Patient-Centered Care Models

People don’t “fail” healthcare. They’re often just blocked by social conditions that healthcare hasn’t accounted for. This isn’t about noncompliance. It’s about no transport, no childcare, no stable housing, no trust, no safe time to be sick. These are social problems. And they’re the real reasons people can’t engage with care—not ignorance, not laziness, not cost alone. 📉 Yet clinical systems still design pathways assuming that if we just offer more services or spend more money, outcomes will improve. But health doesn’t happen in the clinic. It happens in the neighborhood, long before (or if) someone ever walks through the door. So what needs to change in boardrooms? Too often, power and control sit far from the lived realities of patients. We need: - Investment in community-rooted care models, not just institutional ones - Inclusion of neighborhood voices in decision-making - Metrics that reflect social impact, not just throughput or compliance - Systems that accommodate, not punish, social complexity If healthcare wants different results, it must design for the world people actually live in—not the one we assume they do. It’s not about “fixing patients.” It’s about dismantling the barriers to what health can offer people #SocialDeterminants #NeighborhoodHealth #HealthEquity #SystemicChange #ClinicalPathways #PublicHealth #BoardroomToStreet #PowerShift #PatientCentredCare

The new AHA guideline just renamed how we think about heart, kidney, and metabolic disease. They are no longer separate conditions. They are one syndrome. For years, I treated them in silos. Cardiology handled the heart. Nephrology the kidneys. Endocrinology the diabetes. The patient sat in the middle, carrying fragmented care. The 2026 AHA/ACC/ADA/ASN guideline formalises what many of us have quietly suspected for years. Cardiovascular-Kidney-Metabolic syndrome. CKM. One condition. Four stages. Shared biology. The data is uncomfortable. Between 90 and 95 percent of US adults are already in CKM Stage 1 to 4. Here is what the guideline actually shifts in daily practice: 1. Staging replaces labelling. You no longer just have "hypertension" or "prediabetes". You are in Stage 1 (excess adiposity), Stage 2 (metabolic risk or CKD), Stage 3 (subclinical CVD), or Stage 4 (clinical CVD). 2. Risk is quantified with PREVENT equations. A 10-year risk of 7.5 percent or more now guides pharmacotherapy decisions. 3. Kidney assessment requires both eGFR and UACR. Albuminuria is where much hidden cardiovascular risk lives, and it is routinely missed. 4. Social determinants sit inside the care model. Financial strain, food insecurity, housing instability are part of clinical decision-making. 5. Interdisciplinary care replaces referral tennis. A coordination point person holds the plan together. The most important reframe for me is this. Obesity is not a willpower problem. It is dysfunctional adipose tissue driving insulin resistance, inflammation, hypertension, kidney decline, and cardiovascular events. Addressing it early is preventive medicine at its most upstream. The guideline supports lifestyle modification as first-line, with GLP-1 based therapy and metabolic surgery as adjuncts when needed. Not as shortcuts. As tools within a longer plan. What this means for the professionals I work with: If your blood pressure is "borderline", glucose "a bit high", weight "something to watch", and kidney numbers "fine for now", you may already be in Stage 1 or 2. Not diseased. Not yet symptomatic. But on a trajectory. The value of staging is that it makes the invisible visible. It gives you a map before you need the ambulance. The direction this points toward is quieter than most health advice. Regular anthropometric review. Annual blood pressure. Lipids, glycaemia, and kidney function assessed at intervals matched to your stage. Weight managed as a chronic clinical variable, not a personal failing. Slow, compounding, boring in the best possible way. The reflection I would offer. Ask your clinician which CKM stage you are in. If they have not framed it that way yet, the question itself begins the conversation. The earlier the stage is identified, the wider the range of options that remain open to you. That is the quiet promise of this guideline. Not a new drug. Not a new hack. A new lens.

Healing doesn’t always come in the form of strictly regimented exercises or medical equipment. Sometimes, it arrives in a burst of laughter during an engaging activity or the simple delight of overcoming a challenge disguised as a game. Those moments of genuine joy remind us that physical progress is only one part of rehabilitation. Equally important is reigniting the spark that makes us feel fully alive. In many rehab units, therapy sessions are now taking inspiration from gamification - turning standard routines into playful, goal-oriented experiences. The idea is to keep residents motivated by tapping into their natural sense of curiosity and competition. Whether it’s interactive balance exercises, virtual reality simulations, or tabletop games with a therapeutic twist, this approach fosters mobility, mental well-being, and an overall brighter outlook on the recovery process. The key advantage? When people have fun, they’re more likely to stay committed. In a world where every little step toward healing matters, integrating a bit of playful energy can go a long way in helping individuals reclaim both their physical and emotional strength. Have you seen gamification in rehab or therapy settings? What kind of impact did it have? #innovation #technology #future #management #startups

Witnessing the profound impact of social and economic factors on health has reshaped my perspective on healthcare. Our well-being isn't just determined by what happens in clinics but by our access to food, housing, utilities, transportation, and safety. These factors can profoundly influence our lives, especially for those who are marginalized or economically disadvantaged. In the U.S., nearly two-thirds of primary care physicians screen patients for social needs, yet only about a third screen for financial security, a critical concern for many low-income Americans. This gap reveals a significant mismatch between what physicians are looking for and what patients are most worried about. Our current healthcare system is slowly recognizing the importance of addressing these drivers. Providers, payers, and policymakers are taking steps to integrate social and economic needs into clinical care. This includes screening patients for these needs and coordinating with community-based organizations to address them. However, this effort often requires resources that many practices lack, and some argue that addressing non-medical needs falls outside the traditional scope of healthcare. From my perspective, the evidence suggests that meeting these needs can reduce costly healthcare demands and improve outcomes. For example, food insecurity is linked to chronic conditions like diabetes and hypertension, which require ongoing management. By addressing such needs, we can potentially alleviate the burden on emergency and chronic care services. The Centers for Medicare and Medicaid Services (CMS) have facilitated these efforts by creating pathways to address social needs. Yet, many states, particularly in the Midwest and South, have yet to fully leverage these opportunities. Encouraging more states to participate through simplified application processes and clearer guidance could expand these beneficial programs nationwide., investingIn my work, I've seen the critical need for a healthcare system that addresses more than just clinical symptoms. By focusing on the social determinants of health, we can create a more holistic approach to patient care. This means not only screening for and addressing these needs, investing in community resources, and forming strong partnerships with local organizations. As we move forward, we must continue to advocate for policies and practices that integrate social and medical care. This approach will not only improve individual health outcomes and create a more equitable and efficient healthcare system for all. It's time to rethink how we deliver care in America, ensuring every patient has the support they need to live healthy, fulfilling lives. Read more at: https://buff.ly/4buJ798 #healthcare #hospitals #health #doctors

How do people get trustworthy health information in the age of dis-information? It's no longer just about the physician-patient relationship; it's about truth, trust, and the fundamental values of our democracy. The digital transformation that once fueled participation and empowerment has, unfortunately, become a public health risk: Platform power, mis- and disinformation, data misuse, algorithmic discrimination, and intentional manipulation are shaping our information ecosystem. Health information is being weaponized — used deliberately to spread fear and create confusion. The urgency for action has never been clearer. Today, the **Nature Medicine Commission on Quality Health Information for All** is meeting at the Berlin office of the Bertelsmann Foundation. Twenty-four scientists from around the world will come together with one shared mission: to ensure access to reliable health information for everyone. The Commission's work is designed to: 👉 Address the gaps between quality health information and individual/national prosperity. 👉 Promote broad access to reliable, useful health information. 👉 Improve public health by advancing health literacy and information equity for all. 🚨 It’s time to push back against the toxic flood of disinformation and to invest in trusted solutions and infrastructure. As Nobel Peace Prize laureate Maria Ressa said at the UN General Assembly: “Information Integrity is the mother of all battles. Win this and we can win the rest. Lose this and we will lose everything. Please choose courage over comfort, facts over fiction, hope over fear.” #HealthInformationIntegrity Dr. Sebastian Schmidt-Kaehler, Sciana: The Health Leaders Network, Global Health Connector, Rebecca Katherine Ivic, Ph.D., Alain Labrique, Brigitte Mohn, Dr. Rajendra Pratap Gupta, PhD, Bertelsmann Stiftung, Vivianne Ihekweazu, Daniela Schwarzer, Eric Sutherland, Scott C. Ratzan MD, Carolina Batista MD, Ilona Kickbusch, Ken Rabin

📢 New Publication Alert: Beyond Biology in Women's Health Managing a chronic condition isn't just about clinical care; it's about whether a person has a roof over their head, reliable transportation, or food on their table. My team and I recently published new research in the American Journal of Health Promotion, examining how food, housing, and transportation insecurity intersect with chronic conditions such as hypertension, heart conditions, diabetes, and mental health among women. 💡 The Reality of the Numbers: -~27% of our sample experienced food, transportation, and housing insecurities together. -21.2% faced food insecurity. -13.9% struggled with reliable transportation. -11.9% experienced housing instability. While insecurities were prevalent across all chronic conditions, women with anxiety or depression were disproportionately affected, facing significantly higher rates across every category. 🎯 Key Takeaway Chronic disease management is unsustainable if we ignore the structural factors shaping health. We must integrate community and social services directly into clinical care models. Thanks to my co-authors for working with me on this project. Samia Tasnim, DrPHRobin Page, PhD, APRN, CNM, FACNM, FAAN, and Dr. Ping Ma Check out the full article here: [https://lnkd.in/g7XiHGzx] #SDOH #womenshealth #research #socialdeterminantsofhealth #chronicdisease

YES, health literacy includes disease state education and medication education. But it’s also SO much more than that. A quick reminder: personal health literacy is “the degree to which individuals have the ability to ⭐️ FIND, UNDERSTAND, and USE ⭐️ information and services to inform health-related decisions and actions for themselves and others.” 🔎 FIND relates to availability and access — and not just availability of and access to information, but access to people, technology, and systems that provide the information and services needed to inform health-related decisions. Examples of health literacy that support with FINDING: 🔹 Designing search engine optimized — or generative engine optimized — content so patients can find high-quality answers to their health questions 🔹 Providing clinic information in multiple formats (e.g., print, digital, SMS) so patients can easily access basic info like directions, hours, and contact details 🔹 Building intuitive websites or patient portals with simple (!!!) navigation 🧠 UNDERSTANDING refers to an ability to comprehend the information and services they have access to. Once an individual finds or receives information, can they understand it EASILY? Do they know what the services are for and how they can be beneficial? The information component of "understanding" is the most common interpretation of health literacy, but is sometimes most narrowly applied. So while examples do broadly include disease state or medication education… Additional and more specific examples of health literacy that support with UNDERSTANDING include: 🔹 Using visuals, infographics, and analogies to simplify complex health concepts 🔹 Offering translation and interpretation services + multilingual resources 🔹 Creating segmented, culturally relevant educational materials that reflect the beliefs, values, and lived experiences of your patient population 🔹 Performing demonstrations to help patients correctly use tools such as inhalers, self-injections, finger pricks, monitors, etc. 🔹 Publishing clear yet detailed descriptions of various services available through your institution 🛠️ USE drives home the point that just because someone has access to and comprehends information doesn’t mean they know how to apply it in order to make informed decisions. Examples of health literacy that support with USING: 🔹 Helping patients create action plans for managing chronic diseases with step-by-step instructions 🔹 Simplifying forms and appointment systems so patients can actually use their insurance benefits, schedule care, or request records 🔹 Building feedback loops where patients can ask questions or clarify confusion after their visit (and actually receive prompt responses 👀) What other examples or ideas would you add to either of these 3 main categories? #healthliteracy #patientexperience

Recent coverage of Elle MacPherson rejecting conventional medicine to treat HER2-positive breast cancer sent alarm bells ringing across health and medical communities. As communications professionals, we understand the power of media in shaping public opinion—especially when it comes to something as critical as health. HER2-positive breast cancer can be aggressive, but it’s also one of the most researched forms of cancer, with many evidence-based treatments available to extend - or even save - the lives of patients, including targeted therapies, chemotherapy, and immunotherapy. When a high-profile figure promotes alternative treatments, media outlets have a responsibility to present the full context: the proven efficacy of conventional treatments and the risks associated with unverified alternatives. What does responsible media reporting on cancer look like? 1. Balanced Coverage: Reports should balance personal health stories with the presentation of scientifically-backed treatment options. Anecdotal evidence, while compelling, must not overshadow medical facts. 2. Expert Voices: Including insights from oncologists, researchers, and other medical professionals is crucial to ensure that readers understand the complexities of cancer treatment. This helps frame the narrative in a way that promotes informed decision-making. 3. Clear Risk Communication: Reporting on alternative therapies without clearly outlining their risks, lack of clinical evidence, or the potential for harm is irresponsible. The media should always emphasize the importance of consulting with healthcare professionals before making any treatment decisions. 4. Health Literacy: Media outlets have a role to play in educating the public. Their reporting should elevate health literacy, helping readers navigate the often overwhelming world of cancer treatment with clear, accessible, and factual information. As communicators, what can we do? We have the tools to educate both the media and the public. By providing journalists with accurate, balanced, and vetted information and encouraging them to consult with medical experts, we can help prevent the spread of misinformation. It’s about creating stories that empower people with knowledge - not fear - and ensuring they ask the right questions when treatment options are discussed. #HealthcareCommunications #ResponsibleReporting #MediaEthics #HealthLiteracy #EvidenceBasedMedicine

Teaching kids health literacy is generational empowerment. 🫧✊🏼 Many adults in the United States were expected to navigate healthcare, insurance, prescriptions, medical bills, and complex systems without ever being taught how. Health literacy is not "common sense." It is a learned skill...and one that can mold health outcomes across an entire lifetime. Teaching children how healthcare works early can help reduce fear, improve communication with providers, strengthen self-advocacy, and prepare them to make informed decisions as adults. Though it can be intimidating, it doesn't require perfection or medical expertise. Small conversations over time truly matter: • Explaining why preventive care matters • Teaching kids how to describe symptoms • Showing them how appointments are scheduled • Helping them understand insurance and medical costs gradually • Encouraging them to ask questions without shame Health literacy is part of raising informed, empowered future adults. Perhaps — just perhaps — we will be able to inject some change into our healthcare system with more informed adults. #Literacy #Education #Health #Science #Kids

Nutrition in Critical Care: More Than Just Feeding 🍽️🏥 While ventilators support breathing and medications stabilize physiology, nutrition quietly works in the background — preserving strength, supporting recovery, and influencing outcomes. In the ICU, nutrition becomes part of treatment : ✅ Early nutrition support matters ✅ Protein preservation matters ✅ Gut function matters ✅ Continuous monitoring matters 📌 Key reminders from critical care nutrition practice: 🔹 Start nutrition early when feasible 🔹 Prioritize enteral nutrition whenever possible 🔹 Focus on adequate protein delivery 🔹 Avoid overfeeding during the acute phase 🔹 Reassess frequently — critical illness is dynamic 🎯 Guideline Recommendation: 🔹️ Start within 24–48 hours of ICU admission if the gastrointestinal tract is functional 🔹️ Early enteral feeding is associated with Reduced infections , Better gut integrity and Lower complications 🔹️ Prefere Nasogastric tube , Orogastric or Post-pyloric feeding 🔹️ Consider PN When GI tract is Non-functional, Severe malabsorption and Prolonged inability to achieve nutritional goals ▶️ Initial Phase : 20–25 kcal/kg/day After Stabilization : 25–30 kcal/kg/day Avoid overfeeding it may worsen: • Hyperglycemia • Fat accumulation • Increased CO₂ production ▶️ Protein requirements are higher because of catabolism. Recommended : 1.2–2.0 g protein/kg/d ⬆️ Higher protein may be needed in: • Burns • Trauma • Major surgery • Severe protein losses Protein preservation is important to reduce ICU-acquired muscle loss. 🔍Monitoring During Nutrition Therapy: • Feeding tolerance • Blood glucose • Electrolytes • Fluid balance • GI symptoms • Weight changes • Nitrogen balance (when possible) Micronutrients: Critical illness increases requirements for: • Vitamins • Trace elements • Electrolytes Pay attention during Refeeding Risk • Phosphate • Magnesium • Potassium " Feed Early, Feed Safely, Feed Adequately" 📝 Practical approach: Day 1–2 → Start feeding Day 3–5 → Progress toward targets Ongoing → Monitor, adjust, reassess Sometimes the question is not: “Are we feeding the patient?” But rather: “Are we feeding recovery?” Because recovery from critical illness is not only survival — it is preserving the ability to return to life beyond the ICU. 🍽️ References: 📖 ASPEN/SCCM Critical Care Nutrition Guidelines 📖 ESPEN Clinical Nutrition in ICU Guidelines 📖 Evidence-based ICU Nutrition Support Recommendations #CriticalCare #ClinicalNutrition #ICUNutrition #NutritionSupport #Dietitian #CriticalCareNutrition #Healthcare #EnteralNutrition #ClinicalPractice #NutritionMatters