You know your weight. And your physical fitness. And a variety of health-related metrics.
What about your brain fitness?
In years to come, we can expect a growing number of assessments to help each of us address that precise question, using tools that today are only available to researchers and clinicians, raising both opportunities and concerns.
Two recent announcements bring out important events in that direction:
1) Last week, OptumHealth announced an exclusive 3-year agreement (estimated at $18m) with the Australian company Brain Resource.
Quote: “OptumHealth Behavioral Solutions will work with Brain Resource to provide clinicians with a Web-based assessment that measures general cognition (how people process information) and social cognition (how people manage their emotions). This 40-minute assessment is based on well-known and validated tests of memory, attention, executive function, and response speed, and mood, social skills and emotional resilience.”
2) A few weeks ago, we could read that U.S. Troops To Get Cognitive Screening
Quote: “The military will begin giving cognitive tests this summer to troops heading to war, in an effort to get a baseline measure of their reaction time, memory, concentration and other brain functions, which could be referenced in case they are injured.”
I see these instruments as a critical part in the brain fitness puzzle. Neuroimaging techniques such as MRI and fMRI are very important to support clinical and research work, but are not mature or scalable enough to help measure brain functions in millions of healthy individuals. Neuropsychological testing is still today often done with pen and paper, administered by a trained expert, and very resource-intensive.
Brain scientists don´t recognize one overall “brain age” or “intelligence”. We can view our brain functions or cognitive abilities as a variety of skills, some more perception-related, some more memory-related, some more language-related, some more visual, some more abstract-thinking and planning oriented. There is no general “brain age” that can be measured or trained in a meaningful way.
Now, the use of these new technologies also raises concerns, and not just about their reliability and validity.
John Moore of Chilmark Research just commented on the Brain Resource-OptumHealth announcement, pointing out that “it is fairly well-known that many chronic diseases have a high comorbidity factor with mental health, OptumHealth’s partnership with Brain Resource, and its success (or lack thereof) will be an interesting one to follow. And while I applaud this effort, it also raises some pretty scary privacy concerns. How will these assessments be used beyond the confines of the clinician’s office?, What access will OptumHealth have to the data? And what about the employers who have OptumHealth’s parent, United Health Group as an insurer for their employees? Will employers have access to this data, particularly if they start embedding it within HealthAtoZ?”
These are excellent questions. Humana, a health insurance company, recently announced that they were discontinuing their agreement with Posit Science under which they had been offering the Posit Science Brain Fitness Program to their Medicare members. Whereas a number of reasons were offered for that decision (ranging from low uptake rates of the promotions given the legal complexities of reaching out to Medicare users, to low utilization of the product), another concern was mentioned to us during a set of interviews with Humana members: they were concerned about whether a program that had been given to them for free by their insurance company would somehow transmit data back on the mental performance of the user.
Furthermore, we can expect clear public policy implications in this area. Art Kramer recently explained that “the NIH is preparing an “NIH Toolbox” to provide valid, reliable instruments to researchers and clinicians, to solve the problem that exists today, namely, the lack of uniformity among many measures used. The initiative was launched in 2006, and it is a 5-year effort, so we’ll need to wait to see results”.
A with any new tool, we´ll need the define the rules of the road.
1) First of all, we´ll need to make sure it measures what it is supposed to, and with high degrees of reliability.
2) Second, there need to be clear policies in place as to whom can access which data and for which purpose.
3) Finally, we expect the assessments will lead into actionable personalized recommendations to improve if not help maintain cognitive functions.
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There are a variety of dental insurance plans available in the market. A search on the internet will give hundreds of results. It is easy to get confused with so many options. However there are basic principles of insurance which when applied can reduce the overall costs to the individual.
There are the few available dental plans here:
1. Careington Dental Program: – The Careington dental program will provide cost savings not only on routine and preventive care, but on more extensive treatment such as fillings, crowns, root canals, dentures, bridges, oral surgery, and orthodontics. With CAREINGTON Dental Program, members can save up to 60% on dental care expenses and can save upto 20% on specialty services.
2. Liberty Dental Plan: – Liberty Dental Plan of California has been providing and administering dental benefits for over 20years. Californians are changing their dental insurance to a LIBERTY Dental Plan as it provides the benefits that save money on your dental health care.
3. AmeriPlan Dental Plan: – To provide greater value to the consumer, they added prescription medication, vision, and chiropractic care to the program, at no additional charge.
4. Savon Dental Plan: – Until 2005 Savon Dental Plan was available only in the state of Arizona. Realizing the need for their plan on a Nationwide scale, Savon started recruiting dentists Nationwide in June of 2005. Along with the national expansion came a unique idea. Instead of working only to save money for the members, Savon would work to save money for the dentists, too. This lead to the formation of the Nations only Cost Maintained Organization, (C.M.O.)
5. Avia Dental Plan: – Avia was founded in 1993. Avia maintains a large network of established dental providers available in neighborhoods throughout the United States. Avia Dental Plan ® is a discount dental plan. Avia Dental Plan® is an affordable alternative to conventional dental plans. It can also act as a supplement with your current dental plan. Avia discount dental plans are convenient and affordable, offering savings of up to 60% off dentists usual fees.
6. Aetna Dental Plan: – Aetna offers a broad range of traditional and consumer-directed health insurance products and related services, including medical, pharmacy, dental, behavioral health, group life, long-term care and disability plans and medical management capabilities.
7. CIGNA Dental Care: – CIGNA Dental Care standard DHMO offering and Value Plan options offer your employees comprehensive coverage for a wide range of dental services. Most preventive procedures are covered at 100%, giving members the confidence that they can access dental care as needed.
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ORLANDO, Fla., October 30, 2008 — Aetna (NYSE: AET) announced today that it has reached agreement with the Orlando Health physicians group on a three-year contract renewal. Under the new contract, Aetna for the first time will have a direct contract with South Seminole Behavioral Specialists, a behavioral health physicians group that serves Central Florida.
South Seminole Behavioral Specialists added to central Florida network
“Aetna is very pleased to offer its Central Florida members in-network access to behavioral health services,” said Jim McCunney, Aetna’s vice president of network development for Central Florida. “In an environment of rising health care costs, this new agreement is good news for our members.”
Aetna also recently renewed its hospital agreement with Orlando Health, a 1,780-bed system that includes:
· Orlando Regional Medical Center;
· Arnold Palmer Hospital for Children;
· Winnie Palmer Hospital for Women and Babies;
· Lucerne Hospital;
· Dr. P. Phillips Hospital;
· South Lake Hospital;
· South Seminole Hospital; and
· M.D. Anderson Cancer Center Orlando.
Earlier this year, Aetna also signed a five-year agreement with the Orlando Health Visiting Nurse Association. That contract took effect in August.
Orlando Health is a $1.5 billion not-for-profit health care organization and a community-based network of nine hospitals and care centers in the Orlando region. The organization, which includes the area’s only Level One Trauma Centers for adults and pediatrics, is a statutory teaching hospital system that offers both specialty and community hospitals. They are: Orlando Regional Medical Center; Arnold Palmer Hospital for Children; Winnie Palmer Hospital for Women & Babies; Lucerne Hospital; Dr. P. Phillips Hospital; South Seminole Hospital; South Lake Hospital (50 percent partnership); St. Cloud Regional Medical Center (20 percent partnership) and M. D. Anderson Cancer Center Orlando – the first affiliate of one of the nation’s premier cancer centers, The University of Texas M. D. Anderson Cancer Center in Houston. Orlando Health’s areas of clinical excellence are heart and vascular, cancer care, neurosciences, surgery, pediatric orthopedics and sports medicine, neonatology, and obstetrics and gynecology.
Orlando Health is Central Florida’s fifth-largest employer with nearly 14,000 employees and more than 2,000 affiliated physicians.
Aetna provides and administers health benefits to more than 225,000 members in Central Florida. Those members have access to a contracted network of 35 hospitals, 1,626 primary care physicians and 4,434 specialists.
Aetna is one of the nation’s leading diversified health care benefits companies, serving approximately 37.2 million people with information and resources to help them make better informed decisions about their health care. Aetna offers a broad range of traditional and consumer-directed health insurance products and related services, including medical, pharmacy, dental, behavioral health, group life and disability plans, and medical management capabilities and health care management services for Medicaid plans. Our customers include employer groups, individuals, college students, part-time and hourly workers, health plans, governmental units, government-sponsored plans, labor groups and expatriates.
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With the advances of technology changing the way people interact and obtain information, it stands to reason that those in the medical field have taken advantage of the advances to benefit both patient and care provider. Nursing universities should take this into account for their incoming classes to better prepare the students to be successful in the ever-changing, increasingly digital medical environment.
Some of these new medical technologies that have already become a mainstay are those being used by home-care providers. Linda Sheffield, the VP of Nursefinders.com, is quite familiar with the use and advantages of using Telehealth. Telehealth is a remote monitoring system that can send vital sign recordings (blood sugar levels, blood pressure, etc.) from a homebound patient to the assigned nurse. If there are any unusual fluctuations, the nurse will be able to see it right away and visit the patient, instead of waiting for the assigned day or time.
Bluetooth technology has also become an essential tool for nurses who use it to track a patient’s vital signs after being discharged from the hospital. They are sent home with various medical instruments to keep track of vital signs and are equipped with additional Bluetooth technology so that information can be sent electronically to the nurse. There are various providers of such technology, including Advanced Monitored Caregiving (AMC), and as VP of AMC states, “We are building communication bridges between the patients and their care teams.”
The Intel Health Guide is a monitoring system that also acts as an educational tool. Intel Digital Health Group offers a type of system that can record trends in health and help the nurse and patient pinpoint any problems that may arise and discover the source of these problems. GE has created QuietCare, which is a home medical monitoring system that strategically places sensors in key areas of the house. Data is sent to the care-giver when anything unusual happens, in addition to sending vital sign recordings.
There are a vast spectrum of other technological advances that have significantly helped nurses with their job and increased the satisfaction and safety of the patient.Nursing universities should get on board with these changes and begin teaching their students now rather than wait until later. With these added curriculum components, nursing university graduates will already have a thorough understanding of how these systems work. Graduates from nursing schools where this technology is taught will have an advantage over their nursing counterparts from schools where new technology is not part of the program. Nursing universities are the training grounds for the next generation of nurses and other healthcare professionals and they should all be trained to use the advanced technology seen today since it will be a large part of their future careers
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