ReviewHealth Care 2020: Reengineering Health Care Delivery to Combat Chronic Disease
Section snippets
Treatment Options in Chronic Disease
Although chronic disease represents the leading cause of death in the US, 40% of all premature death is due to behaviors amenable to change. Maximizing disease outcomes will therefore require the necessary time and expertise needed for a careful assessment and modification of lifestyle factors.15 In the primary care setting, the median length of a physician visit is <15 minutes, during which a median of 6 topics will be covered, leaving little if any time to formally assess and address the root
Chronic Disease Outcomes and Primary Care Services
Physician adherence to the current evidence base in the management of chronic disease is poor, and patients diagnosed with a chronic disease typically receive only half of the recommended process of care.33, 34 In the case of the 2 most common chronic diseases impacting the population, fewer than 1 in 3 patients with hypertension and hypercholesterolemia attain control of both disorders.34 These gaps in care have been shown subsequently to lead to higher clinical events and added health care
Social Networks
The importance of social network influences on behavior is now well established, having demonstrated considerable impact on smoking, diet, exercise, depression, medication adherence, and obesity.50, 51 Decisions to quit smoking, begin an exercise program, and other health-related behaviors are not made completely by isolated persons, but rather, reflect choices made by groups connected to each other.50 This influence can be extensive, often reaching up to 3 degrees of separation. The fact that
Infrastructure Requirements Going Forward
As health care moves from a volume-to-value strategy, the need to collect and manage data will increase continually, and with it, the necessity to provide analysis, data visualization tools, and education/training surrounding the use of new technologies and the data they generate. Health care systems that develop both discipline and efficiency in data analytics and reporting (as well as the ability to train its staff in the capabilities of these ever-evolving systems) will best manage both
Conclusion
Throughout history, the health care system has reengineered itself continually to meet the medical needs of the time. Isolation wards were created in the late 19th and early 20th centuries to meet the crisis in infectious disease, particularly during the typhoid and influenza epidemics, and mobile army surgical hospitals were crafted in 1945 to better manage surgical emergencies during war. Today, health care must reengineer its care delivery model to manage the chief medical crisis of the 21st
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2022, Mayo Clinic ProceedingsDesigning and evaluating a mobile personal health record application for kidney transplant patients
2022, Informatics in Medicine UnlockedCitation Excerpt :At this stage, the kidneys have almost lost their functions and only need hemodialysis (HD) or transplant therapy for their survival [8]. Studies have thus far shown that transplant can lower the risk of heart disease in comparison with HD [4] and even the risk of death in kidney transplant recipients (KTRs) becomes lower in patients undergoing HD; therefore, kidney transplant can be an appropriate elective therapy for ESRD patients [2]. CKD and ESRD are correspondingly known as common health problems [9] and worldwide public health challenges because of their cost burden and limited financial resources [3,6,10–15], which are prevalent not only in developed countries but also in developing nations such as Iran with the low economy [13,14,16].
Funding: None.
Conflict of Interest: None.
Authorship: Both authors have collaborated on the development of this manuscript and are in support of content.