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social, health, political imagery through the lens of George J Huba PhD © 2012-2019

Posts tagged nursing

ObamaCare revised/enhanced?

Trump/RyanCare another draft not submitted to Congress?

Within the extant and mythical healthcare plans, additional dementia care services need to be included. Most are cost-neutral or may actually save money while providing better patient outcomes.

Case Management makes existing healthcare services (doctor visits, medications, emergency care) work better. At a very small cost that should actually SAVE money, case management can provide better total patient care, cut unnecessary emergency room visits, and achieve better medication outcomes. What isn’t there to like?

Dementia Caregivers are most often UNPAID, female family members forced to juggle their own jobs/finances, families, and general lives to care for a loved one. Support is required for Dementia Caregivers in the forms of training, support, advice, and FINANCIAL COMPENSATION for their services. They do the work, they should get paid for their time. An upgraded system of paid family caregivers should make DementiaCare more effective and reduce other costs in the healthcare system to such a degree that it will be cost-neutral. An unnecessary hospital stay or emergency room visit can cost as much as $10,000 — $20,000. A family caregiver could be paid for 500 hours at $20 per hour for $10,000. Train family caregivers, pay them, and you have a cost neutral system. What isn’t there to like?

Mental Health issues often lead to huge patient distress, anxiety, and medical management problems. They can frustrate caregivers and lead to nonadherence to medication recommendations. Therapy and counseling can help patients and caregivers as well as cutting overall medical costs. What isn’t there to like?

Group Adult Daycare can provide needed respite for family caregivers as well as important social and recreational experiences for patients, thus enhancing their lives and to some degree ability to function independently. What isn’t there to like?

The following mind model provides some details. Click the image to expand it.

 

This mind map was originally prepared in MindManager in the late 2001 for an evaluation of an initiative to increase the capacity of US Nursing Schools to meet the need for graduate-trained gerontological/geriatric nurses. I spent 10 minutes running the original file through iThoughtsX to add some color hues.

This was an evaluation of an important initiative funded by the John A Hartford Foundation (Building Academic Geriatric Nursing Capacity).

Click on the image to expand.

BAGNC

BIG Data is coming (or has already come) to healthcare. [It is supposed to usher in new eras of research, economic responsibility, quality and access to healthcare, and better patient outcomes, but that is a subject for another post because it is putting the carriage before the horse to discuss it here.]

What is a data scientist? A new form of bug, a content expert who also knows data issues, an active researcher, someone trained in data analysis and statistics, someone who is acutely aware of relevant laws and ethical concerns in mining health data, a blind empiricist?

This is a tough one because it also touches on how many $$$$$ (€€€€€. ¥¥¥¥¥ , £££££, ﷼﷼﷼﷼﷼, ₩₩₩₩₩, ₱₱₱₱₱) individuals and corporations can make off the carcass of a dying healthcare system.

Never one to back away from a big issue and in search of those who value good healthcare for all over the almighty $ € ¥ £ ₨ ﷼ ₩ ₱, here are some of my thoughts on this issue.

Click image to zoom.

who is a health data scientist

Content knowledge by a well-trained, ethical individual who respects privacy concerns is Queen. Now and forever.

Keyword Board

topics and subtopics: who is a “health” data scientist? trained in healthcare? methodology research databases management information systems psychology? psychometrics other public health? epidemiology other medicine? nursing? social work? education? biostatistics? medical informatics? applied mathematics? engineering? theoretical mathematics? theoretical-academic statistics? information technology? computer science? other? conclusions must know content 70% methods 30% must honor ethics 100% laws practice privacy criminal civil federal state other greatest concerns correctness of results conclusions ethical standards meaningfulness validity reliability privacy utility expert in content field data analysis data systems ethics and privacy other member? association with ethics standards licensed? physician nurse psychologist social worker other regulated? federal hipaa state other insured? professional liability errors and omissions continuing education requirements? ethics renewal of licensure regulatory standards insurer commonsense laws go away if not well trained content field data analysis not statistics committed clean data meaningfulness subject privacy peer review openness ethics ethics ethics are arrogant narrow-minded purely commercial primarily motivated $$$$$ blind number cruncher atheoretical © 2013 g j huba

I wouldn’t go on a bus trip with a driver who is unlicensed. Would you?

Who is driving the Big Data bus? Data scientists? Mindless algorithms? Content experts and their teams of data scientist support staff? Marketing? Security firms (including those run by governments)? Terrorists?

I say this once, I will say this a million times … Content is Queen.

Algorithms that are primarily empirical without an understanding of the validity of the data being analyzed and the theoretical issues are dangerous.

An algorithm can predict — and I have no doubt several are doing so at this minute — how happy I will be on a global question (how happy are you?) or a behavioral index (at a sporting event, at the bank cashing a check, four days after the death of a parent) or the perceptions of others (just got tagged in somebody’s photo, got mentioned in a tweet, had a happy blog entry, had  birthday, just had a child born, got back a favorable medical test result, used a smiley face).

I have observed and analyzed and proposed new ways of measuring “happiness” and “anxiety” and “grieving” and “intelligence” for 40 years. I don’t really know what “happiness” or “anxiety” or “grieving” or “intelligence” is although I do know a lot about how experts have tried to define these constructs. I do know that a blind algorithm is not going to answer the question of what “happiness” is.

Do you want an algorithm driving the bus or someone who knows the limits of current data? I don’t want a blind algorithm predicting whether I am “happy” (and happy enough to buy something). I don’t want a blind algorithm predicting the economy. I don’t want a blind algorithm predicting how many healthcare visits I should receive under health insurance.

Content is Queen. The algorithms that drive the organization of Big Data need to be guided by content specialists (psychologists, sociologists, physicians, nurses, economists, physicists, chemists, bioelectrical engineers, etc.) not data scientists without expertise in one or more of the relevant content fields.

If the Queen rules, all will probably be well in the kingdom. If blind algorithms rule we probably will end up as batteries in The Matrix.

I vote (before it is too late) for the monarchy of content. I am not a battery.

candy 5codeHubaisms

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