Evolution Of Health Care Delivery PDF

EVOLUTION OF HEALTH CARE DELIVERY By: Jacquiline M. Gealon, RRT PREHISTORIC AND ANCIENT MEDICINE Prehistoric people treat wounds through: ⚬ Immersion in cool water and applying mud to irritated areas ⚬ Sucking stings ⚬ Li...

EVOLUTION OF HEALTH CARE DELIVERY By: Jacquiline M. Gealon, RRT PREHISTORIC AND ANCIENT MEDICINE Prehistoric people treat wounds through: ⚬ Immersion in cool water and applying mud to irritated areas ⚬ Sucking stings ⚬ Licking wounds ⚬ Exerting pressure on wounds to stop bleeding PREHISTORIC AND ANCIENT MEDICINE Medical treatment is intertwined with religion and magic Tribal healers Sucking, bleeding, fumigating, steam baths, medicinal herbs Mesopotamians ⚬ Liver – seat of life Ancient Hebrews ⚬ Disease is a divine punishment or mark of sin 4th Century Hebrews ⚬ Disease was considered an imbalance of the four humors of the body: phelgm, blood, yellow bile and black bile  ANCIENT EGYPT Deities of ancient Egypt were associated with health, illness, and death Isis – healing goddess Hathor – mistress of heaven and protector of women during childbirth Keket – fertility Embalming Linked anatomy and physiology with theology Pills, cake suppositories, enemas, ointments, drops, gargles, fumigation and baths Drugs were made from vegetable, mineral, and animal substances; and imported materials such as saffron, cinnamon, perfumes, spices, sandalwood, gums and antimony  ANCIENT INDIA Life is eternal cycle of creation, preservation, and destruction Detected diabetes by sweetness of urine Treated snakebites by applying tourniquets Surgery of nose, earlobes, harelips and hernias Perform cesarean sections  ANCIENT CHINA Harmony – balance of yin and yang, Tao was considered the way Confucius forbade dissections Nei Ching Five methods of treatment ⚬ Cure the spirit ⚬ Nourish the body ⚬ Give medications ⚬ Treat the whole body ⚬ Acupuncture and moxibustion Treatment – exercise, physical therapy, massage, and administering medicinal herbs, trees, insects, stones, and grains 11th Century – developed an inoculation against smallpox  ANCIENT GREECE Built healing temples of Asclepios in Thessaly Tholos – round building encircled a pool or sacred spring of water for purification Abaton – building for incubation site where cure take place Healing rituals began after sundown and often involved fasting or abstinence from certain food or wine  PRE-HIPPOCRATIC MEDICINE Thales - Basic element in all animal and plant life was water, from which came the earth and air Anaximander - Living creatures originated in water Anaximenes - Air is necessary for life Heraclitus - Fire principal element of life 6th century BC – earth, air, fire and water are basic component of life  HIPPOCRATES Father of Medicine His approach revolutionized medicine from the ancient past and began turning it into and objective science People practicing medicine should be pure and holy ⚬ He taught that one should ￭ Observe all ￭ Study the patient rather than the disease ￭ Evaluate honestly ￭ Assist nature Addressed mental illness, anxiety and depression  CHRISTIANITY Healing message of Christ Healing was not differentiated into physical, mental, or spiritual Luke the physician Christian faith – compassion, forgiveness, and concern for the unfortunate and the dispossessed Roman Emperor Constantine, founded a hospital in the fourth century. Other hospitals were established by Christian community in Caesarea, Edessa, and Bethlehem With the Crusades came the distribution of disease. ⚬ Leprosy, typhus and smallpox ⚬ 1347 – bubonic plague THE RENAISSANCE Paracelsus - father of pharmacology Jean Fernel ⚬ physiology, pathology and therapeutics were standard discipline of medicine ⚬ First suggested that gonorrhea and syphilis are separate diseases Ambroise Pare - Forerunner of clinical surgery Andreas Versalius - father of anatomy Latrochemistry - Combination of alchemy, medicine, and chemistry Jan Baptista van Helmont - First measurement of the relative weight of urine Galileo - Presented laws of motion in mathematical manner Isaac Newton - Discovered gravity  THE RENAISSANCE William Harvey - Continuous circulation of blood in body system Christian Huygens - Centigrade system for measuring temperature Gabriel Daniel Fahrenheit - Developed the system of measuring temperature Marcello Malpighi and Anton van Leeuwenhoek - Forerunners in the invention of microscope Quinine - Was discovered as a treatment for malaria Leonardo da Vinci - Explored human anatomy through dissections  18TH CENTURY Albrecht von Haller - In-depth studies of the nervous system; discovered the relationship of the brain cortex to peripheral nerves, and became founder of modern physiologic theory Lazzaro Spallanzani - Pioneer of experimental fertilization Stephen Hales - Demonstrated blood circulation, stressed importance of the capillary system, and became the first person to record blood pressure with manometer Giovanni Battista Morgagni - father of pathology; Correlated anatomy with pathology Edward Jenner - Smallpox vaccination William Hunter - Specialist in obstetrics, founded the Great Windmill Street School of Anatomy, the first medical school in London.  18TH CENTURY John Hunter - Experimental surgeon; Method of closing off aneurysm; Pioneer in comparative anatomy Philippe Pinel - Humane regimen be instilled at Asylum de Bicetre near Paris (care and treatment for mentally ill patients)  19TH CENTURY Autopsies were the major focus of medicine Carl Rokitansky - Most outstanding morphologic pathologist of his time Rudolf Virchow - All cells come from other cells Claude Bernard ⚬ Founder of experimental physiology and discovered the principle of homeostasis, clarified the multiple functions of the liver, studied digestive activities of the pancreas, and was the first to link pancreas with diabetes. ⚬ He pioneered and established the specialty of internal medicine. Rene -Theophile Hyacinthe Laennec ⚬ Pathologic and clinical understanding of chest diseases including emphysema, bronchiectasis and tuberculosis.  19TH CENTURY ⚬ He was also a pioneer in the invention and use of the stethoscope. Ephraim McDowell - Performed the first successful abdominal surgery to remove a huge cyst from an ovary J. Marion Sims ⚬ Laid foundation for gynecology and founded the Women’s Hospital of the State of New York ⚬ He invented the Sims position and later the speculum and Catheter 1831 - Nitrous oxide gas and chloroform has been discovered but not yet put into practice Joseph Priestly - Discovered nitrous oxide gas. Humphry Davy suggested to use in surgery but was ignored.  19TH CENTURY Crawford W. Long - Used sulfuric ether during surgery in 1842 Joseph Lister ⚬ Discovered that bacteria were often origin of disease ⚬ Safe surgical procedure Louis Pasteur - Germ theory of disease and explained the effectiveness of asepsis and antisepsis Robert Koch - Extensive research into microorganisms and founded bacteriology Benjamin Rush - First American Psychiatrist William Beaumonth - First prominent American Physiologist Gregor Mendel - Foundation of modern genetics - Experiments of heredity of plants  19TH CENTURY Wilhelm Conrad Roentgen - November 8, 1895 – discovered x-rays Pierre and Marie Curie - Discovered radium Provided foundation for the use of radioactivity in the treatment of disease  20TH CENTURY Major Walter Reed - Eradicated yellow fever Paul Ehrlich - father of chemotherapy Pavlov - Extensive research of process of digestion Abel, Rowntree, and Turner - Invented the first artificial kidney that led to dialysis Willem Einthoven - Made the first electrocardiogram Hans Burger - Invent electroencephalogram Lind, Eijkman, Hopkins, Szent-Gyorgi, and Funk ⚬ Defined and isolated vitamins and described their role in life process. Surgical techniques were refined Electron microscope was invented in 1930 Salk vaccine – virtually eliminated the scourge of poliomyelitis  20TH CENTURY Watson and Crick - Accurately described deoxyribonucleic acid (DNA) molecule in 1962 Christiaan Barnard - Performed first successful human heart transplant Computers and imaging equipment Major transplants Coronary bypass surgery Arthroscopic surgery Laparoscopic surgery Lithotripsy Use of Lasers Artificial hips and knees Plastic surgery  21ST CENTURY Rapid expansion of technology and information Research into genetics has greatly expanded our knowledge about heredity Biotechnology Robotic surgery Less blood Faster recovery of patients Fewer overall complications Electrical conduction system of the heart has been mapped  HEALTH AND DISEASE The WHO defines health as “state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity.” Disease - a condition of the living animal or plant body or of one of its parts that impairs normal functioning and is typically manifested by distinguishing signs and symptoms Mortality – death rate Morbidity – occurrence of disease or condition Health care affected by social forces, ethical issues and economic forces.  RISK FACTORS AND PRIMARY CAUSES OF DEATH Heart Disease ⚬ Sedentary lifestyle ⚬ Cigarette smoking ⚬ Hypertension ⚬ Obesity ⚬ Diabetes ⚬ High Cholesterol Cancer ⚬ Cigarette smoking ⚬ Positive stool occult blood ⚬ Failure to perform breast self-examination ⚬ Failure to have Papanicolaou tests (Pap smears)  RISK FACTORS AND PRIMARY CAUSES OF DEATH Cerebrovascular Disease ⚬ Cigarette smoking ⚬ Hypertension ⚬ High cholesterol Accidents ⚬ Failure to use seat belts ⚬ High alcohol use Chronic Lower Respiratory Disease ⚬ Cigarette Smoking DOES ANYONE HAVE ANY QUESTIONS? Raise your hand, please THANK YOU for your attention THE HEALTH CARE ENVIRONMENT By: Jacquiline M. Gealon  HEALTH CARE the state of being free the provision of what is from illness or injury necessary for the health, the condition of being welfare, maintenance, sound in body, mind, or and protection of spirit someone or something the general condition or serious attention or state of the body or mind consideration applied to with reference to doing something soundness and vigor correctly or to avoid a condition in which damage or risk someone or something is thriving or doing well ENVIRONMENT the surroundings or conditions in which a person, animal, or plant lives or operates the natural world, as a whole or in a particular geographical area, especially as affected by human activity the circumstances, objects, or condition by which one is surrounded the sum total of all surroundings of a living organism, including natural forces and other living things, which provide conditions for development and growth as well as of danger and damage HEALTH CARE efforts made to maintain or restore physical, mental, or emotional well-being especially by trained and licensed professionals the act of taking preventive or necessary medical procedures to improve a person’s well-being an organized way of medical care concerned with the maintenance of the health of the whole body. It is delivered by the healthcare providers or professionals in various fields includes a pharmacy, nursing, medicine, dentistry, psychology, physicians etc. HEALTH CARE Healthcare is mainly influenced by the social, economic conditions & health policies of the place and varies across different countries, individuals, groups etc TYPES OF HEALTHCARE Every individual has required different care depending upon their health problem like some require normal care and some require extra special care. So on the basis of patient condition healthcare divides into various types. Following types of healthcare are explained below: 1. Primary Healthcare 2.Secondary Healthcare 3.Tertiary Healthcare TYPES OF HEALTHCARE 1. Primary Healthcare: Primary health care mainly focuses on health equity producing social policy beyond the traditional healthcare system. Its main aim is to provide local care to a patient because professionals related to primary care are normal generalists, deals with a broad range of psychological, physical and social problems etc. rather than specialists in any particular disease area. TYPES OF HEALTHCARE 2. Secondary Healthcare: This healthcare is provided by the medical specialists and other health professionals who do not have direct contact with a patient like urologists, dermatologists, cardiologists etc. TYPES OF HEALTHCARE 3. Tertiary Healthcare: This type of healthcare is known as specialized consultative healthcare usually for inpatients and on referral from primary and secondary healthcare for advanced medical investigation and treatment. Following examples of tertiary care services are plastic surgery, burn treatment, cardiac surgery, cancer management, neurosurgery, complex medical and surgical interventions etc. HEALTH CARE HOSPITAL ENVIRONMENT Hospitals are health care Is the healthful institutions that have an atmosphere and milieu at a organized medical and other healthcare setting in which professional staff, and a patient is undergoing inpatient facilities, and deliver treatment services 24 hours per day, 7 days per week. (WHO – World Health Organization)  Hospitals need to be organized around people‟s needs, working closely with other health and social care services and contributing to strengthening primary health care (PHC) and public health services, to substantially contribute to Universal Health Coverage (UHC). An institution that is built, staffed, and equipped for the diagnosis of disease; for treatment, both medical and surgical, of the sick and the injured; and for their housing during this process. The modern hospital also often serves as a center for investigation and for teaching.  A hospital is a facility supplying specialized staff and equipment to meet the health care needs of the surrounding population. Hospital funding is provided by a variety of sources, including: for- profit and non-profit health care organizations, health insurance companies, religious orders, and charities. Some hospitals have the unique ability to allow both “inpatients” and “outpatients”. Depending upon a patient‟s need after their diagnosis, treatment, surgery, or therapy, they may be required to stay overnight for further observation or recovery. Hospitals that do not have overnight patients are usually referred to as ‘clinics’. HISTORICAL OUTLINE OF HOSPITAL Ancient Time Culture and religion were linked into medicine. Temples of Saturn, and later of Asclepius, were recognized as healing center 230 BC King Ashoka established a chain of hospitals in Hindustan (230 BC) 100 BC Romans established hospitals (valetudinaria) for treatment of inured soldiers HISTORICAL OUTLINE OF HOSPITAL 331 AD Roman Emperor Constantine I (Constantine the Great) established the modern concept of hospital The Christian tradition emphasized the close relationship of the sufferer to the members of the community 370 AD St. Basil the Great established religious foundation in Cappadocia that included a hospital, an isolation unit for those suffering from leprosy HISTORICAL OUTLINE OF HOSPITAL 6th Century St. Benedict of Nursia at Montecassino, founded a hospital where the care of the sick was placed above and before every other Christian duty Religion continued to be the dominant influence in the establishment of hospitals during the Middle Ages 11th Century Pestilence and disease killed crusaders 1099 Hospitallers of the Order of St. John established a hospital that can cater 2000 patients in the Holy Land - later known as St. John Ambulance HISTORICAL OUTLINE OF HOSPITAL 12th Century Arab hospitals in Baghdad and Damascus and in Cordoba in Spain admitted patients regardless of religious belief, race or social order. 1145 Hospital of the Holy Ghost was founded at Montpellier France – became one of the most important centers in Europe for Training Doctors The middle Ages also saw the beginnings of support for hospital-like institution by secular authorities HISTORICAL OUTLINE OF HOSPITAL 1540 Henry VIII stopped building hospitals in England Voluntary Hospitals were established 1524 First Hospital in North America (Hospital de Jesus Nazareno) was built in Mexico City by Hernan Cortes 1751 First incorporated hospital in America was the Pennsylvania Hospital in Philadelphia which obtained a charter from the crown in 1751 HISTORICAL OUTLINE OF HOSPITAL 1540 Henry VIII stopped building hospitals in England Voluntary Hospitals were established 1524 First Hospital in North America (Hospital de Jesus Nazareno) was built in Mexico City by Hernan Cortes 1751 First incorporated hospital in America was the Pennsylvania Hospital in Philadelphia which obtained a charter from the crown in 1751 HISTORICAL OUTLINE OF HOSPITAL Spanish government and missionaries established hospitals in the Philippines. The first hospital was erected by the Spaniards in Cebu during 1565. It was later transferred to Manila for the purpose of treating sick and wounded military personnel. Early hospitals in the Philippines were established by – Franciscans, Brotherhood of the Misericordia, Brotherhood of San Juan de Dios, and the Dominicans San Lazaro hospital was established in 1578 CLASSIFICATION OF HOSPITALS IN THE PHILIPPINES DOH Administrative Order No. 2012 – 0012 Subject: Rules and Regulations Governing the New Classification of Hospitals and Other Health Facilities in the Institution  TYPES OF HOSPITALS 1..) Public Hospitals - A public hospital or government hospital is a hospital which is owned by a government and receives government funding. This type of hospital provides medical care free of charge, the cost of which is covered by the funding the hospital receives. 2.) Private Hospitals - A private hospital is a hospital owned by a for-profit company or a non- profit organisation and privately funded through payment for medical services by patients themselves, by insurers, or by foreign embassies.  TYPES OF HOSPITALS 3.) District - The district hospital is the central health care facility within its geographical region. District hospitals have a large capacity for intensive care and long-term care. Specialized centers for surgery, plastic surgery, obstetrics, and laboratories will also be available. 4.) Specialized - There are various types of specialized hospitals such as, trauma centers, rehabilitation hospitals, children‟s hospitals, geriatric hospitals, psychiatric hospitals. In addition, there are specialty specific hospitals for cardiology, oncology, orthopedics, etc. These specialty hospitals are typically part of a large hospital or hospital network. They are often located on the hospital campus or nearby.  TYPES OF HOSPITALS 5.) Teaching – A teaching hospital combines assistance to patients with teaching to medical students and nurses and often is linked to a medical school or nursing school. Some hospitals are affiliated with a university, college, medical school, or nursing school and offer health care to patients while teaching medical students, physicians, surgeons, and nurses. Teaching hospitals are unique in that they employ physician residents who are in training and work hand in hand with local medical schools. The physician residents are overseen by chief medical residents as well as department chairs of the various medical specialties.  TYPES OF HOSPITALS 6.) Clinic - Clinics generally provide outpatient care only and are smaller than a typical hospital. Clinics are usually operated by a government health agency or a partnership of private physicians and/or surgeons.  There are many departments that can be found within a hospital or clinic, including trauma centers, burn centers, emergency departments, surgery, wound care, or urgent care. There may be outpatient departments such has psychiatric health, physical therapy, dentistry, and rehabilitation. Also, specialized units of equipment, physicians and nurses will support the various departments with expertise or functionality in cardiology, obstetrics and gynecology, oncology, intensive care, neurology, pathology, and radiology. FUNCTIONS OF HOSPITALS 1 Patient care Inpatient, outpatient and day patient, Emergency and elective, Rehabilitation 2 Teaching Vocational, Undergraduate, Postgraduate, Continuing education FUNCTIONS OF HOSPITALS 3 Research Basic research, Clinical research, Health services research, Educational research 4 Health system support Source for referrals, Professional leadership, Base for outreach activities, Management of primary care FUNCTIONS OF HOSPITALS 5 Employment Inside hospital - Health professionals, other health care workers; Outside hospital - Suppliers, Transport services 6 Societal State legitimacy, Political symbol, Provider of social care, Base for medical power, Civic pride MENTAL HEALTH FACILITY Psychiatric hospitals, also known as mental hospitals, mental health units, mental asylums or simply asylums, are hospitals or wards specializing in the treatment of serious mental disorders, such as clinical depression, schizophrenia, and bipolar disorder. Psychiatric hospitals vary widely in their size and grading. Some hospitals may specialize only in short-term or outpatient therapy for low-risk patients. Others may specialize in the temporary or permanent care of residents who, as a result of a psychological disorder, require routine assistance, treatment, or a specialized and controlled environment. MENTAL HEALTH FACILITY Patients are often admitted on a voluntary basis, but people whom psychiatrists believe may pose a significant danger to themselves or others may be subject to involuntary commitment. Psychiatric hospitals may also be referred to as psychiatric wards (or "psych" wards) when they are a subunit of a regular hospital. LONG TERM/ RESIDENTIAL CARE FACILITY At some point, support from family, local programs may not be enough. friends, and People who require help full-time might move to a residential facility that provides many or all of the long-term care services they need. Facility-based long-term care services include: board and care homes, assisted living facilities, nursing homes, and continuing care retirement communities. Some facilities have only housing and housekeeping, but many also provide personal care and medical services. Many facilities offer special programs for people with Alzheimer's disease and other types of dementia. LONG TERM/ RESIDENTIAL CARE FACILITY 1.) Board and Care Homes - Board and care homes, also called residential care facilities or group homes, are small private facilities, usually with 20 or fewer residents. Rooms may be private or shared. Residents receive personal care and meals and have staff available around the clock. Nursing and medical care usually are not provided on site. 2.) Assisted Living - Assisted living is for people who need help with daily care, but not as much help as a nursing home provides. Assisted living facilities range in size from as few as 25 residents to 120 or more. Typically, a few "levels of care" are offered, with residents paying more for higher levels of care. LONG TERM/ RESIDENTIAL CARE FACILITY Assisted living residents usually live in their own apartments or rooms and share common areas. They have access to many services, including up to three meals a day; assistance with personal care; help with medications, housekeeping, and laundry; 24-hour supervision, security, and on-site staff; and social and recreational activities. Exact arrangements vary from state to state. LONG TERM/ RESIDENTIAL CARE FACILITY 3.) Nursing Homes - Nursing homes, also called skilled nursing facilities, provide a wide range of health and personal care services. Their services focus on medical care more than most assisted living facilities. These services typically include nursing care, 24-hour supervision, three meals a day, and assistance with everyday activities. Rehabilitation services, such as physical, occupational, and speech therapy, are also available. LONG TERM/ RESIDENTIAL CARE FACILITY Some people stay at a nursing home for a short time after being in the hospital. After they recover, they go home. However, most nursing home residents live there permanently because they have on-going physical or mental conditions that require constant care and supervision. 4. Continuing Care Retirement Communities - Continuing care retirement communities (CCRCs), also called life care communities, offer different levels of service in one location. Many of them offer independent housing (houses or apartments), assisted living, and skilled nursing care all on one campus. Healthcare services and recreation programs are also provided. LONG TERM/ RESIDENTIAL CARE FACILITY In a CCRC, where you live depends on the level of service you need. People who can no longer live independently move to the assisted living facility or sometimes receive home care in their independent living unit. If necessary, they can enter the CCRC's nursing home. HOSPICE Hospice is specialized type of care for those facing a life-limiting illness. Hospice care addresses the patient‟s physical, emotional, social and spiritual needs. It also helps the patient‟s family caregivers. It takes place in the patient‟s home or in a home-like setting. It concentrates on managing a patient‟s pain and other symptoms so that the patient may live as comfortable as possible and make the most of the time that remains. It is founded on a belief that the quality of life to be as important as length of life  Hospice care is a type of care and philosophy of HOSPICE care that focuses on the palliation of a chronically ill, terminally ill or seriously ill patient's pain and symptoms, and attending to their emotional and spiritual needs. In Western society, the concept of hospice has been evolving in Europe since the 11th century. Then, and for centuries thereafter in Roman Catholic tradition, hospices were places of hospitality for the sick, wounded, or dying, as well as those for travelers and pilgrims. The modern concept of hospice includes palliative care for the incurably ill given in such institutions as hospitals or nursing homes, but also care provided to those who would rather spend their last months and days of life in their own homes. The first modern hospice care was created by Cicely Saunders in 1967.  Hospice is NOT a place. Hospice services can be HOSPICE provided to a person with limited life expectancy and his/her family, wherever they live. This means a patient living in a nursing facility or long-term care facility and his/her family can receive specialized visits/contacts from physicians, nurses, aides, chaplains, social workers, and volunteers, in addition to other care and services provided by the nursing facility. The hospice and the nursing home will have a written agreement in place in order for the hospice to serve residents of the facility.  Ambulatory care or outpatient care is medical care OUT-PATIENT/ provided on an outpatient basis, including diagnosis, observation, consultation, treatment, intervention, and AMBULATORY rehabilitation services. This care can include CARE advanced medical technology and procedures even when provided outside of hospitals. Ambulatory care can be a misleading term, as it actually encompasses a wide range of care and services. By definition, ambulatory care is any same- day medical procedure performed in an outpatient setting. This refers to any medical service that is not performed in a hospital or facility that requires admission. We can further divide ambulatory care into four smaller sub-categories to better help you understand all that ambulatory care encompasses:  1. Wellness - This is normally what you think of when OUT-PATIENT/ you imagine going to the doctor. Ambulatory wellness services are mostly for prevention and basic medical AMBULATORY care. They include doctor‟s clinics, such as primary care, CARE as well as counselling centers for mental health and weight loss. 2. Diagnosis - Diagnostic services can be provided on their own, or as part of a wellness or treatment program. They include X-Rays, lab and blood tests, MRIs and screening for various cancers and illnesses. 3. Treatment - These include same-day surgery centers, substance abuse clinics, chemotherapy and other forms of therapy. 4. Rehabilitation - Rehabilitation includes post-operative therapies, occupational and physical therapy and rehabilitation for drug and alcohol abuse.  In addition to these procedures and services, OUT-PATIENT/ ambulatory care encompasses newer forms of healthcare, such as telemedicine. Telemedicine allows AMBULATORY doctors and nurses to “see” and interact with patients CARE via email, phone and video- chatting. Amelia Roberts, BSN RN, uses telemedicine to assess her patients. Ambulatory care, while outside of a hospital, employs almost all of the same healthcare professionals as inpatient care. Doctors, registered nurses, physical therapists, physical therapy assistants, surgical techs, medical lab techs and medical administration staff can all be found in various ambulatory care settings.  Preventive healthcare (alternately preventive PREVENTIVE medicine, preventative healthcare/medicine, or prophylaxis) consists of measures taken for disease HEALTH CARE prevention, as opposed to disease treatment. Just as health comprises a variety of physical and mental states, so do disease and disability, which are affected by environmental factors, genetic predisposition, disease agents, and lifestyle choices. Health, disease, and disability are dynamic processes which begin before individuals realize they are affected. Disease prevention relies on anticipatory actions that can be categorized as primal, primary, secondary, and tertiary prevention.  Primal and primordial prevention PREVENTIVE Any measure aimed at helping future parents provide their upcoming child with adequate attention, HEALTH CARE as well as secure physical and affective environments from conception to first birthday (i.e., over the child's primal period of life Primordial prevention refers to measures designed to avoid the development of risk factors in the first place, early in life. Primary prevention Methods to avoid occurrence of disease either through eliminating disease agents or increasing resistance to disease. Examples include immunization against disease, maintaining a healthy diet and exercise regimen, and avoiding smoking. PREVENTIVE Secondary prevention Methods to detect and address an existing disease HEALTH CARE prior to the appearance of symptoms. Examples include treatment of hypertension (a risk factor for many cardiovascular diseases), cancer screenings Tertiary prevention Methods to reduce the harm of symptomatic disease, such as disability or death, through rehabilitation and treatment. Examples include surgical procedures that halt the spread or progression of disease Quaternary prevention Methods to mitigate or avoid results of unnecessary or excessive interventions in the health system HOME HEALTH Home health care is a wide range of health care services that can be given in patient‟s home for an CARE illness or injury. Home health care is usually less expensive, more convenient, and just as effective as the care received in a hospital or skilled nursing facility (SNF). Examples of skilled home health services include: ⚬ Wound care for pressure sores or a surgical wound ⚬ Patient and caregiver education ⚬ Intravenous or nutrition therapy ⚬ Injections ⚬ Monitoring serious illness and unstable health status HOME HEALTH In general, the goal of home health care is to treat an illness or injury. Where possible, home health care helps CARE the patient: : Get better Regain their independence Become as self-sufficient as possible Home health care may also help patients maintain their current condition or level of function and slow decline HOME HEALTH Doctor’s orders are needed to start care. Once the doctor refers the patient for home health services, the home CARE health agency will schedule an appointment and come to the patient’s home to talk to about the needs and ask them some questions about their health. The home health agency staff will also talk to the doctor about the care and keep the doctor updated about the progress. It’s important that home health staff see the patient as often as the doctor ordered. HOME HEALTH Examples of what the home health staff should do: Check what the patient is eating and drinking. CARE Check the blood pressure, temperature, heart rate, and breathing. Check that the patient is taking his or her prescription and other drugs and any treatments correctly. Ask if the patient is having pain. Check the patient safety in their home. Teach them about the care so they can take care of themselves. Coordinate the care. This means health staffs must communicate regularly with the patient, the doctor, and anyone else who gives the patient care. TELEMEDICINE Telemedicine is the remote delivery of healthcare services, such as health assessments or consultations, over the telecommunications infrastructure. It allows healthcare providers to evaluate, diagnose and treat patients without the need for an in-person visit.. History of Telemedicine The development of modern telemedicine began with the invention of the telecommunications infrastructure, including the telephone and telegraph. Early on, telemedicine technology was adopted for use in military situations during the Civil War, such as ordering medical supplies or medical consultations. Casualty and injury lists were also delivered via telegraph. TELEMEDICINE The first example of an electronic medical record transfer occurred in 1948 in Pennsylvania, when radiology images were sent 24 miles between two townships via telephone line. A few years later, Canadian radiologists built on that early application of telemedicine technology and created a teleradiology system for use in and around Montreal. In 1959, clinicians at the University of Nebraska transmitted neurological examinations across campus to medical students using two-way interactive television. TELEMEDICINE In the early days of telemedicine, health professionals used the burgeoning technology as a way to reach patients living in rural areas. However, the technology quickly expanded into urban areas, especially those that suffered from health care shortages. In 1967, physicians at the University of Miami, School of Medicine and Miami's Fire Department transmitted electrocardiographic rhythms over existing voice radio channels from fire- rescue units to the city's Jackson Memorial Hospital. TYPES OF Telemedicine can be classified into three main categories: remote patient monitoring, store-and-forward and TELEMEDICINE interactive telemedicine. 1..) Remote patient monitoring -- Also known as telemonitoring, remote patient monitoring allows patients with chronic diseases to be monitored in their homes through the use of mobile medical devices that collect data about blood sugar levels, blood pressure or other vital signs. Remote caregivers can review the data instantly. 2.) Store-and-forward -- Also known as asynchronous telemedicine, store-and-forward telemedicine allows providers to share patient information, such as lab results, with a physician at another location. TYPES OF 3.) Interactive telemedicine -- Interactive telemedicine allows physicians and patients to communicate in real TELEMEDICINE time. Such sessions can be conducted in the patient's home or in a nearby medical facility and include telephone conversations or the use of video conferencing software that complies with Health Insurance Portability and Accounting Act regulations. TELEMEDICINE Telemedicine is a subset of telehealth, which includes both remote clinical service delivery and nonclinical VS. TELEHEALTH elements of the healthcare system. Telehealth refers to a broader spectrum of remote healthcare services than telemedicine and does not necessarily involve clinical services. It includes nonclinical services such as continuing medical education, provider training and administrative meetings. ADVANTAGES Convenience -- Patients do not have to take time away from work for an appointment. There is also OF no travel time or associated expenses, such as paying TELEMEDICINE for gas or child care. Increased access -- Patients in rural areas can obtain specialty services more easily. Similarly, patients who live in underserved areas have increased access to primary, dental and mental healthcare. Reduced cancellations or no-shows -- Because of its convenience for patients, telemedicine can reduce the number of cancellations or no-shows. Providers can reach out prior to or at the appointment time if the patient forgot about the appointment. ADVANTAGES Encourage healthy lifestyle choices -- Telemedicine allows providers to encourage their patients' healthy OF lifestyle choices, such as smoking cessation. TELEMEDICINE DISADVANTAGES OF TELEMEDICINE Inability to prescribe medications -- Many states generally do not allow online prescribing (not to be confused with e-prescribing) without an established relationship between the physician and patient. A physical examination or evaluation may be required before a physician can write a prescription for a patient, but there are inconsistencies in state laws as to what constitutes a physical examination.  Technical training and equipment -- Providers need DISADVANTAGES to be trained on how to use telemedicine equipment. OF TELEMEDICINE There are also the associated costs of the equipment, such as integrated telemedicine carts and encounter management software, to consider. The startup cost of implementing telemedicine may be especially prohibitive to rural facilities. Licensing issues -- Certain states may require providers who practice telemedicine across state lines have a valid license in the state where the patient is located. DOES ANYONE HAVE ANY QUESTIONS? Raise your hand, please THANK YOU for your attention