MIT chemical engineers have devised a new implantable tissue scaffold coated with bone growth factors that are released slowly over a few weeks. When applied to bone injuries or defects, this coated scaffold induces the body to rapidly form new bone that looks and behaves just like the original tissue.

This type of coated scaffold could offer a dramatic improvement over the current standard for treating bone injuries, which involves transplanting bone from another part of the patient

An app which enables healthcare professionals to share photos is to be rolled out across western Europe by the end of the year.  The app was designed to enable doctors to share pictures of their patients, both with each other and with medical students.

So far, more than 150,000 doctors have uploaded case photos with the patient’s identity obscured.  However, some experts have expressed concern about patient confidentiality.  Patients’ faces are automatically obscured by the app but users must manually block identifying marks like tattoos.

Each photo is reviewed by moderators before it is added to the database.

Founder Dr Josh Landy told the BBC that the Figure 1 service did not access any patient records. ‘We do not possess any personal medical data at all. The best way to keep a secret is not to have it. We are not an organisation that delivers healthcare,’ he told the BBC.

But doctors must provide identifying credentials and are also advised to notify their employees and patients to find out about consent policies.

‘Legally, we found that identifying the doctor does not identify the patient,’ said Dr Landy.

‘However some [medical] conditions are so rare that they can’t be posted. One user wanted to post something but there are only seven cases of it in the US and they had all been reportable because they are rare, so the patient could have been identified.’

Anybody can download the app for free, but only verified healthcare professionals can upload photos or comment on them, he added.

‘Everything is there for educational purposes. That said, there are very colourful images – things medics see every day. It’s a transparent view into a world you rarely get to see.’

The app is already available in North America, the UK and Ireland.

While digital services such as UpToDate and DynaMed – both requiring a subscription – are already widely used within the healthcare community as clinical knowledge databases, they are not rivals to Figure 1, said Dr Landy. BBC

The use of electronic reminders such as text messages, emails or voicemails is highly effective at getting surgical patients to adhere to a preadmission antiseptic showering regimen known to help reduce risk of surgical site infections (SSIs), according to a first-of-its-kind<. Each year approximately 400,000 SSIs occur and lead to a death rate approaching nearly 100,000 according to data sources cited by study authors. To help reduce the risk of these dangerous infections, clinicians recommend that surgical patients take antiseptic showers with chlorhexidine gluconate (CHG) 24 to 48 hours before admission. CHG is beneficial because it reduces the microbial burden on the surface of the skin and, thereby, the risk of intraoperative wound contamination.

The Perioperative Surgical Home (PSH) model consistently and significantly improves quality of care for patients and reduces health care costs, reports a first-of-its-kind, large-scale literature review of the PSH in the United States and abroad. The review provides further evidence to support the benefits, and encourage the adoption, of the PSH model.

‘There is a global push for more rigorously coordinated and integrated management of surgical patients to enhance patient satisfaction and improve quality of care and outcomes, while cutting costs,’ said Thomas R. Miller, Ph.D., M.B.A., co-author of the review and director of health policy research at the American Society of Anesthesiologists, Schaumburg, Ill. ‘Whether in the U.S. or overseas, our review found that the PSH model of care is highly effective at achieving these measures by reducing cancellations and surgical delays, lowering complication rates and readmissions, and shortening hospital stays.’

The PSH is a patient-centred, physician-led, multidisciplinary team-based model of coordinated care. In a PSH, a patient’s entire surgical experience – preoperative, intraoperative, postoperative and post-discharge – is fully coordinated and treated as one continuum of care. The PSH model emphasizes the cost-efficient use of resources as well as lead physician, multi-specialty team and patient-shared decision-making.

Interestingly, both U.S. and international studies stressed the importance of the role of physician anaesthesiologists in perioperative patient management and PSH models of care.

‘This literature review provides still more evidence that physician anaesthesiologist-led anaesthesia care teams are associated with better patient outcomes, fewer complications, less pain, earlier return to functionality and home, and lower costs,’ said J.P. Abenstein, ASA president. ‘The Perioperative Surgical Home will advance our goals of improved patient safety, quality of care and cost-effectiveness. Every patient undergoing an invasive procedure deserves the involvement of a physician anaesthesiologist in their care.’

Researchers from Texas A&M University and the ASA performed a comprehensive analysis of 152 peer-reviewed studies published between 1980 and 2013. They compared PSH models in the U.S. and other countries and summarized the findings related to clinical outcomes and efficiencies/cost of surgery in various surgical homes. All studies were categorized as preoperative, intraoperative or postoperative in scope.

According to the review, 82 percent of preoperative studies analysed found that the PSH model had a significant positive impact on preoperative clinical outcomes (32 studies) and reduced costs (23 studies). Studies cited preoperative patient education as a component of the PSH model that significantly reduced length of stays and readmission rates. Additionally, studies cited that minimizing the number of unnecessary preoperative tests was found to reduce costs. In fact, one study found eliminating unneeded tests reduced costs by as much $112 per patient, for a total of $1.01 million over the course of the study.

Eighty-two percent of intraoperative studies analysed found that the PSH model had a significant positive impact on intraoperative clinical outcomes (29 studies) and reduced costs (17 studies). Studies cited design and process flow initiatives such as real-time patient-routing systems (real-time electronic dashboards that ensure access to medical records) as one of the intraoperative components of the PSH model that led to a reduction in O.R. delays, surgical cancellations and improved efficiencies.

Last, 90 percent of postoperative studies analysed found that the PSH model had a significant positive impact on clinical outcomes (71 studies) and reduced costs (23 studies). Studies cited enhanced recovery after surgery programs as a component of the PSH model that significantly helped reduce complications, length of stays and costs by encouraging quicker recovery and earlier discharges.

‘We would like to see the PSH model of care be adopted nationwide,’ said Miller. ‘Large reviews such as this show just how successful this model of care can be at raising the quality of care for patients, while meeting the increasing demands of health care reform.’ EurekAlert