Shared decision making in the Netherlands, is the time ripe for nationwide, structural implementation?
|
|
- Jasper Blair
- 8 years ago
- Views:
Transcription
1 Available online at Z. Evid. Fortbild. Qual. Gesundh. wesen (ZEFQ) xxx (2011) xxx xxx Schwerpunkt Shared decision making in the Netherlands, is the time ripe for nationwide, structural implementation? Trudy van der Weijden 1,, Haske van Veenendaal 2, Ton Drenthen 3, Martine Versluijs 4, Peep Stalmeier 5, Marije Koelewijn-van Loon 1, Anne Stiggelbout 6, Danielle Timmermans 7 1 Dept General Practice\ CAPHRI School for Public Health and Primary Care, Maastricht University, the Netherlands 2 Dutch Institute for Healthcare Improvement CBO, Utrecht, the Netherlands 3 Dutch College of General Practitioners, Utrecht, the Netherlands 4 Federation of Patients and Consumer Organisations in the Netherlands (NPCF), Utrecht, the Netherlands 5 Dept Epidemiology, Biostatistics and HTA, Radboud University Medical Centre, Nijmegen, the Netherlands 6 Dept Medical Decision Making, Leiden University Medical Centre, Leiden, the Netherlands 7 Department of Public and Occupational Health, EMGO institute, VU University Medical Center, Amsterdam, the Netherlands Summary What about policy regarding SDM? The Dutch health care system has been reformed in 2006 to make it more patient-oriented and demand-driven. We shortly describe four strategies of this health care reform. Although research projects are now fully spread over the country, a coordinated research agenda on SDM is lacking. What about tools decision support for patients? The Dutch governmental healthcare internet portal for patients hosts 16 patient decision aids. What about professional interest and implementation? There is quite a strong patient participation movement in the Netherlands, on macro and meso level. Limited effort, related to the local research projects has been put into training professionals in SDM skills. What does the future look like? We need concerted action on the level of educating health care professionals, empowering patients, making patient decision aids easily accessible, supporting the professionals in this new task, and measuring the process of SDM in performance indicators used in quality assurance. The Dutch Platform for SDM that will be launched in Maastricht in June 2011 is therefore a timely and relevant initiative. Key words: patient participation, patient information, shared decision making, health policy, patient preferences, quality assurance in healthcare (As supplied by publisher) Corresponding author. Trudy van der Weijden, MD, PhD, Dept General Practice\ CAPHRI School for Public Health and Primary Care, Maastricht University, the Netherlands. trudy.vanderweijden@maastrichtuniversity.nl (T. van der Weijden). Z. Evid. Fortbild. Qual. Gesundh. wesen (ZEFQ) doi: /j.zefq
2 Partizipative Entscheidungsfindung in den Niederlanden: Ist die Zeit reif für eine landesweite strukturelle Implementierung? Zusammenfassung Wie steht es mit gesetzlichen Regelungen zur PEF? Das niederländische Gesundheitssystem wurde 2006 zugunsten einer stärkeren Patienten- und Bedarfsorientierung reformiert. In diesem Beitrag beschreiben wir kurz vier Strategien dieser Gesundheitsreform. Obwohl Forschungsprojekte sich mittlerweile über das ganze Land erstrecken, mangelt es an einer koordinierten Forschungsagenda zum Thema PEF. Wie steht es mit PEF-Instrumenten Entscheidungshilfen für Patienten? Das staatliche niederländische Internet-Gesundheitsportal für Patienten beinhaltet 16 Entscheidungshilfen für Patienten. Wie steht es mit dem Interesse der Profession und der Implementierung? In den Niederlanden gibt es sowohl auf der Makro- als auch der Mesoebene eine recht starke Bewegung zur Patientenbeteiligung im Gesundheitswesen. Im Vergleich zu lokalen Forschungsprojekten sind im Hinblick auf die Weiterbildung von Fachkräften in PEF-Fertigkeiten dagegen nur begrenzte Anstrengungen unternommen worden. Wie sieht die Zukunft aus? Es bedarf einer konzertierten Aktion im Hinblick auf die Ausbildung der Fachkräfte im Gesundheitswesen, das Empowerment von Patienten, eine leichte Zugänglichkeit von Entscheidungshilfen für Patienten, die Unterstützung der Fachkräfte bei dieser neuen Aufgabe und die Erfassung des PEF-Prozesses mithilfe von Leistungsindikatoren, wie sie in der Qualitätssicherung zur Anwendung kommen. Die niederländische PEF-Plattform, die im Juni 2011 in Maastricht anlaufen soll, ist hierfür eine zeitgemäße und relevante Initiative. Schlüsselwörter: Patientenbeteiligung, Patientenaufklärung, Partizipative Entscheidungsfindung, Gesundheitspolitik, Patientenpräferenzen, Qualitätssicherung im Gesundheitswesen (Wie vom Gastherausgeber eingereicht) Introduction According to a typical Dutch saying Geen woorden maar daden [no words but action] we should stop talking about shared decision making and start to act upon it. Are we in the Netherlands ready for such translation from theory to practice? And if so, what is needed for the implementation of SDM? Obtaining the commitment of the health care professionals seems to be one of the main challenges for active patient involvement in decision making. The challenge is to enrich the professionals paradigm with other than paternalistic models for medical decision-making. First, they should be made aware of the phenomenon of SDM, and fully understand what it implies, before they can accept it as a valuable approach and get intrinsically motivated. Once they are in this stage of change, they should know how to do it, gain specific skills and competencies for this task, and be optimally facilitated and supported, to take the step to real behaviour change and maintain this new behaviour according to the SDM principles as routine behaviour. Clearly, to reach such a paradigm shift is quite a challenge for which complex multifaceted strategies are needed that address broad ranges of barriers at the levels of health professionals, the health care system, and last but not least - the patients. Applying the principles of SDM seems to be difficult for health care professionals. Data on the diffusion of shared decision-making within Dutch health care are scarce. But the general picture is that, although health care professionals might think they perform according to the principles of SDM, actual performance scores are low [1]. Many barriers have been identified from the perspectives of professionals, patients and the organization and prevailing culture of health care. We have learned from negative trials that pushing clinicians to apply SDM will not simply lead to uptake of SDM behaviour. Should we therefore put our efforts on empowering patients? The theme of the International Shared Decision Making (ISDM) 2011 conference Implementation of SDM, patient push or physician s pull is deliberately put in a simplified and dichotomous way, but those who have tried to implement SDM know that the answer is that we need both. The goal of this paper is to describe some current developments in the Dutch health care system and research on SDM. The paper is structured along the following themes: 1) some background information on the health care system, 2) research and research agenda on SDM, 3) milestones to get SDM implemented into the national health care system. In the Netherlands we use quite direct translations from the English language discourse on shared decision making. We use gezamenlijke besluitvorming for shared decision making. We use keuzehulp for decision aid, which would directly translate into choice aid. Background info on the health care system. Does it ensure a good climate for the implementation of SDM? The Dutch government aims to make the Dutch health care system more patient-oriented and demand-driven. We shortly describe four strategies used on macro and meso level to reach this goal. 2 Z. Evid. Fortbild. Qual. Gesundh. wesen xxx (2011) xxx xxx
3 Firstly, as a consequence of the new Health Insurance Act that was launched in 2006, all residents of the Netherlands are obliged to choose a health insurance company, and health insurers cover a standardised package of healthcare. Health insurance companies in their turn are obliged to accept every resident in their area of activity. Regulated competition among health care providers and among health care insurers was introduced. A conscious and rational choice of providers and insurers by patients is a crucial element in such a system. The Dutch government tries to enable consumers to choose rationally between providers and between health care insurers. The underlying assumption is that patients and consumers will actively choose the health care providers that are known to provide high quality of care. A recent evaluation of the health care reform showed that the number of consumers actively switching between health care insurers stabilised on 5% of the consumers per year, after a small increase just after health care reform [2]. Such increase was not seen in use of comparative consumer information with the aim to deliberately choose for a health care provider. Consumers rely, for the time being, on personal experiences as a valuable information source, and seem to support the model of sharing the decision on where to seek specialized care with their general practitioner, the gatekeeper for specialized care [3]. Secondly, decision making on the content of the care is regulated by the Wet op de Geneeskundige Behandelingsovereenkomst (Law on the Medical Treatment Agreement), that was launched in This law is constituted of several obligations and rights for professionals and patients, such as the professionals obligation to discuss the diagnostic and treatment options and inform the patient on consequences and risks of each option. Despite the fact that this law seems to reflect the ethical principle of SDM, it does not generate full-blown SDM performance by the Dutch health care providers, who seem to stick to the prevailing informed consent procedures. So, it was interpreted in the spirit of the informed patient model, and did not raise any call for or awareness of the SDM model or patient decision aids. Moreover, evaluation showed that especially in the area of risk communication and the communication of harms and benefits of medical interventions, health professionals are not adhering to the law [4]. Later this year a new law will be launched. The Law on the Medical Treatment Agreement will be integrated in a new law on Client rights in Health Care (WCZ) that will bundle the existing laws in which patient rights are described. Thirdly, the government initiated a systematic investment of patient experiences with healthcare on a collective level, by founding the Dutch Centre for Consumer Experience in Health Care in December This independent foundation is governed by a board representing patient/consumer organisations, health care insurers, and health care providers. The aim is to implement valid and reliable measurements and comparisons of consumer experiences in health care. This standard is called the Consumer Quality Index that is based on American CAHPS questionnaires. The Consumer Assessment of Healthcare Providers and Systems (CAHPS) program develops standardized surveys of patients experiences with ambulatory and facility-level care. Health care organizations, public and private purchasers, consumers, and researchers use Consumer Quality Index results to assess the patient-centeredness of care, and improve quality of care. Twenty Consumer Quality Indexes are currently available. This might induce attention for patient preferences and therefore for SDM. Fourthly, there is quite a strong patient participation movement in the Netherlands, on macro and meso level. Patients or patient representatives are more and more involved in setting national research agendas [5], developing clinical practice guidelines [6], or in coverage decisions by the Dutch Council of Health insurances. It is not clear yet what this means for the climate for SDM, but some innovative approaches seem to have emerged from this. One example in the area of preventive medicine is a guideline for periodic cardiovascular health checks launched by the Dutch College of General Practitioners. This guideline tries to find a patient-centred answer on the patient-driven demand for health checks. The guideline is first of all built on principles of risk communication and SDM, and less so on the principles of evidence-based medicine. Research and research agenda on SDM Although the Netherlands Organization for Health Research and Development (ZonMW) has financed one single project to support the development of patient decision aids, it did not set any specific budget in their research programming on SDM. Nevertheless, within the running research programs on effective and efficient care, disease management, or guideline implementation and prevention, patient participation on collective or individual decision making in health care is increasingly viewed as important. An example is a 4 year program carried out by the Federation of Patients and Consumer Organisations in the Netherlands (NPCF) in close collaboration with the Dutch Institute for Healthcare Improvement CBO aiming at promoting and facilitating self-management by (chronic) patients. The downside is that finances for this field of research are relatively small compared to other medical and health care themes, and the Dutch government is cutting down on the research budgets. Another problem is that budgets regularly have a specific focus on either the patient or the professional, rather than both sides of the coin. Non-governmental sources for research grants for SDM are funds from disease-specific associations such as for cancer, rheumatoid arthritis, cardiovascular disease, or diabetes. The Dutch Diabetes Federation has a specific research program called Stem van de patient [the patient s voice] for research on self-management, the role of patients with experiential knowledge in empowering other patients, and SDM. Table 1 shows an overview of Dutch research projects on SDM. Compared to Z. Evid. Fortbild. Qual. Gesundh. wesen (ZEFQ) xxx (2011) xxx xxx 3
4 Table 1. Examples of projects executed by the Dutch researchers in this field. City Theme: decision making on: Descriptive; observational studies Leiden - Rectal cancer; preoperative radiotherapy / permanent stoma or low anterior resection / adjuvant chemotherapy [7] - Breast cancer risk; inconclusive DNA-test - Asymptomatic abdominal aneurysm; surgery [8] Amsterdam - Prenatal screening on congenital defects - Breast cancer risk; the genetic counsellor s role - Adjuvant therapy for breast, pancreatic and oesophagus cancer - Asymptomatic abdominal aneurysm; surgery [9] Utrecht - SDM in genetic counselling - SDM related to treatment adherence - SDM in general practice for patients with low back pain - Depression in people with ethnic minority Nijmegen - Prostate cancer treatment decisions [10] - Metastatic breast or colon cancer; palliative chemotherapy or best supportive care - Communicating familial colorectal cancer risk [11] - Genetic breast cancer: prophylactic mastectomy vs screening - Fertility; replacement of 1 or 2 embryos in IVF [12] Groningen - Treatment of cardiovascular risk in diabetes Rotterdam - Prevention; participation in population screening on cancer (cervical, lung, colon, prostate) Maastricht - Cardiovascular risk management [13] - Glucose and cholesterol self test by consumers - Follow-up strategy after breast cancer treatment Twente decision aid developed or studied - Drug treatment for osteoporosis - Adjuvant therapy in gynaecological cancers - Drug treatment in rheumatoid arthritis - Treatment of acquired ankle-foot impairment in stroke - Treatment of arm-hand function in cervical spinal cord injury Evaluation of SDM strategy in health care 4 Z. Evid. Fortbild. Qual. Gesundh. wesen xxx (2011) xxx xxx
5 the overview as it was published in 2007 [14], we can conclude that research projects on SDM are now fully spread over the country, which is good. The studies are rather small initiatives stemming from various sources for grants. We lack a coordinated agenda on SDM research in the Netherlands. Milestones to get SDM implemented into the national health care system There is some awareness for SDM in the Netherlands, e.g. reflected by a recent paper in the Dutch medical journal [15]. Hopefully the awareness will be stimulated by hosting the 6 th ISDM 2011 conference in the Netherlands this year. The theme of the conference is on closing the gap between theory and practice. Patients or patient representatives might help us in thinking about how to translate SDM theory into practice. The ISDM conference outcomes will have an impact on the way we communicate with patients, so they need to be involved to agree, to improve and to work together on the model of SDM. Awareness of patient organisations of ISDM 2011 will facilitate successful implementation of SDM. Key patients from the patient and public involvement movement are advising us on how to best organise patient involvement at the conference. Four patient representatives will be invited to the conference, one of which will give a key note. Just after the closing of the 6 th International Conference of SDM the Dutch Platform of SDM will be launched in Maastricht, in the format of an extra plenary session, financed by one of the largest Dutch health care insurers. This Dutch Platform brings the relevant stakeholders together to enhance the quality and effectiveness of SDM within Dutch healthcare. It is a national informal and not-for-profit association of organizations and individual members to promote the SDM through national collaboration. The platform s specific objectives are: Table 2. Overview of patient decision aids that are available to the public on the governmental patient portal Kiesbeter.nl [chose better.nl]. Title of patient decision aid Pediatrics Drug treatment of children with ADHD Surgical treatment of tonsillitis Treatment of chronic otitis media in children Mental health Treatment of anxiety disorders Treatment of depression Treatment of depression in people with Turkish or Moroccan background Cardiovascular risk Cardiovascular risk management (primary prevention) Cardiovascular risk management in persons with diabetes Cardiovascular risk management in persons with cardiovascular disease Other treatments Surgical treatment of breast cancer Treatment of hernia nucleus pulposi Treatment of menopausal complaints Treatment of spontaneous pneumothorax Prevention and Screening Contraception Screening for prostate cancer Prenatal screening Down Syndrome to share experiences and evidence, and patient decision aids; foster national research collaboration on evaluation of SDM activities and application of rigorous methodologies; propose methods and standards for SDM development, implementation, and evaluation; and organize a national conference on SDM each year. Another milestone is the fact that the Dutch governmental healthcare internet portal hosts 16 patient decision aids, see Table 2. The dissemination of independent decision aids is important, and they may serve as seeds for other parties such as health insurance companies to make decision aids available to the public. Companies with commercial interests in patient choices will otherwise naturally try to invade this patient information market. The patient decision aids were developed with low-budgets and under the pressure of short timeframes. The decision aids will probably score fairly on IPDAS criteria. They are rather well developed on providing information about options and presenting probabilities, but less so on eliciting values and issues such as guiding or coaching. Interestingly, the evidence and options for these patient decision aids were directly distracted from clinical practice guidelines that had just been launched [16]. They were developed by independent committees that were closely linked to the clinical practice guideline committees, with representatives of patient organisations, guideline developers and the scientific organisations of general practitioners and medical specialists. No connection whatsoever has been made between the clinical practice guidelines and the patient decisions aids, they seem to stem from different worlds. There is a gap between the world of decision support for professionals (Guidelines International Network and the world of decision support for patients (International Patient Decision Aids Standards collaboration ipdas.ohri.ca). Accessibility on the governmental patient portal is another problem, they are just difficult to find. The health care insurers show increasing interest in making these decision aids easily accessible, and one of them already fully implemented one of these decision aids (the prenatal screening decision aid) on their own website, to increase accessibility. Conclusion Are we in the Netherlands ready for the translation from talking and theorising on SDM to acting upon it in practice? Maybe. Although we have shown some progress we are not ready yet for full blown implementation. To date, most of the effort has gone into development of patient decision aids and making these available for the public. And within this activity, most effort has been put in developing decision aids for supporting patients in choosing a health care provider, and much Z. Evid. Fortbild. Qual. Gesundh. wesen (ZEFQ) xxx (2011) xxx xxx 5
6 less so for decisions on the content of care. Limited effort, related to the local research projects (Table 1) has been put into training professionals in SDM skills. Nevertheless, the climate for SDM in the Netherlands is quite good. Although SDM is getting into the heads of more and more people, the challenge is to get it into their hearts. We need concerted action on the level of educating health care professionals, empowering patients, making high-quality patient decision aids easily accessible for professionals and patients, supporting the professionals in this new task, and measuring the process of SDM in performance indicators used in quality assurance. The Dutch Platform for SDM is therefore a timely and relevant initiative. Acknowledgements On behalf of the current members of the Dutch Platform of Shared Decision Making in formation, in alphabetical order: Jozien Bensing, Danielle de Meije, Ton Drenthen, Yvonne Heerkens, Janneke Kaper, Marije Koelewijn-van Loon, Hans Ossebaard, Wilma Otten, Ariette Sanders-van Lennep, Peep Stalmeier, Anne Stiggelbout, Danielle Timmermans, Inge van den Broek, Trudy van der Weijden, Haske van Veenendaal, Martine Versluijs. References [1] Van den Brink-Muinen A, van Dulmen AM, Schellevis FG, Bensing JM. Tweede nationale studie naar ziekten en verrichtingen in de huisartspraktijk. Oog voor communicatie: huisarts-patient communicatie in Nederland. [Second national Survey of diseases and performance in general practice. View on communication: general practitioner patient communication in the Netherlands.]: NIVEL Utrecht; the Netherlands, [2] De Jong JD, Van den Brink-Muinen A, Groenewegen PP. The Dutch health insurance reform: switching between insurers, a comparison between the general population and the chronically ill and disabled. BMC Health Services Research 2008;8:58. [3] Moser A, Korstjens I, van der Weijden T, Tange H. Themes affecting health-care consumers choice of a hospital for elective surgery when receiving web-based comparative consumer information. Pat Educ Couns 2010;78: [4] Dute JCJ, Gevers JKM, Hubben JH, Legemaate J, Roscam-Abbing HDC, Sluijters B, et al., De evaluatie van de WGBO [The evaluation of the Law on the Medical Treatment Agreement]. ZonMW, Den Haag, the Netherlands, [5] Abma TA, Broerse JEW. Patient participation as dialogue: setting research agendas. Health Expectations 2010;13: [6] Boivin A, Currie K, Fervers B, Gracia J, James M, Marshall C, et al., on behalf of GIN Public [the Guideline International Network Patient and Public Involvement Working Group]. Patient and public involvement in guidelines: international experiences and future perspectives. Qual Saf Health Care 2010;19:e22. [7] Stiggelbout AM, Jansen SJT, Otten W, Baas-Thijssen MCM, Van Slooten H, Van de Velde CJH. How important is the opinion of significant others to cancer patients adjuvant chemotherapy decision-making? Support Care Cancer 2007;15: [8] Stiggelbout AM, Molewijk AC, Otten W, Van Bockel JH, Bruijninckx CMA, Van der Salm I, et al. The impact of individualized evidence-based decision support on aneurysm patients decision-making, ideals of autonomy, and quality of life. Med Decis Making 2008;28: [9] Knops AM, Ubbink DT, Legemate DA, de Haes JC, Goossens A. Information communicated with patients in decision making about their abdominal aortic aneurysm. Eur J Vasc Endovasc Surg 2010;39: [10] van Tol-Geerdink JJ, Leer JW, van Lin ENJTh, Schimmel EC, Huizenga H, van Daal WAJ, et al. Offering a treatment choice in the irradiation of prostate cancer leads to better informed and more active patients, without harm to well-being. International Journal of Radiation Oncology, Biology, Physics 2008;70: [11] Dekker N, Hermens RPGM, Elwyn G, van der Weijden T, Nagengast FM, van Duijvendijk P, et al. Improving calculation, interpretation and communication of familial colorectal cancer risk: a randomized controlled trial. Implementation Science 2010;5:6. [12] van Peperstraten AM, Nelen LDM, Grol RPTM, Zielhuis G, Adang A, Stalmeier PFM, et al. Patient empowerment for prevention of twins after in vitro fertilisation: randomized controlled trial. BMJ 2010;340:c2501, doi: /bmj.c2501. [13] Koelewijn van Loon MS, van der Weijden T, van Steenkiste B, Ronda G, Winkens B, Severens JL, et al. Involving patients in cardiovascular risk management using nurse-led clinics: a cluster-randomised controlled trial in primary care. Can Med Ass J 2009;181:E [14] Van der Weijden T, van Veenendaal H, Timmermans DRM. Shared decision making in the Netherlands. Zeitschrift für Ärztliche Fortbildung und Qualitätssicherung 2007;101: [15] Ubbink DTh, Knops AM, Legemate DA, Bossuyt PMM, de Haes JCJM, Goossens A. Stand van zaken. Kiezen tussen verschillende behandelopties; hoe informeer ik mijn patiënt? [State of the art. Choosing between different treatment options, how to inform my patient?]. Ned Tijdschr Geneesk 2009;153:B344. [16] Raats CJ, van Veenendaal H, Versluijs MM, Burgers JS. A generic tool for development of decision aids based on clinical practice guidelines. Patient Educ Couns 2008;73: Z. Evid. Fortbild. Qual. Gesundh. wesen xxx (2011) xxx xxx
No. prev. doc.: 8770/08 SAN 64 Subject: EMPLOYMENT, SOCIAL POLICY, HEALTH AND CONSUMER AFFAIRS COUNCIL MEETING ON 9 AND 10 JUNE 2008
COUNCIL OF THE EUROPEAN UNION Brussels, 22 May 2008 9636/08 SAN 87 NOTE from: Committee of Permanent Representatives (Part 1) to: Council No. prev. doc.: 8770/08 SAN 64 Subject: EMPLOYMENT, SOCIAL POLICY,
More informationGuidance on competencies for management of Cancer Pain in adults
Guidance on competencies for management of Cancer Pain in adults Endorsed by: Contents Introduction A: Core competencies for practitioners in Pain Medicine B: Competencies for practitioners in Pain Medicine
More informationThe Centers for Medicare & Medicaid Services (CMS) strives to make information available to all. Nevertheless, portions of our files including
The Centers for Medicare & Medicaid Services (CMS) strives to make information available to all. Nevertheless, portions of our files including charts, tables, and graphics may be difficult to read using
More informationUniversity Medical Centres
University Medical Centres in the Netherlands AMC UMC Utrecht University Medical Centres University Medical Centres and the Health System Reform in the Netherlands: a Position Paper In the last ten years
More informationSemester 2 Semester 1 Quartile 2A Quartile 2B Quartile 1A Quartile 1B 5EC 5EC 5EC. Master Thesis and (if applicable) Internship (35EC)
Master s programme Psychology 2015-2016 The Master s programme in Psychology (60EC, 1 year) offers five (specialization) tracks in the field of psychology: Human Factors & Engineering Psychology (in English)
More informationResearch Agenda for General Practice / Family Medicine and Primary Health Care in Europe Summary EGPRN
Research Agenda for General Practice / Family Medicine and Primary Health Care in Europe Summary EGPRN EUROPEAN GENERAL PRACTICE RESEARCH NETWO RK EGPRN is a network organisation within WONCA Region Europe
More informationIf you have a question about whether MedStar Family Choice covers certain health care, call MedStar Family Choice Member Services at 888-404-3549.
Your Health Benefits Health services covered by MedStar Family Choice The list below shows the healthcare services and benefits for all MedStar Family Choice members. For some benefits, you have to be
More informationPalliative Care Services. Consultant Teams in Hospitals. Adult/Children 4 84 50 NK NK 138 Paediatric only 0 4 4 2 0 10
NETHERLANDS Population: 16,407,491 Current Directory: Printed version Online version None identified x Key Contact/National Association Key contact: Marijke Wulp, Staff member, Agora, National Information
More informationGuide to Chronic Disease Management and Prevention
Family Health Teams Advancing Primary Health Care Guide to Chronic Disease Management and Prevention September 27, 2005 Table of Contents 3 Introduction 3 Purpose 4 What is Chronic Disease Management
More informationMedStar Family Choice Benefits Summary District of Columbia- Healthy Families WHAT YOU GET WHO CAN GET THIS BENEFIT BENEFIT
Primary Care Services Specialist Services Laboratory & X-ray Services Hospital Services Pharmacy Services (prescription drugs) Emergency Services Preventive, acute, and chronic health care Services generally
More informationHEDIS/CAHPS 101. August 13, 2012 Minnesota Measurement and Reporting Workgroup
HEDIS/CAHPS 101 Minnesota Measurement and Reporting Workgroup Objectives Provide introduction to NCQA Identify HEDIS/CAHPS basics Discuss various components related to HEDIS/CAHPS usage, including State
More informationDr Ina Diener Physiotherapy Clinician in Private Practice Lecturer in OMT Stellenbosch, South Africa
Dr Ina Diener Physiotherapy Clinician in Private Practice Lecturer in OMT Stellenbosch, South Africa Invitation... 2 Invitation... To present evidence for the effectiveness of direct access and service
More informationHawaii Benchmarks Benefits under the Affordable Care Act (ACA)
Hawaii Benchmarks Benefits under the Affordable Care Act (ACA) 10/2012 Coverage for Newborn and Foster Children Coverage Outside the Provider Network Adult Routine Physical Exams Well-Baby and Well-Child
More informationPreventive Care Guideline for Asymptomatic Elderly Patients Age 65 and Over
Preventive Care Guideline for Asymptomatic Elderly Patients Age 65 and Over 1. BMI - Documented in patients medical record on an annual basis up to age 74. Screen for obesity and offer counseling to encourage
More informationThe Role of the Patient/Consumer in Establishing a Dynamic Clinical Research Continuum:
The National Working Group on Evidence-Based Health Care The Role of the Patient/Consumer in Establishing a Dynamic Clinical Research Continuum: Models of Patient/Consumer Inclusion August 2008 The Working
More informationRequest for Proposals
OICR Health Services Research Program Knowledge Translation Research Network Request for Proposals Funding Partners: OICR Knowledge Translation Research Network (KT Net) OnePage Letter of Intent (LOI)
More informationADVANCING POPULATION HEALTH: NEW MODELS AND THE ROLE OF RESEARCH
22 nd Annual Health Care Systems Research Network (HCSRN) Conference (formerly HMO Research Network Conference) ADVANCING POPULATION HEALTH: NEW MODELS AND THE ROLE OF RESEARCH Hosted by: Marshfield Clinic
More informationGuide to Health Promotion and Disease Prevention
Family Health Teams Advancing Primary Health Care Guide to Health Promotion and Disease Prevention January 16, 2006 Table of Contents 3 Introduction 3 Purpose 3 Background 4 Developing Health Promotion
More informationRevalidatie. Nederland
Revalidatie Nederland Rehabilitation aims to achieve recovery or improvement in people with long-term physical injury or functional impairment What is Revalidatie Nederland? Revalidatie Nederland is the
More informationRevision of the Directive 98/79/EC on In Vitro Diagnostic Medical Devices. Response from Cancer Research UK to the Commission August 2010
Revision of the Directive 98/79/EC on In Vitro Diagnostic Medical Devices Response from Cancer Research UK to the Commission August 2010 1. Cancer Research UK (CR-UK) 1 is leading the world in finding
More informationBijlage 1 THE ROTER METHOD OF INTERACTION PROCESS ANALYSIS. (adapted version)
Dit rapport is een uitgave van het NIVEL in 2004. De gegevens mogen met bronvermelding (A van den Brink-Muinen, AM van Dulmen, FG Schellevis, JM Bensing (redactie). Tweede Nationale Studie naar ziekten
More informationKaiser Permanente: Health Education. Mei Ling Schwartz, MPH Director, Health & Physician Education Kaiser Permanente Panorama City Medical Center
Kaiser Permanente: Health Education Mei Ling Schwartz, MPH Director, Health & Physician Education Kaiser Permanente Panorama City Medical Center Who Is Kaiser Permanente? Founded in 1945, Kaiser Permanente
More informationPrinciples on Health Care Reform
American Heart Association Principles on Health Care Reform The American Heart Association has a longstanding commitment to approaching health care reform from the patient s perspective. This focus including
More informationSPICE auf der Überholspur. Vergleich von ISO (TR) 15504 und Automotive SPICE
SPICE auf der Überholspur Vergleich von ISO (TR) 15504 und Automotive SPICE Historie Software Process Improvement and Capability determination 1994 1995 ISO 15504 Draft SPICE wird als Projekt der ISO zur
More informationHealthy ageing and disease prevention: The case in South Africa and The Netherlands
Healthy ageing and disease prevention: The case in South Africa and The Netherlands Sebastiana Kalula, 1 Ger Tielen 2 and Monica Ferreira 1 Medical advances, improved health care and prudent health behaviour
More informationRunning head: TEACH-BACK IN PATIENT SELF-MANAGEMENT 1
Running head: TEACH-BACK IN PATIENT SELF-MANAGEMENT 1 Teach-Back in Patient Self-Management Ping Xu Kent State University TEACH-BACK IN PATIENT SELF-MANAGEMENT 2 Teach-Back in Patient Self-Management James
More informationHealth System Strategies to Improve Chronic Disease Management and Prevention: What Works?
Health System Strategies to Improve Chronic Disease Management and Prevention: What Works? Michele Heisler, MD, MPA VA Center for Clinical Practice Management Research University of Michigan Department
More informationConsultation Response Medical profiling and online medicine: the ethics of 'personalised' healthcare in a consumer age Nuffield Council on Bioethics
Consultation Response Medical profiling and online medicine: the ethics of 'personalised' healthcare in a consumer age Nuffield Council on Bioethics Response by the Genetic Interest Group Question 1: Health
More informationCoventry Health Care of Florida, Inc. Coventry Health Plan of Florida, Inc. Coventry Health and Life Insurance Company Commercial Lines of Business
Coventry Health Care of Florida, Inc. Coventry Health Plan of Florida, Inc. Coventry Health and Life Insurance Company Commercial Lines of Business Quality Management Program 2012 Overview Quality Improvement
More informationCancer research in the Midland Region the prostate and bowel cancer projects
Cancer research in the Midland Region the prostate and bowel cancer projects Ross Lawrenson Waikato Clinical School University of Auckland MoH/HRC Cancer Research agenda Lung cancer Palliative care Prostate
More informationFOCUS. Female breast cancer in the elderly; Optimizing Clinical guidelines. USing clinico-pathological and molecular data. Departmentsof Surgery
FOCUS Female breast cancer in the elderly; Optimizing Clinical guidelines USing clinico-pathological and molecular data Departmentsof Surgery Prof. - Surgery dr. van de Velde Dr. - Gerontology Liefers
More informationPrevention of Medical Errors: 2015
Prevention of Medical Errors: 2015 David L. Adelson, Esq. What will we cover? Root-Cause Analysis Error Reduction Error Prevention Patient Safety Most Misdiagnosis or Mistreated Conditions: Addiction Psychiatric
More informationWork and Mental Health: evidence from The Netherlands
Work and Mental Health: evidence from The Netherlands 29 augustus 2008 Jac van der Klink, MD, PhD University Medical Center Groningen, Health Sciences, Public and Occupational Health Do adverse psychosocial
More informationPreventive Care Guideline for Asymptomatic Low Risk Adults Age 18 through 64
Preventive Care Guideline for Asymptomatic Low Risk Adults Age 18 through 64 1. BMI - Documented in patients medical record on an annual basis. Screen for obesity and offer intensive counseling and behavioral
More informationBreast Health Program
Breast Health Program Working together, for your health. Breast Health Program The Breast Health Program at The University of Arizona Cancer Center offers patients a personalized approach to breast cancer,
More informationIN-NETWORK MEMBER PAYS. Out-of-Pocket Maximum (Includes a combination of deductible, copayments and coinsurance for health and pharmacy services)
HMO-OA-CNT-30-45-500-500D-13 HMO Open Access Contract Year Plan Benefit Summary This is a brief summary of benefits. Refer to your Membership Agreement for complete details on benefits, conditions, limitations
More informationBASIC CONCEPTS OF PATIENT EDUCATION
Section I BASIC CONCEPTS OF PATIENT EDUCATION Section I of this book, Basic Concepts of Patient Education, describes the importance of teaching and learning in health care and physical and occupational
More information2015 Medicare Advantage Summary of Benefits
2015 Medicare Advantage Summary of Benefits HNE Medicare Premium No Rx and HNE Medicare Basic No Rx January 1, 2015 - December 31, 2015 H8578_2015_034 Accepted HNE MEDICARE ADVANTAGE ENROLLMENT KIT 2015
More informationAttending Physician s Report
Attending Physician s Report t for use in the United Kingdom Doctor s name Doctor s address XIM/APR Doctor s fax number Doctor s email Application reference Please return to: Patient Name of Birth Address
More informationEvidence-based guideline development. Dr. Jako Burgers/dr. H.P.Muller Dutch Institute for Healthcare Improvement CBO, Utrecht, The Netherlands
Evidence-based guideline development Dr. Jako Burgers/dr. H.P.Muller Dutch Institute for Healthcare Improvement CBO, Utrecht, The Netherlands Outline lecture/workshop 1. Aims and objectives of guidelines
More information[2015] SUMMARY OF BENEFITS H1189_2015SB
[2015] SUMMARY OF BENEFITS H1189_2015SB Section I You have choices in your health care One choice is to get your Medicare benefits through Original Medicare (fee-for-service Medicare). Original Medicare
More informationSUBTITLE D--PROVISIONS RELATING TO TITLE IV SEC 10408 GRANTS FOR SMALL BUSINESSES TO PROVIDE COMPREHENSIVE WORKPLACE WELLNESS PROGRAMS
SUBTITLE D--PROVISIONS RELATING TO TITLE IV SEC 10408 GRANTS FOR SMALL BUSINESSES TO PROVIDE COMPREHENSIVE WORKPLACE WELLNESS PROGRAMS The Secretary of HHS will award grants to eligible employers to provide
More informationPHFAST Public Health Framework ASsessment Tool Adapted from the Public Health Framework for Action and STAR
LEADERSHIP: The state chronic disease prevention and control unit is the unifying voice for the prevention and control of chronic diseases. LS1 LS2 LS3 LS4 LS5 The unit is a key contact for others both
More informationReport to the Australian Senate on anti-competitive and other practices by health funds and providers in relation to private health insurance
5 September 2011 Louise Macleod Director Intelligence, Infocentre and Policy Liaison Branch Australian Competition and Consumer Commission GPO Box 3131 Canberra ACT 2601 By email: phireport@accc.gov.au
More informationEvidence Based Medicine Health Information Infrastructure Transparency and Payment Reform. Ward B. Hurlburt, M.D. October 12, 2002
Evidence Based Medicine Health Information Infrastructure Transparency and Payment Reform Ward B. Hurlburt, M.D. October 12, 2002 Evidence-based medicine - EBM aims to apply the best available evidence
More informationColo s in Amsterdam. Chris Mulder, Jochim Terhaar sive Droste. VU Medisch Centrum Afdeling MDL
Colo s in Amsterdam Chris Mulder, Jochim Terhaar sive Droste VU Medisch Centrum Afdeling MDL Open access colo Threshold low in CRC-family Open access 0 5% CM: scientific evaluation 0,0 KWF/MLDS: basic
More informationHNE Premier 1 (HMO) and HNE Premier 2 (HMO)
2016 Medicare Advantage Summary of Benefits HNE Premier 1 (HMO) and HNE Premier 2 (HMO) January 1, 2016 - December 31, 2016 H8578_2016_429 Accepted HNE MEDICARE ADVANTAGE ENROLLMENT KIT 2016 SECTION I
More information2015 Summary of Benefits
2015 Summary of Benefits Plans 003 and 004 H6298_14_027 accepted Summary of Benefits January 1, 2015 - December 31, 2015 This booklet gives you a summary of what we cover and what you pay. It doesn t list
More informationAdvanced Clinical Social Work Practice in Integrated Healthcare Module 1. Marion Becker, PhD School of Social Work University of South Florida
Advanced Clinical Social Work Practice in Integrated Healthcare Module 1 Marion Becker, PhD School of Social Work University of South Florida Introduction to Integrated Healthcare and the Culture of Health
More informationAlternative Benefit Plan (ABP) ABP Cost-Sharing & Comparison to Standard Medicaid Services
Alternative Benefit Plan (ABP) ABP Cost-Sharing & Comparison to Standard Medicaid Services Most adults who qualify for the Medicaid category known as the Other Adult Group receive services under the New
More informationEURORDIS Position Paper on Centres of Expertise and European Reference Networks for Rare Diseases
EURORDIS Position Paper on Centres of Expertise and European Reference Networks for Rare Diseases EURORDIS - the European Organisation for Rare Diseases represents 310 rare disease organisations from 34
More informationSystematic Reviews. knowledge to support evidence-informed health and social care
Systematic Reviews knowledge to support evidence-informed health and social care By removing uncertainties in science and research, systematic reviews ensure that only the most effective and best-value
More informationSpecialist training programme for elderly care physicians (previously: nursing home physicians) in the Netherlands
Specialist training programme for elderly care physicians (previously: nursing home physicians) in the Netherlands For its population of 16.5 million inhabitants, the Netherlands has approximately 350
More informationCRITICAL ILLNESS BASE COVERAGE
Prepared for: AFG Schools Group ID: AFGSCHOOL Quote Sequence: 100 Proposed Effective Date: 9/1/2013 Lincoln Critical Illness Insurance Plan Highlights Surviving a critical illness is becoming more common
More informationEvidence-Based Practice for Public Health Identified Knowledge Domains of Public Health
1 Biostatistics Statistical Methods & Theory Evidence-Based Practice for Public Health Identified Knowledge Domains of Public Health General Public Health Epidemiology Risk Assessment Population-Based
More informationResearch Prioritization Topic Brief. Topic 3: Care coordination in primary care
Research Prioritization Topic Brief Topic 3: Care coordination in primary care Compare the effectiveness of enhanced care coordination, including multicultural approaches, on improving the healthcare process
More informationApplied Psychology. Course Descriptions
Applied Psychology s AP 6001 PRACTICUM SEMINAR I 1 CREDIT AP 6002 PRACTICUM SEMINAR II 3 CREDITS Prerequisites: AP 6001: Successful completion of core courses. Approval of practicum site by program coordinator.
More informationexecutive summary Scope Aim and targeted readership
executive summary Scope The development, evaluation and introduction of medical innovations and technologies in general and innovative medical devices in particular are considered an increasingly important
More informationAsk Us About Clinical Trials
Ask Us About Clinical Trials Clinical Trials and You. Our specialists and researchers are at the forefront of their fields and are leading the way in developing new therapies and procedures for diagnosing
More informationObjectives of Training in Radiation Oncology
Objectives of Training in Radiation Oncology 2008 This document applies to those who begin training on or after July 1 st, 2009. (Please see also the Policies and Procedures. ) DEFINITION Radiation Oncologists
More informationQuality Improvement Program
Quality Improvement Program Section M-1 Additional information on the Quality Improvement Program (QIP) and activities is available on our website at www.molinahealthcare.com Upon request in writing, Molina
More informationSPECIALTY CASE MANAGEMENT
SPECIALTY CASE MANAGEMENT Our Specialty Case Management programs boost ROI and empower members to make informed decisions and work with their physicians to better manage their health. KEPRO is Effectively
More informationMaster course Physician Assistant for Clinical Midwifery
Master course Physician Assistant for Clinical Midwifery Rotterdam, the Netherlands Irma van der Velden The staff Evelien Cellissen MPA midwifery Rudy Riijke MD,PhD Irma v.d. Velden Medical Biologist
More informationTHE ROLE OF HEALTH INFORMATION TECHNOLOGY IN PATIENT-CENTERED CARE COLLABORATION. 2012 Louisiana HIPAA & EHR Conference Presenter: Chris Williams
THE ROLE OF HEALTH INFORMATION TECHNOLOGY IN PATIENT-CENTERED CARE COLLABORATION 2012 Louisiana HIPAA & EHR Conference Presenter: Chris Williams Agenda Overview Impact of HIT on Patient-Centered Care (PCC)
More information2016 Summary of Benefits
2016 Summary of Benefits Health Net Violet Option 3 (PPO) Douglas and Josephine counties, OR Benefits effective January 1, 2016 H5520 Health Net Life Insurance Company H5520_2016_0202 CMS Accepted 09162015
More informationEvidence-Informed Recommendations in Rehabilitation for Older Adults Aging with HIV: A Knowledge Synthesis
Evidence-Informed Recommendations in Rehabilitation for Older Adults Aging with HIV: A Knowledge Synthesis Work to Date November 2012 Kelly O Brien, Patty Solomon, Joy MacDermid, Barry Trentham, Larry
More informationCURRICULUM VITAE. M. Sc. Anne-Katharina Schiefele
CURRICULUM VITAE Address: Department of Clinical Psychology and Psychotherapy, University of Trier, 54286 Trier, Germany TEL 0049 (0)651 201 2882 E-mail: schiefele@uni-trier.de Birthday: November 30, 1987
More informationPreventive Services for Pregnancy SERVICE WHAT IS COVERED INTERVALS OF COVERAGE Anemia Screening Screening Annual screening for pregnant women
Preventive Services for Pregnancy SERVICE WHAT IS COVERED INTERVALS OF COVERAGE Anemia Annual screening for pregnant women Bacteriuria For pregnant women at 12-16 weeks gestation or first prenatal visit
More informationRegistries: An alternative for clinical trials?
Registries: An alternative for clinical trials? Prof. Dr. Joerg Hasford, M.D., Ph.D. Department of Medical Informatics, Biometry and Epidemiology Ludwig-Maximilians-Universität Email: has@ibe.med.uni-muenchen.de
More informationUSPSTF Grade A B Recommendations
USPSTF Grade Recommendations bdominal aortic aneurysm screening: men The USPSTF recommends one-time screening for abdominal aortic aneurysm by ultrasonography in men aged 65 to 75 who have ever smoked.
More informationBENEFIT PLAN. What Your Plan Covers and How Benefits are Paid. Appendix A. Prepared Exclusively for The Dow Chemical Company
Appendix A BENEFIT PLAN Prepared Exclusively for The Dow Chemical Company What Your Plan Covers and How Benefits are Paid Choice POS II (MAP Plus Option 2 - High Deductible Health Plan (HDHP) with Prescription
More informationThe cost of physical inactivity
The cost of physical inactivity October 2008 The cost of physical inactivity to the Australian economy is estimated to be $13.8 billion. It is estimated that 16,178 Australians die prematurely each year
More informationOpening the psychological black box in genetic counseling
Opening the psychological black box in genetic counseling A counselee-oriented, integrative approach on the impact of DNA-testing for breast and ovarian cancer on the lives of counselees Joël Vos 1 2 Opening
More informationNursing Knowledge for Your Benefit
Nursing Knowledge for Your Benefit Policy of the Icelandic Nurses Association on Nursing and Health Care 2011-2020 About this Policy The present Policy of the Icelandic Nurses Association (INA) was developed
More informationPrimary health care in the Netherlands: current situation and trends
Primary health care in the Netherlands: current situation and trends Prof. Peter P. Groenewegen NIVEL Netherlands Institute for Health Services Research and Utrecht University Contents of my presentation
More informationIndependent Health s Medicare Passport Advantage (PPO)
Independent Health s Medicare Passport Advantage (PPO) (a Medicare Advantage Preferred Provider Organization Option (PPO) offered by INDEPENDENT HEALTH BENEFITS CORPORATION with a Medicare contract) Summary
More informationLevel 1. Nutrition & Lifestyle Oncology Certificate
Level 1 Nutrition & Lifestyle Oncology Certificate ONE MODULE 1 A Cancer Diagnosis Learn what cancer is; how/why it develops; diagnostic tests; inflammatory/ hormonal connections; 5 most important steps
More informationCare Planning and Goal setting in Diabetes management
Care Planning and Goal setting in Diabetes management How can we provide self-management support to people with chronic conditions? Professor Malcolm Battersby Flinders University Flinders Human Behaviour
More informationTABLE OF CONTENTS. Introduction...1. Chapter1 AdvancesinTreatment...2. Chapter2 MedicinesinDevelopment...11. Chapter3 ValueandSpending...
CANCER TABLE OF CONTENTS Introduction...1 Chapter1 AdvancesinTreatment...2 Chapter2 MedicinesinDevelopment......11 Chapter3 ValueandSpending......15 Chapter4 Conclusion...22 INTRODUCTION Researchers and
More informationWe cordially invite you to the first NIHES course on Women s Health.
NIHES RESEARCH TRAINING IN MEDICINE AND THE HEALTH SCIENCES First NIHES Course on WOMEN S HEALTH 28 30 January 2013 introduction We cordially invite you to the first NIHES course on Women s Health. The
More informationAn ANALYSIS of Medicare Benefits per the 2016 Medicare and You Handbook & The State of Delaware's Special Medicfill Plan Benefits
An ANALYSIS of Medicare Benefits per the 2016 Medicare and You Handbook & The State of Delaware's Special Medicfill Plan Benefits The chart below presents the list of benefits covered by Medicare, and
More informationUtilizing a Registry for Health Care Management : A Team Perspective. Linda Follenweider MS PhDc FNP
Utilizing a Registry for Health Care Management : A Team Perspective Linda Follenweider MS PhDc FNP May 31, 2012 Commercial Disclosure I have no relevant financial relationships to disclose prior to presenting
More informationSummary of Benefits Community Advantage (HMO)
Summary of Benefits Community Advantage (HMO) January 1, 2015 - December 31, 2015 This booklet gives you a summary of what we cover and what you pay. It doesn't list every service that we cover or list
More informationKapitel 2 Unternehmensarchitektur III
Kapitel 2 Unternehmensarchitektur III Software Architecture, Quality, and Testing FS 2015 Prof. Dr. Jana Köhler jana.koehler@hslu.ch IT Strategie Entwicklung "Foundation for Execution" "Because experts
More informationMeasures for the Australian health system. Belinda Emms Health Care Safety and Quality Unit Australian Institute of Health and Welfare
Measures for the Australian health system Belinda Emms Health Care Safety and Quality Unit Australian Institute of Health and Welfare Two sets of indicators The National Safety and Quality Indicators Performance
More informationMedical College of Georgia Augusta, Georgia School of Medicine Competency based Objectives
Medical College of Georgia Augusta, Georgia School of Medicine Competency based Objectives Medical Knowledge Goal Statement: Medical students are expected to master a foundation of clinical knowledge with
More informationELEMENTS FOR A PUBLIC SUMMARY. Overview of disease epidemiology. Summary of treatment benefits
VI: 2 ELEMENTS FOR A PUBLIC SUMMARY Bicalutamide (CASODEX 1 ) is a hormonal therapy anticancer agent, used for the treatment of prostate cancer. Hormones are chemical messengers that help to control the
More informationNCQA Health Plan Accreditation. Creating Value by Improving Health Care Quality
NCQA Health Plan Accreditation Creating Value by Improving Health Care Quality NCQA Health Plan Accreditation Creating Value by Improving Health Care Quality Purchasers, consumers and health plans pay
More information11/2/2015 Domain: Care Coordination / Patient Safety
11/2/2015 Domain: Care Coordination / Patient Safety 2014 CT Commercial Medicaid Compared to 2012 all LOB Medicaid Quality Compass Benchmarks 2 3 4 5 6 7 8 9 10 Documentation of Current Medications in
More informationThe Role of Clinical Practice Guidelines, Survivorship Care Plans, and Inter-sectoral Care in Cancer Rehabilitation
The Role of Clinical Practice Guidelines, Survivorship Care Plans, and Inter-sectoral Care in Cancer Rehabilitation Prof. Eva Grunfeld, MD, DPhil, FCFP Ontario Institute for Cancer Research/Cancer Care
More informationShared decision making: Helping the system and patients make quality health care decisions
Shared decision making: Helping the system and patients make quality health care decisions 2 ISBN 13:978-1-897155-49-3 Recommended citation format: S. Chow, G. Teare, G. Basky Shared decision making: Helping
More informationFIRSTCAROLINACARE INSURANCE COMPANY 2015 Summary of Benefits. FirstMedicare Direct PPO Plus (PPO)
FIRSTCAROLINACARE INSURANCE COMPANY 2015 Summary of Benefits FirstMedicare Direct PPO Plus (PPO) Chatham, Hoke, Lee, Montgomery, Moore, Richmond, Scotland Counties 1 P age SECTION I - INTRODUCTION TO SUMMARY
More informationCancer Treatment Planning: A Means to Deliver Quality, Patient-Centered Care
Cancer Treatment Planning: A Means to Deliver Quality, Patient-Centered Care Patricia A. Ganz, M.D. Jonsson Comprehensive Cancer Center UCLA Schools of Medicine & Public Health Overview of Presentation
More informationEvidence-based Clinical Guidelines for stuttering
Evidence-based Clinical Guidelines for stuttering Leonoor Oonk 1, Bert Bast 2,3,4, Joeri van Ormondt 2, Mark Pertijs 1,5 1 University of Applied Sciences Utrecht, the Netherlands, 2 Dutch Stuttering Association,
More informationSurvivorship Care Plans Guides for Living After Cancer Treatment
Survivorship Care Plans Guides for Living After Cancer Treatment Institute of Medicine Report 2005 Recommendations for meeting needs of cancer survivors Implement survivorship care plan Build bridges
More informationUK Experience In Health Insurance Market Andrew Vallance-Owen Group Medical Director. AVO/pmr/ppt/Prague Conference April 2008.ppt
UK Experience In Health Insurance Market Andrew Vallance-Owen Group Medical Director 1 UK PMI - growth over time 8000 7000 6000 12 11 10 9 lives covered (000's) 5000 4000 3000 8 7 6 5 4 PMI penetration
More informationChronic Disease and Physiotherapy
Approved: 2009 Due for review: 2012 Chronic Disease and Physiotherapy Background In 2005 the Australian Health Ministers Conference published its National Chronic Disease Strategy (NCDS). The NCDS identifies
More informationSummary of Benefits January 1, 2016 December 31, 2016. FirstMedicare Direct PPO Plus (PPO)
Summary of Benefits January 1, 2016 December 31, 2016 FIRSTCAROLINACARE INSURANCE COMPANY FirstMedicare Direct PPO Plus (PPO) Chatham, Hoke, Lee, Montgomery, Moore, Richmond, Scotland Counties This booklet
More informationClaudia M. Witt, MD, MBA
Costs and cost-effectiveness of Complementary and Alternative Medicine Complementary and Alternative Medicine Innovation and Added Value for European Healthcare 9 October 2012 European Parliament, Brussels
More information