Broken DNA of Global Health Security

The COVID-19 pandemic has wreaked havoc across the globe causing massive disruptions to life, liberty, and livelihoods. With more than 3.7 million deaths and a projected cumulative output loss of 28 trillion USD through 2025, it is evident that the extant global health security infrastructure is grossly inadequate. The current crisis has uncovered critical deficiencies in preparedness and response to epidemics and the predictive inability of current indices, underscoring the need for new framework and metrics. This paper argues for the global community to treat pandemics as a threat to global security to ensure mustering of political will and financial resources and to organize appropriate, rapid, and sustained domestic and international responses. A public-health-only approach without commensurate national and global security measures will continue to fail to prevent local outbreaks from becoming global catastrophes. A values-based geopolitical order with resolute global leadership, political will, sustainable financing, and solidarity is critical for the world's future.

Need for a Consensus Global Public Health Suicide Prevention Program and Analytics

Domestic and global suicide prevention and remediation efforts are public health matters that would be managed more effectively, with improved outcomes, if done through health systems using interoperable practices and sharing comparable metrics. This position paper explores the need for a consensus global public health suicide prevent program and analytics.

The Continuum of Care in Cross-Border Health Travel

There are several studies showing that a breakdown in the continuum of care occurs when a person crosses an international boundary for healthcare, such as migrants and medical tourists. This study attempted to measure the impact of a lack of standard continuity on the healthcare outcomes by comparing self-reported perceptions of health among a large population of people that traveled across borders. These travelers, without a discernible continuum of care, were surveyed before and after travel. A statistical analysis of self-reported perception data about general health before and after cross-border travel shows a significant decrease in overall health after cross-border travel. Despite some limitations, a moderate amount of the decline can be attributed to the breakdown of the continuum of care between providers on both sides of the border. The development of standards for cross-border healthcare could potentially improve the healthcare received by migrants and medical travelers.

Predictors of Super-Performers in the Home Health Industry

The world is aging. This paper focuses on the home health care sector. The authors have examined the patient experience aspects of the elderly population. The Agency for Healthcare Research and Quality (AHRQ) designed a Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey specifically for the home healthcare population (HHCAHPS). This paper has identified super-performers within the U.S. home healthcare agencies. By super-performers, this research implies agencies that received superior consumer experience ratings among the U.S. home healthcare segment. The authors applied machine learning techniques to compose a predictive model and identify the predictors of super-performer agencies. The study signals the need for clinically oriented variables for a better model. This paper intends to continue this research with the additional clinically-driven care measures for the patients at home.

Accreditation Before, During, and After COVID

Nationally and/or internationally accredited hospitals, in general, had standards in place to address the challenges presented by COVID-19 including infection control and prevention, clinical outcomes, quality of care, patient safety, risk management, and patient satisfaction. The pandemic presents healthcare providers with enormous challenges, some of which were or could have been ameliorated by accreditation standards. Responding to the pandemic and extracting lessons learned will impact the delivery of healthcare services in the future. Healthcare systems and providers have six distinct opportunities to shape a better future: faster learning, the value of standards, protecting the workforce, virtual care, preparedness for threats, and addressing inequity. Accreditation organizations will continue to contribute to improving quality of care during and post-pandemic by providing standards to improve access to and the delivery of healthcare services in the future.

Report From a Virtual Care Task Force

While telehealth has been available for decades, as a result of the COVID-19 pandemic, an unprecedented demand arose for the remote delivery of safe and reliable assessments and treatment recommendations via computers, smart phones, and tablets. Institutions and individual providers needed to accelerate their adoption of virtual care. This ability to provide remote evaluations has helped to protect patients and providers at this time when physical distancing is a priority. This rapid shift to telemedicine has also meant that many providers, with limited experience or training in the virtual delivery of care, were required to adapt to new and unfamiliar technologies as part of their daily practice of medicine. Institutions and individuals have recognized that this sudden and unexpected expansion of virtual care had the potential to increase patient safety risks. Given that telemedicine will remain a mainstay after the COVID-19 pandemic, it will be important to focus on quality and safety issues that are likely to arise but as yet remain to be appreciated. This chapter explores patient safety guidance.