JustCare

Author: Julie Potyraj

  • Big data in health care

    Big data in health care

    In the fourth article of a multipart series on health literacy and innovation in health care, developed through the online master of public health at the George Washington University, I explain Big Data and its potential to help improve the patient experience for older adults. You can find the first article, a primer on health technology, here, the second on mHealth (mobile health), here, and the third on Electronic Medical Records (EMRs) here.

    Although “big data” has become a modern buzz phrase, a formal definition of the term is difficult to come by. Microsoft describes big data as “the process of applying serious computing power — the latest in machine learning and artificial intelligence — to seriously massive and often highly complex sets of information.”

    No matter the exact definition, one thing is clear: Big data enables unprecedented insight, improved decision-making, and greater efficiency and productivity. Here are just some of the ways it’s being used in health care:

    Evidence-based medicine: We rely on doctors to use evidence-based medicine–scientific methods that have been proven to work–when treating us. Put differently, doctors are supposed to know, based on research, which treatments work best for particular conditions. But, trials can be small, research results can differ and often doctors don’t have a clear answer as to what is the best treatment. Big data permits analysis of thousands of patient records to determine which treatments work best for which conditions in particular subpopulations of patients, improving physician knowledge about which treatments to use for particular patients.

    Clinical trials: Applicant data enables researchers to select the most ideal subjects for a trial. Additionally, data sharing can allow independent researchers to review data used in clinical trials to ensure the accuracy of findings or to help answer questions not posed in the original research.

    Public health: Data from wearable fitness trackers and remote monitoring devices can provide key information on population health. For example, health technology company Asthmapolis developed a GPS-enabled tracker that records asthmatics’ inhaler use. This data is uploaded to a database and used to pinpoint individual, group, and population-based trends, which help physicians identify prevention opportunities and develop personalized treatment plans.

    Big data is revolutionizing business in the 21st century — and health care is no exception. When it comes to its potential, we’ve only just scratched the surface.

    The enormous challenge remains security. The risk of people hacking into patients’ Electronic Medical Record (EMR) data is not insignificant. 100 million health records were stolen in 2015 and more than 113 million records in 2014.

    The consequences of a security breach can be serious, especially since EMRs generally include patients’ social security numbers and medical diagnoses. Patients’ identity can be stolen and they can suffer financial loss. Their safety could also be compromised. For example, people with malicious intent could keep a heart pacemaker or drug infusion pump from working properly.

    Here’s more from Just Care

  • Electronic medical records or EMRs

    Electronic medical records or EMRs

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    In the third article of a multipart series on health literacy and innovation in health care,  developed through the online master of public health at the George Washington University, I explain EMRs–electronic medical records– and their potential to help improve the patient experience for older adults. You can find the first article, a primer on health technology, here and the second on mHealth (mobile health), here.

    An electronic medical record (EMR) refers to an electronically stored record of health-related information about a person. Many people believe that these electronic records can promote better care and patient safety, while reducing health care costs. But, many also have concerns about privacy issues.

    This EMR information, which includes standard medical and clinical data, can be created, managed, and used by health care providers and their staff within a single health care practice. It is typically used to diagnose and treat patients. And, it is not easily shared with other doctors.

    EMRs should not be confused with electronic health records (EHRs). EHRs feature a more comprehensive patient history that includes data collected beyond a single doctor or other health care provider’s office. EHRs tend to be shareable among different health care providers. About eighty percent of doctors use EHRs today.

    EMRs provide a wealth of benefits compared to traditional paper records. In addition to eliminating the problem of lost or misplaced files, EMRs allow health care providers to efficiently:

    • Schedule and manage patient appointments
    • Access test results
    • Monitor blood pressure readings, vaccinations, and other health parameters
    • Identify patients who are due for screenings and/or preventive care visits
    • Track cumulative patient data over time
    • Reduce medical errors

    Charting activities are expedited by EMRs as well, since physicians and mid-level providers can enter information during a patient encounter instead of hours later. This allows for the scheduling of more patients and improves accuracy of information.

    Individuals like their ability to communicate with their doctors via text and email. It can reduce the need to actually visit the doctor’s office. And, they can get new prescriptions and receive medical test results online.

    Despite the potential of EMRs to reduce medical errors, improve patient safety, and enhance overall quality of care, adoption in the United States has been slow. Some of the barriers to adoption include high capital cost, concerns about obsolescence, lack of skilled resources for implementation and support, and privacy and security concerns. Local and national initiatives to encourage EMR adoption have shown some promise to date.

    Here’s more from Just Care:

  • Mobile health or mHealth

    Mobile health or mHealth

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    In the second article of a multipart series on health literacy and innovation in health care,  developed through the online master of public health at the George Washington University, I explain mHealth–mobile health, for short– its challenges, and how it could potentially improve the patient experience for older adults. You can find the first article, a primer on health technology here.

    Mobile health, also known as mHealth, uses mobile and wireless devices to collect and share data between patients and doctors and other providers. There is no universally agreed upon definition for mHealth. However, it typically refers to using mobile technologies and mobile applications to improve people’s health. Today, there are about 165,000 mHealth apps on the market.

    Smart phones are among the most common devices in mHealth. But mHealth can also refer to apps or software programs on mobile devices. These apps can increase connection and communication between patient and providers, resulting in improved efficiency and quality of care. According to the World Health Organization, the networks formed by these connected devices and applications “are transforming the way health services and information are accessed, delivered, and managed.”

    The use of mobile technologies in health care has become increasingly popular in low- and middle-income countries where health services are limited. However, this mode of health delivery is also important in the United States. It is estimated that within the next few years, China and the United States will have the largest mHealth markets.

    Currently, most Americans engage with mHealth to look up medical information and to track and manage their health. Only a small percentage of Americans use mHealth applications to communicate directly with health providers. In order for mHealth to be more widely adopted, policymakers and health providers will have to address the following challenges:

    • Lack of regulations for mHealth devices
    • A reimbursement policy for doctors who use mHealth initiatives
    • Discrepancies in health insurance coverage
    • Legal challenges with quality control
    • Privacy and security issues

    With mHealth, there are also many potential benefits. It could encourage positive behavior change or allow care providers to remotely monitor patients. It could provide older adults with more accessible and affordable care options. The use of mobile technologies in health care could also help reduce travel to and from medical appointments. Additionally, mHealth could potentially create a way for doctors to prescribe medication and track treatment regimens. This use of mHealth could be especially helpful for older adults who rely on multiple medications to manage chronic conditions.

    However, until there are official standards for mHealth services, providers and patients alike may be hesitant to embrace it as an everyday way to deliver health care.

    Here’s more from Just Care:

  • Health tech–A primer

    Health tech–A primer

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    What is the Internet of Things exactly or the Quantified Self? And, is it really important for you to know about them? It could be that if you understood their relevance, it would help improve your health. You decide for yourself. This health tech primer is the first of a nine-part series on health tech literacy and tech innovations in healthcare, developed through the online master of public health at the George Washington University.

    Health literacy is critical to better health. But, the data show that older adults have low health literacy—understanding of health information and services– relative to the rest of the population. Improving health literacy leads to better health quality. It also promotes better health outcomes and greater patient satisfaction.

    Low health literacy can lead to poor health outcomes, greater use of health care services, and health care safety risks, including medication errors, according to the CDC. The CDC defines health literacy as “the degree to which an individual has the capacity to obtain, communicate, process, and understand basic health information and services to make appropriate health decisions.” Health literacy skills help people identify and access the health services they need. These skills are essential for the prevention and management of diseases.

    Good clear reliable information can improve people’s health literacy. Given the high risk of chronic disease, injury, and mental disorders, older adults must have the tools necessary to make the best decisions for their health.

    The U.S. Department of Health and Human Services’ Office of Disease Prevention and Health Promotion finds these health literacy benefits:

    • Improved communication between people and their health providers
    • Adherence to treatment
    • Better self-care
    • Better health outcomes
    • Improved patient experience
    • Greater cost savings

    Technology has transformed the delivery of health care. Advances in health technology can improve patients’ experience and health outcomes. We’ve seen this with electronic storage of health records, remote monitoring, and wearable devices. Many organizations are also integrating health technology into the management of chronic disease.

    Older Americans’ interaction with technology needs to grow and expand. Currently, older adults are not keeping up with health technology. Though 85 percent of older adults have at least one chronic disease, only 25 percent of them used health technology in 2014.

    In order to promote health technology literacy, this Health Tech Terms series will define each of the following concepts, as well as provide an explanation about their relevance to older adults:

    • mHealth
    • Health IT
    • EMRs
    • Big Data
    • Internet of Things
    • Quantified Self
    • Data Security in Health Care
    • Health informatics

    By improving your health tech literacy, you will have a more informed and confident perspective of the risks and benefits of health technologies on the care you receive.

    Here’s more from Just Care:

  • Coping strategies for people with dementia

    Coping strategies for people with dementia

    In the final part of a four-part series on caregiving and dementia, Julie Potyraj, community manager for the online master of public health at The George Washington University, explores multiple coping strategies for people with dementia. 

    Dementia brings about an array of physical, cognitive, and emotional changes. Each person will find his or her own unique way of coping as the disease progresses through its various stages. Below are several types of coping strategies that can help people with dementia maintain a good quality of life for as long as possible.

    Practical strategies. The cognitive decline associated with Alzheimer’s disease and dementia can make it difficult for a person to store and recall information. Memory problems can be addressed by using sticky notes, calendars, and other tools to remind the person of certain tasks like taking medication. Assistive technology devices like smartphones are also helpful. Establishing a regular routine can make it easier for a person with dementia to recall patterns of usual activity during the day.

    Health strategies. Good nutrition can’t cure dementia, but it can lessen the intensity of some symptoms while contributing to an overall feeling of well-being. People with dementia should focus on eating whole grains, fruits and vegetables, and lean protein; limit sugar, salt, and saturated fat intake; and drink plenty of water. Regular exercise is also beneficial.

    Emotional strategies. People with dementia often go through a grieving process in which they mourn the loss of the person they once were. Using humor and positivity and practicing living “in the moment” can help people weather the dementia storm.

    Social strategies. Staying socially engaged can help people with dementia–as it helps older adults more generally–maintain their brain vitality. In fact, studies have shown that involvement in group activities and strong personal relationships can have a protective effect against the disease.

    While caring for a loved one with dementia, caregivers must also consider developing their own coping strategies in order to prevent burnout. These might include joining a support group, practicing meditation or yoga, eating well, and getting plenty of sleep. People who look after someone with dementia should also reach out to friends, family, and volunteer organizations to ask for help with the daily stress of caregiving.

    Here’s more from Just Care:

  • Helping people with dementia stay independent

    Helping people with dementia stay independent

    In part three of a four-part series on caregiving and dementia, Julie Potyraj, community manager for the online master of public health at The George Washington University, looks into how caregivers can help preserve the independence and morale of dementia patients.

    Dementia can wreak havoc with people’s ability to do things for themselves. However, there are steps that can be taken to help dementia patients remain happy and independent in their homes during the early stages of the disease.

    Physical activity: Engaging in daily physical activity, such as walking, can help people with dementia maintain strength and flexibility. This allows them to continue performing routine tasks. If walking is not possible, even light stretching exercises can help.

    Socializing: By staying engaged with others and participating in shared activities (such as a hobby), people with dementia are able to stay independent for longer while also enjoying a better quality of life. Regular social interaction promotes a sense of belonging while reducing isolation.

    Home adaptation: There are ways to make the home environment safer and more accessible for people with Alzheimer’s or other forms of dementia. Modifications include painting doors a vivid color so that they’re easier to find and use, adding clear signs to help with navigation around the home, or installing reinforced handrails on both sides of stairways. For more, check out this Just Care post on safety at home for people with dementia.

    Assistive technology: This term refers to systems or devices that support people’s ability to maintain autonomy. Assistive technology such as smartphones and tablets can help dementia patients with speech, safe walking, hearing and eyesight, and memory and cognition.

    Lastly, caregivers can foster independence by basing their care on the needs of the individual—not what they think they should be doing as a caregiver. For instance, if someone is still able to prepare simple meals, they should be allowed to do so under supervision. Maintaining a positive and encouraging attitude can go a long way in helping people with dementia remain confident and capable for as long as possible.

    Here’s more from Just Care:

  • How to communicate with a person with dementia

    How to communicate with a person with dementia

    In part two of a four-part series on caregiving and dementia, Julie Potyraj, community manager for the online master of public health at The George Washington University, explores strategies that caregivers can utilize while communicating with someone who has dementia.

    Alzheimer’s disease and other types of dementia can negatively affect a person’s ability to communicate effectively, particularly during the later stages of the disease. People may begin to speak less frequently and, when they do speak, they may lose their train of thought or have difficulty organizing words in a logical way. Some people may revert back to their native language or use “made up” words to describe familiar objects.

    Communicating with someone who has dementia requires skill, patience, and understanding. Below are some strategies from the Alzheimer’s Society that caregivers can employ to keep exchanges flowing smoothly.

    • Speak slowly and use simple words and sentences. This will make it easier for a person with dementia to understand what you are saying.
    • Maintain eye contact. This helps the person with dementia stay focused on you and what you’re saying.
    • Offer continual reassurance. Be comforting. Tell the individual that it’s okay to take their time in trying to explain their thoughts or emotions.
    • Avoid overcorrecting. Do not criticize or always attempt to correct what the person says. Instead, try repeating their words back to help them clarify their thoughts. Avoid arguing.
    • Encourage body language. When words are ineffective in relaying the person’s message, ask them to gesture with their hands.
    • Limit surrounding distractions. Turn off the TV or move to a quieter area before attempting to communicate or understand what the person is saying.
    • Do not stand too close. Standing too close to someone with dementia may make the person feel overwhelmed and intimidated.
    • Look for—and focus on—the emotions at play. In some cases, the feelings being expressed are more significant than the words being used. Try to identify what the person is feeling by paying attention to tone of voice and gestures.

    Lastly, be aware of your own attitude and body language and how they affect the individual with dementia. Be sure to maintain a relaxed demeanor and friendly facial expressions. When you do, the person with dementia will feel more at ease.

    Here’s more from Just Care:

  • Caregiving: Understanding the emotional impact of dementia

    Caregiving: Understanding the emotional impact of dementia

    In part one of a four-part series on caregiving and dementia, Julie Potyraj, community manager for the online master of public health at The George Washington University, looks into the emotional symptoms many dementia patients experience and what caregivers can do to help.

    It’s understood that dementia can impair a person’s ability to remember, communicate, think, and reason. But beyond the practical aspects of the disease, dementia has emotional consequences as well. Below are some common behavioral and psychiatric symptoms that can occur in many dementia patients.

    Depression or anxiety after diagnosis. A dementia or Alzheimer’s disease diagnosis can trigger intense emotions in many people. The person diagnosed may experience feelings ranging from shock and disbelief to grief and fear. For people with lasting feelings of sadness or anxiety, talk therapy can be helpful, or, in some cases, medication.

    Changes in emotional responses. People with dementia may have less control over how they’re feeling and their emotional expressions. They may have volatile mood swings, irritability, or become inappropriately agitated in certain situations. Some people may appear to be distant or disinterested in what’s going on around them.

    Anger and agitation. In later stages of the disease, a person may have physical or emotional outbursts, visible emotional distress, or periods of agitation. Feelings of anger can be exacerbated by new places and people, loud noise, or a lot of activity.

    Lower self-esteem. People with dementia may feel “out of control” and lose confidence in themselves or their ability to perform basic functions. They may also feel the impact of the social stigma of dementia and perceive a real or imagined difference in the way people treat them. All of this can have a devastating effect on someone’s sense of self-worth.

    What Caregivers Can Do

    Fortunately, there are things caregivers can do to help lessen the brunt of emotional changes in their loved one with dementia. These include:

    • Validating the patient’s worries instead of dismissing them.
    • Giving the person adequate time to calm down after an outburst.
    • Trying not to take emotional responses personally.
    • Employing a healthy sense of humor, when appropriate.

    Caregivers are also encouraged to involve their loved one in everyday tasks—for example, asking what they would like for dinner. This can give the patient a sense of control during a time when they feel they have no say in what’s happening around them. Empathy and patience go a long way in helping to preserve the dignity of those struggling with dementia.

    Here’s more from Just Care:

  • Five tips to relieve caregiver strain

    Five tips to relieve caregiver strain

    If you’re a family caregiver, you need to take care of yourself. Most importantly, you need to accept your own feelings as natural and normal. And you need to find a way to cope; coping is an individual journey and may require some trial and error. Below are five tips to relieve caregiver strain and help you care for yourself.

    1. Identify someone who supports you. It should be someone with whom you can talk openly–a spouse, friend or therapist.
    1. Change your daily habits as little as possible. You take care of yourself by building self-care into your routines. Continue to eat, sleep and exercise as you always have to the extent possible. Major changes to your routines can have big effects on your mental health. Make meeting all of your needs a priority.
    1. Build healthy routines. Stay connected on a daily basis to your friends, family and neighbors so that you are not socially isolated. Stay active and exercise. Avoid unhealthy coping habits such as drinking excessively.
    1. Find a community. Seek out others with similar experiences. It can feel good to share experiences, learn from other caregivers and know that you are not alone.
    1. Don’t reinvent the wheel. There are a wide variety of community services for individuals of differing abilities. This includes transportation and food services, along with professional mental and physical care that may be affordable.

    This is the third in a three-part series on caregiver strain. You can read the other two parts here: Part 1: What it means to be a caregiver today: The data and Part 2: To help relieve stress, understand and recognize caregiver strain

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  • To help relieve stress, understand and recognize caregiver strain

    To help relieve stress, understand and recognize caregiver strain

    As a family caregiver, you provide support for a variety of reasons, but the most important is that you care deeply about your loved ones. And, if you’re like most caregivers, you find the work rewarding. However, the satisfaction from the work often hides the toll it takes on your health. Strains on your emotional, mental and physical health can be difficult to spot. To help relieve stress, understand and recognize caregiver strains; you’re not alone.

    Emotional Health

    Family caregivers give emotional support to their loved ones. As a caregiver, your challenge is often that you provide support for a loved one’s fear, depression or anxiety, at the same time that you experience the same emotions. You may also feel anger and resentment about your new role. It’s not unusual for caregivers to direct their anger toward their loved ones for being the source of new responsibilities, toward others who have not stepped up to help, or even toward the world or their faith for bringing this new responsibility upon them. And, it’s OK.

    Mental Health

    Research shows that caregivers experience elevated levels of stress and depression. Many caregivers feel constant anxiety or worry related to their ability to care for their loved ones. You may experience grief over your loved one’s loss of independence and may pre-emptively grieve the loss of someone who is either terminally ill or losing mental ability. You may feel angry about the situation or feel like you are not doing enough. All of these emotions add up and explain why nearly half of caregivers experience symptoms of major depression.

    Physical Health

    The mental and emotional strain of caregiving can translate into physical ailments stemming from changes in sleep patterns and changes to self-care and health-related routines. Caregivers are three times more likely to be highly vulnerable to health issues than non-caregivers. Compared to individuals who are not caring for an older adult, caregivers experience higher rates of physical illness including chronic pain and compromised immune systems.

    This is Part Two of a three-part series.  Click here to read Part One, What it means to be a caregiver today: The data.

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