Showing posts with label clinic. Show all posts
Showing posts with label clinic. Show all posts

Friday, November 20, 2020

Improving patient care with rich data

Many older adults are thriving thanks to advances in healthcare technology. Instead of trips to the doctor or emergency room when they experience a change in their health, seniors are taking advantage of solutions such as remote patient monitoring (RPM). RPM can help healthcare providers monitor patients around the clock while they remain at home. This is transforming senior patient care, ensuring a patient’s safety and wellbeing while allowing them to live independently.

The COVID-19 pandemic has spurred interest by healthcare providers in solutions such as RPM, keeping at-risk patients safely in their homes while still providing continuous, stellar care.

Having access to patients’ current vital statistics (such as blood pressure, oxygen levels, weight, temperature etc.) is important for healthcare providers, but RPM provides more than just daily data points. It also offers context through a set of rich data that allows healthcare providers to:
  • Track patients’ vital statistics in real time or over time
  • Quickly spot trends and determine a course of action because healthcare providers can see data in context
  • Proactively make an assessment—solving small problems before they become big ones
  • Communicate one-on-one with patients via the RPM device to gain additional information about their condition


Rich data using RPM can often give healthcare providers a better overview of the patient’s health than a single encounter in an office or an emergency room. By expanding health data about a patient to include their vital statistics over time as well as in real time, healthcare providers can better understand their patient’s health and spot any trends that cause concern.
RPM in Use

A few examples stand out when it comes to showing the value of rich data in a remote healthcare environment:

A patient with high blood pressure. By tracking a patient’s blood pressure both over time and in real time, RPM solutions can spot anomalies such as an unusually high blood pressure reading or a trend upward over the course of a week. The healthcare provider can then use that rich data to contact the patient using the RPM device for immediate follow up, ask questions such as “are you feeling dizzy?” and determine a course of action. Sometimes that may be a trip to the hospital or doctor’s office, and other times a healthcare provider can make a recommendation that keeps the patient in their home.


A patient with chronic heart failure (CHF). CHF is one of the highest impact areas for RPM—it’s a disease for which there is no cure and needs constant supervision. Patients must weigh themselves daily, as well as take their blood pressure and oxygen levels frequently. By having this information at their fingertips, healthcare providers can intervene in a preventative or proactive way, helping patients eliminate visits to the emergency room or a doctor’s office. If a doctor has information every day about the patient, they can help keep them at home and allow them to live their lives more independently.

RPM solutions can also “learn” from the patient’s behavior and determine how to make it easier for them to participate fully in their care. An example of this is if a patient fails to consistently take their medicines at the same time every day, the RPM solution can help them find a better time each day. Reminders can be adjusted and sent at different times to establish a more consistent time.

Making the Connection


For RPM solutions to be successful, patient engagement is key, and that means ease of use is critical. By providing solutions with simple functionality and two-way voice communications, patients and doctors can effectively communicate, improving patient care. One recent successful pilot, for example, showed improved outcomes for patients and significant cost savings for providers. Users cited ease of use as one of the main reasons they would participate in future deployments.

One of the biggest challenges with remote healthcare is connectivity. Many solutions are connected by Wi-Fi, which has a steep learning curve for seniors and often can be unreliable. Healthcare solutions need 24/7 connectivity, and that can only be delivered via cellular networks.

By adding the reliability of cellular with the rich data provided by RPM solutions, both healthcare providers and patients can ensure they are providing and receiving the best care possible.


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Saturday, October 10, 2020

Impact of endometrioma and bilaterality on IVF/ICSI cycles

A Turkish study has found that that presence of endometrioma in patients with endometriosis negatively impacts fertility parameters, but has no effect on embryo quality, clinical pregnancy rates (PR), or live birth rates (LBR)1.


The study in the Journal of Gynecology Obstetrics and Human Reproduction also concluded bilaterality does not influence any fertility parameters or PR.



Done retrospectively, the researchers sought to investigate the effects of endometrioma and the impact of bilaterality on in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) outcomes.

A total of 159 women who underwent IVF/CSI cycles at Zekai Tahir Burak Women’s Health Education and Research Hospital in Ankara, Turkey, between March 2015 and March 2018, were recruited for the study.

Patients were divided into two groups: the study group (n = 73) of infertile women with either unilateral or bilateral ovarian endometrioma with any IVF indication; and the control group (n = 86) without endometrioma.

Basal follicle-stimulating hormone (FSH) levels and total gonadotropin doses used during ovarian stimulation were significantly higher and antral follicle count (AFC) was significantly lower in the study group compared to the control group.

But the differences in these variables between the unilateral (n = 43) and the bilateral (n = 30) endometrioma group were non-significant.

Anti-Müllerian hormone (AMH) levels for unilateral and bilateral endometrioma were also comparable: 1.4 ng/ML and 1.23 ng/mL, respectively.

However, the number of endometriomas > 4 cm was significantly higher in the bilateral than in the unilateral group.

The study also found that the number of dominant follicles at trigger day and total oocyte retrieved were significantly higher in the control group than in the study group. But when compared between the unilateral and the bilateral endometrioma group, these differences were insignificant.

Still, the number of metaphase II (MII) oocytes was significantly higher in the control group compared to the unilateral group, whereas the difference was non-significant between the control group and the bilateral group.

For all procedures, sperm was obtained via ejaculation, and there were no cycles cancelled in the control group. However, in the study group, 12 cycles were cancelled because fertilized embryos could not be procured: 6 cycles each from the unilateral and bilateral group.

There were also four patients in the study group with no dominant follicle development, two each from the unilateral and bilateral group.

In addition, there were eight total fertilization failures, four each from the two groups.

“Given the higher cancelling rates, the prognosis for patients with endometrioma seems to be worse than in patients without endometrioma,” wrote the authors.

On the other hand, the number of embryos achieved and blastocysts obtained were similar between the three groups (no laterality, unilateral and bilateral), as were rates of pregnancy, live birth, and early pregnancy loss.

There was also no statistically significant difference between the control and the unilateral groups for all grades of embryo.

However, the number of grade 2 embryos was significantly lower in the bilateral group compared to the control group. But for blastocyst and grade 1 embryo numbers, the bilateral group had comparable findings to the other two groups.

“Based on our results, we speculate that bilaterality doesn’t exert additional damage on ovarian reserve more than unilateral endometrioma does,” wrote the authors.



Reference

Yilmaz N, Ceran MU, Ugurlu EN, et al. Impact of endometrioma and bilaterality on IVF/ICSI cycles in patients with endometriosis. J Gynecol Obstet Hum Reprod. Published online June 30, 2020. doi:10.101

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Maintaining adolescent confidentiality in care

A presentation at the virtual 2020 American Academy of Pediatrics National Conference and Exhibition showed how two health care systems walk the line to protect their adolescent patients’ right to privacy.


Especially for ob/gyns, maintaining patient privacy is crucial. Adolescent patients may be concerned about this, especially if the nature of the visit is especially personal. Will their parents find out about their STD test results?


During the presentation “Mum’s the word: Adolescent consent to care and confidentiality (and EHRs)” at the virtual 2020 American Academy of Pediatrics National Conference & Exhibition, Ryan H. Pasternak, MD, MPH, FAAP, professor of clinical pediatrics at the Louisiana State University School of Medicine in New Orleans, and Kirsten B. Hawkins, MD, MPH, FAAP, FSAHM, discussed how the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule affects adolescent confidentiality, the 21st Century CURES act and electronic health records, and how their health systems protected adolescent confidentiality.

Medical Practice Supplies


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Manual Prescription Pad (Large - Yellow)


Manual Prescription Pad (Large - Pink)

Manual Prescription Pads (Bright Orange)

Manual Prescription Pads (Light Pink)

Manual Prescription Pads (Light Yellow)

Manual Prescription Pad (Large - Blue)

Manual Prescription Pad (Large - White)


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