Boomers, Got Fit (bit)?

Posted on September 23, 2015 by Bernadette Keefe

Boomers – Got Fit (bit)?

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 →

Falls Prevention Day 2015: Will the real ______________, please stand up!

Posted on September 22, 2015 by Bernadette Keefe

National Falls Prevention Awareness Day ~ September 23, 2015

“Take a Stand to Prevent Falls”

Bernadette Keefe MD

“One of every three older adults falls each year, but less than half talk to their healthcare providers about it.” – Lawrence Z. Rubenstein MD, MPH Chair Geriatrics – U. of Oklahoma Health Sciences Center

Introduction

Tomorrow, September 23, 2015, the U.S. will celebrate the 8^th Annual Falls Prevention Awareness Day. The announcement on the National Council for Aging (NCOA) Falls Prevention Day website reads:

“The 8^th annual Falls Prevention Awareness Day (FPAD) will be observed on September 23, 2015 – the first day of fall. The event seeks to raise awareness about how to prevent fall – related injuries among older adults. The 2015 theme is Take A Stand to Prevent Falls and the official twitter hashtag for this year’s event is #FPAD15 Continue reading →

Our (Cultural) Sugar High

Posted on September 3, 2015 by Bernadette Keefe

Sugar-comparisons HIGH

Bernadette Keefe MD

‘We need to start talking about how our food supply is making many of us sick.”

“Sugar high” is the term used to describe the cascade of responses after eating a sugar load. A high sugar load, especially a pure sugar load, triggers is a rapid release of insulin to counteract the high blood sugar. With that response, glucose is absorbed into cells and the blood sugar plummets. We feel hunger with the low blood sugar and if we consume a sugary snack or meal, the cycle restarts. The taste of sugar is also ‘addictive’ over time. At this time we have a cultural sugar high, a palate tuned to the taste of sugar, across our nation and indeed the world. It has led to unprecedented levels of Type 2 diabetes and obesity. Continue reading →

Population Health: Our lives, Our data

Posted on August 17, 2015 by Bernadette Keefe

By Bernadette Keefe MD

On July 16^th 2015 I had the pleasure of being on a panel discussing Population Health Management with eloquent, smart colleagues: Dan Munro (@danmunro) Janice McCallum (@janicemccallum), Deryk Van Brunt (@HCI_Solutions) and Justin Lanning (@LanningHlthcare). It was a fascinating wide ranging discussion covering the definition of population health, the mechanisms and strategies of population health management (including the overriding importance of data collection/analysis and practicing medicine/providing healthcare in teams), the value of universal medical coverage (despite ACA still too many uncovered), issues around security and privacy of data and the lack of health information technology standards and EHR interoperability (need for a patient identifier), patient empowerment and access to records and relevant health data to enable better self care, issues regarding the social determinants of health and examples of strategy/success stories, incentives and tools for value based care and optimal outcomes, the challenges of behavioral/ lifestyle change, health literacy and patient engagement, the importance of context to better treat patients and obtain improved outcomes, the role of community in population health and the utterly unsustainable level of cost of healthcare in the U.S., among other topics.

Continue reading →

losing our marbles – the dementia epidemic

Posted on July 28, 2015 by Bernadette Keefe

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.

Continue reading →

population health: that means us

Posted on May 26, 2015 by Bernadette Keefe

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.

Continue reading →

joint clinician/patient EHR

Posted on May 26, 2015 by Bernadette Keefe

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

Posted on May 26, 2015 by Bernadette Keefe

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 →

Falls in the older adult – Just not sexy enough?

Posted on May 26, 2015 by Bernadette Keefe

Two weeks ago, a $1 Million prize was announced in San Francisco Bay area: The Palo Alto Longevity Prize. Palo Alto Investors and guru Yoon Jun will award the money in batches to those researchers able to restore to youthful parameters certain physical functions in elderly animals. The group ultimately hopes to unlock the key to immortality.

Wow! After that first wow, all I could think about was why there are no prizes for:

Figuring Out How to Age Comfortably, Gracefully and with As Much Quality of Life as Possible;
Emphasizing the Improvement Over Quality, Not Quantity, of Life; or
Tackling the Awful Problem of Falls in Our Elderly.

The Elderly Falling….hmmmm….that just doesn’t quite have quite the “sizzle” of immortality, does it? Nonetheless,It Is A Big Deal! Continue reading →

online is just courtship

Posted on May 26, 2015 by Bernadette Keefe

In my earlier days of social media (specifically #hcsm -healthcare social media) I felt that extending the healthcare information reach implied further engagement ONLINE. After all, with so many edifying healthcare tweet chats, a plethora of compelling healthcare conferences, multiple supportive and informative patient/disease chats, and a virtual banquet of really smart, passionate people to engage with: What’s There Not to Love; So Just Extend, Post, Link, Chat and Tweet Away!

All the above remains true and is, gloriously, ever increasing. Granted in some areas of healthcare social media there is a lack (perhaps lag) with respect to MDs on Twitter, but I am convinced that will change soon. With respect to the ultimate potential of healthcare social media, the sky is the limit.

Continue reading →

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