Fireside Chats – A Celebration of Self Care and Care for Each Other

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Bernadette Keefe MD

A Holiday Post that translates to any gathering with loved ones ~ BK

The Path to Wellness

‘Tis the season of celebration. As we are in a festive month, I’d like to talk about a few celebratory health related ‘fireside chats’ that we might consider when we gather with our families and friends this holiday season. Conversations around health and healthcare are often avoided as they can invite a difficult mixture of bad news, fear, criticism, advice, or unwanted cajoling. I’d like to flip these chats towards celebration by identifying four major things in life that are both good for us, and are, at essence, a cause for celebration.

For this post on holiday “fireside chats; a celebration of self-care”, I chose four major topics to delve into: emotional health, physical exercise, food and food culture and the circle of life. Included within are videos, text and references that I hope hone in on the essence of self care, and the process of creating healthy lives for ourselves, and our loved ones.

Let’s celebrate the role of self-care in the lives of ourselves, our families, and our friends!

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Boomers, Got Fit (bit)?

Boomers – Got Fit (bit)?

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Bernadette Keefe MD

“You can’t manage what you don’t measure.”                              

 (credited to by not said by W. Edwards Deming)

 Introduction

If you are 50 years of age or older you are a baby boomer, that means by 2030, there will be 77 Million people over the age of 65 in the U.S. alone. The U.S. National Institute of Aging has designated September as a Go-4-Life month: a national exercise and physical activity campaign for people 50+. The goal is to empower older adults to become more physically active. The last week in September marks the beginning of Active Aging Week (September 27 – October 3) for the United States, Canada and Australia. Each day is devoted to a specific healthy life habit: from walking to nutrition to social connection.

The importance of our lifestyle/behaviors, to overall health is now undeniable. It is thought that 70% of chronic disease is caused directly or indirectly by the poor lifestyle choices we make. Now we can seamlessly measure our daily behaviors through fitness trackers. Continue reading

losing our marbles – the dementia epidemic

The marble saga continues! This shot was taken in our back yard. I must say the marble is a remarkably patient model...

I think my favorite part of this one is how the lines from the tall grass in the background seem to echo the swirls inside the marble.

By Bernadette Keefe MD

All of us have personally known or heard the familiar drill. Dad couldnʼt find his way home. Mom didnʼt recognize her best friend. More and more memory lapses are occurring. Thereʼs a kitchen mishap. Finally the trip to family doc with the dreaded questions: Is It Alzheimerʼs? Is It Dementia?

The answer is yes, and they have a lot of company.

4.5 Million in the US are currently living with Dementia. The estimated prevalence of dementia among persons older than 70 years in US was nearly 15% in 2010. It is estimated that by 2050 there will be 13 Million people in the US living with dementia. There was hope that the incidence might be tapering off and even declining (from data comparing 1993 to 2002), however with the recent sharp increases in prevalence of diabetes and obesity over the past decade, it is feared that the numbers may rise precipitously.

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Quadruple Aim: Care of the Physician

Quadruple Aim

By Bernadette Keefe MD and Matthew Katz MD

The classic ‘triple aim’ for healthcare is a framework developed by the Institute for Healthcare Improvement (IHI) that describes an approach to optimizing health system performance. IHI asserts 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, and
  • Reducing the per capita cost of health care

Numerous publications suggest that the list be expanded to a ‘Quadruple Aim’ to include: Improving the Care of and Experience of The Provider (ie MDs/other HCPs).

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population health: that means us

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Population Health: ACA and ACOs

Population health has become the lynchpin of healthcare delivery in the United States, especially since the passage of the Affordable Care Act (ACA) in March 2010. (This law was passed due to the unsustainable costs of US health care coupled with less than stellar population health outcomes in the US.) A key way the ACA proposes to reduce health care costs is through the formation of Accountable Care Organizations (ACO). These are networks of doctors, hospitals, and ancillary health care providers who form networks to coordinate patient care and share financial and medical responsibility for that care. Required by ACOs is coordination by primary care physician, care of Medicare patients, and answering to multiple measures of quality. Providers get paid more for keeping their patients (their local population) healthy and out of the hospital.

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joint clinician/patient EHR

doctor-patient smartphones

Question number 4 for our “20 Questions for Health IT” project. Please comment in the comments section or on twitter using the #20HIT tag. View the other questions and comments here 

Question from Bernadette Keefe, MD:

How can an electronic health record (EHR) combine the formal record from clinicians with the patient’s ongoing chronicling of their health status? Continue reading

unstructured data: the star waiting in the wings

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Data-filled electronic health records hold the promise of predictive, personalized medicine and improved population health. Up until now, much of the data retrieved from records is structured data, information recorded in specific data fields. However, the total amount of structured data accounts for as little as 20% of the EHR with as much as 80% of EHR data unstructured. For example, all MD and other health care provider notes anhd all written reports accompanying examinations (e.g., radiologic data) is unstructured data. Continue reading