Full Name
Prof Mark L. Zeidel
Designation
Herrman L. Blumgart Professor of Medicine, Harvard Medical School
Chairman, Department of Medicine, Beth Israel Deaconess Medical Center
Chairman, Department of Medicine, Beth Israel Deaconess Medical Center
Bio
Herrman L. Blumgart Professor of Medicine, Harvard Medical School
Chairman, Department of Medicine, Beth Israel Deaconess Medical Center
Chairman, Department of Medicine, Beth Israel Deaconess Medical Center
Topic
Population Health: The US Perspective | Screening and Management of Chronic Kidney Disease
Abstract
Population Health: The US Perspective
While Singapore is advancing rapidly in efforts to apply population health approaches to provide value and high quality care to its citizens, the US presents a patchwork of different approaches. To provide insights for a Singapore audience, I mention several aspects of US healthcare, allowing comparisons with Singapore. The talk emphasizes first that the US is not a single healthcare system, but many. Each state is a different environment with widely differing outcomes. The economic incentives driving US healthcare prevent alignment of providers and payors, and the incentives provided by the payors are capricious and unreliable as supports for the infrastructure needed to gather the data and improve population health. I point out that several US systems, including the Veterans Affairs System, Kaiser Permanente and Geisinger, are making strides in population health, because they are both payer and provider. Finally, I point out that, despite the barriers, physicians in general and academic physicians in particular, have a moral obligation to use population health approaches to assure high quality, reliable care for all of their patients, and I provide some examples from our own hospital.
Screening and Management of Chronic Kidney Disease
This talk bookends with the talk by Prof. Vathsala, which focuses on management of kidney transplantation, focusing on what general internists can do to help patients with kidney impairment and potential renal failure. The talk summarizes the clinical and population impact of chronic kidney disease (CKD), the importance of and approaches to screening for CKD, the increasing importance of identifying causes of CKD, and the management of complications of loss of renal function, including hypertension, hyperkalemia, acidosis, hyperphosphatemia and anemia. I emphasize newer approaches and insights, including assuring equity in screening, the impact of recent discoveries in renal genetics, our increasing ability to slow the progression of kidney disease and the potential for us to halt or cure renal failure in certain populations.
While Singapore is advancing rapidly in efforts to apply population health approaches to provide value and high quality care to its citizens, the US presents a patchwork of different approaches. To provide insights for a Singapore audience, I mention several aspects of US healthcare, allowing comparisons with Singapore. The talk emphasizes first that the US is not a single healthcare system, but many. Each state is a different environment with widely differing outcomes. The economic incentives driving US healthcare prevent alignment of providers and payors, and the incentives provided by the payors are capricious and unreliable as supports for the infrastructure needed to gather the data and improve population health. I point out that several US systems, including the Veterans Affairs System, Kaiser Permanente and Geisinger, are making strides in population health, because they are both payer and provider. Finally, I point out that, despite the barriers, physicians in general and academic physicians in particular, have a moral obligation to use population health approaches to assure high quality, reliable care for all of their patients, and I provide some examples from our own hospital.
Screening and Management of Chronic Kidney Disease
This talk bookends with the talk by Prof. Vathsala, which focuses on management of kidney transplantation, focusing on what general internists can do to help patients with kidney impairment and potential renal failure. The talk summarizes the clinical and population impact of chronic kidney disease (CKD), the importance of and approaches to screening for CKD, the increasing importance of identifying causes of CKD, and the management of complications of loss of renal function, including hypertension, hyperkalemia, acidosis, hyperphosphatemia and anemia. I emphasize newer approaches and insights, including assuring equity in screening, the impact of recent discoveries in renal genetics, our increasing ability to slow the progression of kidney disease and the potential for us to halt or cure renal failure in certain populations.
