For breast cancer patients, detecting and diagnosing their condition is traditionally a lengthy process requiring multiple imaging scans. A source of frustration and anxiety for women, this process can take several weeks from initial mammogram to final diagnosis.
Tomosynthesis shows comparability to 2D mammography for diagnostic work-ups
In the United States, we see nearly 800,000 strokes each year—amounting to a new or recurrent stroke occuring every 40 seconds. Fortunately, with notable improvements in care, many more people are surviving strokes than in the past. Stroke survival, however, brings its own set of demands on the health care delivery system, with many patients needing extensive support from physicians, therapists, and family members.
Current efforts around developing certified Comprehensive Stroke Centers (written about earlier this week on The Pipeline) are focused on enhancing acute and post-acute care for stroke, but with much of the health care dialogue centered on population care management, a focus on stroke prevention may become a more realistic goal for the delivery system.
An article published last week in BMJ Open suggests that the possibility of reducing the incidence of stroke can be realized through improved management of known risk factors. While the study arrives at its conclusion in a weak manner, the story is compelling.
Stroke prevention: A possibility under accountable care?
At the end of September, the Joint Commission released proposed requirements for certification as a Comprehensive Stroke Center. These new requirements build off of the exisiting certification program for Primary Stroke Centers (PSCs), which was launched in 2003 and has seen impressive growth since its inception.
To date, more than 800 hospitals nationwide have achieved this distinction, which signals a dedication to providing evidenced-based care for stroke patients in an efficient and high-quality manner. The Comprehensive Stroke Center program will certify hospitals that can provide advanced therapies for acute stroke patients, but can also provide enhanced long-term management of these patients. Assuming the final rules closely resemble the current proposed guidelines, it's possible that not many hospitals will be able to meet the extensive requirements. Few hospitals should be engaged in providing advanced stroke services, especially considering the intensity of resources needed and the complexity of care required.
The Joint Commission developed the proposed requirements along with The American Heart Association (AHA) and the American Stroke Association (ASA). Similar to PSC certification, the proposed requirements follow the Brain Attack Coalition’s recommendations—in this case the “Recommendations for Comprehensive Stroke Centers” that were first published in 2005—and provide detailed specifications on the capabilities, technology, physicians, and services needed to be considered a comprehensive program by the joint commission. A detailed account of the requirements can be found on the Joint Commission's website, but here we'd like to highlight some of the key aspects needed.
Joint Commission releases proposed guidelines for Comprehensive Stroke Center certification