THIS IS NOT YOUR FATHERS HEALTHCARE SYSTEM By Douglas Ratner, M'D

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THIS IS NOT YOUR FATHERS HEALTHCARE SYSTEMBy
Douglas Ratner, M.D
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INTRODUCINGThe wealth from the health
programThe Environmental house call programThe
hospital without walls program
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Recommended Competencies for Environmental health
Practitioners

• Assessment
• Management
• Communication

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Assessment

• Information GatheringThe capacity to identify
  sources and compile relevant and appropriate
  information when needed.
• Data Analysis and InterpretationThe capacity to
  analyze data, recognize meaningful test results,
  interpret results, and present the results in an
  appropriate way to different type of audiences.
• Evaluation The capacity to evaluate the
  effectiveness or performance of procedures,
  interventions, and programs.

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Management

• Problem SolvingThe capacity to develop insight
  into and appropriate solutions to environmental
  health problems.
• Project Management The capacity to plan,
  implement and maintain fiscally responsible
  programs and projects using skills and prioritize
  projects across the employees entire workload.
• The capacity to use Computer and Information
  Technology
• The capacity to produce reports to document
  actions, keep records, and inform appropriate
  parties.

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Communication

• Educate public on environmental health issues.
• Communicate risk and exchange information with
  colleagues, clients, policy makers and media
  through public speaking, print and electronic
  media and interpersonal relations.
• Conflict resolution within the agency, in the
  community and with regulated parties.
• Marketing To convey the concepts, importance and
  value of environment and public health to clients
  and public.

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Environmental House Call Program

• Target Audience
• Environmental House Call kits.
• Environmental House Call Home visit.

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Target Audience

• Pulmonary and Allergy patients.
• Cancer prevention
• Neurological problems like chronic headaches.
• Cardiac conditions like angina exacerbations.
• Renal failure.
• Gastrointestinal problems such as nausea and
  constipation.
• General such as fatigue, myalgias and unexplained
  malaise.

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Environmental House Call Kits
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Allergen control kit

• Audio cassette.
• Ventpro TM-heating vent filter.
• Treated dust cloth.
• Vacu-filt TM-vacuum cleaner filter.
• Filtrete TM- air conditioner filter.
• Allergy Control pillow cover.
• Electronic carbon monoxide analyzer.
• Allergy Control product material with coupons.

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Indoor Pollutant Control Kit

• Audio Cassette.
• Electronic carbon monoxide detector.
• Lead-in-dust test kit.
• Lead-in-water test kit.
• Lead-in-paint analysis.
• Radon alpha track canister.
• Microwave leakage indicator.

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Safety Control Kit

• Cord windups (2).
• VCR lock.
• Auto swivel outlet cover.
• Dual outlet covers (6).
• Switch locks.
• Oven lock.
• Stove knob covers (4).
• Cabinet and drawer latches (7).
• Medicine cabinet latch.

• Cabinet slide lock.
• Bath pal (thermometer for measuring water temp.
• Small object tester.
• Comer protectors (4)
• Bottle of ipecac syrup.
• Electronic carbon monoxide analyzer.
• Child safety booklet.
• Fire safety booklet.

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Environmental House Call Home Visit Components.

• Comprehensive safety check.
• Lead and mercury in paint analysis.
• Lead in dust sampling.
• Lead, nitrates, and organics in drinking water
  analysis.
• Carbon monoxide, sulfur dioxide and nitrogen
  dioxide levels for furnaces and gas stoves.
• Ventilation assessment.
• Radon levels.

• Methyl chloroform levels from shower heads.
• Asbestos friability and analysis.
• Electromagnetic radiation measurement.
• Mold spore evaluations in carpets and behind
  walls.
• Relative temperature and moisture levels.
• Environmental house call program video/tape/CD

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Environmental House Call Options
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Module 1

• Comprehensive Safety Hazard Check.
• Comprehensive Indoor Environmental Pollutant
  Check.
• Environmental House Call Manual
• Comprehensive computerized safety check report
  and solutions.
• Comprehensive environmental pollutant check
  report and solutions.
• General information on indoor pollutants and
  health effects.
• Wealth from health and general preventive
  medicine information section.
• Latest articles and research in these areas.
• Information on Overlook hospital, home care, and
  Managed Care.
• Environmental Symptoms Survey Questionnaire and
  analysis.
• Product Catalog (Allergy Control Products, etc.)
  at reduced prices.

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Module II

• For Pulmonary and Allergic patients only.
• It includes
• All components for Module 1 except for Heavy
  Metal analyses such as lead, etc.
• Environmental House Call

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Module III

• Cancer Prevention and other systems other than
  pulmonary and allergic patients.
• It includes.
• All components for Module I except for Dust
  mites, mold spore evaluations, etc

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Institute for Healthcare Innovation
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Hospital without walls Training center

• Self Management of chronic diseases
• Deploy remote medical monitoring and tele health
  for chronic disease sufferers.
• Develop cost-efficient monitoring for the
  uninsured and underinsured population.
• Create a training center to teach hospital
  systems to create hub for these activities in
  their catchments areas.

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Environmental house call Training center

• Decreasing health risk from indoor and outdoor
  Environmental exposures
• Identification of environmental causes of
  childhood and chronic diseases.
• To evaluate the effectiveness of environmental
  programs with special emphasis on lead, carbon
  monoxide poisoning, asthma, and cancer.
• Assess the knowledge of home inspectors, homecare
  nursing and other health care professionals.
• Develop community based approach to maximize
  detection and remediation of indoor pollutants.
• Enlist support of state representatives and
  public health officials.
• Partner with CDC and HUDs Healthy Housing
  initiatives.

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Wealth from HealthTraining Center

• Enact an Innovative, Proven, Credit- Driven
  Incentive based
• Behavioral Modification System to
• Improve prevention and self-management of ones
  chronic diseases.
• Involve community retailers, employers, and
  government officials in further enhancing such a
  system.

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National Healthy Homes Training Center and Network
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Background

• Many environmental public health and housing
  practitioners lack the requisite training and
  tools to identify and respond to residential
  environmental health hazards.
• To build Capacity and Competency among
  practitioners and to promote cross-disciplinary
  activities, the US Center for Disease Control
  funded the National Center for Healthy Housing
  (NCHH) to develop a
• National Healthy Homes Training Center and
  Network.

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In the first year CDC funding will enable NCHH to

• Design curriculum and course content to fulfill
  core competencies in classroom settings as well
  as through distance learning/e-learning.
• Conduct at least on pilot training session.
• Prepare existing academic partners to serve as
  pilot site and potential expansion sites.

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Goals

• Provide training for public health practitioners
  in the assessment and treatment of housing
  related health hazards.
• Promote cross training of public health and
  housing practitioners.
• Create a forum for the exchange of practical
  guidance about healthy housing strategies among
  federal, state, tribal and local agency staff.
• Develop a mechanism for the ongoing introduction
  of new research findings into public health
  training and practice.
• Identify and optimize opportunities for
  networking, collaboration and partnership.

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Classification

• Noise
• lt 40 dBa- comfortable
• Asphyxiates
• Nitric oxide, Nitrous oxide, Nitrogen and Carbon
  Monoxide.
• Systemic Toxicant
• Lead, Arsenic, Mercury and Chlorinated
  hydrocarbons.
• Carcinogens
• Radon, Asbestos, Cigarette smoke and
  Hydrocarbons.
• Reproductive Toxicants
• Lead, Benzene and PCBs

• Irritants
• Sulfur dioxide, Nitrogen dioxide, Ozone, soaps,
  Bleach, Detergents, Pesticides etc
• Narcotics and Anesthetics
• Acetone, Ethanol, Methanol, Toluene etc.
• Allergens
• Viruses, Bacteria and Fungi..
• Pulmonary Toxicants.
• Sulfur dioxide, Ozone and Allergens e.g
  Molds/Mites.

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