Workshop
The Roundtable on Health Literacy brings together leaders from academia, industry, government, foundations, and associations and representatives of patient and consumer interests who work to improve health literacy. To achieve its mission, the roundtable discusses challenges facing health literacy practice and research and identifies approaches to promote health literacy through mechanisms and partnerships in both the public and private sectors.
To explore the aspects of health literacy that impact the ability of patients to understand and follow discharge instructions and to learn from examples of how discharge instructions can be written to improve patient understanding of-and hence compliance with-discharge instructions, the Roundtable on Health Literacy held a public workshop. The workshop featured presentations and discussions that examined the implications of health literacy for discharge instructions for both ambulatory and inpatient facilities. Facilitating Patient Understanding of Discharge Instructions summarizes the presentations and discussions of the workshop. This report gives an overview of the impact of discharge instructions on outcomes, and discusses the specifics of inpatient discharge summaries and outpatient after-visit summaries. The report also contains case studies illustrating different approaches to improving discharge instructions.
76 pages
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6 x 9
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paperback
ISBN Paperback: 0-309-30738-4
ISBN Ebook: 0-309-30739-2
DOI:
https://doi.org/10.17226/18834
Institute of Medicine. 2014. Facilitating Patient Understanding of Discharge Instructions: Workshop Summary. Washington, DC: The National Academies Press.
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Workshop_in_brief
The 2014 epidemic of Ebola Virus Disease (EVD), caused by a filovirus, has affected multiple countries in West Africa (Guinea, Liberia, Sierra Leone, Nigeria, and Senegal), along with Spain and the United States, becoming the worst EVD outbreak since its discovery in 1976. Until 2014, previous outbreaks have been confined to smaller geographic areas and often only affected a few hundred people. Confirmed and suspected cases of EVD have now occurred in the United States through human-to-human transmission, requiring the U.S. medical and public health systems to prepare for and respond to domestic cases of EVD. The heightened awareness and attention to the disease in the United States has also led to questions from affected communities on specific characteristics of the virus, how the virus behaves, and personal protective equipment and personal protective behaviors that can be used to prevent its spread and reduce exposure.
At the request of the Office of the Assistant Secretary for Preparedness and Response, the National Institutes of Health, and the Centers for Disease Control and Prevention, the Institute of Medicine , in collaboration with the National Research Council, convened a workshop on November 3, 2014, with key stakeholders and experts to discuss the research priorities that could guide medical and public health practice. Discussions included the degree of transmission and biopersistence of the virus under a range of conditions and on a variety of materials, as well as issues of handling potentially infected materials, decontamination, and the training and personal protective equipment usage of traditional and nontraditional workers involved in the full spectrum of this response. Research Priorities to Inform Public Health and Medical Practice for Ebola Virus Disease summarizes the presentations and discussion of the workshop.
10 pages
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8.5 x 11
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ISBN Ebook: 0-309-31671-5
DOI:
https://doi.org/10.17226/19004
Institute of Medicine and National Research Council. 2014. Research Priorities to Inform Public Health and Medical Practice for Ebola Virus Disease: Workshop in Brief. Washington, DC: The National Academies Press.
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Workshop
On November 7-8, 2013, the Institute of Medicine's Roundtable on Environmental Health Sciences, Research, and Medicine held a workshop to discuss approaches related to identifying and reducing potential environmental public health risks to new and existing industrial chemicals present in society. Industrial chemicals include chemicals used in industrial processes or commercial products, not including those found in food, pesticides, or pharmaceuticals.
Identifying and Reducing Environmental Health Risks of Chemicals in Our Society is a summary and synthesis of the presentations and discussions that took place during the two days of the workshop. The workshop examined successes and areas for improvement within current regulatory programs for assessing industrial chemical safety, frameworks for chemical prioritization to inform targeted testing and risk management strategies, concepts of sustainability and green chemistry that support the design and use of safer alternatives, and efforts to reduce the risk of chemicals in our society.
179 pages
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6 x 9
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paperback
ISBN Paperback: 0-309-30115-7
ISBN Ebook: 0-309-30116-5
DOI:
https://doi.org/10.17226/18710
Institute of Medicine. 2014. Identifying and Reducing Environmental Health Risks of Chemicals in Our Society: Workshop Summary. Washington, DC: The National Academies Press.
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Health literacy is the degree to which individuals can obtain, process, and understand the basic health information and services they need to make appropriate health decisions. Nearly half of all American adults - 90 million people - have inadequate health literacy to navigate the health care system. Implications of Health Literacy for Public Health is the summary of a workshop convened by the Institute of Medicine Roundtable on Health Literacy in November 2013 that focused on the implications of health literacy for the mission and essential services of public health. The workshop featured the presentation of a commissioned paper on health literacy activities under way in public health organizations. Other presentations examined the implications of health literacy for the mission and essential services of public health, for example, community health and safety, disease prevention, disaster management, or health communication. This report includes the commissioned paper and summaries of the workshop presentations.
176 pages
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6 x 9
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paperback
ISBN Paperback: 0-309-30365-6
ISBN Ebook: 0-309-30366-4
DOI:
https://doi.org/10.17226/18756
Institute of Medicine. 2014. Implications of Health Literacy for Public Health: Workshop Summary. Washington, DC: The National Academies Press.
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Workshop
Health is influenced by a wide range of factors, many of which fall outside of the health care delivery sector. These determinants of health include, for example, the characteristics of how people live, work, learn, and play. Decision and policy making in areas such as transportation, housing, and education at different levels of government, and in the private sector, can have far-reaching impacts on health. Throughout the United States there has been increasing dialogue on incorporating a health perspective into policies, programs, and projects outside the health field.
Applying a Health Lens to Decision Making in Non-Health Sectors is the summary of a workshop convened in September 2013 by the Institute of Medicine Roundtable on Population Health Improvement to foster cross-sectoral dialogue and consider the opportunities for and barriers to improving the conditions for health in the course of achieving other societal objectives (e.g., economic development, efficient public transit). The roundtable engaged members, outside experts, and stakeholders on three core issues: supporting fruitful interaction between primary care and public health; strengthening governmental public health; and exploring community action in transforming the conditions that influence the public's health. This report is a discussion of health in all policies approaches to promote consideration for potential health effects in policy making in many relevant domains, such as education, transportation, and housing.
94 pages
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6 x 9
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paperback
ISBN Paperback: 0-309-29975-6
ISBN Ebook: 0-309-29976-4
DOI:
https://doi.org/10.17226/18659
Institute of Medicine. 2014. Applying a Health Lens to Decision Making in Non-Health Sectors: Workshop Summary. Washington, DC: The National Academies Press.
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Although health literacy is commonly defined as an individual trait, it does not depend on the skills of individuals alone. Health literacy is the product of the interaction between individuals' capacities and the health literacy-related demands and complexities of the health care system. Specifically, the ability to understand, evaluate, and use numbers is important to making informed health care choices.
Health Literacy and Numeracy is the summary of a workshop convened by The Institute of Medicine Roundtable on Health Literacy in July 2013 to discuss topics related to numeracy, including the effects of ill health on cognitive capacity, issues with communication of health information to the public, and communicating numeric information for decision making. This report includes a paper commissioned by the Roundtable, "Numeracy and the Affordable Care Act: Opportunities and Challenges," that discusses research findings about people's numeracy skill levels; the kinds of numeracy skills that are needed to select a health plan, choose treatments, and understand medication instructions; and how providers should communicate with those with low numeracy skills. The paper was featured in the workshop and served as the basis of discussion.
164 pages
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6 x 9
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paperback
ISBN Paperback: 0-309-29980-2
ISBN Ebook: 0-309-29981-0
DOI:
https://doi.org/10.17226/18660
Institute of Medicine. 2014. Health Literacy and Numeracy: Workshop Summary. Washington, DC: The National Academies Press.
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Substantial empirical evidence of the contribution of social and behavioral factors to functional status and the onset and progression of disease has accumulated over the past few decades. Electronic health records (EHRs) provide crucial information to providers treating individual patients, to health systems, including public health officials, about the health of populations, and to researchers about the determinants of health and the effectiveness of treatment. Inclusion of social and behavioral health domains in EHRs is vital to all three uses. The Health Information Technology for Economic and Clinical Health Act and the Patient Protection and Affordable Care Act place new importance on the widespread adoption and meaningful use of EHRs. "Meaningful use" in a health information technology context refers to the use of EHRs and related technology within a health care organization to achieve specified objectives. Achieving meaningful use also helps determine whether an organization can receive payments from the Medicare EHR Incentive Program or the Medicaid EHR Incentive Program.
Capturing Social and Behavioral Domains in Electronic Health Records is the first phase of a two-phase study to identify domains and measures that capture the social determinants of health to inform the development of recommendations for meaningful use of EHRs. This report identifies specific domains to be considered by the Office of the National Coordinator, specifies criteria that should be used in deciding which domains should be included, identifies core social and behavioral domains to be included in all EHRs, and identifies any domains that should be included for specific populations or settings defined by age, socioeconomic status, race/ethnicity, disease, or other characteristics.
136 pages
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6 x 9
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paperback
ISBN Paperback: 0-309-30110-6
ISBN Ebook: 0-309-30111-4
DOI:
https://doi.org/10.17226/18709
Institute of Medicine. 2014. Capturing Social and Behavioral Domains in Electronic Health Records: Phase 1. Washington, DC: The National Academies Press.
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Workshop
Understanding the Connections Between Coastal Waters and Ocean Ecosystem Services and Human Health discusses the connection of ecosystem services and human health. This report looks at the state of the science of the role of oceans in ensuring human health and identifies gaps and opportunities for future research. The report summarizes a workshop convened by the Institute of Medicine's Roundtable on Environmental Health Sciences, Research, and Medicine. Participants discussed coastal waters and ocean ecosystem services in the United States in an effort to understand impacts on human health. Understanding the Connections Between Coastal Waters and Ocean Ecosystem Services and Human Health focuses on key linkages by discussing the ecosystem services provided by coastal waterways and oceans that are essential for human health and well-being; examining the major stressors that affect the ability of coastal waterways and ocean systems to provide essential services; and considering key factors that can enhance the resiliency of these systems.
144 pages
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6 x 9
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paperback
ISBN Paperback: 0-309-29468-1
ISBN Ebook: 0-309-29469-X
DOI:
https://doi.org/10.17226/18552
Institute of Medicine. 2014. Understanding the Connections Between Coastal Waters and Ocean Ecosystem Services and Human Health: Workshop Summary. Washington, DC: The National Academies Press.
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Including Health in Global Frameworks for Development, Wealth, and Climate Change is the summary of a three-part public webinar convened by the Institute of Medicine Roundtable on Environmental Health Sciences, Research, and Medicine and its collaborative on Global Environmental Health and Sustainable Development. Presenters and participants discussed the role of health in measuring a country's wealth (going beyond gross domestic product), health scenario communication, and international health goals and indicators. The workshop focused on fostering discussion across academic, government, business, and civil society sectors to make use of existing data and information that can be adapted to track progress of global sustainable development and human health. This report examines frameworks for global development goals and connections to health indicators, the role for health in the context of novel sustainable economic frameworks that go beyond gross domestic product, and scenarios to project climate change impacts.
86 pages
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6 x 9
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paperback
ISBN Paperback: 0-309-29478-9
ISBN Ebook: 0-309-29479-7
DOI:
https://doi.org/10.17226/18554
Institute of Medicine. 2014. Including Health in Global Frameworks for Development, Wealth, and Climate Change: Workshop Summary. Washington, DC: The National Academies Press.
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Liquid fuels are a major part of modern life. They supply energy for ground, water, and air transportation as well as power for industrial and farming machinery. But fossil fuels - the dominant liquid fuel in use for well over a century - have many disadvantages. The use of fossil fuels has obvious health downsides, such as emissions of pollutants that are directly harmful to health. The burning of fossil fuels produces greenhouse gases, which contribute to global warming, itself a long-term threat to human health. There have also been health concerns related to insecurity of liquid fuel supplies and the potential of international conflicts being caused by fuel scarcity. Furthermore, there are concerns that the world's large but still limited supply of fossil fuels could be strained by the increasing demand that results from societies around the world achieving greater prosperity. In the face of these concerns, new policies have been created that encourage the development of renewable sources of energy in general and biofuels in particular.
In January 2013, the Roundtable on Environmental Health Sciences, Research, and Medicine of the Institute of Medicine held a 2- day, interactive, public workshop on the intersection of biofuels, climate change, and human health. Workshop attendees explored public health issues related to the composition of traditional and alternative fuels and fuel additives, and they discussed the known and potential health impacts associated with the use of these fuels and fuel additives. The Nexus of Biofuels, Climate Change, and Human Health is the summary of that workshop. This report examines air, water, land use, food, and social impacts of biomass feedstock as an energy resource, and the state of the science and health policy implications of using different types (and generations) of biofuels as an energy source.
200 pages
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6 x 9
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paperback
ISBN Paperback: 0-309-29241-7
ISBN Ebook: 0-309-29242-5
DOI:
https://doi.org/10.17226/18493
Institute of Medicine. 2014. The Nexus of Biofuels, Climate Change, and Human Health: Workshop Summary. Washington, DC: The National Academies Press.
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Population Health Implications of the Affordable Care Act is the summary of a workshop convened in June 2013 by the Institute of Medicine Roundtable on Population Health Improvement to explore the likely impact on population health improvement of various provisions within the Affordable Care Act (ACA). This public workshop featured presentations and discussion of the impact of various provisions in the ACA on population health improvement.
Several provisions of the ACA offer an unprecedented opportunity to shift the focus of health experts, policy makers, and the public beyond health care delivery to the broader array of factors that play a role in shaping health outcomes. The shift includes a growing recognition that the health care delivery system is responsible for only a modest proportion of what makes and keeps Americans healthy and that health care providers and organizations could accept and embrace a richer role in communities, working in partnership with public health agencies, community-based organizations, schools, businesses, and many others to identify and solve the thorny problems that contribute to poor health.
Population Health Implications of the Affordable Care Act looks beyond narrow interpretations of population as the group of patients covered by a health plan to consider a more expansive understanding of population, one focused on the distribution of health outcomes across all individuals living within a certain set of geopolitical boundaries. In establishing the National Prevention, Health Promotion, and Public Health Council, creating a fund for prevention and public health, and requiring nonprofit hospitals to transform their concept of community benefit, the ACA has expanded the arena for interventions to improve health beyond the "doctor's" office. Improving the health of the population - whether in a community or in the nation as a whole - requires acting to transform the places where people live, work, study, and play. This report examines the population health-oriented efforts of and interactions among public health agencies (state and local), communities, and health care delivery organizations that are beginning to facilitate such action.
72 pages
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6 x 9
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paperback
ISBN Paperback: 0-309-29434-7
ISBN Ebook: 0-309-29435-5
DOI:
https://doi.org/10.17226/18546
Institute of Medicine. 2014. Population Health Implications of the Affordable Care Act: Workshop Summary. Washington, DC: The National Academies Press.
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One of the many benefits of the U.S. food system is a safe, nutritious, and consistent food supply. However, the same system also places significant strain on land, water, air, and other natural resources. A better understanding of the food-environment synergies and trade-offs associated with the U.S. food system would help to reduce this strain. Many experts would like to use that knowledge to develop dietary recommendations on the basis of environmental as well as nutritional considerations. But identifying and quantifying those synergies and trade-offs, let alone acting on them, is a challenge in and of itself. The difficulty stems in part from the reality that experts in the fields of nutrition, agricultural science, and natural resource use often do not regularly collaborate with each other, with the exception of some international efforts.
Sustainable Diets is the summary of a workshop convened by The Institute of Medicine's Food Forum and Roundtable on Environmental Health Sciences, Research, and Medicine in May 2013 to engender dialogue between experts in nutrition and experts in agriculture and natural resource sustainability and to explore current and emerging knowledge on the food and nutrition policy implications of the increasing environmental constraints on the food system. Experts explored the relationship between human health and the environment, including the identification and quantification of the synergies and trade-offs of their impact. This report explores the role of the food price environment and how environmental sustainability can be incorporated into dietary guidance and considers research priorities, policy implications, and drivers of consumer behaviors that will enable sustainable food choices.
156 pages
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6 x 9
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paperback
ISBN Paperback: 0-309-29667-6
ISBN Ebook: 0-309-29668-4
DOI:
https://doi.org/10.17226/18578
Institute of Medicine. 2014. Sustainable Diets: Food for Healthy People and a Healthy Planet: Workshop Summary. Washington, DC: The National Academies Press.
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Natural gas extraction from shale formations, which includes hydraulic fracturing, is increasingly in the news as the use of extraction technologies has expanded, rural communities have been transformed seemingly overnight, public awareness has increased, and regulations have been developed. The governmental public health system, which retains primary responsibility for health, was not an early participant in discussions about shale gas extraction; thus public health is lacking critical information about environmental health impacts of these technologies and is limited in its ability to address concerns raised by regulators at the federal and state levels, communities, and workers employed in the shale gas extraction industry.
Health Impact Assessment of Shale Gas Extraction is the summary of a workshop convened in 2012 by the Institute of Medicine (IOM) Roundtable on Environmental Health Sciences, Research, and Medicine to discuss the human health impact of shale gas extraction through the lens of a health impact assessment. Eminent scientists, physicians, public health experts, and representatives from government agencies at federal and state levels, from nongovernment organizations, from the business sector, and from interest groups representing the interests of the citizens met to exchange ideas and to inform on hydraulic fracturing as a means of extraction of natural gas. This report examines the state of the science regarding shale gas extraction, the direct and indirect environmental health impacts of shale gas extraction, and the use of health impact assessment as a tool that can help decision makers identify the public health consequences of shale gas extraction.
154 pages
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6 x 9
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paperback
ISBN Paperback: 0-309-28791-X
ISBN Ebook: 0-309-28792-8
DOI:
https://doi.org/10.17226/18376
Institute of Medicine. 2014. Health Impact Assessment of Shale Gas Extraction: Workshop Summary. Washington, DC: The National Academies Press.
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Leveraging Culture to Address Health Inequalities: Examples from Native Communities is the summary of a workshop convened in November 2012 by the Roundtable on the Promotion of Health Equity and the Elimination of Health Disparities of the Institute of Medicine. The workshop brought together more than 100 health care providers, policy makers, program administrators, researchers, and Native advocates to discuss the sizable health inequities affecting Native American, Alaska Native, First Nation, and Pacific Islander populations and the potential role of culture in helping to reduce those inequities. This report summarizes the presentations and discussion of the workshop and includes case studies that examine programs aimed at diabetes prevention and management and cancer prevention and treatment programs.
In Native American tradition, the medicine wheel encompasses four different components of health: physical, emotional, mental, and spiritual. Health and well-being require balance within and among all four components. Thus, whether someone remains healthy depends as much on what happens around that person as on what happens within. Leveraging Culture to Address Health Inequalities addresses the broad role of culture in contributing to and ameliorating health inequities.
106 pages
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6 x 9
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paperback
ISBN Paperback: 0-309-29256-5
ISBN Ebook: 0-309-29257-3
DOI:
https://doi.org/10.17226/18496
Institute of Medicine. 2013. Leveraging Culture to Address Health Inequalities: Examples from Native Communities: Workshop Summary. Washington, DC: The National Academies Press.
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Global Development Goals and Linkages to Health and Sustainability is the summary of a public three-part webinar series hosted by the Global Environmental Health and Sustainable Development Innovation Collaborative between October and December, 2012. Experts within the fields of environmental and global health and members of government, academia, and civil society discussed global development goals that will focus on sustainable development to inform the Rio+20 post-2015 development agenda framework, which will likely be adopted at the September 2015 UN General Assembly. This report focuses on possible health-related measures and metrics that can be utilized for creating new Sustainable Development Goals as the Millennium Development Goals sunset in 2015, using existing measurements that can be adapted to track progress of global sustainable development and human health.
94 pages
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6 x 9
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paperback
ISBN Paperback: 0-309-28864-9
ISBN Ebook: 0-309-28865-7
DOI:
https://doi.org/10.17226/18392
Institute of Medicine. 2014. Global Development Goals and Linkages to Health and Sustainability: Workshop Summary. Washington, DC: The National Academies Press.
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Organizational Change to Improve Health Literacy is the summary of a workshop convened in April 2013 by the Institute of Medicine Board on Population Health and Public Health Practice Roundtable on Health Literacy. As a follow up to the 2012 discussion paper Ten Attributes of a Health Literate Health Care Organization, participants met to examine what is known about implementation of the attributes of a health literate health care organization and to create a network of health literacy implementers who can share information about health literacy innovations and problem solving. This report discusses implementation approaches and shares tools that could be used in implementing specific literacy strategies.
Although health literacy is commonly defined as an individual trait, there is a growing appreciation that health literacy does not depend on the skills of individuals alone. Health literacy is the product of the interaction between individuals' capacities and the health literacy-related demands and complexities of the health care system. System changes are needed to better align health care demands with the public's skills and abilities. Organizational Change to Improve Health Literacy focuses on changes that could be made to achieve this goal.
124 pages
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6 x 9
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paperback
ISBN Paperback: 0-309-28805-3
ISBN Ebook: 0-309-28806-1
DOI:
https://doi.org/10.17226/18378
Institute of Medicine. 2013. Organizational Change to Improve Health Literacy: Workshop Summary. Washington, DC: The National Academies Press.
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SMART Vaccines—Strategic Multi-Attribute Ranking Tool for Vaccines—is a prioritization software tool developed by the Institute of Medicine that utilizes decision science and modeling to help inform choices among candidates for new vaccine development. A blueprint for this computer-based guide was presented in the 2012 report Ranking Vaccines: A Prioritization Framework: Phase I.
Ranking Vaccines: A Prioritization Software Tool,Phase II extends the proof-of-concept presented in the Phase I report, which was based on multi-attribute utility theory. This report refines a beta version of the model developed in the Phase I report and presents its next iteration, SMART Vaccines 1.0.
Ranking Vaccines: Phase II discusses the methods underlying the development, validation, and evaluation of SMART Vaccines 1.0. It also discusses how SMART Vaccines should—and, just as importantly, should not—be used. The report also offers ideas for future enhancements for SMART Vaccines as well as for ideas for expanded uses and considerations and possibilities for the future.
160 pages
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7 x 10
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paperback
ISBN Paperback: 0-309-26638-6
ISBN Ebook: 0-309-26639-4
DOI:
https://doi.org/10.17226/13531
Institute of Medicine. 2013. Ranking Vaccines: A Prioritization Software Tool: Phase II: Prototype of a Decision-Support System. Washington, DC: The National Academies Press.
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The Institute of Medicine (IOM) Committee on Quality Measures for the Healthy People Leading Health Indicators was charged by the Office of the Assistant Secretary for Health to identify measures of quality for the 12 Leading Health Indicator (LHI) topics and 26 Leading Health Indicators in Healthy People 2020 (HP2020), the current version of the Department of Health and Human Services (HHS) 10-year agenda for improving the nation's health.
The scope of work for this project is to use the nine aims for improvement of quality in public health (population-centered, equitable, proactive, health promoting, risk reducing, vigilant, transparent, effective, and efficient) as a framework to identify quality measures for the Healthy People Leading Health Indicators (LHIs). The committee reviewed existing literature on the 12 LHI topics and the 26 Leading Health Indicators. Quality measures for the LHIs that are aligned with the nine aims for improvement of quality in public health will be identified. When appropriate, alignments with the six Priority Areas for Improvement of Quality in Public Health will be noted in the Committee's report. Toward Quality Measures for Population Health and the Leading Health Indicators also address data reporting and analytical capacities that must be available to capture the measures and for demonstrating the value of the measures to improving population health.
Toward Quality Measures for Population Health and the Leading Health Indicators provides recommendations for how the measures can be used across sectors of the public health and health care systems. The six priority areas (also known as drivers) are population health metrics and information technology; evidence-based practices, research, and evaluation; systems thinking; sustainability and stewardship; policy; and workforce and education.
134 pages
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6 x 9
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paperback
ISBN Paperback: 0-309-28557-7
ISBN Ebook: 0-309-28558-5
DOI:
https://doi.org/10.17226/18339
Institute of Medicine. 2013. Toward Quality Measures for Population Health and the Leading Health Indicators. Washington, DC: The National Academies Press.
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