Love innovation? Ideas worth spreading in healthcare.....
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How do you imagine healthcare development in the current financial context?
This could make for a bleak picture EXCEPT that stringent financial times mean we need to explore new possibilities for healthcare development - unless there is a consensus otherwise. This means including the community beyond the standard health reference framework.
Does the system deliver what is expected? what is being paid for? As for the burning financing questions as it is not my area of expertise - will have to leave to those with finance and economic experience.
To look at the new approaches to current healthcare problems in the context of the World Health Organisation (WHO) report from the Global Disease Burden project (scroll down for information on the context), I thought I'd focus today on two topics in no particular order:
1. Malaria
2. Research
Contents at a Glance
- Insecticide treated nets work against Malarial disease in kids - Cochrane Database 1998
- SO, why do we care about Malaria? It results in death of ~ 1 million children every year but also serves as a case study
- Context - World Health Organization*
Insecticide treated nets work against Malarial disease in kids - Cochrane Database 1998
Front cover World Malaria Report 2008 - graph increase delivery treated nets (orange)
Exploring new potential for healthcare development that includes the community beyond the standard health reference framework is important to me working in healthcare and makes for very interesting possibilities.Report's cover designed by Anne Guilloux and Christopher Dye. The bars show the growing number of insecticide-treated nets (ITN) sold or delivered worldwide between 2001 and 2006. There was a modest increase in the number of conventional ITN delivered in 2005 and 2006 (blue bars), and a large increase in the number of long-lasting insecticidal nets delivered (orange bars), especially to countries in the African Region.
Household surveys and data from national malaria control programmes (NMCPs) show that the coverage of all interventions in 2006 was far lower in most African countries than the 80% target set by the World Health Assembly. Supplies of insecticide-treated nets (ITN) to NMCPs were sufficient to protect an estimated 26% of people in 37 African countries.
Scroll down for information on the Cochrane Collaboration research library.
SO, why do we care about Malaria? It results in death of ~ 1 million children every year but also serves as a case study
World Malaria report 2008
The health reference framework has clear evidence for over 10 years (Cochrane Database of Systematic Reviews 1998 - see the Cochrane Collaboration module for more information) that insecticide treated nets are highly effective in reducing childhood morbidity and mortality from Malaria. The authors concluded that major infrastructural input was needed for prevention.
The clearest idea I've come across on organising and measuring the latter infrastructural input is from Jacqueline Novogratz's talk on new approaches to addressing such challenges (scroll down to see YouTube presentation module further along under this lens). The fact that a minority (26% of the population that need protection) had nets in the face of good medical research evidence means that approaches had to change to effect an improved outcome. The problems identified had to do with net production, distribution and investment in equipment. These new broader approaches involved the business and local community in addition to the work in the healthcare sector. Jacqueline mentions supporting the manufacture and distribution of insecticide-treated nets in a factory in Tanzania increasing production from around 1.5 million in 2005 to 7 million nets in 2006/7 from which led additional benefits in the form of 1000 extra jobs, significant contribution to the national economy and the creation of local distribution networks.
Q: If around a quarter of the African population who need malaria nets have them and long-lasting treated nets have a 5 year lifespan - does that mean for those of you with business expertise - that there is capacity for at least 3 more factories for production and price competition purposes?
Context - World Health Organization*
Global Burden of Disease Project (Oct 2008)
- Cardiovascular diseases are the leading causes of death in the world
- HIV/AIDS is the leading cause of adult death in Africa
- Population ageing is contributing to the rise in cancer and heart
- Lung cancer is the most common cause of death from cancer in the world
- Complications of pregnancy account for almost 15 % of deaths in women of reproductive age worldwide
- Hearing loss, vision problems and mental health disorders (estimates of 120 million people worldwide affected by depression) are the most common causes of disability
- Road traffic injuries are projected to rise from the 9th leading cause of death globally in 2004, to 5th in 2030
- *World Health Organization
- Established in 1948, the World Health Organization has a constitution stating that its objective "is the attainment by all peoples of the highest possible level of health."[1] Its major task is to combat disease, especially key infectious diseases, and to promote the general health of the people of the world.
Context - the Cochrane Collaboration Library; Clinical Knowledge Summaries
This version first published online: July 27. 1998
Last assessed as up-to-date: January 19. 2004
Sleeping under mosquito nets treated with insecticide aims to prevent malaria in areas where the infection is common. They are widely promoted by international agencies and governments to reduce the bad effects of malaria on health. This review showed that good quality studies of impregnated nets markedly reduce child deaths and illnesses from malaria.
Insecticide-treated nets can reduce deaths in children by one fifth and episodes of malaria by half.
- The Cochrane Collaboration; Cochrane library reviews
- This database offers free access to health research abstracts that follow the Cochrane methodology and, where available, the plain language summaries of all Cochrane systematic reviews. Links to the full-text versions are available on each page (see below for more information on access).
Browse abstracts & summaries:-
By topic (according to Cochrane Review Groups)
Full list of reviews (alphabetical list by title)
Full list of protocols (alphabetical list by title)
Full list of registered titles (alphabetical list by title)
By date and origin
New reviews only (all new reviews from the current issue)
Updated reviews only (all updated reviews from the current issue)
By date range
By country of author
Special collections
Audio summaries of selected reviews (Podcasts from The Cochrane Library)
Evidence Aid summaries (resources for natural disasters and other healthcare emergencies)
Cochrane Methodology abstracts
Other languages
Abstracts in Spanish (from La Biblioteca Cochrane Plus)
Summaries in German (approx. 700 German summaries) - Clinical Knowledge Summaries - safe practical clinical answers fast
- Clinical Knowledge Summaries - CKS
What is CKS?
The NHS Clinical Knowledge Summaries (formerly PRODIGY) are a reliable source of evidence-based information and practical 'know how' about the common conditions managed in primary care. They are aimed at healthcare professionals working in primary and first-contact care.
How does it help?
CKS provides quick answers to real-life questions that arise in the consultation, linking to detailed answers that clearly outline the evidence on which they are based.
Research - Illustration of a complex task common to all healthcare..
Medical research project planning...
Credit for the image above to David Dilts, PhD published by the Huffington post: (http://images.huffingtonpost.com/2009-08-13-87Steps_450.jpg).
Exploring new possibilities for healthcare development that includes ongoing research is essential. As Dan Ariely illustrates in his writings about behavioural economics; the only way to determine whether or not an intervention should be applied in a setting is to test it out (unless you have the evidence already). Scroll down for Dan's YouTube presentation. I believe that this is as true of the healthcare setting as any other sector and it differs between countries. And within countries there are differences between communities. Without research, expensive implementation (translation) into daily practice could fail; some would say is likely to fail depending on the outcome measured.
As research continues, the amount of information resource that accumulates will need to be organised so that it may be accessed and also that it may be processed in its entirety; thus avoiding needless repetition.
There are two main questions I have along with observations and ideas - perhaps you might like to add to these:
Q: How do you maintain research development apace to benefit the population in the light of financial stringency and complex research planning exercises?
For what it's worth I think this question needs to be addressed by committed individuals in a position to take responsibility for research to continue as necessary in a sensible streamlined manner.
Q: How is information retained in an accessible format that reflects the sum of the information known so far on a global scale?
For example the vast (and growing) information resources of the international Cochrane Collaboration (see module link) or the multidisciplinary expertise of the US Agency for Healthcare Research and Quality (see context link under this lens) may need to cross-reference large amounts of material for the benefit at population level....
I don't know the answer - but this is where Blaise Aguera y Arcas' presentation (see YouTube vid) on new approaches to data storage technology comes into play. He illustrates how large amounts of data available electronically can be stored in a complete manner using Photosynth technology to give a composite image of the globally available resources.....
I just wonder if this has further applications? to research resources perhaps? even electronic health records for patient care? particularly applications in radiology/ imaging technology...maybe?
Context - the Agency for Healthcare Research and Quality
- Agency for Healthcare Research and Quality
- This link provides access to information on health services research work including the link to the U.S. Preventive Services Task Force (USPSTF).
The USPSTF was convened by the U.S. Public Health Service in 1984 and sponsored by the Agency for Healthcare Research and Quality (AHRQ) since 1998, is the leading independent panel of experts in prevention and primary care.
The USPSTF conducts rigorous, impartial assessments of the scientific evidence for the effectiveness of a broad range of clinical preventive services, including screening, counseling, and preventive medications. Its recommendations are considered the "gold standard" for clinical preventive services.
Reference YouTube vids
Dan Ariely, James B. Duke Professor of Behavioral Economics at Duke University -Behavioural Economics.
Blaise Aguera y Arcas is an architect at Microsoft Live Labs, architect of Seadragon, and the co-creator of Photosynth.
The COCHRANE Library on Youtube!
Some questions - any ideas?
First lens - what can I say? - Thank you for stopping by!
Please note the opinions above are personal to me. I appreciate any details on factual corrections.
These are some questions I have along with observations and ideas - perhaps you might like to add to these?
Q: If around a quarter of the African population who need malaria nets have them and long-lasting treated nets have a 5 year lifespan - does that mean for those of you with business expertise - that there is capacity for at least 3 more factories for production and price competition purposes?
Q: How do you maintain research development apace to benefit the population in the light of financial stringency and complex research planning exercises?
Q: How is information retained in an accessible format that reflects the sum of the information known so far on a global scale?
New Link List
- Research to Reform: Achieving Health System Change - 2009
- The Agency for Healthcare Research and Quality will host an agenda on many topics including:
Track A: Health Care Infrastructure
Track B: Organization of How Services Are Delivered
Track C: Health Care Quality and Safety
Track D: Improving Americans' Health Status
Track E: Provider Performance and Payment Reform
Track F: Increasing Patient and Consumer Involvement in Their Care
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The Blue Sweater: Bridging the Gap Between Rich and Poor in an Interconnected World
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Great Stuff on Amazon
Predictably Irrational, Revised and Expanded Edition: The Hidden Forces That Shape Our Decisions
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by 2c_l-p
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