In 1996, the Institute of Medicine (IOM) released its report Telemedicine: A Guide to Assessing Telecommunications for Health Care. In that report, the IOM Committee on Evaluating Clinical Applications of Telemedicine found telemedicine is similar in most respects to other technologies for which better evidence of effectiveness is also being demanded. Telemedicine, however, has some special characteristics-shared with information technologies generally-that warrant particular notice from evaluators and decision makers. Since that time, attention to telehealth has continued to grow in both the public and private sectors. Peer-reviewed journals and professional societies are devoted to telehealth, the federal government provides grant funding to promote the use of telehealth, and the private technology industry continues to develop new applications for telehealth. However, barriers remain to the use of telehealth modalities, including issues related to reimbursement, licensure, workforce, and costs. Also, some areas of telehealth have developed a stronger evidence base than others. The Health Resources and Service Administration (HRSA) sponsored the IOM in holding a workshop in Washington, DC, on August 8-9 2012, to examine how the use of telehealth technology can fit into the U.S. health care system. HRSA asked the IOM to focus on the potential for telehealth to serve geographically isolated individuals and extend the reach of scarce resources while also emphasizing the quality and value in the delivery of health care services. This workshop summary discusses the evolution of telehealth since 1996, including the increasing role of the private sector, policies that have promoted or delayed the use of telehealth, and consumer acceptance of telehealth. The Role of Telehealth in an Evolving Health Care Environment: Workshop Summary discusses the current evidence base for telehealth, including available data and gaps in data; discuss how technological developments, including mobile telehealth, electronic intensive care units, remote monitoring, social networking, and wearable devices, in conjunction with the push for electronic health records, is changing the delivery of health care in rural and urban environments. This report also summarizes actions that the U.S. Department of Health and Human Services (HHS) can undertake to further the use of telehealth to improve health care outcomes while controlling costs in the current health care environment.

"The Nation has lost sight of its public health goals and has allowed the system of public health to fall into 'disarray'," from The Future of Public Health. This startling book contains proposals for ensuring that public health service programs are efficient and effective enough to deal not only with the topics of today, but also with those of tomorrow. In addition, the authors make recommendations for core functions in public health assessment, policy development, and service assurances, and identify the level of government--federal, state, and local--at which these functions would best be handled.

Drawing on the work of the Roundtable on Evidence-Based Medicine, the 2007 IOM Annual Meeting assessed some of the rapidly occurring changes in health care related to new diagnostic and treatment tools, emerging genetic insights, the developments in information technology, and healthcare costs, and discussed the need for a stronger focus on evidence to ensure that the promise of scientific discovery and technological innovation is efficiently captured to provide the right care for the right patient at the right time. As new discoveries continue to expand the universe of medical interventions, treatments, and methods of care, the need for a more systematic approach to evidence development and application becomes increasingly critical. Without better information about the effectiveness of different treatment options, the resulting uncertainty can lead to the delivery of services that may be unnecessary, unproven, or even harmful. Improving the evidence-base for medicine holds great potential to increase the quality and efficiency of medical care. The Annual Meeting, held on October 8, 2007, brought together many of the nation's leading authorities on various aspects of the issues - both challenges and opportunities - to present their perspectives and engage in discussion with the IOM membership.

The anthrax incidents following the 9/11 terrorist attacks put the spotlight on the nation's public health agencies, placing it under an unprecedented scrutiny that added new dimensions to the complex issues considered in this report. The Future of the Public's Health in the 21st Century reaffirms the vision of Healthy People 2010, and outlines a systems approach to assuring the nation's health in practice, research, and policy. This approach focuses on joining the unique resources and perspectives of diverse sectors and entities and challenges these groups to work in a concerted, strategic way to promote and protect the public's health. Focusing on diverse partnerships as the framework for public health, the book discusses: The need for a shift from an individual to a population-based approach in practice, research, policy, and community engagement. The status of the governmental public health infrastructure and what needs to be improved, including its interface with the health care delivery system. The roles nongovernment actors, such as academia, business, local communities and the media can play in creating a healthy nation. Providing an accessible analysis, this book will be important to public health policy-makers and practitioners, business and community leaders, health advocates, educators and journalists.

The compelling and sometimes frightening stories of 30 deadly diseases - and of humanity's efforts to combat them.

The book is grounded upon the author's extensive professional involvement with physical diseases that are a powerful expression of the patients' emotional themes and life-stories. They are meaning-full diseases. They occur commonly, and are the most compelling argument for an urgent acknowledgment of the role of meanings in the healing process. Following the pattern of his first book, Somatic Illness and the Patient's Other Story, the author shows in case after case that listening and responding to the "story" of patients suffering from persistent physical diseases frequently leads to major reversal of the disease processes. This present book takes a crucial second step. There must be an understandable basis for meaning-full diseases. Resistance to them relates in part to the inability of current Western scientific and biomedical theories to explain them. The author sets out to construct conceptual frameworks, within which clinicians and patients can see that a close relationship between life experience and the appearance of physical disease really does make sense.

Proof that high health care spending is linked directly to poverty. In Poverty and the Myths of Health Care Reform, Dr. Richard (Buz) Cooper argues that US poverty and high health care spending are inextricably entwined. Our nation's health care system bears a financial burden that is greater than in any other developed country in large part because impoverished patients use more health care, driving up costs across the board. Drawing on decades of research, Dr. Cooper illuminates the geographic patterns of poverty, wealth, and health care utilization that exist across neighborhoods, regions, and states—and among countries. He chronicles the historical threads that have led to such differences, examines the approaches that have been taken to combat poverty throughout US history, and analyzes the impact that structural changes now envisioned for clinical practice are likely to have. His research reveals that ignoring the impact of low income on health care utilization while blaming rising costs on waste, inefficiency, and unnecessary care has led policy makers to reshape clinical practice in ways that impede providers who care for the poor. The first book to address the fundamental nexus that binds poverty and income inequality to soaring health care utilization and spending, Poverty and the Myths of Health Care Reform is a must-read for medical professionals, public health scholars, politicians, and anyone concerned with the heavy burden of inequality on the health of Americans.

Anatole Broyard, long-time book critic, book review editor, and essayist for the New York Times, wants to be remembered. He will be, with this collection of irreverent, humorous essays he wrote concerning the ordeals of life and death—many of which were written during the battle with cancer that led to his death in 1990. A New York Times Notable Book of the Year “A heartbreakingly eloquent and unsentimental meditation on mortality . . . Some writing is so rich and well-spoken that commentary is superfluous, even presumptuous. . . . Read this book, and celebrate a cultured spirit made fine, it seems, by the coldest of touches.”—Los Angeles Times “Succeeds brilliantly . . . Anatole Broyard has joined his father but not before leaving behind a legacy rich in wisdom about the written word and the human condition. He has died. But he lives as a writer and we are the wealthier for it.”—The Washington Post Book World “A virtuoso performance . . . The central essays of Intoxicated By My Illness were written during the last fourteen months of Broyard’s life. They are held in a gracious setting of his previous writings on death in life and literature, including a fictionalized account of his own father’s dying of cancer. The title refers to his reaction to the knowledge that he had a life-threatening illness. His literary sensibility was ignited, his mind flooded with image and metaphor, and he decided to employ these intuitive gifts to light his way into the darkness of his disease and its treatment. . . . Many other people have chronicled their last months . . . Few are as vivid as Broyard, who brilliantly surveys a variety of books on illness and death along the way as he draws us into his writer’s imagination, set free now by what he describes as the deadline of life. . . . [A] remarkable book, a lively man of dense intelligence and flashing wit who lets go and yet at the same time comtains himself in the style through which he remains alive.”—The New York Times Book Review “Despite much pain, Anatole Broyard continued to write until the final days of his life. He used his writing to rage, in the words of Dylan Thomas, against the dying of the light. . . . Shocking, no-holds-barred and utterly exquisite.”—The Baltimore Sun