community care

The argument has raged for some time and shows no sign of abating any time soon: screening for diseases, yes or no? Take the case of prostate cancer screening: Richard Ablin - the author of “The Great Prostate Hoax”, and the man who claims to be the first to have identified PSA (a protein created by the walnut-sized prostate gland that can easily be measured) - maintains that PSA testing can do, and often does, more harm than good. Ablin, of the University of Arizona, has noted that a man’s PSA levels may be high but that doesn’t mean that he has cancer. On the reverse side of the coin, a low PSA level doesn’t necessary mean that a potential patient’s worries are over in this regard.Yet the fact remains that around one-in-three men aged from 40-60 has traces of prostate cancer, and the risk rises with ageing. So all men should be regularly tested, right? Well, not necessarily… Ablin and others argue that over-testing can very easily lead to over-treatment, including unnecessary invasive surgery to remove the prostate gland. The over-treatment argument has also been used in respect of breast cancer screening, although the figures tend to show that it works very well in a preventative sense and even better in detecting early breast cancer in target age groups. Yet over-treatment is clearly an issue, with many women (plus those aforementioned men with early ‘signs’ of prostate cancer) simply wanting all traces of the disease, or potential disease, removed right away, regardless of the potential cost to them personally or, indeed, fiscally to society in general. So over-treatment is clearly something that cannot be side-stepped. The counter-arguments - and they are very strong ones - is that our ‘social contract’ has obligations to ensure the highest standards possible regarding...
Shouldn’t we be rewarded for healthy behaviour rather than repeatedly punished for being ‘bad’? Fat tax and sugar tax, duty on cigarettes and vodka – everyone can think of a ‘sin tax’ they pay from time to time. These are the penalties we pay for making unhealthy choices. The idea of sin taxes has been gaining ground in recent years. The success of price rises on cigarettes and alcohol in curbing consumption is leading governments to consider what other disease-causing products could be taxed out of existence . In Europe, Denmark were the early movers: they introduced a tax on fatty foods in 2011. It applied to meat, dairy products, oils and certain other foods which contained more than 2.3% of saturated fat. The tax ‘worked’ in that it raised revenue and cut consumption of fatty foods by 4% . However, the policy didn’t last long. It was scrapped within 18 months because the government said the tax was too difficult and expensive to collect. Japan is taking a different route . Instead of hitting shoppers in the pocket to reduce the size of their gut, authorities impose fines on employers and local governments who fail to keep waistlines in check. Other countries, including the UK and Ireland have targeted sugary drinks by proposing a ‘soda tax’ to nudge consumers into making healthier choices. Celebrity chef Jamie Oliver – a campaigner for healthy eating – hailed the move as a victory for children’s health. He was so happy about the new tax that he did a little dance at the end of a TV interview which was captured by BBC! There’s no doubt that taxes can be used to push people into making ‘better’ choices. But what ever happened to incentives for positive change? GPs in the UK get bonuses...
We built the War on Cancer website to give patients and their families a storytelling platform. Now it’s time to add new features and bring the medtech industry and healthcare sector into the community In January 2015, I was living in London with my best friend Fabian Bolin . Fabian was preparing to move to LA to pursue his acting career when he began to feel ill. His leukaemia diagnosis came as a total shock and changed our lives forever. Fabian started blogging about his experience as a cancer patient and gained quite a following. I was helping with some of the administrative and practical issues he faced, and supporting him along his journey. One day, when his story began to make headlines and his inbox was full of encouraging messages of support from total strangers, we started to talk about how this could become something even bigger. That’s when we started War on Cancer . At first, we had a simple idea: we wanted to enable people to share their stories and to experience the love that had helped Fabian during a difficult time. But as the project evolved, we saw an opportunity to do more. The storytelling platform is the cornerstone of the community – it helps people through their recovery process and provides others with insights into the reality of undergoing cancer treatment. Our vision is for a more inclusive community where we invite patients and their loved ones, but also medtech companies and the healthcare industry – everyone who has a part to play in eradicating cancer. The potential is considerable. Not only do we want patients to interact with one another, we envision a community where companies, health professionals and others can also create a profile and engage. Through these channels, companies could create seminars,...
Authors: this article was written by Hans Martens, Martha Emneus , Anders Green and Camilla Sortso . This is the first blog of the series presenting the economic value of being in good health and the broader consideration of cost of disease. Europe’s health systems are struggling to maintain sustainability. One of the major challenges is the exponential increase in the prevalence of chronic diseases and the number of patients in advanced and costly disease stages. A challenge, which is predicted to only increase in the years to come. Chronic diseases make high demands on health systems for continuous, quality care. For patients, chronic diseases are associated with shorter lifetime, reduced quality of life and economic as well as socio-economic burdens on the patients, their caregivers - formal or informal. For society, the burden is excess healthcare, pharmaceuticals, nursing, reduced labour market participation and ability to be socially and economically active and premature mortality. Altogether these costs underpin the major challenge of chronic diseases for our societies – not least in Europe where health is a collective rather than an individualised responsibility. This challenge must be dealt with by the health systems and perhaps by reconsidering where investments should be made in the future as with many of the chronical diseases onset and progression can be prevented if diagnosed early and precisely and if the process is well managed. Among chronic diseases, diabetes mellitus is one of the most burdensome with app. 371 million people diagnosed globally and evidence of rapidly increasing prevalence. In a recent study from Denmark it was estimated that costs of diabetes amounted to 14,349 Euro per person year. Of these, health care costs accounted 17% and pharmaceuticals 4%, while for example loss of productivity amounted to 42%. And this is not the whole story, because...
In the second of a two-part series, Dr. Johnny Walker talks about Jinga Life and the power of managing healthcare at home. Read the first part here . We have an ever growing clinical demand and an ever rising consumer expectation to deliver "best of breed" services across every step of the patient journey. We are living in a world where consumer-led market disruption is the norm in business, where technology that at one point was contained purely in the realm of Sci-Fi is now ubiquitous and commoditized. The current resources are strained and incapable of delivering services in this way and we are buckling under the daily fight for survival at the clinical coal face. The traditional healthcare system is simply unsustainable despite the phenomenal efforts of everyone within the ecosystem in putting their shoulder to the wheel. We need to rethink the healthcare structures. An important observation from my experience is that, in 92% of cases, the ever present custodian of well-being in a family is female. Whether this is accompanying the patient, or being the first person members of the family call when they are sick, the centre of well-being in many family units is the female, the protector, the shepherd, the warrior. The Jinga [1] . Jinga Life aims to engage, embrace, enable, empower, and educate the Jinga. By populating an Electronic Health Record, designed and maintained by the Jinga for the family, extending primary care models to include the home, and using simple technologies to increase the connectivity between the Jinga and the family’s care professionals, Jinga Life desires to place the Jinga at the centre of her healthcare team. Our vision is to change focus from the traditional hospital based doctor focused solution, and put the Jinga at the core of her and her...
Never before has there been a more compelling time and a more urgent need to disrupt and transform the way we delivery healthcare to the people of our planet. I am the son of a wonderfully devoted Australian country GP who later became the country surgeon in the Hunter Valley in New South Wales. A father of 8, Dad was seemingly forever on-call and, with the exception of his faithful stethoscope, his scary scalpel and his trusty truck, he had absolutely zero technological assistance. No pager, no mobile phones, no EHR, no teleradiology. He was a truly old school practitioner and a mighty man, dedicated to his calling and adored by his patients. As a young lad, accompanying Dad in his old truck on long journeys late at night on those windy roads between each of the country hospitals (trying so hard to stay awake and keep my promise to Mum to make sure Dad did not fall asleep at the wheel), I knew there had to be a better, faster, safer, more effective and more efficient way of delivering healthcare. When my time came, and I followed proudly in Dad's brave footprints, I quietly committed to change the way the traditional hospital based and doctor dependent healthcare service was delivered. I got my chance years later when I set about exploring the possibility of building a simple tele-radiology system over the old 3K copper telephone system to link small isolated communities distributed over an enormous geographical area. This was not an idea borne without experience, as I had found myself performing obstetric ultrasound scans from the back of a truck in remote parts of Western Australia, in oppressive heat, shortly after completing my degree and qualifying as a radiologist. Working with pregnant mums to be in an aboriginal community,...