Happiness is elusive for many people. It requires a re-boot of your personna. traits for unhappy people
Here are some traits of unhappiness
1. You have a reactive personality you respond to external stimuli immediately with an intense emotional response. You fail to detach yourself from the event. Some events however are very difficult to externalize, such as divorce, death of a spouse, going to prison, loss of employment, and bankruptcy plus many others. However you cannot generalized. Stress for one person may be quite different from another.
2.You are driven for success, as measured by money
3. You see things as good or bad, black or white.
4. You fail to learn from negative experience.
5.. You have few friends
6.. You do not exercise and/or have poor nutritional habits.
7. You feel like a failure due to finances, divorce, rejection, failure to accomplish a goal.
The good news is that all can be altered.
13 Habits of Exceptionally Likeable People
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Monday, December 28, 2015
Saturday, December 26, 2015
Thursday, December 24, 2015
MentalHealthDigitalInnovationChallenge
MentalHealthDigitalInnovationChallenge
MedStartr grew out of the New York Health Innovation Meetup Group, also called Health 2.0 NYC or just H2NYC. H2NYC has been creating live events intended to foster an ecosystem around healthcare innovation since 2008. We also have been recording them, livestreaming them, and publishing them online since 2010. Today our events bring the crowd to crowdfunding all over the World, jumpstarting healthcare innovation ecosystems everywhere we go. To learn more about how we can help your organization or municipality please contact us.
Are we using technology in the field of mental health?
Barriers to care
1. Cost
2. Uncertainty about insurance coverage
3. Accessibility (difficulty in finding care)
4. Societal stigma about therapy.
UPLIFT
The innovation challenge and answer
Smart phone based, and readily available for a one time fee of $ 10.00 Inexpensive, and scalable.
It uses a proven evidence based therapeutic process CBT (cognitive based therapy). CBT is the most evidence based therapy in development for 50 years. There have been 19 randomized controlled studies of computeried programs for depressed adults. Over 50% of people needing therapy for major depression do not get it. And only one in five received APA standardized treatment.
Uplift is an adaptive treatment. It if flexible and follows exactly the practice pattern of CBT, and assigns homework to the patient, verifying their progress.
At the current time there are no programs such as this available on the iTunes store or Google Play.
The need is apparent. There are 12 million clinically depressed individuals who have access to a smart phone.
U.S mental health care $147 billion/year
Can therapy be computerized ? According to Psious, a hardware/software combination Virtual Reality applicatioin is already being used by psychotherapists to duplicate anxiety producing scenarios (anxiety, phobias such as agrophobia), During the process behavioral modification takes place.
Biofeedback Module
VR Headset and Smartphone
Courage is a novel game playing platform for the treament of depression
Wednesday, December 16, 2015
The Experts Were Wrong About the Best Places for Better and Cheaper Health Care - The New York Times
As part of his push for the Affordable Care Act in 2009, President Obama came to Central High School to laud this community as a model of better, cheaper health care. “You’re getting better results while wasting less money,” he told the crowd. His visit had come amid similar praise from television broadcasts, a documentary film and a much-read New Yorker article.
All of the attention stemmed from academic work showing that Grand Junction spent far less money on Medicare treatments – with no apparent detriment to people’s health. The lesson seemed obvious: If the rest of the country became more like Grand Junction, this nation’s notoriously high medical costs would fall.
But a new study casts doubt on that simple message.- Oops !
The Price Ain’t Right? Hospital Prices and Health Spending on the Privately Insured*
Moreover, whereas Medicare
hospital prices are set by a regulator (as is true for prices for health care services in most
countries), hospital prices for the privately insured are market-determined. However, this may change wth the Affordable Care Act, the transition from volume based reimbursement to new models of care, including quality of care and HEDIS scores which reflect hospital and health care compliance with recomendations from NQAH.
hospital prices are set by a regulator (as is true for prices for health care services in most
countries), hospital prices for the privately insured are market-determined. However, this may change wth the Affordable Care Act, the transition from volume based reimbursement to new models of care, including quality of care and HEDIS scores which reflect hospital and health care compliance with recomendations from NQAH.
Health care providers’
transaction prices – have been treated as commercially sensitive and have been largely
unavailable to researchers. As a result, there is a great deal that is unknown about how and why
health care providers’ prices vary across the nation and the extent to which providers’ negotiated
prices influence overall health spending for the privately insured.
transaction prices – have been treated as commercially sensitive and have been largely
unavailable to researchers. As a result, there is a great deal that is unknown about how and why
health care providers’ prices vary across the nation and the extent to which providers’ negotiated
prices influence overall health spending for the privately insured.
Add to that is the complex algorithm upon which payments are based, including the DRG (Diagnostic Related Group). There are roughly 999 listed by CMS Future payments will be altered by a penalty for non-compliance with the standards... It is not really an incentive where hospitals would be rewarded with an increase in payments, but a penalty for not complying, another negative incentive. Do more, get paid less.
The research looked not only at Medicare but also at a huge, new database drawn from private-insurance plans – the sorts used by most Americans for health care. And it shows that places that spend less on Medicare do not necessarily spend less on health care over all. Grand Junction, as it happens, is one of the most expensive health care markets in the country for the privately insured – despite its unusually low spending on Medicare.
All of these figures were based upon 2011, prior to the Affordable Care Act. Stay tuned for more gobbledy-gook.
The Experts Were Wrong About the Best Places for Better and Cheaper Health Care - The New York Times
Thursday, December 10, 2015
Alarming News About Your Physician(s) Burnout increasing among U.S. doctors
Burnout among U.S. doctors is getting worse, according to a study that shows physicians are worse off today than just three years earlier. Mayo Clinic researchers, working with the American Medical Association, compared data from 2014 to measures they collected in 2011 and found higher measures on the classic signs of professional burnout. More than half of physicians felt emotionally exhausted and ineffective. More than half also said that work was less meaningful.
The data dovetail with a recent JAMA study, which found much greater prevalence of depression among doctors in training than in the general population.
Washington Post
This should be alarming news for you as a patient. Why ? Is your physician worried about making payroll,overhead expenses, saving for retirement, educating his/her children, and the immediate need for paying off astronomical student loans between $100,000 dollars and $250,000 dollars. Shouldn't your physicians be using all their energy for caring for you and also continuing medical education. The prospect of a medico-legal misadventure are highly probable in a physician's career. The professional bar for performance is very high (as it should be). The vast majority of physicians are not self-serving and have am ethical and moral interest in your health. Few enter the profession with the idea of becoming rich, only to maintain a reasonable standard of living, educate their children and save for retirement. Their income results in a considerable tax responsibility. If one is a small practice doctor the personal financial liabilities are immense for overhead, dues, subscription fees, professional society dues, state licensees, the cost of specialty recertification and more.
Taken together, experts say the problems require solutions that offer a systemic approach. All health care organizations have a shared responsibility to address the situation, they add.
The responsibility is not just for health care organizations, but is that of general society to protect those who sacrifice much to care for you.. When was the last time you asked your physician how he was doing ? If you like your doctor, perhaps a letter to your congressman or senator stating what you observe and not demand unreasonable bureaucracy being placed upon your caregivers. They serve you, the patient, healthy, sick or otherwise. They are not government employees unless they work for a state, county, or federal agency such as the Veterans Administration, military service, or public health agency. The vast majority of doctors are now seeking employment, just to escape the endless worsening tunnels of managed care, federal regulations and mandates for automated medicine, electronic health records. All of these factors shorten a career life add disability issues and increase the shortage of physicians.. There are few highly paid specialty groups, radiology, neurosurgery, and several interventional medical specialties, such as gastroenterology, and cardiology.
It would be a unique experience to see how federal regulations could be designed to lower stress and cost for physicians.
I am not holding my breath.
Burnout increasing among U.S. doctors - The Washington Post
Signs of depression are 'unacceptably high' among doctors in training, study finds
Friday, December 4, 2015
Monday, November 30, 2015
The Most Common Causes of Eye Injuries in the US
In the past the most common causes of eye injuries was 4th of July fire crackers, baseball injuries or racketball injuries. Today the incidence of those causes have almost been eliminated by prevention. Most localities ban fireworks, the use of protective eye wear in sports, and in occupations has almost completely eliminated eye injuries from those sources.
Falling was the No. 1 cause of eye injuries overall and accounted for more than 8,425 hospitalizations. Researchers also found that the cost to treat eye injuries at hospitals rose by 62 percent during that period and now exceeds $20,000 per injury.
Serious ocular trauma injuries include orbital fractures and being pierced by objects. These injuries can be expensive to treat, and in many cases are preventable. With that in mind, researchers at Johns Hopkins University decided to identify the most common causes of eye injuries as well as the associated hospital costs so that prevention efforts could be better targeted. Such interventions could perhaps lower eye injury rates and overall health care costs for eye trauma inpatient visits.
•Kids injured in accidents, vehicle collisions and by sharp objects:
For children ages 10 and under, the leading cause of eye injury was being struck by accident by a person or object. Car crashes and accidentally being pierced or cut by a sharp object (such as scissors) were second and third on the list of causes.
•The median cost of treating these eye injuries shot up from $12,430 to $20,116 between the years 2002 to 2011, an increase of 62 percent. The researchers found costs to be higher at large hospitals and for older patients. Income did not correlate with costs. However, the Johns Hopkins team says that other factors not included in the study could play a role, too. More...
It is recommended that you wear protective eye wear when fighting, sanding metal, and other objects, playing baseball, or racketball, and target practice,
The Most Common Causes of Eye Injuries in the US
Falling was the No. 1 cause of eye injuries overall and accounted for more than 8,425 hospitalizations. Researchers also found that the cost to treat eye injuries at hospitals rose by 62 percent during that period and now exceeds $20,000 per injury.
Serious ocular trauma injuries include orbital fractures and being pierced by objects. These injuries can be expensive to treat, and in many cases are preventable. With that in mind, researchers at Johns Hopkins University decided to identify the most common causes of eye injuries as well as the associated hospital costs so that prevention efforts could be better targeted. Such interventions could perhaps lower eye injury rates and overall health care costs for eye trauma inpatient visits.
They identified a sample of nearly 47,000 patients ages 0 to 80 diagnosed with ocular trauma from 2002 to 2011 using a national health care database. They examined the total cost of hospitalization, cause of injury, type of injury and length of hospital stay. The researchers then grouped injured people by age. Their findings include:
•Falls are the leading cause of eye injury:
Most of the 8,425 falls recorded happened to those 60 and older. Among the types of falls, slipping caused nearly 3,000 eye injuries. Falling down stairs was cited as a cause of eye injury 900 times.
•Fighting was second most common cause of ocular trauma:
In total, nearly 8,000 hospitalizations for eye injuries were caused by fighting and various types of assault.
“Unarmed fight or brawl” came in at No. 2 overall among specific causes of eye injuries requiring hospitalization, but was the top cause reported for ages 10 to 59.
•Fighting was second most common cause of ocular trauma:
In total, nearly 8,000 hospitalizations for eye injuries were caused by fighting and various types of assault.
“Unarmed fight or brawl” came in at No. 2 overall among specific causes of eye injuries requiring hospitalization, but was the top cause reported for ages 10 to 59.
•Kids injured in accidents, vehicle collisions and by sharp objects:
•The median cost of treating these eye injuries shot up from $12,430 to $20,116 between the years 2002 to 2011, an increase of 62 percent. The researchers found costs to be higher at large hospitals and for older patients. Income did not correlate with costs. However, the Johns Hopkins team says that other factors not included in the study could play a role, too. More...
It is recommended that you wear protective eye wear when fighting, sanding metal, and other objects, playing baseball, or racketball, and target practice,
The Most Common Causes of Eye Injuries in the US
Saturday, November 28, 2015
Wednesday, November 25, 2015
Kaiser program brings hospital care to the patient's home
Who says primary care is dead? It is just relocating....house-calls of the 21st Century
Audio from this story
Frequent medical visits had become a way of life earlier this year for John and Audrey Stanton of Hemet in Riverside County.
Audio from this story
Frequent medical visits had become a way of life earlier this year for John and Audrey Stanton of Hemet in Riverside County.
John, 86, suffered from serious eye problems; a painful skin infection called cellulitis, and more recently, repeated shortness of breath — all of which kept landing him in the hospital."It was one thing after another. Like the doctor said, 'Somebody is after you!'" Stanton laughs. And for his 81-year-old wife Audrey, the nearly two-hour drive to-and-from Kaiser in Riverside was a tough haul."I’m not a long distance driver so I had to be real careful," she says. "It was stressful."
But that stress dissipated last summer when John was admitted to the hospital — at home.
"I thought, 'Wow! This is amazing. I love this!'" he says. "This is what people need!"
Pneumonia, cellulitis or congestive heart failure Stanton is one of about 125 patients who’ve been enrolled in an experimental hospital at home program run out of Kaiser’s Permanente’s Riverside Medical Center. Launched two years ago, the program is designed for people who need treatment - typically only given in the hospital — for one of three conditions: pneumonia, cellulitis or congestive heart failure.
"Our goals are to have patients be safe at home and to have them recover at home and to have a high-quality experience," says Dr. Earl Quijada, one of three Kaiser doctors assigned to the program. Not every patient with one of the three conditions qualifies for the program. It's restricted to those who are not at risk for complications that could require more intensive care, says Dr. Nirav Shah, senior vice president and chief operating officer for clinical operations at Kaiser Permanente Southern California.
"We ask if that patient wants to be admitted [to the hospital] or admitted at home," Shah says. "If they choose to be admitted at home, we'll send a truck home with them with all the equipment they need."
For John Stanton, the program saved two to three days in the hospital as well as a number of return trips for follow-up visits, Quijada says.
"Things are just so much more relaxed"
Stanton’s at-home care for a pneumonia diagnosis involved an intravenous antibiotic; a phlebotomist to check his blood and house calls from a nurse and Quijada. Hospital rounds — usually done by the patient's health care team in the hallway outside the patient's room — took place instead on the phone.
Kaiser program brings hospital care to the patient's homeTuesday, November 24, 2015
The Affordable Care Act is it Working ?
If you are a Republican chances are very good you say Obamacare (ACA) is a failure. If you are a Democrat you talk about its successes. The corollary is if you don't like Obamacare you are a Republican and if you like it you are a Democrat.
Which came first is like the chicken and the egg conundrum.
Obamacare is entering it's third year of transition. Some pundits have it as entering a holding area to be monitored as some of it's vital organ systems are struggling to survive.
The ACA was passed during a political firestorm, and a majority Democratic congress. The only people who knew what was written in the statute were those who wrote the actual Bill. Some prominent Democrats overtly expressed "you won't know what is in it until we pass it". Enough time has passed that we know that to be true, but we also don't know what is coming next.
The health landscape has changed dramatically in the past decade as has the economy. The calculus has changed in regard to reimbursement models and organizational stability.
Several things are happening that should set off warning bells (if congress even listens or cares) in the middle of world crises.
Politics and health care have been mixed,and patients now find their health is competing with ISIS, the war on terror and everything in the national budget. Physicians have always known and saw this several decades ago in 1963 when Medicare was added to social security entitlements.. As health expenses were met with an 80% coverage, and with the lack of cost containment medicare fueled health inflation. For more than two decades health expenditures grew at more than twice the rate of the gross domestic product, fueled by the black hole of the federal government and it's ability to manipulate budgets by borrowing and printing more currency. Now it is a part of the seventeen trillion dollar national debt. Annually health contributes to 17% of the GDP.
The ACA went into effect in 2013 and beginning then there have been enormous changes in health care financing, the administration and delivery of medical care.
Health insurance companies, health plans, and related enterprises such as pharma are adjusting to the limitations on profitability for operations.
Mergers and acquisitions have long been part and parcel of the health business scene. However the rate and size of the shifting health space has increased in numbers and size.
Health care business will survive in this hostile environment, as a necessity of life, the demand for services is infinite. The balance between restricting necessary health care and it's availability is precarious
Aetna, Anthem reassure investors on forecast, exchanges
Pfizer, Allergan announce $160 billion merger, 'inversion' deal would shift HQ overseas
LAO Finds Rapid Medi-Cal Enrollment
Some insurers are treading lightly and reassessing their involvement in health insurance exchanges
Monday, November 23, 2015
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