Survey on Acceptance of Passive Technology Monitoring for Early Detection of Cognitive Impairment

Introduction: Digital biomarkers may act as a tool for early detection of changes in cognition. It is important to understand public perception of technologies focused on monitoring cognition to better guide the design of these tools and inform patients appropriately about the associated risks and benefits. Health care systems may also play a role in the clinical, legal, and financial implications of such technologies. Objective: To evaluate public opinion on the use of passive technology for monitoring cognition. Methods: This was a one-time, Internet-based survey conducted in English and Spanish. Results: Within the English survey distributed in the USA (n = 173), 58.1% of respondents would be highly likely to agree to passive monitoring of cognition via a smartphone application. Thirty-eight percent of those with a higher degree of experience with technology were likely to agree to monitoring versus 20% of those with less experience with technology (p = 0.003). Sixty-two percent of non-health-care professionals were likely to agree to monitoring versus 45% of health-care workers (p = 0.012). There were significant concerns regarding privacy (p < 0.01). We compared the surveys answered in Spanish in Costa Rica via logistic regression (n = 43, total n = 216), adjusting for age, education level, health-care profession, owning a smartphone, experience with technology, and perception of cognitive decline. Costa Rican/Spanish-speaking respondents were 7 times more likely to select a high probability of agreeing to such a technology (p < 0.01). English-speaking respondents from the USA were 5 times more likely to be concerned about the impact on health insurance (p = 0.001) and life insurance (p = 0.01). Conclusions: Understanding public perception and ethical implications should guide the design of digital biomarkers for cognition. Privacy and the health-care system in which the participants take part are 2 major factors to be considered. It is the responsibility of researchers to convey the ethical and legal implications of cognition monitoring.

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Case-management for nursing care of patient with stroke: a cross-cultural critical reflective analysis

Health & Research Journal ◽

10.12681/healthresj.19703 ◽

2016 ◽

Vol 2 (3) ◽

pp. 178

Author(s):

Dimitrios Theofanidis

Keyword(s):

Health Care ◽

Case Management ◽

Health Care Professionals ◽

Health Care Systems ◽

Financial Burden ◽

Quality Care ◽

Stroke Care ◽

Discussion Paper ◽

Health Care Reforms ◽

The Usa

Introduction: Stroke remains a heavy financial burden on health care systems around the world. Yet, health care reforms have called for sophisticated management systems in order to provide high-quality care on equal terms for the entire population within a cost-conscious environment. Aim: The main aim of this discussion paper is to define and reflect cross-culturally on the merits of the Case-Management (CM) approach for contemporary stroke care delivery.Methods: Critical reflective analysis was used for this paper’s needs, whereby readers are gradually introduced to skills of critical and reflective thinking. This can then be applied into a clinical context which may assist nurses to achieve a better understanding of their professional role within the complexities of contemporary health care delivery.Discussion: An overview for stroke care differences between Greece and USA is provided using the following critical analysis components: Situation, Experience evaluated, Personal Reflections and Opportunities for Change.Conclusions: CM in the USA aims to meet the urgent challenges of stroke care. CMs are health care professionals whose role is to serve as client advocates and to coordinate services whilst assuring financial and gate keeping functions as required. As these services are currently unavailable in Greece, despite adverse financial circumstances, efforts should be made to introduce a culturally adopted CM initiative for stroke care.

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The Corporatization of Health Care: An Evaluation and An Alternative

Health Services Management Research ◽

10.1177/095148489600900205 ◽

1996 ◽

Vol 9 (2) ◽

pp. 107-114 ◽

Cited By ~ 8

Author(s):

K. Jacobs ◽

V. Nilakant

Keyword(s):

Health Care ◽

Decision Making ◽

Health Care Organizations ◽

Health Care Systems ◽

Work Organization ◽

Corporate Form ◽

Care Systems ◽

The Usa ◽

The Impact ◽

Medical Task

The corporatization of health care organizations has become a significant international trend. This paper examines that trend, comparing the development of corporate health care in the USA with the impact of the New Zealand health reforms. The paper traces the evolution of the organizations of health care systems and explains the emergence of the corporate form. We argue that the corporate model of work organization is unsuited to the complex and ambiguous nature of the medical task as it ignores inherent interdependencies. An alternative is needed which addresses work practices rather than just participation in decision making and is based on a concept of mutual interdependence and support in the execution of work.

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Development and Impact of Helping Babies Breathe Educational Methodology

PEDIATRICS ◽

10.1542/peds.2020-016915e ◽

2020 ◽

Vol 146 (Supplement_2) ◽

pp. S123-S133 ◽

Cited By ~ 1

Author(s):

Nalini Singhal ◽

Douglas D. McMillan ◽

Renate Savich ◽

Dismas Matovelo ◽

Data Santorino ◽

...

Keyword(s):

Health Care ◽

Learning Strategies ◽

Health Care Professionals ◽

Educational Program ◽

Health Care Systems ◽

Group Discussion ◽

Neonatal Resuscitation ◽

Educational Materials ◽

Helping Babies Breathe ◽

The Impact

The educational pedagogy surrounding Helping Babies Breathe (HBB) has been transformative in going beyond a curriculum focused only on basic neonatal resuscitation; indeed, it created the framework for an educational program that has served as a model for replication for other impactful programs, such as the Helping Mothers Survive and other Helping Babies Survive curricula. The tenets of HBB include incorporation of innovative learning strategies such as small group discussion, skills-based learning, simulation and debriefing, and peer-to-peer learning, all of which begin the hard work of changing behaviors that may eventually affect health care systems. Allowing for adaptation for local resources and culture, HBB has catalyzed innovation in the development of simplified, pictorial educational materials, in addition to low-tech yet realistic simulators and adjunct devices that have played an important role in empowering health care professionals in their care of newborns, thereby improving outcomes. In this review, we describe the development of HBB as an educational program, the importance of field testing and input from multiple stakeholders including frontline workers, the strategies behind the components of educational materials, and the impact of its pedagogy on learning.

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Implementation of a Digitally Enabled Care Pathway (Part 2): Qualitative Analysis of Experiences of Health Care Professionals

Journal of Medical Internet Research ◽

10.2196/13143 ◽

2019 ◽

Vol 21 (7) ◽

pp. e13143 ◽

Cited By ~ 4

Author(s):

Alistair Connell ◽

Georgia Black ◽

Hugh Montgomery ◽

Peter Martin ◽

Claire Nightingale ◽

...

Keyword(s):

Health Care ◽

At Risk ◽

Early Detection ◽

Real Time ◽

Health Care Professionals ◽

Care Pathway ◽

Digital Technologies ◽

Response Team ◽

Working Practices ◽

The Impact

Background One reason for the introduction of digital technologies into health care has been to try to improve safety and patient outcomes by providing real-time access to patient data and enhancing communication among health care professionals. However, the adoption of such technologies into clinical pathways has been less examined, and the impacts on users and the broader health system are poorly understood. We sought to address this by studying the impacts of introducing a digitally enabled care pathway for patients with acute kidney injury (AKI) at a tertiary referral hospital in the United Kingdom. A dedicated clinical response team—comprising existing nephrology and patient-at-risk and resuscitation teams—received AKI alerts in real time via Streams, a mobile app. Here, we present a qualitative evaluation of the experiences of users and other health care professionals whose work was affected by the implementation of the care pathway. Objective The aim of this study was to qualitatively evaluate the impact of mobile results viewing and automated alerting as part of a digitally enabled care pathway on the working practices of users and their interprofessional relationships. Methods A total of 19 semistructured interviews were conducted with members of the AKI response team and clinicians with whom they interacted across the hospital. Interviews were analyzed using inductive and deductive thematic analysis. Results The digitally enabled care pathway improved access to patient information and expedited early specialist care. Opportunities were identified for more constructive planning of end-of-life care due to the earlier detection and alerting of deterioration. However, the shift toward early detection also highlighted resource constraints and some clinical uncertainty about the value of intervening at this stage. The real-time availability of information altered communication flows within and between clinical teams and across professional groups. Conclusions Digital technologies allow early detection of adverse events and of patients at risk of deterioration, with the potential to improve outcomes. They may also increase the efficiency of health care professionals’ working practices. However, when planning and implementing digital information innovations in health care, the following factors should also be considered: the provision of clinical training to effectively manage early detection, resources to cope with additional workload, support to manage perceived information overload, and the optimization of algorithms to minimize unnecessary alerts.

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Prioritization Preferences among General Practitioners in Hungary

East European Politics and Societies and Cultures ◽

10.1177/0888325410390207 ◽

2011 ◽

Vol 26 (1) ◽

pp. 20-32 ◽

Cited By ~ 1

Author(s):

László Gulácsi ◽

Ottó Hajdú

Keyword(s):

Health Care ◽

General Practitioners ◽

Health Care Professionals ◽

Health Care Systems ◽

Health Benefit ◽

Cost Utility ◽

Qaly Gain ◽

Actual Distribution ◽

Distributional Preferences ◽

The Impact

Cost-utility analyses use the quality-adjusted life-year (QALY) as a measure of health benefit. Normally, they treat every QALY gain equally, that is, attach the same weight (or value) to each QALY gained. However, it appears that this practice does not reflect the distributional preferences of the general public nor of health care professionals. Maximizing the QALY gain from a given budget is not the only aim in priority setting. This article presents a study into such distributional preferences of general practitioners (GPs) for prioritization at the patient level in Hungary. Given the special position GPs have in many health care systems, including the Hungarian, more knowledge of their preferences is important. The authors used a discrete choice experiment to study these preferences, focusing on factors related to the characteristics of the patients, the disease, and treatment effects. Results show that the most important factors influencing the GPs’ decision were the age of the patient, the mortality of the disease, the impact of the disease on patients’ quality of life, and the potential for the full restoration of the previous health status. The treatment of patients without comorbidities was preferred to that of patients with comorbidities. Importantly, these preferences in GPs may steer the actual distribution of health care.

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Access to Experimental Therapies and AIDS

Dialogue ◽

10.1017/s0012217300011744 ◽

1991 ◽

Vol 30 (3) ◽

pp. 399-418 ◽

Cited By ~ 2

Author(s):

John Russell

Keyword(s):

Health Care ◽

Health Care Professionals ◽

Health Care Systems ◽

Terminally Ill ◽

Public Health Care ◽

The Political ◽

Medical Patients ◽

The Public ◽

Experimental Therapies ◽

The Impact

For a variety of reasons, the AIDS epidemic is forcing a thorough reassessment of many of the standards by which the terminally ill and other medical patients are treated by health-care systems throughout the world. This has generally been a good thing. It has provided needed motivation for public policy-makers to take seriously a range of health-care issues that have often been downplayed, ignored, or debated with vigour only within the relatively mute pages of the academic journals of health-care professionals, philosophers, law professors and others. Issues such as euthanasia, testing for dangerous communicable diseases, palliative care, and even important general questions about the distribution and availability of health-care resources have been pushed toward the front of the public health-care agenda largely because of the impact of AIDS. And it is fair to say that these matters are often being addressed with an urgency and sensitivity that would be absent without the political impetus that was unleashed along with this disease. One of the most controversial issues that has arisen concerns access to experimental therapies by the terminally ill. As is the case in other areas, the political forces generated by the AIDS tragedy have created an opportunity for productive review of policies and practices that undoubtedly deserve scrutiny and reform. However, my aim in this paper is to urge caution on some of the advocates of reform. I will argue that many recent proposals to enhance access to experimental therapies by the terminally ill rest on philosophically unsupportable grounds and pose an unjustifiable threat to the public interest in finding safe and effective therapies for terminal illnesses.

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An analysis of seriousness, predictability and preventability of adverse drug reactions reported at a tertiary care teaching hospital in Kerala, India: a retrospective observational record based study

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20184861 ◽

2018 ◽

Vol 7 (12) ◽

pp. 2433

Author(s):

Jihana Shajahan ◽

Abdul Aslam Parathoduvil ◽

Sangeetha Purushothaman

Keyword(s):

Health Care ◽

Adverse Drug Reactions ◽

Health Care Professionals ◽

Health Care Systems ◽

Tertiary Care ◽

Drug Reactions ◽

Mortality And Morbidity ◽

Monitoring Centre ◽

Care Systems ◽

The Impact

Background: Adverse drug reactions (ADR) are the leading cause of mortality and morbidity in all health care systems. Hospital based ADR monitoring and reporting programmes can throw some light upon the profile of ADRs and ways to prevent them, facilitating rational drug use. An attempt has been made in this study to analyse the seriousness, predictability, preventability, severity and outcome of ADRs occurring in a tertiary care hospital.Methods: This was a retrospective observational study based on the data collected from ADRs reported to an approved ADR monitoring centre (AMC). Data collected was evaluated for seriousness, predictability, preventability, severity and outcome using appropriate scales. Simple descriptive statistics was used for analysis.Results: The total number of ADRs reported was 300. Among this 39% reactions were serious. The commonest reason for considering as serious reaction was prolongation of hospitalization. The overall predictability was 40.4%. Total preventability was found to be 18.3%. Assessment of severity showed 55.3 %, 41.7%, 3% reactions in mild, moderate and severe grades respectively. 64.3% patients had recovered from the reaction and 30% were recovering at the time of reporting ADR. Only 0.3% ADRs caused death.Conclusions: Authors hope this study will foster the culture of reporting and analysing ADRs among health care professionals and students. The findings from the study can create awareness among health care professionals regarding the impact of ADRs on the treatment course.

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The Impact and Implications of The COVID-19 Pandemic on Organ Procurement Outside of an Epicenter

Progress in Transplantation ◽

10.1177/15269248211002808 ◽

2021 ◽

pp. 152692482110028

Author(s):

Janice Jene Hudgins ◽

Allison Jo Boyer ◽

Kristen Danielle Orr ◽

Clint Allen Hostetler ◽

Jeffrey Paul Orlowski ◽

...

Keyword(s):

Health Care ◽

Initial Phase ◽

Organ Procurement ◽

Health Care Systems ◽

Health Data ◽

Organ Procurement Organization ◽

Care Systems ◽

The Impact ◽

Variable Impact ◽

Single Organ

The COVID-19 pandemic has been well-documented to have a variable impact on individual communities and health care systems. We describe the experience of a single organ procurement organization (OPO), located in an area without a large cluster of cases during the initial phase of the COVID-19 pandemic. A review of community health data describing the impact of COVID-19 nationally and in Oklahoma was conducted. Additionally, a retrospective review of available OPO data from March 2019-May 2020 was performed. While the amount of donor referrals received and organs recovered by the OPO remained stable in the initial months of the pandemic, the observed organs transplanted vs. expected organs transplanted (O:E) decreased to the lowest number in the 15-month period and organs transplanted decreased as well. Fewer organs from Oklahoma donors were accepted for transplant despite staff spending more time allocating organs.

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Building capacity for implementation—the KT Challenge

Implementation Science Communications ◽

10.1186/s43058-021-00186-x ◽

2021 ◽

Vol 2 (1) ◽

Author(s):

Agnes T. Black ◽

Marla Steinberg ◽

Amanda E. Chisholm ◽

Kristi Coldwell ◽

Alison M. Hoens ◽

...

Keyword(s):

Health Care ◽

Patient Care ◽

Health Care Professionals ◽

Qualitative Data ◽

Practice Change ◽

Evidence Based ◽

Science Literature ◽

Health Care Settings ◽

Improvement Programs ◽

The Impact

Abstract Background The KT Challenge program supports health care professionals to effectively implement evidence-based practices. Unlike other knowledge translation (KT) programs, this program is grounded in capacity building, focuses on health care professionals (HCPs), and uses a multi-component intervention. This study presents the evaluation of the KT Challenge program to assess the impact on uptake, KT capacity, and practice change. Methods The evaluation used a mixed-methods retrospective pre-post design involving surveys and review of documents such as teams’ final reports. Online surveys collecting both quantitative and qualitative data were deployed at four time points (after both workshops, 6 months into implementation, and at the end of the 2-year funded projects) to measure KT capacity (knowledge, skills, and confidence) and impact on practice change. Qualitative data was analyzed using a general inductive approach and quantitative data was analyzed using non-parametric statistics. Results Participants reported statistically significant increases in knowledge and confidence across both workshops, at the 6-month mark of their projects, and at the end of their projects. In addition, at the 6-month check-in, practitioners reported statistically significant improvements in their ability to implement practice changes. In the first cohort of the program, of the teams who were able to complete their projects, half were able to show demonstrable practice changes. Conclusions The KT Challenge was successful in improving the capacity of HCPs to implement evidence-based practice changes and has begun to show demonstrable improvements in a number of practice areas. The program is relevant to a variety of HCPs working in diverse practice settings and is relatively inexpensive to implement. Like all practice improvement programs in health care settings, a number of challenges emerged stemming from the high turnover of staff and the limited capacity of some practitioners to take on anything beyond direct patient care. Efforts to address these challenges have been added to subsequent cohorts of the program and ongoing evaluation will examine if they are successful. The KT Challenge program has continued to garner great interest among practitioners, even in the midst of dealing with the COVID-19 pandemic, and shows promise for organizations looking for better ways to mobilize knowledge to improve patient care and empower staff. This study contributes to the implementation science literature by providing a description and evaluation of a new model for embedding KT practice skills in health care settings.

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Sustainability of Biosimilars in Europe: A Delphi Panel Consensus with Systematic Literature Review

Pharmaceuticals ◽

10.3390/ph13110400 ◽

2020 ◽

Vol 13 (11) ◽

pp. 400

Author(s):

Arnold G. Vulto ◽

Jackie Vanderpuye-Orgle ◽

Martin van der Graaff ◽

Steven R. A. Simoens ◽

Lorenzo Dagna ◽

...

Keyword(s):

Health Care ◽

Literature Review ◽

Systematic Literature Review ◽

Health Care Systems ◽

Delphi Panel ◽

The European Union ◽

Modified Delphi ◽

Care Systems ◽

Supply Risks ◽

The Impact

Introduction: Biosimilars have the potential to enhance the sustainability of evolving health care systems. A sustainable biosimilars market requires all stakeholders to balance competition and supply chain security. However, there is significant variation in the policies for pricing, procurement, and use of biosimilars in the European Union. A modified Delphi process was conducted to achieve expert consensus on biosimilar market sustainability in Europe. Methods: The priorities of 11 stakeholders were explored in three stages: a brainstorming stage supported by a systematic literature review (SLR) and key materials identified by the participants; development and review of statements derived during brainstorming; and a facilitated roundtable discussion. Results: Participants argued that a sustainable biosimilar market must deliver tangible and transparent benefits to the health care system, while meeting the needs of all stakeholders. Key drivers of biosimilar market sustainability included: (i) competition is more effective than regulation; (ii) there should be incentives to ensure industry investment in biosimilar development and innovation; (iii) procurement processes must avoid monopolies and minimize market disruption; and (iv) principles for procurement should be defined by all stakeholders. However, findings from the SLR were limited, with significant gaps on the impact of different tender models on supply risks, savings, and sustainability. Conclusions: A sustainable biosimilar market means that all stakeholders benefit from appropriate and reliable access to biological therapies. Failure to care for biosimilar market sustainability may impoverish biosimilar development and offerings, eventually leading to increased cost for health care systems and patients, with fewer resources for innovation.

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