Nancy Lynn Keating | |
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| Born | |
| Alma mater | Virginia Tech University of Chicago Pritzker School of Medicine Harvard T.H. Chan School of Public Health Brigham and Women's Hospital |
| Scientific career | |
| Institutions | Brigham and Women's Hospital Harvard Medical School |
Nancy Keating is an American physician who works at the Brigham and Women's Hospital and is a professor at Harvard Medical School. Her research considers the factors that influence quality care for people suffering from cancer.
Keating grew up in Maryland. She attended Fallston High School. [1] Keating was an undergraduate student at Virginia Tech, where she majored in biochemistry. [2] She was a medical student at the University of Chicago Pritzker School of Medicine [3] and completed her internships and residency at the Brigham and Women's Hospital. [4] She was a medical clinical fellow at the Harvard Medical School. [3] Alongside her fellowship in health care policy, Keating was a student in the Harvard T.H. Chan School of Public Health where she earned a Master's in public health and specialized in clinical effectiveness. [3]
Keating was appointed to the faculty at the Harvard Medical School in 1998.[ citation needed ] She was awarded the Society of General Internal Medicine Outstanding Junior Investigator Award in 2005, [5] and promoted to Professor in 2014. Her research considers healthcare equity and improving access to quality cancer care. [3] [6] [7]
Keating is a member of the National Cancer Institute Cancer Care Outcomes Research and Surveillance (canCORS) consortium. CanCORS examines the treatment pathways and outcomes of patients with colorectal cancer. She analyzed the quality of cancer care for people in the Veterans Health Administration. [8] She considered how geography, ethnicity and age impacted veteran health outcomes. She showed that cancer-related imaging was lower in the Veterans Health Administration than in the fee-for-service Medicare. [9] She also showed that Black veterans were considerably less likely to receive surgery for early stage lung cancer or appropriate radiotherapy than their white counterparts. [10] [11]
Keating is interested in end-of-life care for people who experience advanced cancer. [12] She showed that variations in the intensity of end-of-life treatment have less to do with patients' wishes than they do with treatment availability and a physician's discomfort in speaking about end-of-life choices. [12] Keating is committed to oncologists providing appropriate and correct information to people with cancer. She has shown that very few people with fatal cancers have an accurate understanding of their illness, with almost half not every talking to their parents about their life expectancy. [13] She has examined variations in the cost and quality of cancer care across Massachusetts. [6]
Keating is evaluating the Oncology Care Model of the Centers for Medicare & Medicaid Services. [14] [15] The Oncology Care Model provides a new approach to delivering oncology services, using new financial incentives and appropriate levels of care across the United States. [16]
Keating was married in 2003. [2]
Internal medicine or general internal medicine is the medical specialty dealing with the prevention, diagnosis, and treatment of internal diseases. Doctors specializing in internal medicine are called internists, or physicians in Commonwealth nations. Internists are medical specialists that are skilled in the management of patients who have undifferentiated or multi-system disease processes. Internists care for hospitalized (inpatient) and ambulatory (outpatient) patients and may play a major role in teaching and research. Internists are qualified physicians with postgraduate training in internal medicine and should not be confused with "interns", a term for doctors in their first year of residency training.
Palliative care is an interdisciplinary medical caregiving approach aimed at optimizing quality of life and mitigating suffering among people with serious, complex, and often terminal illnesses. Within the published literature, many definitions of palliative care exist. The World Health Organization (WHO) describes palliative care as "an approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial, and spiritual." In the past, palliative care was a disease specific approach, but today the WHO takes a broader patient-centered approach that suggests that the principles of palliative care should be applied as early as possible to any chronic and ultimately fatal illness. This shift was important because if a disease-oriented approach is followed, the needs and preferences of the patient are not fully met and aspects of care, such as pain, quality of life, and social support, as well as spiritual and emotional needs, fail to be addressed. Rather, a patient-centered model prioritizes relief of suffering and tailors care to increase the quality of life for terminally ill patients.
The Veterans Health Administration (VHA) is the component of the United States Department of Veterans Affairs (VA) led by the Under Secretary of Veterans Affairs for Health that implements the healthcare program of the VA through a nationalized healthcare service in the United States, providing healthcare and healthcare-adjacent services to veterans through the administration and operation of 146 VA Medical Centers (VAMC) with integrated outpatient clinics, 772 Community Based Outpatient Clinics (CBOC), and 134 VA Community Living Centers Programs. It is the largest division in the Department, and second largest in the entire federal government, employing over 350,000 employees. All VA hospitals, clinics and medical centers are owned by and operated by the Department of Veterans Affairs, and all of the staff employed in VA hospitals are government employees. Because of this, veterans that qualify for VHA healthcare do not pay premiums or deductibles for their healthcare but may have to make copayments depending on the medical procedure. VHA is is not a part of the US Department of Defense Military Health System.
A medical guideline is a document with the aim of guiding decisions and criteria regarding diagnosis, management, and treatment in specific areas of healthcare. Such documents have been in use for thousands of years during the entire history of medicine. However, in contrast to previous approaches, which were often based on tradition or authority, modern medical guidelines are based on an examination of current evidence within the paradigm of evidence-based medicine. They usually include summarized consensus statements on best practice in healthcare. A healthcare provider is obliged to know the medical guidelines of his or her profession, and has to decide whether to follow the recommendations of a guideline for an individual treatment.
Fee-for-service (FFS) is a payment model where services are unbundled and paid for separately.
Patient safety is a discipline that emphasizes safety in health care through the prevention, reduction, reporting and analysis of error and other types of unnecessary harm that often lead to adverse patient events. The frequency and magnitude of avoidable adverse events, often known as patient safety incidents, experienced by patients was not well known until the 1990s, when multiple countries reported significant numbers of patients harmed and killed by medical errors. Recognizing that healthcare errors impact 1 in every 10 patients around the world, the World Health Organization (WHO) calls patient safety an endemic concern. Indeed, patient safety has emerged as a distinct healthcare discipline supported by an immature yet developing scientific framework. There is a significant transdisciplinary body of theoretical and research literature that informs the science of patient safety with mobile health apps being a growing area of research.
The doctor–patient relationship is a central part of health care and the practice of medicine. A doctor–patient relationship is formed when a doctor attends to a patient's medical needs and is usually through consent. This relationship is built on trust, respect, communication, and a common understanding of both the doctor and patients' sides. The trust aspect of this relationship goes is mutual: the doctor trusts the patient to reveal any information that may be relevant to the case, and in turn, the patient trusts the doctor to respect their privacy and not disclose this information to outside parties.
Lung cancer screening refers to cancer screening strategies used to identify early lung cancers before they cause symptoms, at a point where they are more likely to be curable. Lung cancer screening is critically important because of the incidence and prevalence of lung cancer. More than 235,000 new cases of lung cancer are expected in the United States in 2021 with approximately 130,000 deaths expected in 2021. In addition, at the time of diagnosis, 57% of lung cancers are discovered in advanced stages, meaning they are more widespread or aggressive cancers. Because there is a substantially higher probability of long-term survival following treatment of localized (60%) versus advanced stage (6%) lung cancer, lung cancer screening aims to diagnose the disease in the localized stage.
Breast-conserving surgery (BCS) refers to an operation that aims to remove breast cancer while avoiding a mastectomy. Different forms of this operation include: lumpectomy (tylectomy), wide local excision, segmental resection, and quadrantectomy. BCS has been increasingly accepted as an alternative to mastectomy in specific patients, as it provides tumor removal while maintaining an acceptable cosmetic outcome. This page reviews the history of this operation, important considerations in decision making and patient selection, and the emerging field of oncoplastic breast conservation surgery.
Oncology is a branch of medicine that deals with the study, treatment, diagnosis and prevention of tumors. A medical professional who practices oncology is an oncologist. The name's etymological origin is the Greek word ὄγκος (ónkos), meaning "tumor", "volume" or "mass". Oncology is concerned with:
William K. Oh, is an American medical oncologist, academic and industry leader and expert in the management of genitourinary malignancies, including prostate, renal, bladder and testicular cancers.
Unnecessary health care is health care provided with a higher volume or cost than is appropriate. In the United States, where health care costs are the highest as a percentage of GDP, overuse was the predominant factor in its expense, accounting for about a third of its health care spending in 2012.
Peter B. Bach is a physician and writer at Memorial Sloan-Kettering Cancer Center where he is Director of the Center for Health Policy and Outcomes. His research focuses on healthcare policy, particularly as it relates to Medicare, racial disparities in cancer care quality, and lung cancer. Along with his scientific writings he is a frequent contributor to The New York Times and other newspapers.
Health care quality is a level of value provided by any health care resource, as determined by some measurement. As with quality in other fields, it is an assessment of whether something is good enough and whether it is suitable for its purpose. The goal of health care is to provide medical resources of high quality to all who need them; that is, to ensure good quality of life, cure illnesses when possible, to extend life expectancy, and so on. Researchers use a variety of quality measures to attempt to determine health care quality, including counts of a therapy's reduction or lessening of diseases identified by medical diagnosis, a decrease in the number of risk factors which people have following preventive care, or a survey of health indicators in a population who are accessing certain kinds of care.
OpenNotes is a research initiative and international movement located at Beth Israel Deaconess Medical Center.
Financial toxicity describes the negative impact medical expenses can have on patients in terms of their health related quality of life, leading to negative mental and physical effects as well as, in some cases, bankruptcy, loss of job or income, or even homelessness.
James X. Zhang is an American health economist and health services researcher at the University of Chicago known for his innovative approaches in exploring complex data to measure a range of factors influencing healthcare delivery and outcomes.
Elliott S. Fisher is a health policy researcher and advocate for improving health system performance in the United States. He helped develop the concept of accountable care organizations and championed their adoption by Medicare. The development of the Affordable Care Act was influenced by his research on disparities in healthcare spending and utilization across the United States. He has strongly supported a rapid transition from fee-for-service to pay-for-performance models in the U.S. healthcare industry. He is a tenured faculty member at Dartmouth College, where he teaches in the Masters in Public Health program.
The Oncology Care Model (OCM) is an episode-based payment system developed by the Center for Medicare and Medicaid Innovation. The multipayer model is designed for discrete instances of care, especially those involving chemotherapy, which triggers the six-month episode. The program combines fee-for-service (FFS) payments for established services, monthly payments for additional care under a structured guideline, and performance-based payments weighed against quality metrics and benchmarks.
Kimmie Ng is a physician at Dana–Farber Cancer Institute who is known for her work on colorectal cancer in young patients.
| Authority control: Academics |
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