artificial intelligence and machine learning. Still, not everyone sees it that way. Some worry that they'll be replaced. Others take offense to the fact that they're seen as replaceable. But just like the rise of ATMs led to an INCREASE in the number of bank tellers, we'll see AI drive unpredictable, and generally positive change in the healthcare industry. Some will be displaced, but if they're open to it they'll be in a position to take on new and even more valuable roles that we can't even imagine today. Side note: AI may just help us deal with the projected doctor shortage. I know what you're thinking: That's big talk from an industry that recently gave you the EMR. That's fair, but there is a way to do this right. And that's what we're going to talk about today. Today's guests are Shahid Shah (usually co-host, but today I'm calling him a guest) and Dr. Chesley Richards, CDC Deputy Director for Public Health Scientific Services. Together we'll discuss the rapid pace of technological change in healthcare and what that means for doctors, vendors and patients. We'll show you how AI will complement and enhance the capabilities of today's clinicians and allow them to focus on keeping us healthy. We'll show you how technology, when its properly deployed and used, can be incredibly effective. And perhaps, most importantly, we'll tell you why listening is the starting point and potentially the most important thing you can do to ensure this all goes well. An overview of The Health IT Leadership Summit w/ Jody Braner and an introduction to today's podcast guests (0:00 - 10:20) Given all the advances in technology such as Artificial Intelligence, Machine Learning, Predictive Analytics, Precision Medicine, etc. will doctors have jobs in 10 years? (11:10) Similarly, what will HealthIT vendors be working on in 10 years? (20:30) Looking at vaccines as technology, and applying that technology intelligently and in a way that was designed to work in specific communities and regions allowed us to eradicate diseases like Smallpox (29:38) How can tech vendors realign themselves to support the goal of cures instead of focusing on disease management and administration? (32:00) What hurdles do we have to get over so that collectively we're getting back to our focus on cures over just treatment? (35:15) Why does population health matter? (38:00) Let's discuss the dangers of technology and how it can adversely impact the delivery of care when it's not properly deployed and used. (41:00) We often think of technology as a way to digitize and automate what I do today. Why don't we take the opportunity to ask what we can do better? What can we stop doing altogether? (43:00) How can we power all of this in new ways with data? (47:35) How can the CDC and other organizations open up more data for public experimentation? (52:00) What new workforce needs or changes will emerge in healthcare in the coming years? (56:00) We can use data to cut down on the time from idea thru randomized trial to approval of new drugs - today that might take up to 17 years!!!! (1:01:35) This is a very engaging and insightful conversation, and one I know will make you think about a few things differently. I can honestly say that I loved listening to the final product and I believe you will too. Enjoy! ~ Don Lee About Chesley Richards and CDC Chesley Richards M.D., M.P.H., F.A.C.P. is Centers for Disease Control and Prevention (CDC) Deputy Director for Public Health Scientific Services as well as Director, Office of Public Health Scientific Services. In these two roles, Dr. Richards is a key advisor to the CDC Director and oversees the National Center for Health Statistics (NCHS) and the Center for Surveillance, Epidemiology, and Laboratory Services (CSELS) with activities that include the MMWR, Vital Signs publications, the Epidemic Intelligence Service and other scientific training programs, the Guide to Community Preventive Services, and a broad range of cross cutting epidemiology, public health surveillance, and laboratory services. Dr. Richards earned his M.D. from the Medical University of South Carolina, an M.P.H. in Health Policy and Administration from University of North Carolina at Chapel Hill and is a graduate of the Epidemic Intelligence Service (EIS) at CDC, the Cancer Control Education Fellowship at UNC Lineberger Cancer Center and the Program on Clinical Effectiveness at Harvard School of Public Health. He completed Internal Medicine (Medical College of Georgia), Geriatric Medicine (Emory University) and General Preventive Medicine and Public Health (UNC Chapel Hill). Learn more: https://www.cdc.gov About The 8th Annual Health IT Leadership Summit Created in 2010 by the Georgia Department of Economic Development, the Metro Atlanta Chamber and the Technology Association of Georgia's Health Society, the Health IT Leadership Summit brings together leaders from across the healthcare continuum to discuss how the industry can drive innovation to enable better healthcare delivery at lower costs to more people. November 7, 2017 - Atlanta, GA “Join industry thought leaders as we explore and collaborate on the importance of connectivity and working together for the advancement of healthcare delivery. Hear how health IT is formalizing analytics, encouraging patient engagement and implementing value-based care. What is working? What is not working? Learn about success stories and road blocks. This event is also an opportunity for your voice to be heard, as each session includes audience question and answer sessions. You will hear from security professionals, providers, innovative companies and other leading professionals. We also have a few exciting demonstrations to share. I look forward to seeing you!” Jodie Braner, 2017 HIT Summit Chair Learn more and register: https://healthitleadershipsummit.com/ Weekly Updates If you like what we're doing here, then please consider signing up for our weekly newsletter. You'll get one email from me each week detailing: New podcast episodes and blog posts. Content or ideas that I've found valuable in the past week. Insider info about the show like stats, upcoming episodes and future plans that I won't put anywhere else. Plain text and straight from the heart :) No SPAM or fancy graphics and you can unsubscribe with a single click anytime. The #HCBiz Show! is produced by Glide Health IT, LLC in partnership with Netspective Media. 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Rosalind English discusses with David Hart QC a recent challenge to the refusal by the NHS to fund a specialist drug for a child suffering from a metabolic condition.

Date: March 7, 2013 Featuring: Gene H. Burke, MD, Vice President and Executive Medical Director for Clinical Effectiveness, Sentara Healthcare Michael Howell, MD, Director of Healthcare Delivery Science, Director of Critical Care Quality, Beth Israel Deaconess Medical Center Lisa L. Maragakis, MD, MPH, FSHEA, Director of Hospital Epidemiology and Infection Control, Johns Hopkins Hospital Scott A. Miller, MD, FACP, Vice President, Medical Affairs, Sentara Leigh Hospital Tom Talbot, MD, MPH, Chief Hospital Epidemiologist, Vanderbilt University Medical Center One of the cornerstones of infection prevention in any health care setting, including when someone is being cared for at  home, is good hand hygiene. Much of the attention in recent years has focused on hospitals and their rates of hand hygiene compliance among staff. And rightly so. Among the biggest contributors to hospital-acquired infections are, inadvertently, health professionals themselves... and others who come in contact with patients.The good news is that awareness of the necessity of strict hand hygiene compliance has never been greater… not just in the US, but in acute care settings globally. And this awareness has been coupled with practices that are being adhered to more reliably than ever before. But not everywhere, all the time; organizations that can tout rates as high as 95% are still the exception, not the rule, and good performers continue to face challenges closing the gap.WIHI host Madge Kaplan gathered infection prevention leaders and clinicians from four organizations whose recent innovations with hand hygiene at their facilities represent what could be the best bet yet that 100% compliance is achievable. Sentara, Johns Hopkins, Vanderbilt, and Beth Israel Deaconess Medical Center all have fresh approaches that rely on new kinds of auditing tools to discern what really works; better surveillance, monitoring, and measuring; reengineering; constant education; and a laser-like focus on behavior and culture change.  What’s working in your organization? How are you getting your hand hygiene compliance rates to move upward? Compare and contrast your methods with those of our guests on this WIHI.

David W. Bates, M.D., M.Sc. Chief, Division of General Internal Medicine, Brigham and Women's Hospital Medical Director of Clinical and Quality Analysis, Partners HealthCare Dr. Bates is an internationally renowned expert in patient safety, using information technology to improve care, quality-of-care, cost-effectiveness, and outcomes assessment in medical practice. He is a Professor of Medicine at Harvard Medical School, and a Professor of Health Policy and Management at the Harvard School of Public Health, where he co-directs the Program in Clinical Effectiveness. He directs the Center for Patient Safety Research and Practice at Brigham and Women's Hospital. He served as external program lead for research in the World Health Organization's Global Alliance for Patient Safety and is the immediate past president of the International Society for Quality in Healthcare (ISQua) and the editor of the Journal of Patient Safety. He has been elected to the Institute of Medicine, the American Society for Clinical Investigation, the Association of American Physicians and the American College of Medical Informatics, and was chairman of the Board of the American Medical Informatics Association. He has published over 700 peer-reviewed papers and has an h-index of 115, which ranks him among the 400 most cited biomedical researchers of any type. Websites: www.patientsafetyresearch.org 00:00 The Prospect Study. 03:35 Facilitating Engagement and Minimizing Harm. 04:40 “Sometimes it's the right thing not to do some of the things on the checklist, but sometimes we're just too busy.” 05:00 Patients and Care Partners contributing to the overall Quality of Care. 06:00 Why Brigham and Women's Hospital chose to focus on Patient and Caregiver Engagement. 07:00 “Healthcare is so multifactorial there are many, many ways to make it better.” 08:20 The Nature of Innovation. 10:00 The stages in Brigham and Women's Hospital's pipelines. 14:20 Narrowing focus. 16:00 David discusses Clinical Imperative. 16:40 Defining Costs. 17:35 Working with ValueScope to address Patient Costing. 20:00 An example of Patient Cost. 25:00 Social Determinants. 26:00 High Cost Patient Management. 26:50 Using the LACE Risk Stratification tool. 29:20 Achieving gains with Caregivers. 29:40 “What are the Key Barriers to Care?” 31:00 SCAMPs - Standardized Clinical Assessment and Management Plans. 34:45 You can learn more by emailing David directly at dbates@partners.org.

This episode features Dr. Peter Bonis, Chief Medical Officer, and Dr. Denise Basow, President and CEO of Clinical Effectiveness for Wolters Kluwer Health, discussing current challenges in the U.S. healthcare space, including undesirable variability in care, suboptimal patient outcomes and rising costs, and the digital solutions necessary to address these problems. We hope this will be a valuable insight into how a coordinated, harmonized, multitargeted digital solution might meet these challenges and improve healthcare delivery and outcomes for patients, clinicians, and payers.

Dr. Simpson is the president and chief executive officer of AcademyHealth. A nationally recognized health policy researcher and pediatrician, she is a passionate advocate for the translation of research into policy and practice. Her research focused on improving the performance of the health care system and included studies of the quality and safety of care, health and health care disparities and the health policy and system response to childhood obesity. Before joining AcademyHealth, Dr. Simpson was director of the Child Policy Research Center at Cincinnati Children's Hospital Medical Center and professor of pediatrics in the Division of Health Policy and Clinical Effectiveness, Department of Pediatrics, University of Cincinnati. She served as the Deputy Director of the Agency for Healthcare Research and Quality from 1996 to 2002. Dr. Simpson serves on the Robert Wood Johnson Clinical Scholars Program National Advisory Council, and the Editorial boards for the Journal of Comparative Effectiveness Research and Frontiers in Public Health Systems and Services Research. Dr. Simpson earned her undergraduate and medical degrees at Trinity College (Dublin, Ireland), a master's in public health at the University of Hawaii, and completed a post-doctoral fellowship in health services research and health policy at the University of California, San Francisco. She was awarded an honorary Doctor of Science degree by the Georgetown University School of Nursing and Health Studies in 2013. 00:00 What Academy Health is.00:45 How Academy Health improves the health system by using health evidence to inform current health policy decision makers.04:00 How Academy Health helps organizations learn from each other.07:40 “What are we learning from the research?”09:00 “The decisions will be made, and our goal is to bring evidence into that decision-making process.”14:45 “The reality is that it's not one or the other, it's a continuum in between.”16:00 A continuum of research between explanation and intervention.16:30 “What works, and at what cost?”22:20 The three counsels at Academy Health: Education, Methods, and Measurements.24:00 The 19 different themes happening at Academy Health's annual meeting in Boston.27:30 Academy Health's partnership with the Annual Health Datapalooza.28:00 “Data Liberation and Data Application.”30:00 The “tsunami of data available” at the Annual Health Datapalooza.34:00 You can find out more information at www.academyhealth.org or by emailing Lisa at lisa.simpson@academyhealth.org.

WSP - N Kinney, S Clinical Effectiveness Committee A Catalyst For Improving Patient Care by OPENPediatrics

Treatment failure during venom immunotherapy (VIT) may be associated with a variety of risk factors. Our aim was to evaluate the association of baseline serum tryptase concentration (BTC) and of other parameters with the frequency of VIT failure during the maintenance phase. In this observational prospective multicenter study, we followed 357 patients with established honey bee or vespid venom allergy after the maintenance dose of VIT had been reached. In all patients, VIT effectiveness was either verified by sting challenge (n = 154) or patient self-reporting of the outcome of a field sting (n = 203). Data were collected on BTC, age, gender, preventive use of anti-allergic drugs (oral antihistamines and/or corticosteroids) right after a field sting, venom dose, antihypertensive medication, type of venom, side effects during VIT, severity of index sting reaction preceding VIT, and duration of VIT. Relative rates were calculated with generalized additive models. 22 patients (6.2%) developed generalized symptoms during sting challenge or after a field sting. A strong association between the frequency of VIT failure and BTC could be excluded. Due to wide confidence bands, however, weaker effects (odds ratios

Professor Simon Gowers speaks about the clinical effectiveness of treatments for anorexia and the cost-effectiveness of three treatment strategies for adolescents with anorexia nervosa.

Background: Children with congenital hearing impairment benefit from early detection and treatment. At present, no model exists which explicitly quantifies the effectiveness of universal newborn hearing screening (UNHS) versus other programme alternatives in terms of early diagnosis. It has yet to be considered whether early diagnosis (within the first few months) of hearing impairment is of importance with regard to the further development of the child compared with effects resulting from a later diagnosis. The objective was to systematically compare two screening strategies for the early detection of new-born hearing disorders, UNHS and risk factor screening, with no systematic screening regarding their influence on early diagnosis. Methods: Design: Clinical effectiveness analysis using a Markov Model. Data Sources: Systematic literature review, empirical data survey, and expert opinion. Target Population: All newborn babies. Time scale: 6, 12 and 120 months. Perspective: Health care system. Compared Strategies: UNHS, Risk factor screening (RS), no systematic screening (NS). Outcome Measures: Quality weighted detected child months (QCM). Results: UNHS detected 644 QCM up until the age of 6 months ( 72,2%). RS detected 393 child months (44,1%) and no systematic screening 152 child months (17,0%). UNHS detected 74,3% and 86,7% weighted child months at 12 and 120 months, RS 48,4% and 73,3%, NS 23,7% and 60,6%. At the age of 6 months UNHS identified approximately 75% of all children born with hearing impairment, RS 50% and NS 25%. At the time of screening UNHS marked 10% of screened healthy children for further testing ( false positives), RS 2%. UNHS demonstrated higher effectiveness even under a wide range of relevant parameters. The model was insensitive to test parameters within the assumed range but results varied along the prevalence of hearing impairment. Conclusion: We have shown that UNHS is able to detect hearing impairment at an earlier age and more accurately than selective RS. Further research should be carried out to establish the effects of hearing loss on the quality of life of an individual, its influence on school performance and career achievement and the differences made by early fitting of a hearing aid on these factors.