The Changing Face of Healthcare

Several significant forces in the last several years have been changing the way healthcare has and will continue to be delivered. The emergence of more unique ways to deliver care such as clinics incorporated into businesses and factories, the increased use of mid-level providers (nurse practitioners & physician assistants), the increase integration of technologies such as telemedicine and robotics and the shift from interventional reimbursement to outcomes reimbursement are just a few examples.

Compounding these are the ever-increasing costs of healthcare, the strain of funding Medicare on the U.S. economy, and the complications of insurance and healthcare payments under the affordable care act, ACA.

This has led to changes in how businesses intend to interface with the healthcare system going forward. CVS’s acquisition of Aetna will try to leverage healthcare delivery through their pharmacy structure. United Healthcare’s acquisition of DaVita hopes to leverage cost containment and resource control by directly controlling physicians. And the recently announced collaboration among Berkshire Hathaway, Amazon and J.P. Morgan Chase presents a yet unknown structure whose stated goals is improved quality and less cost. How they will implement their strategy is yet to emerge.

The decline in hospital admission over the last several decades has further led to restructuring by hospital corporations such as Tenet. Premise Health has emerged as a company placing physicians and other healthcare providers directly in corporate/business offices.

The big question then with these new ventures are how do organizations know what works financially and how do they track performance… In other words, how do you track, measure and value the relationships between cost and outcomes?

How can the analyst measure which methods(s) may generate better or best outcomes?

A simple return on investment, ROI, calculation will not provide needed nor valid insights. However, the use of cost-effectiveness analysis (CEA) would provide quite useful, valid and actionable information. CEA uses decision tree models to compare not only cost outcomes but effectiveness outcomes of various treatments on patient health and even on future healthcare usage based on various current actions. It can further be used to determine how effective a set amount of money spent on a particular treatment or method will impact outcomes (i.e. willingness to pay calculation). CEA models are flexible and can incorporate a wide variety of scenarios. As opposed to Big Data, CEA makes use of Broad Data so that comparisons of treatment modalities can be evaluated using real life outcomes. It can compare effects on a discrete problem such as a cancer tumor, or on chronic ongoing diseases such as COPD or CHF.

As the delivery of effective yet profitable, or at least cost effective, healthcare becomes more challenging, methods for evaluating treatments and programs become more necessary if not essential. Methods must be implemented to evaluate these new treatments and programs once they are in place so adjustments can be made. CEA enable organizations to both initially evaluate and subsequently monitor new methods and programs in a meaningful way.

Setting The Record Straight on Meat Health

Red meat is often wrongly portrayed as being unhealthy. Even chicken has been getting attacked by some in the media as being unhealthy or not environmentally friendly. Vegan, fish and other non-meat diets have been proposed as healthier alternatives. The result of this onslaught of negative meat messages has influenced many persons including moms and dads to drastically cut back on their meat and poultry purchases. Perceptions may be seen as reality, yet truth trumps non truths. Parents and other consumers want what is best for their health and that of their families. They are also aware that a lot of false information is out there and as such are open to scientific facts that can correct their misconceptions. Below are the facts:

1) “You would need to eat a massive amount of spinach to equal (the iron content) in a steak,” says Christopher Golden, an ecologist and epidemiologist at Harvard University in Cambridge, Massachusetts. (As quoted by in the article ‘Brain food- clever eating’.)
2) Let’s get precise. For a woman to receive her recommended daily intake of 18 mg of iron would need just 300 grams of cooked bovine liver, 625 grams of cooked beef or an astounding 2.4 kg of spinach!
3) In addition, the Iron found in vegetables is harder to absorb than the iron found in meat as it is attached to fibre which inhibits its absorption.

1) Being deficient in the micronutrients found in meat have been linked with low IQ, autism, depression and dementia says Dr. Charlotte Neumann, a pediatrician at the University of California, as quoted in the above article.
2) Zinc found in meat is crucial for learning and memory.
3) Vitamin B12 found in meat preserves the sheaths that protect nerves.

Due to its antioxidant powers, zinc is involved in creating antibodies to fight free radicals that increase our risk for chronic diseases.

1) The protein in meat helps build and repair body tissues.
2) Muscles are made of protein. That is why athletes who are building muscle strength increase their meat protein consumption.
3) The protein and zinc found in meat are important for muscle growth and repair.

Meat contains all of the nine essential amino acids that your body cannot make by itself. Say ‘hello’ to histidine, leucine, isoleucine, lycine, methionine, phenylalanine, tryptophan, threonine, and valine. Meat supplies all nine. That is why it is called a complete protein.

1) Meat contains lots of the B vitamins needed for the production of hormones, red blood cells and for the proper functioning of your nervous system.
2) Say ‘hello’ to niacin, folic acid, thiamine, biotin, panthothenic acid, vitamin B12 and vitamin B6. They are all found in meat.

So let’s counter those negative meat health myths, by setting the record straight.

Physical and Psychological Effects of Heroin Abuse

Every day, at least 115 people die from an opioid overdose in the United States of America and around 4-6 percent people dependent on opioids switch to heroin, abused as a cheaper substitute to the prescription drugs. It is an illegal opioid prepared from poppy plant and listed as a Schedule I drug under the Controlled Substances Act by the Drug Enforcement Administration (DEA). People with dried out prescriptions of painkillers resort to heroin, which is cheaper and easily available. It is smoked, snorted or injected for its euphoric effects.

According to the United Nations, the number of heroin users in the U.S. is the highest in last 20 years. Many drug dealers mix it with fentanyl and other fatal drugs to reduce the cost and increase the potency. Gullible users buy it thinking it’s pure heroin and end up suffering from deadly consequences. Sold in a number of forms, such as solid black chunks, white or brown powder or sticky black substance, heroin is fast in delivering its potent effects. It blocks the brain’s ability to perceive pain by depressing the central nervous system.

As it imitates the brain’s natural process of seeking pleasure, its preliminary experience can lead to tolerance, which slowly transitions to dependence and addiction. With time, more and more quantity of the drug is required to produce the same effects. Eventually, all that users care about is drug acquisition by any means. They isolate themselves from social obligations and personal responsibilities, and prefer to stay alone.

Heroin causes changes in white and gray matter of brain

Recurrent exposure to heroin is not only habit forming; it also starts affecting the white and gray matter of the brain, which in turn, starts affecting the hormonal and neuronal functions of the body. These changes cannot be undone easily. According to the researchers, exposure to heroin might result in the disruption of the brain’s white matter, which connects different regions of the brain with each other and facilitates the transmission of chemical and electrical signals. In the same manner, gray matter located in the regions controlling muscle movements and emotions, hearing, speech, sight, behavior and decision making is also affected by recurrent drug use.

It leads to a disruption in the gray matter volume in the frontal cortex region. This is the area where complicated thinking takes place and information is processed for recollecting and understanding. The disruption in white and gray matter regions of the brain can lead to long-term incongruences in the hormonal and neuronal systems and with repeated intake, the ability to react to stressful situations, make decisions and control behavior decreases.

In addition to short-term physical symptoms, heroin abuse can also lead to long-term health consequences, like increased risk of HIV and other infections due to shared needles, mental health issues like depression and paranoia, reproductive issues like irregular menstrual cycle, and damage to nose tissues due to snorting. Heroin abuse can also lead to troubled relationships, financial problems, legal battles, unemployment and homelessness. Some of the behavioral signs indicating heroin abuse and addiction could be stealing or borrowing money, and hostile or deceptive behavior.

When used in excess and for a longer period, the risk of overdose increases. Some of the overdose effects are depressed heart rate, slowed breathing (condition known as respiratory depression), coma and even death. When the user tries to abruptly stop drug use, it can lead to uncomfortable withdrawal symptoms manifested in the form of muscle and bone pain, nausea, agitation, insomnia, and vomiting, drug cravings, cold sweat, diarrhea and fever.

Treatment for drug abuse and mental issues

As heroin withdrawal can be enormously painful, it is sensible to seek treatment under the supervision of a medical professional at a rehab center. Chronic use of any drug requires care from trained and experienced specialists who can diagnose the underlying problem and administer the right recovery plan. The treatment may include detox, medication and behavioral therapies. When a drug user also suffers from a mental illness, it’s called co-occurring disorder or dual diagnosis. Both the conditions need to be treated simultaneously for complete recovery. Leaving one undiagnosed or untreated can worsen both the problems.