Download Health Care: Past, Present, and Future

Healthcare
By: Kristine Cargill, Tifenie Harris, Kayla Klosterman,
Lindsey Post, Rebecca Williams, William Winowiecki
Mental Health In Michigan - Past
Prior to opening of mental institutions, people classified as insane were locked in
cellars, attics, and jails
Care of mentally ill patients shifted after the opening of mental institutions
Kalamazoo Asylum for the Insane (Kalamazoo Public Library, n.d.)
•
•
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States first mental institution
Opened August 1859
Pioneered improved medical treatment of mentally ill patients
By 1959 - Consisted of 3500 patients and was a city on its own including a bakery, library,
greenhouse, and other resources
• Used such treatments as insulin shock therapy
State Psychopathic Hospital (Hill & Hirchbein, n.d.)
• Opened in 1906 with direction from Professor William J Herdman
• Facility focus was to diagnosis and research mental illnesses
Rise of mental health intuitions rose in the first half of the 1900’s
1965 - 41 state-operated psychiatric hospitals and centers for persons with
developmental disabilities (Public Sector Consultants Inc., 2010)
Mental Health in Michigan - Present
Care of mentally ill patients shifted from institutions to the current community
based care after President Kennedy signed Mental Retardation Facilities and the
Community Mental Health Centers Construction Act of 1963 (Michigan
Psychiatric Society, 2012)
The new community based system was arranged in the Mental Health Code,
Public Act 258 of 1974 and the revisions under Public Act 290 of 1995 (Michigan
Psychiatric Society, 2012)
People with mental illnesses are managed through a local Community Mental
Health Services Programs (CMHSPs) (Michigan Psychiatric Society, 2012)
• 46 Community Mental Health Programs & 5 state hospitals in 2010 (Public Sector Consultants
Inc., 2010)
Focus of care today in treating the whole patient: mental, physical, family,
financial
Patients live in their own community and homes – have access to care for
managing mental health medications, individual and group therapy, and acute
care in hospitals when needed during a crisis
Patients play an active role in planning their care
Mental Health in Michigan - Future
Increased awareness and acceptance of mental illness will create an increase
of patients seeking mental health care
More Community Health Programs will be developed to provide easier
access to care for patients
Pharmacologic improvements and mental health research will provide
patients with more health care options
Aortic Stenosis
Aortic Stenosis is when the aortic
valve is narrowing and its inhibits
delivery of blood throughout the
body. Some of the signs and
symptoms of this disease are fatigue,
fainting, heart failure, and chest pain.
http://www.medicinenet.com/aortic_
stenosis/article.htm
Older Procedures for Aortic Stenosis
Patient’s
In cases of severe aortic stenosis, it was
always recommended to replace the
aortic valve with a pig valve or
mechanical valve.
In elderly patients it was always
contraindicated to operate due to the
risk factors against the benefits. But
now…….
http://www.medicinenet.com/aortic_st
enosis/article.htm
Transcatheter Aortic Valve Replacement
At Munson Medical Center, Traverse City
Michigan, in August of 2012 they
performed the first TAVR procedure in
this region. What the TAVR procedure
entails is entering through the femoral
artery using a small incision and
catheterizing the valve verses splitting
the chest open and performing open
heart surgery. What this entails is shorter
hospital stays and minimal risks for
infection. This procedure is only
performed on the clients with severe
stenosis whom aren’t qualified for open
heart valve replacement.
http://www.munsonhealthcare.org/News
/MunsonApprovedforNewHeartProcedur
e
http://www.harthosp.org/Portals/1/Images/21/
tavr.jpg
PAST HEALTHCARE
• Dr . Wilhem Roentgen discovered x-rays in 1895. This allowed health care
professionals to “examine visual images of the human body without performing
intrusive procedures” (Basu, 2012).
• Albert Solomon developed mammography in 1913. It had been used for the use of
early detection of breast cancer since 1927.
• In 1959, ultrasound was developed “to detect tumors and examine the health of
unborn babies” (Basu, 2012).
• Magnetic resonance imaging (MRI) was developed in 1972, “a test that uses a
magnetic field and pulses of radio wave energy to make pictures of organs and
structures inside the body”.
• Computerized axial tomography scanner was developed in 1982, a test that “uses xrays to make detailed pictures of structures inside of the body”.
http://www.webmd.com/a-to-z-guides/magnetic-resonance-imaging-mri
http://www.webmd.com/hw-popup/ct-or-cat-scan
Picture retrieved from http://www.bing.com/images/search?q=mri&view=
detail&id=E1097F9C9BEB5C50B55C08865C5A29E112B98F5A&first=38
PRESENT HEALTHCARE
• Health care today is becoming more advanced. Many of the
devices that we use today have gone digital. Due to health care
going digital, patients are able to receive procedures that are less
invasive.
• In order to obtain precise data to treat patients, doctors are using
modern technology.
• Images obtained from CT scans, MRI scans, ultrasounds, and even
x-rays can be sent to doctors over the internet so that they are
able to see the image without having to step foot in the hospital.
(Topol, 2011)
• Doctors are able to put orders in the system for their patients
from the convenience of their office, or even their home through
the new computerized physician order entry (CPOE). (Topol, 2011)
Picture retrieved from
http://www.bing.com/images/search?q=mri&view=detail&id=17DFE0030787014A1FAB6E2582BC6DA159FE81B
0&first=73
FUTURE HEALTHCARE
• Even though we are using computer based charting, not
everything is charted in the computer. We still have paper
charting. “Eventually all paper based patient related data will be
converted to electronic medical records, thereby eliminating the
need for paper based records” (Hamilton, 2011).
• Telemedicine is “a process of connecting physicians and patients
through modern day technology, such as the internet”
(Hamilton, 2011). Telemedicine is something that will eventually
eliminate the need for patients to make office visits with their
physician. They will be able to get medical advice from the
comfort of their own home.
• Robots will be used by the surgeons to assist them in surgeries.
Having the robots assistance will cause less invasive surgeries.
The incision area will not need to be as large, which also makes
the recovery time shortened.
http://www.bing.com/images/search?q=da+vinchi+surgery&view=detail&id=A62042FB0CFB706986E11A3B7CDD017005FC5DB3&first=1p
://
Medicare in 2010
Medicare is an insurance policy for people
over the age of 65 and it is
continuously changing because people
want to get better insurance
for the money they are paying.
The major problems with Medicare during 2010 was the coverage and
the payments. The past problems with Medicare were called “the
donut hole” because some seniors hit a point where they weren’t
getting insurance to pay for their medications since they had reached a
certain limit and some weren’t able to pay for it on their own because
there medications were very expensive but there was a way to help
with the cost of medications, it was a rebate check for $250 that senior
citizens had the chance for when they reached their limit.
http://money.usnews.com/money/blogs/the-best-life/2009/11/13/2010-medicare-changes-demand-careful-review
http://www.rd.com/health/healthcare/medicarewhats-new-for-2012/
Medicare Currently
In 2012 the Medicare coverage was able to change to covering
drug benefits and health-care unlike in the previous years.
Compared to 2011 in 2012 elders are only charged a
small amount out-of-pocket co-pay. Some of the different
parts of Medicare can be charged a smaller amount for a co-pay
compared to years before.
The “donut hole” in Medicare is still a problem now but it is
Shrinking. At the moment generic medications can be discounted
by 14% which is double the discount from 2011 which was 7%.
An additional change that has occurred over the years is that if
someone had Medicare or Medicaid they don’t have to pay for any
co-payment of their medications.
http://www.rd.com/health/healthcare/medicarewhats-new-for-2012/
The Future of Medicare
The “donut hole” that has been a problem for
years with Medicare could
be non existent in 2020 and someone that has
Medicare would only be
paying 25% of any prescription medication
they needed.
Some parts of the future of Medicare are looking bad because there might be
a $716 billion cut after 2013 because of the Affordable Care Act. There is also a
possibility that the age that people can start using Medicare will raise because there are
so many people that are starting to use it. The “baby boomers” are going to start
getting older and they will start to need Medicare and it will cause problems for the
people that need it after them. Some of the premiums that people have to pay every
month could also start to rise and when people don’t have an income other than Social
Security it makes it difficult for them to afford their Medicare and medications.
http://www.rd.com/health/healthcare/medicarewhats-new-for-2012/
http://articles.orlandosentinel.com/2012-10-19/news/fl-medicare-guide-qa-20121019_1_coverage-gap-doughnut-holedrug-coverage
http://www.aarp.org/health/medicare-insurance/info-05-2012/future-of-medicare-proposals.html
Nursing and Hospitals in Michigan
Past
Nursing
• Bed side care relied upon mother, wife or good neighbor
to care for or keep an eye on patients at their homes.
• Children were born and the doctors relied upon their own
wife's or a preachers wife to go in and help with the care.
Hospitals
• Logbook by Capt. Alex Harrison indicated someone was
hospitalized with a date of Oct 11, 1785
• Hospital barrack conditions in Detroit June 24, 1790
• Hospitals = one room, 21 single berths and one chimney
• Earliest hospital in Detroit which is still in existence is St.
Mary’s June 9, 1845
Nursing and hospitals in Michigan
Present
Nursing
• New healthcare delivery models
• Shortage of nurses – helps drive to do more with less
• Nurse going beyond being the caregiver to being the integrators, care
coordinators and efficiency experts
• News models have in common
1. Moving nurse from caregiver to “care integrators”
2. Team approach
3. Bridging the care to outside the primary care
4. Home being a setting for care
5. Targeting people who access healthcare on a regular basis
6. Focusing more on patients
7. Using technology as an advantage
8. Improving satisfaction, quality and cost
Nursing and hospitals in Michigan
Present continued
Hospitals
• Mandates for hospitals to improve quality and continuity of care
• Financial cuts may force community hospitals to merge with larger
hospitals
• Penalties for 30 day readmissions for certain medical conditions = number
one reason for readmission is patients do not understand their discharge
instructions
Nursing and Hospitals in Michigan
Future
Nurses
• Robots – future of patient care
• Radiofrequency – ID tags that track every employee
• Smart beds – track patients breathing and heart rates to their
chart
Hospitals
• Will have two goals
1. improve clinical care
2. cut error rates
• By 2015 The home will be the main place of care. Monitoring
equipment at home that will be sent automatically to the Doctor
– will keep patients out of ER’s and urgent cares
• Michigan has 31 hospitals who use robots to rapidly diagnose
stroke before the narrow window of treatment closes
Pharmacies in the Past
In the past pharmacies were commonly called drug stores.
In the mid to late 1800’s many doctors began creating
medicines. Some of these doctors dropped their practices
and focused solely on the development of drugs. They did
not need a pharmacy degree although degrees began to
be offered in 1895 at the University of Michigan.
Pharmacists learned through apprenticeships.
Many pharmacies were not located in their own building,
one called the Opera House Pharmacy was located in
Baird’s Opera House in Lansing, other locations were just
as interesting.
Most drug stores also had things such as food and soda
fountains.
Lansing was a major center for pharmacy operations
between 1873 and 1920. Over 86 druggists, chemists, and
drug manufacturers appeared in the city directory during
that time.
Almost all pharmacists were males.
Pharmacists main role was to fill prescriptions.
The University of Michigan started to teach Pharmacy in
1868, Ferris State University (then Ferris State Industrial
School) taught its first pharmacy student in 1893, and
Wayne State University (then the Detroit College of
Medicine) offered its first Pharmaceutical degree in 1891.
Old prescription bottles from http://www.glswrkauction.com/contest06-7.htm
Pharmacies Today
Today pharmacies can be found in nearly
every community.
Walgreens, CVS, and Rite-Aid are popular
retail pharmacy chains found in Michigan.
Pharmacies are also located in hospitals.
Pharmacists work with insurance
companies for cost effective care for the
patients.
Pharmacies have started to use electronic
prescriptions and online pharmacies are
frequently used.
A greater focus is on patient care as
opposed to strictly filling prescriptions.
Only three Colleges of pharmacy exist in
the state, they are at Wayne State, Ferris
State, and The University of Michigan.
Most pharmacists go to school for at least 6
years and receive a PharmD degree.
Walgreens Logo from http://www.wehokey.com/
Pharmacies in the Future
Pharmacists may take on an even more patient care centered role with more
direct patient interaction.
Although pharmacy activities may become more automated, the role of a
pharmacist will adapt to the changes. Pharmacists will have a stronger focus on
advising on medications and educating patients to help them become better able
to manage their diseases.
Pharmacists will continue to be a valuable and accessible member of the
healthcare team.
If the demand for pharmacists continue to rise, more pharmacy school may open
in the state beyond the three existing today.
References
* Each link below is hyperlinked to the slide it belongs to.
Clicking on the link will bring you to the slide.
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Hill, W. & Hirchbein, L. (n.d.). A century of improving mental health care at Michigan. Retrieved from
http://www.psych.med.umich.edu/about/history.asp
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Kalamazoo Public Library. (n.d.). Kalamazoo psychiatric hospital. Retrieved from http://www.kpl.gov/local -history/health/kph.aspx
•
Michigan Psychiatric Society. (2012). Mental health in Michigan. Retrieved from
http://www.mpsonline.org/info/Pages/MentalHealthinMichigan.aspx
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Public Sector Consultants Inc. (2010). Mental health in Michigan. Retrieved from http://www.rosehillcenter.org/wpcontent/uploads/2010/01/Mental-Health-in-Michigan-July-2010.pdf
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http://www.medicinenet.com/aortic_stenosis/article.htm
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http://www.harthosp.org/Portals/1/Images/21/tavr.jpg
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Basu, C. 2012. History of health information technology images. Retrieved from http://www.ehow.com/facts_7563543_history -healthinformation-technology-imaging.html
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CT or CAT scan. Retrieved from http://www.webmd.com/hw-popup/ct-or-cat-scan
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Hamilton, B. Future of healthcare-Impact of technology. Articlesbase, 3 July 2011. Web. 3 Nov. 2012. Retrieved from
http://www.articlesbase.com/print/4980922
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Information and recourses: Magnetic resonance imaging (MRI). Retrieved from http://www.webmd.com/a -to-z-guides/magneticresonance-imaging-mri
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Topol, E. The future of healthcare: Information technology. Modern healthcare, 25 July 2011. Web. 4 Nov. 2012.
•
Picture retrieved from
http://www.bing.com/images/search?q=mri&view=detail&id=E1097F9C9BEB5C50B55C08865C5A29E112B98F5A&first=38
•
Picture retrieved from
http://www.bing.com/images/search?q=mri&view=detail&id=17DFE0030787014A1FAB6E2582BC6DA159FE81B0&first=73
•
Picture retrieved from
httwww.bing.com/images/search?q=da+vinchi+surgery&view=detail&id=A62042FB0CFB706986E11A3B7CDD017005FC5DB3&first=1p://
•
http://money.usnews.com/money/blogs/the-best-life/2009/11/13/2010-medicare-changes-demand-careful-review
•
http://www.medicare.gov/quality-care-finder/
•
http://www.rd.com/health/healthcare/medicarewhats-new-for-2012/
•
http://sandiegofreepress.org/
•
http://articles.orlandosentinel.com/2012-10-19/news/fl-medicare-guide-qa-20121019_1_coverage-gap-doughnut-hole-drug-coverage
References Continued
•
http://www.aarp.org/health/medicare-insurance/info-05-2012/future-of-medicare-proposals.html
•
http://thepragmatictheory.wordpress.com/2012/08/23/exactly-how-obamacare-cuts-medicare/
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Andrews, Michelle. “Technology of all kinds is transforming the way medical systems work.” The High-Tech
Hospitals of the Future. U.S. News, 15 July 2009. Web. 11 Nov. 2012.
•
Beattie, Linda. “Models are redefining the role of nursing.” New Healthcare Delivery. N.p.,2009. Web.11
Nov.2012
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McKinney, Maureen. “Many hospitals will struggle to escape or absorb penalty for readmissions.” Preparing for
Impact. N.p.,n.d. Web. 11 Nov. 2012.
•
Smith, Richard R. History of Hospitals and Nursing in Michigan. N.p., n.d Web. 11 Nov. 2012.
•
http://en.wikipedia.org/wiki/University_of_Michigan_College_of_Pharmacy
•
http://www.pharmacytimes.com/publications/issue/2010/September2010/NGP_Future_of_Pharmacy -0910
•
http://www.netdoctor.co.uk/healthy-living/wellbeing/role-of-pharmacists.htm
•
http://www.usmedicine.com/articles/as-role-of-pharmacist-evolves-expands-va-challenged-to-fillpositions.html#.UKGEPcWHKSq
•
http://www.michiganpharmacists.org/public/pharmacy/
•
http://www.drugstoremuseum.com/sections/level_info2.php?level=1&level_id=49
•
http://www.glswrk-auction.com/contest06-7.htm
•
http://www.ferris.edu/HTMLS/colleges/pharmacy/about/Historical-Information-.htm
•
http://cphs.wayne.edu/history.php
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http://umhistory.dc.umich.edu/history/Faculty_History/Pharmacy_History/College_of_Pharmacy.html
•
http://www.wehokey.com/
Kristine Cargill- Slides 1-3
William Winowiecki- Slides 4-6
Tifenie Harris- Slides 7-9
Kayla Klosterman- Slides 10-12, reference slide and putting slide show together
Rebecca Williams- Slides 13-16
Lindsey Post- Slides 17-19