Sensing Savvy

Diabetes: Diabetes is the most common cause of kidney failure. The results of the Diabetes Prevention Program (DPP) funded by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) show that moderate exercise, a healthier diet, and weight reduction can prevent the development of type 2 diabetes in persons at risk.

In November, the Centers for Medicare and Medicaid (CMS) issues their final physician payment rule for 2019. Now that the new year is underway, you’ll likely begin noticing the impact of various changes laid out by the new rule. 

Here are the top four points about CMS’ final physician payment rule to know:

A working vascular access is the lifeline for a hemodialysis patient. It is also an Achilles heel, for when it fails, another access (frequently a catheter) must be quickly placed for life preserving hemodialysis to continue. While an arteriovenous fistula (a natural conduit connecting an artery and a vein) is the preferred vascular access, expanded polytetrafluoroethylene (ePTFE) synthetic grafts are frequently used as the second choice for a vascular access, before placing a catheter.

What’s your No. 1 goal for patient care? As a nephrologist or nephrology care professional, it’s likely keeping your patients alive. But, according to a recent study performed at the Icahn School of Medicine in Mount Sinai, NY, many patients have a different leading objective.

Over the first half of this decade, 20 million adults have gained health insurance coverage as a result of the Patient Protection and Affordable Care Act of 2010. Yet even as the number of uninsured was reduced, millions of Americans still lack coverage.

In response to the emerging consensus among scientists and health authorities that national health priorities should emphasize disease prevention, a government-sponsored Healthy People program was established in 1979 to promote nationwide disease prevention.

Life-threatening bleeds (LTB) from arteriovenous fistulas or grafts are significant bleeds which are not stopped by application of a normal amount of pressure as is commonly used to stop bleeding after dialysis needle removal. In many cases they occur spontaneously at home between dialysis sessions, away from the clinic or caregiving team. Although access-related LTBs are not common, they can result in the loss of the patient’s access and even be fatal.

As a healthcare professional, you know your treatment plans are only as powerful as your patients’ commitment. Your patients’ quality of life not only depends on your expertise but also on how well they implement their care plan after they leave your office. And when it comes to patients with end-stage renal disease (ESRD), non-adherence to dialysis and supporting factors such as diet and medication can lead to severe complications and an increased risk of mortality. Unfortunately, at least 50 % of hemodialysis patients are believed to be non-adherent, according to a study by the Department of Internal Medicine at Cairo University.

Italian neurosurgeons have ushered in a new era in brain surgery when, on November 14^th, they performed their first aneurysm clipping operation with the patient awake. "Awake surgery," which until now been used by neurosurgeons for the removal of brain tumors in critical areas, has now expanded its reach to aneurysm clipping surgery. By having the patient awake during the operation, the surgical team at the Hospital S. Chiara in Trento, Italy was able to monitor not only the patient’s primary motility and sensitivity but also the control of higher and more complex cognitive functions such as language, comprehension, processing of emotions, and vision as a metal clip was meticulously applied to a middle cerebral artery to close off a cerebral aneurysm. Performing the surgery while a patient is awake also lowers intraoperative risks of neurological deficits and ventilator associated morbidities.   

In January of 2018, Amazon announced the launch of an independent healthcare  company with backing from JPMorgan Chase and Berkshire Hathaway.
This new venture, combined with retail health clinics and telehealth, is offering consumers health services at lower prices and with more convenience than hospital outpatient facilities. 

The emergence of differing healthcare models is putting more pressure on hospitals and health systems to stay competitive and examine costs.