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Institute for Healthcare Improvement: The IHI Triple Aim. The IHI Triple Aim is a framework developed by the Institute for Healthcare Improvement that describes an approach to optimizing health system performance. It is IHI’s belief that new designs must be developed to simultaneously pursue three dimensions, which we call the “Triple Aim”: Improving the patient experience of care (including quality and satisfaction);Improving the health of populations; andReducing the per capita cost of health care.

Why the Triple Aim? The US health care system is the most costly in the world, accounting for 17% of the gross domestic product with estimates that percentage will grow to nearly 20% by 2020. [Source: National Healthcare Expenditure Projections, 2010-2020. Centers for Medicare and Medicaid Services, Office of the Actuary.] Approach In most health care settings today, no one is accountable for all three dimensions of the IHI Triple Aim. Concept Design Benefits to an Approach in Line with the IHI Triple Aim. Diabetesresearchclinicalpractice.

To view the full text, please login as a subscribed user or purchase a subscription. Click here to view the full text on ScienceDirect. Abstract Despite significant advances in diagnosis and treatment, the persistence of inadequate metabolic control continues. Poor glycemic control may be reflected by both the failure of diabetes self-management by patients as well as inadequate intervention strategies by clinicians. The purpose of this systematic review is to summarize existing knowledge regarding various barriers of diabetes management from the perspectives of both patients and clinicians. A search of PubMed, CINAHL, ERIC, and PsycINFO identified 1454 articles in English published between 1990 and 2009, addressing type 2 diabetes, patient's barriers, clinician's barriers, and self-management. To access this article, please choose from the options below. Tilt Motion | A new slant on storytelling.

Clinical Diabetes | Mobile. Authors In recent years, we have witnessed an increasing focus on “evidence-based medicine.” Indeed, for the first time, the American Diabetes Association (ADA) this year has provided evidence gradings for its position statement on “Standards of Medical Care for Patients With Diabetes Mellitus.” This position statement is reprinted in abridged form in this issue (page 24). The entire document can be found in Diabetes Care1 or on the ADA Web site at What is evidence-based medicine?

What are its strengths and limitations? Sackett and colleagues defined evidence-based medicine as “the conscientious, explicit, and judicious use of clinically relevant research in making decisions about the care of individual patients.”2 The strength of evidence-based medicine is that it moves clinical practice from anecdotal experience and expert opinion to a strong scientific foundation. The ADA is moving in this direction. Footnotes William H. Clinical Guidelines and Recommendations | Agency for Healthcare Research & Quality. National Guideline Clearinghouse™ The National Guideline Clearinghouse™ (NGC), an AHRQ initiative, is a publicly available database of evidence-based clinical practice guidelines and related documents.

Updated weekly with new content, the NGC provides physicians and other health professionals, health care providers, health plans, integrated delivery systems, purchasers, and others an accessible mechanism for obtaining objective, detailed information on clinical practice guidelines and to further their dissemination, implementation, and use. U.S. Preventive Services Task Force (USPSTF) Created in 1984, the U.S. Preventive Services Task Force (USPSTF or Task Force) is an independent group of national experts in prevention and evidence-based medicine that works to improve the health of all Americans by making evidence-based recommendations about clinical preventive services such as screenings, counseling services, or preventive medications. Guide to Clinical Preventive Services, 2012-2014. Diabetes Resources for Health Care Professionals | NDEP. Decision Aids In participatory decision-making, physicians actively engage patients in treatment and other care decisions.

Such patient participation appears to be associated with better understanding of care. [2] Participation in decision-making can play a key role in patient understanding of diabetes self-management and subsequent self-care practices. [3] People with diabetes with limited education benefit from specific instruction in foot care, food choices, and monitoring hemoglobin A1c. [3] Involving patients in treatment decision-making alone, however, does not appear to be sufficient to improve biomedical outcomes. [2] [4] Diabetes-Specific Recommendations and Guidelines American Academy of Family Physicians American Association of Clinical Endocrinologists American College of Physicians American Diabetes Association Standards of Medical Care in Diabetes American Geriatrics Society American Heart Association Indian Health Service The Endocrine Society U.S. Other Resources.

Hunger And Weight Gain With Insulin | Diabetic Connect. I have Type 2 diabetes. For years I could easily lose weight— even when I didn't try very hard. I didn't get treatment due to lack of money and insurance. I've had insurance for about a year and started out with 1000 mg Metformin 2 x day and still had BG readings near 245. My doctor put me on Lantus slow-acting insulin, 60 units 1 x day at bedtime. The great news is I have more energy, am less irritable, sleep better and my fasting BG level is usually around 105-115. I eat less carbs but still not ideal. I've read recently that carbs makes some people crave more carbs. I feel so whiny and dense because this should be a no-brainer, but I need to know how others who've experienced extreme cravings have managed it, and did you have to restrict your calories greatly in order to lose weight after starting insulin?

Motivational Interviewing and Diabetes: What Is It, How Is It Used, and Does It Work? Motivational interviewing (MI) has recently become a topic of great interest in the diabetes behavioral field, having been the focus of workshops and research presentations at national meetings such as the Society of Behavioral Medicine, the American Diabetes Association, the North American Association for the Study of Obesity, and the Behavioral Research in Diabetes Exchange. The Motivational Interviewing Network of Trainers (MINT) was founded in 1995 and sponsors a website ( through which MI trainers and researchers share information and ideas. This site provides information, research findings, and training opportunities and is a good starting point for further exploration of MI.

Hettema et al.7 have cogently reported on the emerging theory of how MI affects behavior change. Further work is being conducted to tease out how the increase in change talk is related to outcome. Thus, in a successful MI session, the patient is doing most of the talking. Motivational Interviewing Beyond the Clinical Setting: The AiM App | RMI-Family Project. For many people, there is no doubt that mobile devices play a major role in their day-to-day existence. From keeping one organized to maintaining contact with friends, family, and co-workers, these devices just seem to be getting harder and harder to get away from. Given the number of hours these devices spend attached to their owners, there is much potential to use them to facilitate behavior change. This is the rationale behind the “AiM App to Improve Motivation.” Recently, this app came to my attention. I found the idea of attempting to bring the clinical practice of motivational interviewing to a mobile device, for people seeking to make changes in their lives, quite fascinating.

What? Who? When? Where? Why? How? The actual process is quite simple: select a lifestyle behavior to be changed, such as drinking, studying, smoking, or exercise; consider the reasons for changing; examine and score three areas of motivation (importance, confidence and readiness); review progress over time. HTML5 vs. Native Apps | 8th & Walton Blog. Every supplier needs a website, and increasingly, suppliers also want apps. Movista’s Stan Zylowski talked with Andy Schuch about the different frameworks available for apps. Can you do without an app? As consumers increasingly use their smartphones while shopping, suppliers increasingly want to reach shoppers with an app.

Don’t forget, however, the Zero Moment of Truth: most shoppers have already done their research and made their decisions before they come into the store. This omnichannel reality means that a responsive website — a website that look good on any size of screen and is accessible on any device — is the highest priority. Once you have that in place, it’s time to think about an app. A native app, built just for the Apple operating system or the Android operating system, etc., has some advantages: The alternative to native apps is HTML5. An HTML5 app will work on all mobile devices, as long as they have internet connections. Comments comments.

AdherenceRx. > Frequently Asked Questions Why should we use AdherenceRx's Behavioral Coaching model versus other adherence strategies we currently use? Unlike many adherence strategies such as reminder letters, devices, incentive programs, coaching and medication assistance services, AdherenceRx offers: > A patient-centric approach not predicated on a pre-determined number of interactions and customized to meet individual patient needs.

> A solid research base for behavioral change integrating well-established foundations in psychology. What type of professionals are the coaches? Do patients work with multiple coaches? What communication methods are used for the AdherenceRx program? How long is a recommended coaching program? Can AdherenceRx scale programs at a national level? How are patients enrolled in the program? What type of reporting is offered? Emmi Solutions Partners with AdherenceRX. AdherenceRx Partners with Emmi Solutions to Expand Its Web-Based Patient Self-Management Tools in their Behavioral Health Coaching Model. CHICAGO, IL - Jun 10, 2009 AdherenceRx, a leader in physician and pharmacist prescribed health coaching services steeped in the methodology of behavior science, has partnered with Emmi Solutions, the market leader in interactive patient engagement programs, to deliver reliable and integrated patient self-management services.

At the direction of a patient's health coach, patients are prescribed a series of interactive patient education modules aimed at improving health literacy via a unique and effective technology platform that tracks patient engagement. Interactive patient education is becoming essential in establishing baseline metrics related to a patient's health literacy and understanding of a particular health condition. About AdherenceRx. EmmiPrevent Demo.

Summary of the HIPAA Privacy Rule. Permitted Uses and Disclosures Permitted Uses and Disclosures. A covered entity is permitted, but not required, to use and disclose protected health information, without an individual’s authorization, for the following purposes or situations: (1) To the Individual (unless required for access or accounting of disclosures); (2) Treatment, Payment, and Health Care Operations; (3) Opportunity to Agree or Object; (4) Incident to an otherwise permitted use and disclosure; (5) Public Interest and Benefit Activities; and (6) Limited Data Set for the purposes of research, public health or health care operations.18 Covered entities may rely on professional ethics and best judgments in deciding which of these permissive uses and disclosures to make. (1) To the Individual. A covered entity may disclose protected health information to the individual who is the subject of the information. (2) Treatment, Payment, Health Care Operations.

. (3) Uses and Disclosures with Opportunity to Agree or Object. Field Assistance Bulletin. Printer Friendly Version Date: February 14, 2008 Memorandum For: Virginia C. Smith, Director of EnforcementRegional Directors From: Daniel J. MaguireDirector of Health Plan Standards and Compliance Assistance Subject: Wellness Program Analysis Issue What types of health promotion or disease prevention programs offered by a group health plan must comply with the Department’s final wellness program regulations and how does a plan determine whether such a program is in compliance with the regulations? Background On December 13, 2006, the Departments of Labor, the Treasury, and Health and Human Services published joint final regulations on the nondiscrimination provisions of the Health Insurance Portability and Accountability Act (HIPAA).

The regulations apply to group health plans and group health insurance issuers on the first day of the plan year beginning on or after July 1, 2007. Wellness Program Checklist Insert the first day of the current plan year: _______________________________. The effect of a diabetes collaborative care management program on clinical and economic outcomes in patients with type 2 diabetes.