Latest news with #patientoutcomes
Medscape
3 days ago
- Health
- Medscape
Team Familiarity: Key to Better Outcomes in Surgery?
Familiarity between surgeons and anesthesiologists was associated with improved outcomes in gastrointestinal, gynecologic oncologic, and spine surgeries, with each additional procedure performed together associated with reduced odds of 90-day postoperative major morbidity. METHODOLOGY: Researchers conducted a retrospective cohort study using administrative healthcare data in Canada to assess the link between how often teams of surgeons and anesthesiologists worked together and outcomes for their patients. They included men and women aged 18 years or older who underwent high-risk elective surgeries with a postoperative stay over 24 hours from 2009 to 2019. Clinician familiarity was measured by case volume, defined as the average annual number of procedures performed by the same surgeon-anesthesiologist pair in the 4 years prior to the index operation. Procedures included cardiac, high- and low-risk GI, genitourinary, gynecologic oncologic, orthopedic, neurosurgery, spine, thoracic, vascular, and head and neck surgeries. The primary outcome was 90-day major morbidity. TAKEAWAY: The analysis included 711,006 procedures. For most surgeries, the median dyad volume was three or fewer procedures per team per year, except for cardiac and orthopedic surgeries, which had median volumes of nine and eight procedures per group per year, respectively. Each additional procedure per year for the same surgeon-anesthesiologist pair was associated with a 4% reduction in the odds of 90-day morbidity for low-risk GI surgery (adjusted odds ratio [aOR], 0.96; 95% CI, 0.95-0.98) and an 8% reduction in the odds for high-risk GI surgery (aOR, 0.92; 95% CI, 0.88-0.96). For gynecologic oncologic and spine surgeries, each additional procedure performed per year by the same surgeon-anesthesiologist pair was associated with a 3% reduction in the odds of 90-day morbidity (aOR, 0.97; 95% CI, 0.94-0.99 and aOR, 0.97; 95% CI, 0.96-0.99, respectively). No significant association was found for other procedures. Dyad volume was also independently associated with 30-day major morbidity for high-risk (aOR, 0.90; 95% CI, 0.86-0.94) and low-risk (aOR, 0.96; 95% CI, 0.94-0.97) GI surgeries. IN PRACTICE: 'These findings indicate that for each additional procedure performed by a specific surgeon-anesthesiologist dyad, there is a corresponding decrease in the likelihood of experiencing 90-day major morbidity. Each procedure done together matters,' the authors of the study wrote. 'Increasing the familiarity of surgeon-anesthesiologist dyads or the number of procedures they do together represents an opportunity to improve patient outcomes for GI, gynecology oncology, and spine surgery,' they added. 'These results make coordinated scheduling of consistent surgeon-anesthesiologist dyads (and nurse staffing) an attractive process measure for surgical quality improvement,' experts wrote in an commentary accompanying the journal article. SOURCE: The study was led by Julie Hallet, MD, MSc, of the Department of Surgery at the University of Toronto, Toronto, Ontario, Canada. It was published online on May 28, 2025, in JAMA Surgery . LIMITATIONS: The use of routinely collected health administrative data may have introduced the risk for misclassification and limited the details on factors affecting patient outcomes. Owing to the focus on surgeon-anesthesiologist dyads, the contributions from other team members, such as nurses, trainees, and assistants, were excluded. The analysis was limited to high-risk and elective surgeries. DISCLOSURES: This study was supported by ICES, which is funded by the Ontario Ministry of Health and the Ministry of Long-Term Care and the Sunnybrook AFP Innovation Fund. One author reported receiving grants during the conduct of the study and personal fees and grants outside the submitted work. Another author reported receiving consulting fees from pharmaceutical and medical device companies.
Forbes
4 days ago
- Business
- Forbes
How SDoH Platforms Are Driving Smarter Healthcare Decisions
Raghvendra Tripathi | Sr Director/Enterprise Architect Principal | Independent Researcher | IEEE Senior Member. If you've spent any time in healthcare leadership or management, you know that patient outcomes hinge on more than just clinical care. Social determinants of health (SDoH)—everything from housing stability to education and food access—play a huge role in shaping health outcomes. But integrating those complex, often siloed factors into healthcare strategies has always been a challenge. That's where innovative solutions like an SDoH enterprise platform come in, turning diverse social and economic data into actionable insights. When my team first looked at tackling SDoH integration, the biggest hurdle was the sheer breadth and complexity of data sources. You're dealing with data from electronic medical records, census reports like the American Community Survey, public health indices such as the CDC Social Vulnerability Index and even real-time assessments from local community organizations. Each source speaks a different format or "language," making it tough to connect the dots efficiently. The breakthrough came with a cloud-based platform that standardizes and consolidates this data—what we call the "SDoH Enterprise." Imagine a system where race, ethnicity, language preferences and even nuanced factors like sexual orientation and gender identity are harmonized across EMRs and community datasets. This platform uses rigorous standardization protocols, like OMB guidelines for demographics and ISO codes for language, ensuring consistency. At the heart of this is a cloud warehouse powered by Snowflake, which acts as a central hub for all this information. Whether it's batch uploads or real-time feeds, the platform makes data accessible and actionable. What I find truly exciting are the tools that can be built on top of this integrated data. For instance: • Geospatial Dashboards: These reduce complexity by visualizing how social factors vary across neighborhoods and populations. It's like having a map that highlights areas at risk for health disparities. • EMR Integration: Providers get real-time prompts about patients' social needs, allowing them to tailor care plans effectively. Plus, partnerships with community organizations mean referrals can be closed in a "loop," ensuring patients truly get the support they need. • APIs For Accessibility: Seamless API connections enable sharing insights across systems, empowering everyone from care coordinators to public health officials. • Smart Engagement: Analytics identify which members are at risk or would benefit most from particular interventions, allowing programs to focus resources wisely and improve member experiences. Implementing this type of platform changed the game for us. We saw a significant uptick in identifying future high-cost members before their health spiraled, reducing unnecessary hospital visits and emergency care. Care coordination improved as healthcare providers could see a fuller picture of each patient's context. Even better, enterprise-wide reporting standardization means leadership teams can evaluate the effectiveness of SDoH initiatives with hard data—creating accountability and guiding future investments. If you're navigating the complexities of value-based care and population health management, incorporating SDoH platforms has become increasingly important for comprehensive healthcare delivery and outcomes. The key includes: 1. Starting With Data Standards: Ensure your systems speak a common language. 2. Investing In Integration: Centralize your data for real-time, actionable insights. 3. Leveraging Analytics: Use predictive modeling to prioritize resource allocation. 4. Partnering Outside Healthcare: Community organizations are critical allies in addressing social needs. 5. Tracking and Iterating: Use impact reporting to refine and scale programs effectively. The potential here extends well beyond current programs. Long-term, the goal is healthier communities and more equitable care—with technology and data as the backbone. As I've seen firsthand, embedding social determinants into healthcare delivery transforms how care teams work and, ultimately, how patients live. Let's keep the conversation going—how is your organization tackling SDoH? What lessons have you learned? The way forward is collaborative, and sharing insights can help all of us lead smarter, more compassionate health systems. Forbes Technology Council is an invitation-only community for world-class CIOs, CTOs and technology executives. Do I qualify?
Travel Daily News
23-05-2025
- Health
- Travel Daily News
AI-powered training course wins IAPCO Innovation Award
Kenes Group's Nuria Fernández Roldán spearheaded AI design and delivery to enhance medical education for greater patient outcomes. The International Association of Professional Congress Organisers (IAPCO) announce Nuria Fernández Roldán, Online Education Specialist at Kenes Group, as the winner of the IAPCO Innovation Award 2025 for her visionary work in transforming medical education through artificial intelligence. IAPCO President Sissi Lignou presented the 11th annual IAPCO Innovation Award – which is supported by IMEX and recognises those who push the boundaries of what is possible, and then take action to bring meaningful change – at the prestigious IMEX Frankfurt Gala Dinner on 21st May. This year's award-winning project, AI-Powered Simulation Training: Mastering Sensitive Discussions on Weight Management, is a breakthrough online course hosted on UNLOK Education, Kenes Group's digital learning platform. This short course is designed to help healthcare professionals navigate emotionally sensitive conversations with patients living with chronic conditions like Type 2 Diabetes. This fully digital, self-paced course blends emotionally engaging actor-led simulations with real-time emotional recognition AI. Nuria Fernández Roldán said that by analysing facial expressions, tone of voice, and engagement levels, the course which is only 15 minutes long, provides personalised feedback on verbal and non-verbal communication, empowering healthcare professionals to navigate complex conversations with greater sensitivity. 'We saw the potential to use emotional recognition AI to help healthcare professionals handle conversations with their patients more sensitively and without judgement.' 'This technology provides an opportunity for self-reflection and growth in a way that traditional training does not,' said Fernández. Launched at the Advanced Technologies and Treatments for Diabetes (ATTD) 2024 Congress, the course has alredy trained over 300 medical professionals worldwide, with participants praising its innovation and human-centric approach. Kenes Group continues to lead the way in integrating AI into professional healthcare training with plans to expand into more patient and clinicial scenarios. In presenting the award, Sissi Lignou said Fernández and Kenes Group are a great example of working to raise the standards of professionalism across the meetings indsutry, which is the mission of IAPCO. 'This innovation truly represents the best of what our industry can achieve when we lead with compassion, creativity, and purpose,' said Lignou.
Medscape
22-05-2025
- Health
- Medscape
Frailty in the ICU: Many Definitions, No Easy Solutions
SAN FRANCISCO — Frailty is hard to define and hard to distinguish from the effects of illness, injury, and medical interventions, but the frailty of patients in the intensive care unit (ICU) can have profound effects on outcomes, including the risk for mortality. In a scientific symposium on frailty in the ICU, presented during the American Thoracic Society (ATS) 2025 International Conference, researchers outlined both the challenges of assessing frailty in the ICU and the effects of frailty on patients in the ICU and after discharge. 'I think the ICU is a unique rubric to understand the role of frailty, stress, and maladaptive physiologic responses in mediating short- and long-term outcomes,' said Aluko Akini Hope, MD, from Oregon Health Sciences University in Portland, Oregon. Despite some unique challenges in the ICU setting, frailty can be measured using approaches that consider both frailty phenotype and cumulative deficits, Hope said. He defined physical frailty as 'a clinical state in which the patient has reduced functional reserve and increased vulnerability to stressors due to maladaptive changes across multiple physiologic systems.' Although definitions and means of assessing frailty vary, they can be roughly grouped into two main conceptual models. The phenotypic model relies on physical factors such as recent weight loss > 10 lbs, low grip strength, exhaustion, slow gait, and low physical activity. The cumulative health deficit model can be summed up as 'the more individuals have wrong, the more likely they are to be frail,' Hope said. Multiple Assessment Tools Frailty can be assessed with a variety of approaches, including the frailty index, which generates a score calculated by dividing the number of deficits a patient has by the total number of health variables considered. The assessment using this index can be reduced to approximately 30 items with good predictive validity, Hope said. The predictive power of this model relies, however, on clinical documentation in the electronic health record and is subject to residual confounding. In contrast to the frailty index, the Clinical Frailty Scales is based on clinical judgment of experienced clinicians to summarize the overall frailty or fitness level of older patients. The 9-point scale ranks patients from being 'very fit' to terminally ill and is associated with both morbidity and mortality outcomes in ICUs. This scale, widely used in ICUs in Canada for research purposes, has strong interrater reliability in ICU multidisciplinary teams, Hope commented. The phenotypic approach may be more difficult than other measures to use in a critical care setting because it relies on physical aspects such as ability to rise from a chair, slow walking speed, low physical activity, and exhaustion. These measures all rely on patient or caregiver recall. Performance measures to identify frailty include a sit-to-stand test, balance test, gait speed, and mobility stress testing, which may be appropriate in the post-ICU setting but can be hard to apply in a critical care unit. Impact on Outcomes Lauren Ferrante, MD, MHS, from the Yale School of Medicine in New Haven, Connecticut, noted that although the prevalence of frailty increases with age, from 3.2% in 65- to 70-year-olds to 25.7% in 85- to 89-year-olds in one study, many older adults are not frail, and making assumptions about frailty based only on appearance or immediate circumstances can result in either over- or undertreatment of patients. However, it is identified 'frailty is strongly associated with adverse ICU and hospital outcomes, including mortality,' she said. In addition, frailty 'is associated with worse patient-centered outcomes, including health-related quality-of-life and functional outcomes,' Ferrante said. She summarized findings from the literature on the effects of frailty on outcomes. For example, in a study published this year in the Annals of Intensive Care , investigators looked at the impact of frailty and older age on weaning patients from invasive mechanical ventilation and found that the highest proportion of patients for whom weaning failed was in those patients who were deemed to be frail, and that frailty had more consistent effect on weaning duration and success rates than older age. A separate study from the Canadian Critical Care Trials group, published in Intensive Care Medicine in 2024, found that frail patients were more likely than non-frail patients to experience ICU delirium and had higher in-hospital and 6-month mortality rates. Ferrante and colleagues, Hope and colleagues, and others have also looked at frail patients in longitudinal and cohort studies and found that frailty is associated with post-ICU disabilities and poor functional outcomes. In addition, patients who are frail have a 3.5-fold higher likelihood of new admissions to a nursing home after a critical illness than non-frail patients. And as John Muscedere, MD, Queen's University in Kingston, Ontario, Canada, and colleagues reported in a systematic review and meta-analysis, also presented at ATS 2025 International Conference, compared with non-frail patients, those who were frail had a more than twofold relative risk for in-hospital death, had a more than 2.5-fold relative risk for long-term mortality, and were significantly less likely to be discharged home. 'We should be thinking more about augmenting processes of care for frail ICU across the continuum to post-discharge care,' Ferrante said. She recommend considering automated methods of ascertaining frailty such as the eFrailty Index in the Epic medical record system, which automatically generates a frailty index score from chart data and has the potential to be adapted for use in the ICU. Clinicians should be cautioned, however, not to conflate automated measurements with severity of illness, which could yield false positive results, she emphasized. A Confusing Entity An ICU specialist who attended the session told Medscape Medical News that he wasn't convinced that the research presented during the session fully addressed the problem of frailty in the ICU. 'I really worry when we think about frailty as a construct in the ICU that we end up putting the cart before the horse. It's something that we know when we see it, but it's very difficult to measure, and we're talking about different things. When we say the word 'frailty' we're not always talking about the same thing, and I definitely worry when we think about developing specific interventions, particularly around ICU patients,' said Jeremy Kahn, MD, MS, professor of critical care medicine and health policy and management at the University of Pittsburgh, Pittsburgh. 'If we don't really understand what frailty is then we're going to end up with a lot of negative studies that may be several different diseases that we're conflating as one,' he said. Asked by Medscape Medical News whether the idea of an automated frailty index had merit, he replied that 'it's definitely more objective, but then it does raise the question whether you're measuring something new. We have lots of measures around comorbidities, we have age, which is very predictive, and not to say that frailty isn't a real thing, but if we can't measure it in a way differently from age or comorbidities, we're just using the electronic health record.' In the absence of an accurate objective measure of frailty, clinicians may be measuring things that they already know, such as comorbidities, or may be identifying patient populations that are diverse and may not be amenable to a single intervention, Kahn told Medscape Medical News . Hope, Ferrante, and Kahn reported having no relevant financial disclosures.
Yahoo
22-05-2025
- Health
- Yahoo
Prompt Intervention for Severe Aortic Stenosis Patients Demonstrates Lower Healthcare Costs, Improved Clinical Outcomes
PARIS, May 22, 2025--(BUSINESS WIRE)--Edwards Lifesciences (NYSE: EW) today announced new economic and clinical evidence on severe aortic stenosis (AS) presented as a late-breaking clinical trial at EuroPCR 2025, further contributing to the extensive body of research on this disease. The results of a new real-world study of more than 24,000 patients demonstrated that intervening on the disease before symptoms develop reduces the economic and resource burden on the healthcare system and improves patient outcomes. Prompt intervention for severe AS patients before symptoms developed resulted in: Significantly lower costs for the healthcare system at 1 year ($36,000 less per patient); Shorter length of stay during their treatment (2.2 fewer days); and Fewer follow-up heart failure hospitalizations 1 year after treatment (80 percent less). Additionally, compared with asymptomatic severe AS, delaying treatment until the disease progressed resulted in a more than seven times higher rate of death within one year after aortic valve replacement (AVR). "We are dedicated to advancing robust evidence to help improve outcomes for patients with severe aortic stenosis," said Larry Wood, Edwards' corporate vice president and group president, Transcatheter Aortic Valve Replacement and Surgical. "These latest findings underscore the importance of early referral to a Heart Valve Team and timely care of patients with severe AS, reducing the economic and resource burden for hospitals." Along with prior data from the EARLY TAVR trial, these results reinforce the value of early referral and evaluation by a Heart Valve Team for all patients with severe AS. "We continue to believe that watchful waiting is not an effective strategy for the management of severe AS," said Philippe Genereux, M.D., director of the structural heart program at Gagnon Cardiovascular Institute, Morristown Medical Center, Morristown, New Jersey. "The latest findings highlight the significant clinical and economic advantages of timely referral and treatment for severe AS patients." About Edwards Lifesciences Edwards Lifesciences is the leading global structural heart innovation company, driven by a passion to improve patient lives. Through breakthrough technologies, world-class evidence and partnerships with clinicians and healthcare stakeholders, our employees are inspired by our patient-focused culture to deliver life-changing innovations to those who need them most. Discover more at and follow us on LinkedIn, Facebook, Instagram and YouTube. This news release includes forward-looking statements within the meaning of Section 27A of the Securities Act of 1933, as amended, and Section 21E of the Securities Exchange Act of 1934, as amended. We intend the forward-looking statements contained in this release to be covered by the safe harbor provisions of such Acts. These forward-looking statements can sometimes be identified by the use of forward-looking words, such as "may," "might," "believe," "will," "expect," "project," "estimate," "should," "anticipate," "plan," "goal," "continue," "seek," "intend," "optimistic," "aspire," "confident" and other forms of these words and include, but are not limited to, statements made by Mr. Wood and statements regarding expected benefits of prompt intervention before symptoms develop, patient benefits and outcomes, reduction in economic and resource burdens for the healthcare system and expectations and other statements that are not historical facts. Forward-looking statements are based on estimates and assumptions made by management of the company and are believed to be reasonable, though they are inherently uncertain and difficult to predict. Our forward-looking statements speak only as of the date on which they are made, and we do not undertake any obligation to update any forward-looking statement to reflect events or circumstances after the date of the statement. Investors are cautioned not to unduly rely on such forward-looking statements. Forward-looking statements involve risks and uncertainties that could cause results to differ materially from those expressed or implied by the forward-looking statements based on a number of factors as detailed in the company's filings with the Securities and Exchange Commission. These filings, along with important safety information about our products, may be found at Edwards, Edwards Lifesciences, the stylized E logo, and EARLY TAVR are trademarks of Edwards Lifesciences Corporation. All other trademarks are the property of their respective owners. View source version on Contacts Media Contact: Heather Bukant, 949-250-2753Investor Contact: Mark Wilterding, 949-250-6826 Error in retrieving data Sign in to access your portfolio Error in retrieving data Error in retrieving data Error in retrieving data Error in retrieving data
