VP70 Structuring The Process Of Innovation Uptake In Tunisia

2017 ◽  
Vol 33 (S1) ◽  
pp. 181-182
Author(s):  
Mouna Jameleddine ◽  
Asma Ben Brahem ◽  
Hela Grati ◽  
Hella Ouertatani ◽  
Wafa Allouche ◽  
...  
Keyword(s):  
Decision Making ◽  
Clinical Practice ◽  
Healthcare System ◽  
Medical Devices ◽  
Public Procurement ◽  
Flow Chart ◽  
Hospital Level ◽  
Specific Flow ◽  
Health Technologies ◽  
The Impact

INTRODUCTION:Tunisia recently implemented a Health Technology Assessment (HTA) agency (INASanté) to inform decisions around health technologies and to improve clinical practice by means of the elaboration of Clinical Practice Guidelines (CPG). However many decisions on new and emerging technologies, their implementation and coverage in the health care system are still taken at the hospital level without any structured process that informs the decisions. The aim of this project was to improve the methods and flow-chart of decision-making processes on innovation uptake in the Tunisia Healthcare System.METHODS:By means of the toolkit of EuroScan for the implementation of an early awareness and alert system (EAAS), and its checklist, it was discussed specifically within INASanté the characteristics of the Tunisia Healthcare System and its specificities regarding decisions on drugs and medical devices. The analysis included the process of innovation uptake at the hospital level and its specific flow-chart. In depth interviews and a devoted workshop were performed with personal in INASanté: two physicians (one involved in CPG elaboration and the second in accreditation), three pharmacists (HTA), one nutritionist (HTA), two librarians and other stakeholders, including the Directorate of Hospitals.RESULTS:The uptake of innovations in Tunisia does not follow a structured process. In fact, there is no central purchase of medical devices in Tunisia and most medical devices are purchased by hospitals within a tender process in accordance with the Tunisian public procurement law. The main pitfalls are: lack of awareness around innovations that could impact the system, non-structured process of information sharing among the different decision-makers that promotes inequity in access to technologies and services, and lack of explicit criteria that determine decisions around health technologies.CONCLUSIONS:Tunisia requires a structured and informed process on decisions around innovation uptake in the healthcare system. The principles that should govern this system are: anticipation of the impact of new health technologies, establishing priorities and criteria for decision making in all places of decision. The decisions should be recorded and publicly shared to avoid inequities in the access to technologies.

The end of the laboratory developed test as we know it? Recommendations from a national multidisciplinary taskforce of laboratory specialists on the interpretation of the IVDR and its complications

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Paul C. D. Bank ◽  
Leo H. J. Jacobs ◽  
Sjoerd A. A. van den Berg ◽  
Hanneke W. M. van Deutekom ◽  
Dörte Hamann ◽  
...  
Keyword(s):  
Clinical Practice ◽  
The Netherlands ◽  
Medical Devices ◽  
Task Force ◽  
Large Impact ◽  
Guidance Document ◽  
Scientific Societies ◽  
Clinical Laboratories ◽  
The Impact

AbstractThe in vitro diagnostic medical devices regulation (IVDR) will take effect in May 2022. This regulation has a large impact on both the manufacturers of in vitro diagnostic medical devices (IVD) and clinical laboratories. For clinical laboratories, the IVDR poses restrictions on the use of laboratory developed tests (LDTs). To provide a uniform interpretation of the IVDR for colleagues in clinical practice, the IVDR Task Force was created by the scientific societies of laboratory specialties in the Netherlands. A guidance document with explanations and interpretations of relevant passages of the IVDR was drafted to help laboratories prepare for the impact of this new legislation. Feedback from interested parties and stakeholders was collected and used to further improve the document. Here we would like to present our approach to our European colleagues and inform them about the impact of the IVDR and, importantly we would like to present potentially useful approaches to fulfill the requirements of the IVDR for LDTs.

The impact on clinical practice of the 2015 reforms to the New South Wales Mental Health Act

2016 ◽  
Vol 25 (1) ◽  
pp. 43-47 ◽  
Author(s):  
Christopher James Ryan ◽  
Sascha Callaghan
Keyword(s):  
Mental Health ◽  
Decision Making ◽  
Clinical Practice ◽  
Persons With Disabilities ◽  
Mental Health Act ◽  
Recovery Movement ◽  
South Wales ◽  
Management Plans ◽  
Decision Making Model ◽  
The Impact

Objectives: The Mental Health Act 2007 (NSW) ( MHA) was recently reformed in light of the recovery movement and the United Nations Convention on the Rights of Persons with Disabilities. We analyse the changes and describe the impact that these reforms should have upon clinical practice. Conclusions: The principles of care and treatment added to the MHA place a strong onus on clinicians to monitor patients’ decision-making capacity, institute a supported decision-making model and obtain consent to any treatment proposed. Patients competently refusing treatment should only be subject to involuntary treatment in extraordinary circumstances. Even when patients incompetently refuse treatment, clinicians must make every effort reasonably practicable to tailor management plans to take account of any views and preferences expressed by them or made known via friends, family or advance statements.

The politics of bounded procurement: Purists, brokers and the politics-procurement dichotomy

2014 ◽  
Vol 14 (1) ◽  
pp. 33-61 ◽  
Author(s):  
Alexandru V. Roman
Keyword(s):  
Decision Making ◽  
Public Procurement ◽  
The Body ◽  
The Political ◽  
Original Research ◽  
Complex Environments ◽  
Structured Interviews ◽  
The Future ◽  
Environmental Instability ◽  
The Impact

The last two decades have witnessed a tremendous growth in the body of literature addressing the importance and the impact of contracting and public procurement within the context of devolution of government. The austere budgetary and financial outlooks of the future suggest that the significance of the area will only continue to grow. As such, generating explanatory frameworks, within dimensions such as decisionmaking and accountability in public procurement, becomes crucial. Drawing from original research this article suggests one possible frame for understanding administrative decision-making in complex environments. Based on semi-structured interviews with public procurement specialists, the study identifies two decision-making patterns− broker and purist. It is asserted that the decision-making dynamics exhibited by administrators are contingent on their perceptions regarding environmental instability, in particular the political volatility surrounding their work.

scholarly journals PHP40 THE IMPACT ON DECISION-MAKING OF CHANGING COST-EFFECTIVENESS OF HEALTH TECHNOLOGIES OVERTIME

2005 ◽  
Vol 8 (6) ◽  
pp. A193
Author(s):  
F Pang ◽  
K Toiley
Keyword(s):  
Decision Making ◽  
Cost Effectiveness ◽  
Health Technologies ◽  
The Impact

The impact and influence of hope and hype in decision-making about health technologies

2015 ◽  
Vol 28 (5) ◽  
pp. 218-220 ◽  
Author(s):  
Christy Simpson
Keyword(s):  
Decision Making ◽  
Health Technologies ◽  
The Impact

INTRODUCTION OF INNOVATIVE MEDICAL DEVICES AT FRENCH UNIVERSITY HOSPITALS: AN OVERVIEW OF HOSPITAL-BASED HEALTH TECHNOLOGY ASSESSMENT INITIATIVES

2015 ◽  
Vol 31 (1-2) ◽  
pp. 12-18 ◽  
Author(s):  
Nicolas Martelli ◽  
Mathilde Billaux ◽  
Isabelle Borget ◽  
Judith Pineau ◽  
Patrice Prognon ◽  
...  
Keyword(s):  
Decision Making ◽  
Health Technology Assessment ◽  
Medical Device ◽  
Medical Devices ◽  
Technology Assessment ◽  
Health Technology ◽  
Local Health ◽  
University Hospitals ◽  
Health Technologies ◽  
Management Processes

Objectives: Local health technology assessment (HTA) to determine whether new health technologies should be adopted is now a common practice in many healthcare organizations worldwide. However, little is known about hospital-based HTA activities in France. The objective of this study was to explore hospital-based HTA activities in French university hospitals and to provide a picture of organizational approaches to the assessment of new and innovative medical devices.Methods: Eighteen semi-structured interviews with hospital pharmacists were conducted from October 2012 to April 2013. Six topics were discussed in depth: (i) the nature of the institution concerned; (ii) activities relating to innovative medical devices; (iii) the technology assessment and decision-making process; (iv) the methodology for technology assessment; (v) factors likely to influence decisions and (vi) suggestions for improving the current process. The interview data were coded, collated and analyzed statistically.Results: Three major types of hospital-based HTA processes were identified: medical device committees, innovation committees, and “pharmacy & management” processes. HTA units had been set up to support medical device and innovation committees for technology assessment. Slow decision making was the main limitation to both these committee-based approaches. As an alternative, “pharmacy & management” processes emerged as a means of rapidly obtaining a formal assessment.Conclusions: This study provides an overview of hospital-based HTA initiatives in France. We hope that it will help to promote hospital-based HTA activities in France and discussions about ways to improve and harmonize practices, through the development of national guidelines and/or a French mini-HTA tool, for example.

Mobile Health App for Chronic Wound Management (Preprint)

2021 ◽  
Author(s):  
David Reifs ◽  
Ramon Reig Bolaño ◽  
Francesc Garcia Cuyas ◽  
Marta Casals Zorita ◽  
Sergi Grau Carrion
Keyword(s):  
Artificial Intelligence ◽  
Decision Making ◽  
Clinical Practice ◽  
Chronic Wound ◽  
Mobile App ◽  
Assessment System ◽  
Management Tool ◽  
Cloud Platform ◽  
Wound Assessment ◽  
The Impact

BACKGROUND Chronic ulcers, and especially ulcers affecting the lower extremities and their protracted evolution, are a health problem with significant socio-economic repercussions. The patient's quality of life often deteriorates, leading to serious personal problems for the patient and, in turn, major care challenges for healthcare professionals. Our study proposes a new approach for assisting wound assessment and criticality with an integrated framework based on a Mobile App and a Cloud platform, supporting the practitioner and optimising organisational processes. This framework, called Clinicgram, uses a decision-making support method, such as morphological analysis of wounds and artificial intelligence algorithms for feature classification and a system for matching similar cases via an easily accessible and user-friendly mobile app, and assesses the clinician to choose the best treatment. OBJECTIVE The main objective of this work is to evaluate the impact of the incorporation of Clinicgram, a mobile App and a Cloud platform with Artificial Intelligence algorithms to help the clinician as a decision support system to assess and evaluate correct treatments. Second objective evaluates how the professional can benefit from this technology into the real clinical practice, how it impacts patient care and how the organisation’s resources can be optimised. METHODS Clinicgram application and framework is a non-radiological clinical imaging management tool that is incorporated into clinical practice. The tool will also enable the execution of the different algorithms intended for assessment in this study. With the use of computer vision and supervised learning techniques, different algorithms are implemented to simplify a practitioner's task of assessment and anomaly spotting in clinical cases. Determining the area of interest of the case automatically and using it to assess different wound characteristics such as area calculation and tissue classification, and detecting different signs of infection. An observational and an objective study have been carried out that will allow obtaining clear indicators of the level of usability in clinical practice. RESULTS A total of 2,750 wound pictures were taken by 10 nurses for analysis during the study from January 2018 to November 2021. Objective results have been obtained from the use and management of the application, important feedback from professionals with a score of 5.55 out of 7 according to the mHealth App Usability Questionnaire. It has also been possible to collect the most present type of wound according to Resvech 2.0 of between 6 and 16 points of severity, and highlight the collection of images of between 0 and 16 cm2 of area 88%, with involvement of subcutaneous tissue 53.21%, with the presence of granulated tissue 59.16% and necrotic 30.29% and with a wet wound bed 61.54%. The usage of app to upload samples increase from 31 to 110 samples per month from 2018 to 2021. CONCLUSIONS Our real-world assessment demonstrates the effectiveness and reliability of the wound assessment system, increasing professional efficiency, reducing data collection time during the visit and optimising costs-effectivity in the healthcare organisation by reducing treatment variability. Also, the comfort of the professional and patient. Incorporating a tool such as Clinicgram into the chronic wound assessment and monitoring process adds value, reduction of errors and improves both the clinical practice process time, while also improving decision-making by the professional and consequently having a positive impact on the patient's wound healing process.

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