Friday, June 19, 2009

[EQ] Chronic disease management and the use of remote patient monitoring

Chronic disease management and the use of remote patient monitoring

LSE Health, London School of Economics and Political Science

Eurohealth Volume 15 Number 1, 2009

Available online at: http://www.euro.who.int/document/OBS/Eurohealth15_1.pdf

“…..Chronic diseases, such as heart disease and diabetes, have substantial health and economic impacts. Routine consultations to monitor these conditions place a considerable strain on health service resources. Consequently, there has been an increased interest in utilising information technology to help manage patients.

– the use of remote monitoring – allows for the collection of routine information on the health status of individuals outside the doctor’s office and is the focus of

much of this issue of Eurohealth.

“……Chronic disease management (CDM) encompasses the ongoing management of chronic conditions over a period of time using evidence-based care. In an article on CDM in the US, Kenneth Thorpe highlights the huge burden of chronic disease in terms of mortality and health care spending. He calls for prevention efforts directed at patient education, improved coordination among practitioners and better patient-doctor collaboration. In their article on CDM in Europe, David Scheller-Kreinsen and colleagues, present key strategies used to manage chronic diseases, summarising existing evidence on their effectiveness and describing common obstacles to effective CDM.

Four articles specifically address remote monitoring. In their article on the clinical perspective, Jillian Riley and Martin Cowie contrast traditional models of CDM with the inclusion of remote monitoring in a heart failure population, presenting both the clinical benefits and patient perspective. Paul Trueman tackles the economic perspective, describing the potential benefits of remote monitoring and commenting on the growing body of evidence on the clinical and cost effectiveness of such interventions. Michael Palmer and colleagues look at the European Commission’s adoption of a Communication to support the deployment of telemedicine for the benefit of patients, health care systems and society. Finally, James Barlow and Jane Hendy use the case of the UK to present the challenges of adopting integrated mainstream telecare services. A common thread running through these contributions are the challenges in providing appropriate incentives for health care professionals to implement changes to improve chronic care, including the use of telemedicine.

Other features in this issue include two perspectives from the European Commission. One discusses the EU Directive on patients’ rights in cross-border health care and its implications for the National Health Service in the UK. The second focuses on the EU Green Paper on the health care workforce, which is intended to support Member States as they confront an ageing but increasingly mobile population…..”

Sherry Merkur Deputy Editor

David McDaid Editor

Philipa Mladovsky Deputy Editor

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This message from the Pan American Health Organization, PAHO/WHO, is part of an effort to disseminate
information Related to: Equity; Health inequality; Socioeconomic inequality in health; Socioeconomic
health differentials; Gender; Violence; Poverty; Health Economics; Health Legislation; Ethnicity; Ethics;
Information Technology - Virtual libraries; Research & Science issues. [DD/ KMS Area]

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[EQ] Investing in and implementing population health strategies

How can European health systems support investment in and the implementation of population health strategies?

David McDaid, LSE Health and Social Care, London School of Economics and Political Science, London, United Kingdom, and European Observatory on Health Systems and Policies

Michael Drummond, Centre for Health Economics, University of York, United Kingdom

Marc Suhrcke, Venice Office, WHO Regional Office for Europe

POLICY BRIEF - HEALTH SYSTEMS AND POLICY ANALYSIS

World Health Organization, on behalf of the European Observatory on Health Systems and Policies 2008

Available online PDF [36p.] at: http://www.euro.who.int/document/hsm/1_hsc08_ePB_2.pdf

“…..Poor health in Europe has substantial health and socioeconomic costs. Much of this burden might be avoided by implementing effective population health strategies, both within and outside the health system. A broad approach to promoting population health requires a combination of upstream and downstream measures. Upstream measures may include measures that, among other goals, can help promote health, such as fiscal redistribution, improving the quality of housing and using incentives to encourage students to stay in school. Downstream measures include health promotion and primary disease prevention action, often targeting individual behaviour and lifestyle.

To support investment in population health strategies, health systems must be able to identify not only what works and at what cost but also in what context. Mechanisms to allow such information to be fed into the policy deliberation process and also to facilitate the implementation of agreed population health strategies are then required….”

Contents

Key messages

Executive summary

Policy brief

The case for investing in health promotion and disease prevention strategies in Europe

Policy options: generating and using existing evidence on the effectiveness and cost-effectiveness of population health strategies

Policy options moving forward: strengthening the evidence base and examining institutional arrangements

Identifying alternative ways of bringing about change

Summary

References

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[EQ] Public Health Law Program

Public Health Law 101

US Centers for Disease Control and Prevention

Website: http://www2a.cdc.gov/phlp/phl101/

CDC’s Public Health Law Program has developed this new, foundational course on public health law as a learning resource for public health practitioners, students, and others. The course comprises 9 slide lecture units for delivery by legal counsel to health departments and by other persons trained in law.

Scope: This course provides an introduction to fundamental principles of law, ethics, and the legal system as they frame public health practice in the United States

Contents: The course comprises 9 slide lecture units (see below) covering basic principles of law and topical areas in relation to front-line public health practice. Each unit is designed for delivery in approximately 1 hour, but can be expanded or abridged according the sponsoring program’s interests.

The course design is modeled on CDC’s “Public Health Emergency Law” course (also publicly available at www2.cdc.gov/phlp/phel.asp) and its contents have been adapted substantially from key elements contained in the CDC-developed text, “Law in Public Health Practice, Second Edition” published by Oxford University Press in 2007.

The 9 lecture units are:

· Unit 1: Key Concepts of U.S. Law in Public Health Practice

· Unit 2: Ethics and the Law

· Unit 3: Administrative Law

· Unit 4: Role of the Legal Counsel

· Unit 5: Law of Public Health Surveillance, Investigations, and Emergencies

· Unit 6: Privacy and Confidentiality

· Unit 7: Infectious Diseases

· Unit 8: Environmental Public Health, Occupational Health, and Injuries

· Unit 9: Chronic Diseases and Birth Defects (under development and not yet available)

Public Health Emergency Law 3.0 & Forensic Epidemiology 3.0 Training Curricula

Website: http://www2a.cdc.gov/phlp/phel.asp

Public Health Emergency Law 3.0 is targeted at public health practitioners and emergency management professionals to improve their understanding of the role of law in public health emergency response. Materials include three lecture units with PowerPoint slides, an interactive case study, and a Course Manager's Guide. Notes for instructors and other supplemental information are also included.

Forensic Epidemiology 3.0 is designed to help public health and law enforcement agencies strengthen their coordinated response to pandemic influenza and similar prevention disease outbreaks. Materials include a new CDC-developed case study on pandemic influenza as well as scenarios and training materials from other developers. The CD-ROM also contains the complete training resources developed for Forensic Epidemiology 1.0 focused on improving coordinated public health-law enforcement investigation of suspected bioterrorist events.

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