The Alaska Federal Healthcare Access Network (AFHCAN) offers a diagnostic “store and forward” telehealth platform with the ability to create a telemedicine case with textual information and data from biomedical peripherals, and send data for consultation. Health care professionals are able to view the data and respond to the case using a standard PC workstation.
Telehealth connects approximately 180 Alaska Native community village clinics, 25 subregional clinics, 4 multiphysician health centers, 6 regional hospitals, and the Alaska Native Medical Center in Anchorage. Approximately 75 percent of the AFHCAN's telehealth usage is for primary care services.[1] Through growing acceptance of telehealth, more than 700 users in Alaska continually provide feedback and request new products and features. As a part of its mission, AFHCAN continues to review, develop, and deploy new telehealth technologies.
Telehealth is the distribution of health-related services and information via electronic information and telecommunication technologies. It allows long-distance patient and clinician contact, care, advice, reminders, education, intervention, monitoring, and remote admissions. Telemedicine is sometimes used as a synonym, or is used in a more limited sense to describe remote clinical services, such as diagnosis and monitoring. When rural settings, lack of transport, a lack of mobility, conditions due to outbreaks, epidemics or pandemics, decreased funding, or a lack of staff restrict access to care, telehealth may bridge the gap as well as provide distance-learning; meetings, supervision, and presentations between practitioners; online information and health data management and healthcare system integration. Telehealth could include two clinicians discussing a case over video conference; a robotic surgery occurring through remote access; physical therapy done via digital monitoring instruments, live feed and application combinations; tests being forwarded between facilities for interpretation by a higher specialist; home monitoring through continuous sending of patient health data; client to practitioner online conference; or even videophone interpretation during a consult.
The term managed care or managed healthcare is used in the United States to describe a group of activities intended to reduce the cost of providing health care and providing American health insurance while improving the quality of that care. It has become the predominant system of delivering and receiving American health care since its implementation in the early 1980s, and has been largely unaffected by the Affordable Care Act of 2010.
...intended to reduce unnecessary health care costs through a variety of mechanisms, including: economic incentives for physicians and patients to select less costly forms of care; programs for reviewing the medical necessity of specific services; increased beneficiary cost sharing; controls on inpatient admissions and lengths of stay; the establishment of cost-sharing incentives for outpatient surgery; selective contracting with health care providers; and the intensive management of high-cost health care cases. The programs may be provided in a variety of settings, such as Health Maintenance Organizations and Preferred Provider Organizations.
The Indian Health Service (IHS) is an operating division (OPDIV) within the U.S. Department of Health and Human Services (HHS). IHS is responsible for providing direct medical and public health services to members of federally recognized Native American Tribes and Alaska Native people. IHS is the principal federal health care provider and health advocate for Indian people.
UC Davis Medical Center (UCDMC) is part of UC Davis Health and a major academic health center located in Sacramento, California. It is owned and operated by the University of California as part of its University of California, Davis campus. The medical center sits on a 142-acre (57 ha) campus (often referred to as the Sacramento Campus to distinguish it from the main campus in nearby Davis) located between the Elmhurst, Tahoe Park, and Oak Park residential neighborhoods. The site incorporates the land and some of the buildings of the former Sacramento Medical Center (which was acquired from the County of Sacramento in 1973) as well as much of the land (and two buildings) previously occupied by the California State Fair until its 1967 move to a new location.
Health information exchange (HIE) is the mobilization of health care information electronically across organizations within a region, community or hospital system. Participants in data exchange are called in the aggregate Health Information Networks (HIN). In practice, the term HIE may also refer to the health information organization (HIO) that facilitates the exchange.
Los Angeles County Department of Health Services operates the public hospitals and clinics in Los Angeles County, and is the United States' second largest municipal health system, after NYC Health + Hospitals.
The Alaska Native Tribal Health Consortium (ANTHC) is a non-profit health organization based in Anchorage, Alaska, which provides health services to 158,000 Alaska Natives and American Indians in Alaska. Established in 1997, ANTHC is a consortium of the tribal regional health organizations. The Board of Directors for ANTHC equally represent all tribal regions of Alaska and each region has parity.
The University of New Mexico Hospital is a public teaching hospital located in Albuquerque, New Mexico, immediately north of the main campus of the University of New Mexico. The hospital is the only Level I trauma center in the state of New Mexico, and also houses the only certified burn unit and designated stroke center in the state. In addition, UNMH also contains the only children's hospital in New Mexico, and is the state's sole source of 13 pediatric sub-specialties. As a safety net hospital, UNMH serves a large percentage of the uninsured and under-insured population of the state. The hospital is the main teaching facility for the University of New Mexico School of Medicine.
Connected health is a socio-technical model for healthcare management and delivery by using technology to provide healthcare services remotely. Connected health, also known as technology enabled care (TEC) aims to maximize healthcare resources and provide increased, flexible opportunities for consumers to engage with clinicians and better self-manage their care. It uses readily available consumer technologies to deliver patient care outside of the hospital or doctor's office. Connected health encompasses programs in telehealth, remote care and disease and lifestyle management, often leverages existing technologies such as connected devices using cellular networks and is associated with efforts to improve chronic care. However, there is an increasing blur between software capabilities and healthcare needs whereby technologists are now providing the solutions to support consumer wellness and provide the connectivity between patient data, information and decisions. This calls for new techniques to guide Connected Health solutions such as "design thinking" to support software developers in clearly identifying healthcare requirements, and extend and enrich traditional software requirements gathering techniques.
The Alaska Native Medical Center (ANMC) is a non-profit health center based in Anchorage, Alaska, United States, which provides medical services to 158,000 Alaska Natives and other Native Americans in Alaska. It acts as both the secondary and tertiary care referral hospital for the Alaska Region of the Indian Health Service (IHS). Established in 1997, ANMC is jointly owned and managed by the Alaska Native Tribal Health Consortium and Southcentral Foundation as well as tribal governments, and their regional health organizations.
A healthcare center, health center, or community health center is one of a network of clinics staffed by a group of general practitioners and nurses providing healthcare services to people in a certain area. Typical services covered are family practice and dental care, but some clinics have expanded greatly and can include internal medicine, pediatric, women’s care, family planning, pharmacy, optometry, laboratory testing, and more. In countries with universal healthcare, most people use the healthcare centers. In countries without universal healthcare, the clients include the uninsured, underinsured, low-income or those living in areas where little access to primary health care is available. In the Central and East Europe, bigger health centers are commonly called policlinics.
The practice of dental care in rural Alaska is overseen by the American Dental Association and other organizations under the jurisdiction of dentistry in the United States, and it involves several unique programs funded by the United States federal government and the Alaska Native Corporations. Dental health in rural Alaska differs due to factors such as distance affecting accessibility and retention, environmental or general racism, fear, and lack of access to quality housing and food. Many Alaska Natives live in rural villages accessible only by boat or bush plane. There are many programs to increase awareness of the importance of dental care among Alaska Natives while helping them to receive the professional care and guidance that they need. There are many dental issues that are disproportionately common within the rural Alaska Native population, such as tooth disease. To help with these health issues, dentists, as and dental therapist aides travel to these villages to perform care. These programs are mostly funded by
Southeast Alaska Regional Health Consortium (SEARHC) is a non-profit medical, dental, vision and mental health organization serving the health interests of the residents of Southeast Alaska.
Medical image sharing is the electronic exchange of medical images between hospitals, physicians and patients. Rather than using traditional media, such as a CD or DVD, and either shipping it out or having patients carry it with them, technology now allows for the sharing of these images using the cloud. The primary format for images is DICOM. Typically, non-image data such as reports may be attached in standard formats like PDF during the sending process. Additionally, there are standards in the industry, such as IHE Cross Enterprise Document Sharing for Imaging (XDS-I), for managing the sharing of documents between healthcare enterprises. A typical architecture involved in setup is a locally installed server, which sits behind the firewall, allowing secure transmissions with outside facilities. In 2009, the Radiological Society of North America launched the "Image Share" project, with the goal of giving patients control of their imaging histories by allowing them to manage these records as they would online banking or shopping.
Native American reservation inequality underlies a range of societal issues that affect the lives of Native American populations residing on reservations in the United States. About one third of the Native American population, about 700,000 people, lives on an Indian Reservation in the United States. Reservation poverty and other discriminatory factors have led to persisting social inequality on Native American reservations. Disparities between many aspects of life at the national level and at the reservation level, such as quality of education, quality of healthcare, substance use disorders, teenage pregnancy, violence, and suicide rates are significant in demonstrating the inequality of opportunities and situations between reservations and the rest of the country.
Telepharmacy is the delivery of pharmaceutical care via telecommunications to patients in locations where they may not have direct contact with a pharmacist. It is an instance of the wider phenomenon of telemedicine, as implemented in the field of pharmacy. Telepharmacy services include drug therapy monitoring, patient counseling, prior authorization and refill authorization for prescription drugs, and monitoring of formulary compliance with the aid of teleconferencing or videoconferencing. Remote dispensing of medications by automated packaging and labeling systems can also be thought of as an instance of telepharmacy. Telepharmacy services can be delivered at retail pharmacy sites or through hospitals, nursing homes, or other medical care facilities.
American Well Corporation, doing business as Amwell, is a telemedicine company based in Boston, Massachusetts, that connects patients with doctors over secure video. Amwell sells its platform as a subscription service to healthcare providers to put their medical professionals online and its proprietary software development kits, APIs, and system integrations enable clients to embed telehealth into existing workflows utilized by providers and patients.
The United States public policy agenda on issues affecting Native Americans under the Obama administration includes the signing of the Tribal Law and Order Act of 2010, which allowed tribal courts to extend and expand sentences handed down to them in criminal cases, strengthening tribal autonomy. Obama also supported and enforced the Executive Order 13175, which requires the federal government to consult with tribal governments when deliberating over policies and programs that would affect tribal communities. Under the Obama Administration was also the launching of Michelle Obama's program Let's Move In Indian Country, which aims to improve opportunities for physical activity, to increase access to healthy food in tribal communities, and to create collaborations between private and public sectors to build programs that will end childhood obesity in Native communities. Obama also supported tribal communities through certain provisions of the American Recovery and Reinvestment Act of 2009, which allocated $510 million for rehabilitation of Native American housing, and the settlement of the Keepseagle case, a lawsuit against the United States Department of Agriculture for discriminating against tribal communities by not allowing them equal access to the USDA Farm Loan Program. Most recently, Obama signed Executive Order 13592, which seeks to improve educational opportunities for American Indian and Alaska Natives. Obama has been praised by many tribal leaders, including those who claim he has done more for Native Americans than all of his predecessors combined.
e-consult is a mechanism developed by the Department of Veterans Affairs that enables primary care providers to obtain specialists' inputs into a patient's care treatment without requiring the patient to go to a face-to-face visit.
The United States has many regions which have been described as medical deserts, with those locations featuring inadequate access to one or more kinds of medical services. An estimated thirty million Americans, many in rural regions of the country, live at least a sixty-minute drive from a hospital with trauma care services. Limited access to emergency room services, as well as medical specialists, leads to increases in mortality rates and long-term health problems, such as heart disease and diabetes. Regions with higher rates of Medicaid and Medicare patients, as well those who lack any health insurance coverage, are less likely to live within an hour's drive of a hospital emergency room.
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