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I am Raj I From India i am a share market tips provider and web developer.


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Harry Diaz

Nottingham Dental
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Located in Katy, TX, Nottingham Dental is your local, comprehensive dental clinic for the entire family! We can help you begin your journey to a healthy, beautiful smile. Our goal is to provide patients with the highest quality dental care in a comfortable, relaxed and friendly environment.

Dentist Katy Tx


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James  Divine

Sun Ridge Smiles
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At Sun Ridge Smiles, we proudly offer a full suite of services to provide high-quality dentistry to our El Paso community. From routine cleanings to dental fillings to wisdom teeth removal, we are fully equipped to treat a diverse range of dental needs. We look forward to taking care of your smile now and for many years to come!

 

Sunridge Dental


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Jason Clark

Dentist Houston Tx
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URBN Dental is the premier Houston Tx Dentist that will offer the highest quality material and laboratories at low insurance PPO prices. It is no wonder URBN Dental has been voted the best Dentist in Houston Texas. URBN Dental is the expert in General Dentistry, Invisalign, and Cosmetic Dentistry. Most procedures have zero downtime, allowing you to resume regular activities the same day.

 

Dentist Offices In Houston


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sammy sean

Best breast cream
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Women with small size breast can now enhance their breast size easily. Here are the best quality Breast Enlargement Creams in Vita Health Care that really work fast.


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Eugene Tracy

Physiotherapist Gold Coast
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If you are looking for the best physiotherapist at the Burleigh Central to keep yourself fit and healthy.You should come and visit us for the best services. We have experts and experienced, dedicated physiotherapists and massage therapists for you to satisfy completely.

 

Gold Coast Physio


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Peel Court Pharmacy

Peel Court Pharmacy
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We're your local, independent late-night pharmacy and we pride ourselves on the quality of pharmacy services and patient care we deliver 100 hours a week right up to 10.30pm (check website for details)!
We serve most surgeries locally and are happy to collect and deliver your prescriptions. Online NHS prescription ordering and NHS minor ailments scheme

 

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0182 763 118


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David Mclin

Springfield Wellness Center
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Neurodegenerative diseases are accompanied by chronic viral infections, which may result in an increase of neurodegenerative diseases progression, emerged. Neurodegenerative diseases are chronic degenerative pathologies of the Central Nervous System characterized by progressive loss of specific neurons that lead to a decline in brain functions.his includes diseases such as amyotrophic lateral sclerosis, Parkinson's disease,Alzheimer’s and CTE.At Springfield Wellness Center, Our training program prepares physicians and mental health practitioners to provide the highest measure of care with the intravenous application of Brain Restoration or Nicotinamide Adenine Dinucleotide (BR+/NAD).


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  • Everyone connected with healthcare supports interoperability saying it improves care, reduces medical errors and lowers costs
  • But interoperability is a long way from reality and electronic patient records are only part of an answer
  • Could Blockchain a technology disrupting financial systems resolve interoperability in healthcare?
  • Blockchain is an open-source decentralized “accounting” platform that underpins crypto currencies
  • Blockchain does not require any central data hubs, which in healthcare have been shown to be easily breached
  • Blockchain technology creates a virtual digital ledger that could automatically record every interaction with patient data in a cryptographically verifiable manner
  • Some experts believe that Blockchain could improve diagnosis, enhance personalised therapies, and prevent highly prevalent devastating and costly diseases
  • Why aren’t healthcare leaders pursuing Blockchain with vigour?
 
Why Blockchain technology will not disrupt healthcare

Blockchain technology is disrupting financial systems by enhancing the reconciliation of global transactions and creating an immutable audit trail, which significantly enhances the ability to track information at lower costs, while protecting confidentiality. Could Blockchain do something similar for healthcare and resolve the challenges of interoperability by providing an inexpensive and enhanced means to immutably track, store, and protect a variety of patient data from multiple sources, while giving different levels of access to health professionals and the public?
 
Blockchain and crypto currencies

You might not have heard of Blockchain, but probably you have heard of bitcoin; an intangible or crypto currency, which was created in 2008 when a programmer called Satoshi Nakamoto (a pseudonym) described bitcoin’s design in a paper posted to a cryptography e-mail list. Then in early 2009 Nakamoto released Blockchain: an open source, global decentralized accounting ledger, which underpins bitcoin by executing and immutably recording transactions without the need of a middleman. Instead of a centrally managed database, copies of the cryptographic balance book are spread across a network and automatically updated as transactions take place. Bitcoin gave rise to other crypto-currencies. Crypto currencies only exist as transactions and balances recorded on a public ledger in the cloud, and verified by a distributed group of computers.
 
Broad support for interoperability
 
Just about everyone connected with healthcare - clinicians, providers, payers, patients and policy makers - support interoperability, suggesting data must flow rapidly, easily and flawlessly through healthcare ecosystems to reduce medical errors, improve diagnosis, enhance patient care, and lower costs. Despite such overwhelming support, interoperability is a long way from a reality. As a result, health providers spend too much time calling other providers about patient information, emailing images and records, and attempting to coordinate care efforts across disjointed and disconnected healthcare systems. This is a significant drain on valuable human resources, which could be more effectively spent with patients or used to remotely monitor patients’ conditions. Blockchain may provide a solution to challenges of interoperability in healthcare.
 
Electronic patient records do not resolve interoperability

A common misconception is that electronic patient records (EPR) resolve interoperability. They do not. EPRs were created to coordinate patient care inside healthcare settings by replacing paper records and filing cabinets. EPRs were not designed as open systems, which can easily collect, amalgamate and monitor a range of medical, genetic and personal information from multiple sources. To realize the full potential and promise of interoperability EPRs need to be easily accessible digitally, and in addition, have the capability to collect and manage remotely generated patient healthcare data as well as pharmacy and prescription information; family-health histories; genomic information and clinical-study data. To make this a reality existing data management conventions need to be significantly enhanced, and this is where Blockchain could help.

 

Blockchain will become a standard technology
 
Think of a bitcoin, or any other crypto currency, as a block capable of storing data. Each block can be subdivided countless times to create subsections. Thus, it is easy to see that a block may serve as a directory for a healthcare provider. Data recorded on a block can be public, but are encrypted and stored across a network. All data are immutable except for additions. Because of these and other capabilities, it seems reasonable to assume that Blockchain may become a standard technology over the next decade.
 
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Blockchain and healthcare

Because crypto currencies are unregulated and sometimes used for money laundering, they are perceived as “shadowy”. However, this should not be a reason for not considering Blockchain technology. 30 corporations, including J.P. Morgan and Microsoft, are uniting to develop decentralized computing networks based on Blockchain technology. Further crypto currencies are approaching the mainstream,  and within the financial sector, there is significant and growing interests in Blockchain technology to improve interoperability. Financial services and healthcare have similar interoperability challenges, but health providers appear reluctant to contemplate fundamental re-design of EPRs; despite the fact that there is a critical need for innovation as genomic data and personalized targeted therapies rise in significance and require advanced data management capabilities. Here are 2 brief examples, which describe how Blockchain is being used in financial services.
 
Blockchain’s use in financial services
 
In October 2017, the State Bank of India (SBI) announced its intention to implement Blockchain technology to improve the efficiency, transparency, security and confidentiality of its transactions while reducing costs. In November 2017, the SBI’s Blockchain partner, Primechain Technologies suggested that the key benefits of Blockchain for banks include, “Greatly improved security, reduced infrastructure cost, greater transparency, auditability and real-time automated settlements.”
 
Dubai, a global city in the United Arab Emirates, is preparing to introduce emCash as a crypto currency, and could become the world’s first Blockchain government by 2020. The changes Dubai is implementing eventually will lead to the end of traditional banking. Driving the transformation is Nasser Saidi, chief economists of the Dubai International Financial Centre, a former vice-governor of the Bank of Lebanon and a former economics and industry minister of that country. Saidi perceives the benefits of Blockchain to include the phasing out of costly traditional infrastructure services such as accounting and auditing.

 
Significant data challenges

Returning to healthcare, there are specific challenges facing interoperability, which include: (i) how to ensure patient records remain secure and are not lost or corrupted given that so many people are involved in the healthcare process for a single patient, and communication gaps and data-sharing issues are pervasive, and (ii) how can health providers effectively amalgamate and monitor genetic, clinical and personal data from a variety of sources, which are required to improve diagnosis, enhance treatments and reduce the burden of devastating and costly diseases. 
 
Vulnerability of patient data

Not only do EPRs fail to resolve these two basic challenges of interoperability they are vulnerable to cybercriminals. Recently there has been an epidemic of computer hackers stealing EPRs. In June 2016 a hacker claimed to have obtained more than 10m health records, and was alleged to be selling them on the dark web. Also in 2016 in the US there were hundreds of breaches involving millions of EPRs, which were reported to the Department of Health and Human Services. The hacking of 2 American health insurers alone, Anthem and Premera Blue Cross, affected some 90m EPRs.
 
In the UK, patient data and NHS England’s computers are no less secure. On 12 May 2017, a relatively unsophisticated ransomware called WannaCry, infected NHS computers and affected the health service’s ability to provide care to patients. In October 2017, the National Audit Office (NAO) published a report on the impact of WannaCry, which found that 19,500 medical appointments were cancelled, computers at 600 primary care offices were locked and five hospitals had to divert ambulances elsewhere. Amyas Morse, head of the NAO suggests that, “The NHS needs to get their act together to ensure the NHS is better protected against future attacks.”

 
Healthcare legacy systems
 
Despite the potential benefits of Blockchain to healthcare, providers have not worked out fully how to move on from their legacy systems and employ innovative digital technologies with sufficient vigour to effectively enhance the overall quality of care while reducing costs. Instead they tinker at the edges of technologies, and fail to learn from best practices in adjacent industries.  
 
“Doctors and the medical community are the biggest deterrent for change”
 
Devi Shetty, heart surgeon, founder, and Chairperson of Narayana Health articulates this failure“Doctors and the medical community are the biggest deterrent for the penetration of innovative IT systems in healthcare to improve patient care . . . IT has penetrated every industry in the world with the exception of healthcare. The only IT in patient care is software built into medical devices, which doctors can’t stop. Elsewhere there is a dearth of innovative IT systems to enhance care,” see video. Notwithstanding, Shetty believes that, “The future of healthcare is not going to be an extension of the past. The next big thing in healthcare is not going to be a new drug, a new medical device or a new operation. It is going to be IT.”
 
 
Google, Blockchain and healthcare
 
Previous HealthPad Commentaries have suggested that the failure of healthcare providers to fully embrace innovative technologies, especially those associated with patient data, has created an opportunity for giant technology companies to enter the healthcare sector, which shall dis-intermediate healthcare professionals.

In May 2017, Google announced that its AI-powered subsidiary, DeepMind Health, intends to develop the “Verifiable Data Audit”, which uses Blockchain technology to create a digital ledger, which automatically records every interaction with patient data in a cryptographically verifiable manner. This is expected to significantly reduce medical errors since any change or access to the patient data is visible, and both healthcare providers and patients would be able to securely track personal health records in real-time.

 
Takeaways

Blockchain is a new innovative and powerful technology that could play a significant role in overcoming the challenges of interoperability in healthcare, which would significantly help to enhance the quality of care, improve diagnosis, reduce costs and prevent devastating diseases. However, even if Blockchain were the perfect technological solution, which enabled interoperability, change would not happen in the short term. As Max Planck said, “A new scientific innovation does not triumph by convincing its opponents and making them see the light, but rather because its opponents eventually die, and a new generation grows up that is familiar with it.” While we wait for those who control our healthcare systems to die, billions of people will continue to suffer from preventable lifetime diseases, healthcare costs will escalate, healthcare systems will go bankrupt, and productivity in the general economy will fall.
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  • People are using A&E departments as convenient drop-in clinics for minor ailments because they cannot get GP appointments
  • In January 2017 the British Red Cross said A&E was struggling with a "humanitarian crisis" to keep up with a rush of patients over  the winter
  • UK’s Prime Minister suggests that all GP surgeries should open from 8am to 8pm, 7 days a week 
  • Primary care in England is in crisis, fuelled by a large and increasing demand and a shrinking supply of GPs
  • 75% of GPs across 540 general practices over the age of 55 are nearing retirement, and newly trained GPs are seeking employment abroad
  • By 2020 there could be a shortfall of 10,000 GPs in England
  • Curing the primary care crisis would relieve pressure on A&E departments
  • A simple, cheap and easy-to-use online dashboard could help relieve the primary healthcare crisis
 
A smarter approach to the UK’s GP crisis
 
Could the vast and escalating primary care crisis in England be helped with a new and innovative online dashboard, which automatically sends short videos contributed by clinicians to patients’ mobiles to address their FAQs?
 
Dr Seth Rankin an experienced GP thinks it can. Click on the photo below to access a short video, which demonstrates how the dashboard works.

 
 
 

UK’s Secretary of State predicted the healthcare crisis
 
The UK’s Secretary of Health has frequently stressed the urgent need for more innovation in healthcare. In 2015 he said: “If we do not find better, smarter ways to help our growing elderly population remain healthy and independent, our hospitals will be overwhelmed – which is why we need effective, strong and expanding general practice more than ever before in the history of the NHS.
 
An easy and effective way to improve GP services

Most patients don’t remember half of what is said in short GP consultations. This is why videos are so important. Unlike doctors and pamphlets videos never get tired, never wear out, and are available 24/7, 365 days a year. Unlike the Internet, the dashboard provides premium reliable healthcare information, which easily can be consumed by patients and shared among family, friends and carers. The video content can be viewed many times, from anywhere, and at anytime. The dashboard is fully automated [see figure below], relieves GPs of a lot of unnecessary work, and importantly, reports on how patients’ use the different videos,” says Rankin; CEO of the London Doctors Clinic; and formally the managing partner of the Wandsworth Medical Centre, and co-chair of Wandsworth CCG’s Diabetes Group.
 
A fully automated dashboard to improve efficiency and increase the quality of care
 
 
Reducing unnecessary A&E visits

‘The dashboard uses videos of local healthcare professionals because both patients and doctors want to improve their connectivity. The dashboard is embedded with about 120 short, 60 to 80 second, talking-head videos, which address patients’ frequently asked questions. Research suggests that the average attention span for people watching videos on mobiles is between 60 to 80 seconds. The dashboard has been specifically designed to help increase patients’ knowledge of their condition, propel them towards self-management, slow the onset of complications, lower the number of unnecessary visits to A&E, reduce face-time with GPs, and enhance the quality of care,” says Rankin.
 
Essential behavioral techniques

The efficacy of healthcare education is enhanced by embedded behavioral techniques, which nudge people to change their diets and lifestyles, improve self-monitoring of their condition, and increase adherence to medications.  The HealthPad dashboard benefits from such behavioral techniques.
 
Part of comprehensive communications system

The dashboard has been developed by health professionals with significant patient input, and aims to get effective educational content to the largest number of people at the lowest price possible; and without requiring effort from health professionals to mediate or facilitate the flow of the knowledge. To achieve this the dashboard is not a “lock-in” system, but designed to be easily and cheaply re-engineered to integrate with various other communications systems, see diagram below. The only thing that the dashboard requires is a connection to the Internet. 
 

 
GP surgeries at saturation point

A 2016 study published in The Lancet suggests that between 2007 and 2014 the workload in NHS general practice in England had increased by 16%, and that it is now reaching saturation point. According to Professor Richard Hobbs of Oxford University and lead author of the study, "For many years, doctors and nurses have reported increasing workloads, but for the first time, we are able to provide objective data that this is indeed the case . . . . . As currently delivered, the system [general practice in England] seems to be approaching saturation point . . . . . Current trends in population growth, low levels of recruitment and the demands of an ageing population with more complex needs will mean consultation rates will continue to rise.”
 
More than 1m patients visit GPs every day

A 2014 Deloitte’s report commissioned by the Royal College of General Practitioners (RCGP) suggests that the GP crisis in England is the result of chronic under-funding and under-investment when the demand for GP services is increasing as the population is ageing, and there is a higher prevalence of long-term conditions and multi-morbidities.
 
Each day in England, more than 1m patients visit their GPs. Some GPs routinely see between 40 to 60 patients daily. Over the past 5 years, the number of GP consultations has increased by 60m each year, and now stands at about 370m a year. Over the same period, the number of GPs has grown by only 4.1%.
 
Stress levels among GPs are high and increasing

Deloitte’s findings are confirmed by of a 2016 comparative study undertaken by the prestigious Washington DC-based Commonwealth Fund, which concluded that increasing workloads, bureaucracy and the shortest time with patients has led to 59% of NHS GPs finding their work either “extremely” or “very” stressful: significantly higher stress levels than in any other western nation. GP stress levels are likely to increase.
 
In a speech made in June 2015, the UK’s Secretary of Health said, “Within 5 years we will be looking after a million more over-70s. The number of people with three or more long term conditions is set to increase by 50% to nearly three million by 2018. By 2020, nearly 100,000 more people will need to be cared for at home.” Dr. Maureen Baker, the former chair of the Royal College of General Practitioners (RCGP) has warned that, “Rising patient demand, excessive bureaucracy, fewer resources, and a chronic shortage of GPs are resulting in worn-out doctors, some of whom are so fatigued that they can no longer guarantee to provide safe care to patients.” And Dr  Helen Stokes-Lampard, the new head of the RCGP, warns that patients are being put at risk because they often have to wait for a month before they can see a GP.

 
Newly trained GPs are seeking employment abroad

Trainee GPs are dwindling and young GPs are moving abroad. According to data from the General Medical Council (GMC), between 2008 and 2014 an average of 2,852 certificates were issued annually to enable British doctors to work abroad. We now have a dangerous situation where there are hundreds of vacancies for GP trainees. Meanwhile, findings from a 2015 British Medical Association (BMA) poll of 15,560 GPs, found that 34% of respondents plan to retire in the next five years because of high stress levels, unmanageable workloads, and too little time with patients.
 
5,000 more GPs by 2020

In 2016 the government announced a rescue package that will see an extra £2.4bn a year ploughed into primary care services by 2020. This is expected to pay for 5,000 more GPs and extra staff to boost practices. When the Secretary of Health trailed this in 2015, doctors’ leaders did not view it as a viable solution. Dr Chaand Nagpaul, chair of the BMA’s GP committee, warned that, “delivering 5,000 extra GPs in five years, when training a GP takes 10 years, was a practical impossibility and would never be achieved.” In 2016, Pulse, a publication for GPs, suggested that the Health Secretary understands that he cannot deliver on his election promise of 5,000 new doctors by 2020, and is negotiating with Apollo Hospitals, an Indian hospital chain, to bring 400 Indian GPs to England.
 
Pharmacists in GP surgeries
 
In July 2015 the NHS launched a £15m pilot scheme, supported by the RCGP and the Royal Pharmaceutical Society (RPS), to fund, recruit and employ clinical pharmacists in GP surgeries to provide patients with additional support for managing medications and better access to health checks.
 
Dr Maureen Baker said, “GPs are struggling to cope with unprecedented workloads and patients in some parts of the country are having to wait weeks for a GP appointment yet we have a ‘hidden army’ of highly trained pharmacists who could provide a solution”. Ash Soni, former president of the RPS suggested that it makes sense for pharmacists to help relieve the pressure on GPs, and said, “Around 18m GP consultations every year are for minor ailments. Research has shown that minor aliment services provided by pharmacists can provide the same treatment results for patients, but at lower cost than at a GP surgery.”
 
Progressive and helpful move
 
The efficacy for an enhanced role for pharmacists in primary care has already been established in the US, where retail giants such as CVS, Walgreens and Rite Aid provide convenient walk-in clinics staffed by pharmacists and nurse practitioners. Over time, Americans have grown to trust and value their relations with pharmacists, which has significantly increased adherence to medications, and provided GPs more time to devote to more complex cases. Non-adherence is costly, and can lead to increased visits to A&E, unnecessary complications, and sometimes death. According to a New England Healthcare Institute report, Thinking Beyond the Pillbox, failure to take medication correctly, costs the US healthcare system $300bn annually, and results in 125,000 deaths every year. 
 
Takeaway

People with complex conditions deserve to be seen by a GP who is not stressed and who can devote the time and attention they need. “Videos could play a similar role to practice-based pharmacists. Both deal with simple day-to-day patient questions, and relieve pressure on GPs, which allows them to focus their skills where they are most needed,” says Rankin.
 
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