Purchasing for Safety: A Human Factors-Influenced Procedure for Evaluating Medical Products

2017 ◽  
Vol 6 (1) ◽  
pp. 118-124 ◽  
Author(s):  
Helen J. A. Fuller ◽  
Nancy J. Lightner ◽  
Kyle D. Maddox ◽  
Hasan Shanawani ◽  
Tandi Bagian ◽  
...  
Keyword(s):  
Health Care ◽  
Patient Safety ◽  
Health Care Providers ◽  
The United States ◽  
Health Administration ◽  
Care Providers ◽  
Purchasing Decisions ◽  
Medical Products ◽  
Safety Concerns ◽  
Technical Requirements

Safety reports related to products and devices used in health care have demonstrated that not all items can be considered equal in terms of usability, compatibility, and functionality, which can result in patient safety concerns. Hospital systems use a wide variety of products when providing care to patients. This variability may contribute to purchasers failing to fully understand and define the needs for these products. In addition, it is necessary to define what a high-quality product is, including what minimal technical requirements it must meet. The Veteran’s Health Administration (VHA) is the largest health care system in the United States; as such, it possesses the ability to learn from a large group of health care providers as well as a great deal of purchasing power. Purchasing for Safety is a procedure for investigating medical devices or products with an end goal of improving the purchasing decision. Purchasing for Safety can help hospitals and health care systems to systematically evaluate medical products and devices for issues that may lead to patient safety concerns. By conducting careful testing and documenting methods and findings, the test team can assist stakeholders in making purchasing decisions that may ultimately result in better patient care. The greater formality introduced in Purchasing for Safety will help hospitals justify purchasing decisions, and the thoroughness of the investigation will promote patient safety.

scholarly journals “Availability of healthcare providers for rural veterans eligible for purchased care under the veterans choice act”

2018 ◽  
Vol 18 (1) ◽  
Author(s):  
Michael E. Ohl ◽  
Margaret Carrell ◽  
Andrew Thurman ◽  
Mark Vander Weg ◽  
Teresa Hudson ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Rural Areas ◽  
Adult Population ◽  
Healthcare Providers ◽  
The United States ◽  
Veterans Health ◽  
Health Administration ◽  
Care Providers ◽  
Level Data

Abstract Background Military Veterans in the United States are more likely than the general population to live in rural areas, and often have limited geographic access to Veterans Health Administration (VHA) facilities. In an effort to improve access for Veterans living far from VHA facilities, the recently-enacted Veterans Choice Act directed VHA to purchase care from non-VHA providers for Veterans who live more than 40 miles from the nearest VHA facility. To explore potential impacts of these reforms on Veterans and healthcare providers, we identified VHA-users who were eligible for purchased care based on distance to VHA facilities, and quantified the availability of various types of non-VHA healthcare providers in counties where these Veterans lived. Methods We combined 2013 administrative data on VHA-users with county-level data on rurality, non-VHA provider availability, population, household income, and population health status. Results Most (77.9%) of the 416,338 VHA-users who were eligible for purchased care based on distance lived in rural counties. Approximately 16% of these Veterans lived in primary care shortage areas, while the majority (70.2%) lived in mental health care shortage areas. Most lived in counties that lacked specialized health care providers (e.g. cardiologists, pulmonologists, and neurologists). Counterintuitively, VHA played a greater role in delivering healthcare for the overall adult population in counties that were farther from VHA facilities (30.7 VHA-users / 1000 adults in counties over 40 miles from VHA facilities, vs. 22.4 VHA-users / 1000 adults in counties within 20 miles of VHA facilities, p < 0.01). Conclusions Initiatives to purchase care for Veterans living more than 40 miles from VHA facilities may not significantly improve their access to care, as these areas are underserved by non-VHA providers. Non-VHA providers in the predominantly rural areas more than 40 miles from VHA facilities may be asked to assume care for relatively large numbers of Veterans, because VHA has recently cared for a greater proportion of the population in these areas, and these Veterans are now eligible for purchased care.

scholarly journals Is patient safety sufficient in Japan? Differences in patient safety between Japan and the United States – Learning from the United States

2016 ◽  
Vol 5 (6) ◽  
pp. 1 ◽  
Author(s):  
Masahiro Hirose
Keyword(s):  
United States ◽  
Health Care ◽  
Patient Safety ◽  
Medical Ethics ◽  
Health Care Providers ◽  
The United States ◽  
Individual Responsibility ◽  
University Hospital ◽  
Care Providers ◽  
University Hospitals

In Japan, patient safety has been promoted at all levels since the 1999 landmark adverse medical event at Yokohama City University Hospital (YCUH). However, patients do not believe that health care is becoming safer. Furthermore, two university hospitals (UHs) that were designated as “advanced treatment hospitals” had their status revoked by the Health Ministry as of June 1, 2015 due to patient safety problems. The history of patient safety in Japan can be roughly divided into two terms: 1999-2009 and since 2010. In the first term, a basic patient safety system was established that included the creation of a patient safety division and an incident-reporting system from the perspective of systems error rather than individual responsibility. Additionally, many companies have promoted the improvement and development of drugs and medical devices in collaboration with health care providers. The two recent serious medical errors at UHs seemed to occur partially due to a lack of medical ethics. Unlike in the United States (US), in Japan, there is no medical license renewal system, the organizations that govern physicians are weak, and the framework of lifelong education is inadequate. Therefore, the second term involves a mindset of quality-driven patient safety. It requires health care providers and policy makers to change their mindset toward medical ethics and patient safety by learning from the US and demands a strong organization and framework to govern physicians in Japan.

scholarly journals Telehealth for Cancer Care in Veterans: Opportunities and Challenges Revealed by COVID

2020 ◽  
pp. OP.20.00520
Author(s):  
Cindy Y. Jiang ◽  
Nadeem T. El-Kouri ◽  
David Elliot ◽  
Jenna Shields ◽  
Megan E. V. Caram ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Cancer Care ◽  
The United States ◽  
Lessons Learned ◽  
Veterans Health ◽  
Health Administration ◽  
Care Providers ◽  
Potential Cost ◽  
Tertiary Center

The Veterans Health Administration system is one of the largest integrated health care providers in the United States, delivering medical care to > 9 million veterans. Barriers to delivering efficient health care include geographical limitations as well as long wait times. Telehealth has been used as a solution by many different health care services. However, it has not been as widely used in cancer care. In 2018, the US Department of Veterans Affairs (VA) Pittsburgh Healthcare System expanded the use of telehealth to provide antineoplastic therapies to rural patients by creating a clinical video telehealth clinic of the Virtual Cancer Care Network. This allows oncologists located at the tertiary center to virtually deliver care to remote sites. The recent COVID-19 pandemic forced oncologists across the VA system to adopt telehealth to provide continuity of care. On the basis of our review and personal experience, we have outlined opportunities for telehealth to play a role in every step of the cancer care journey from diagnosis to therapy to surveillance to clinical trials for medical, surgical, and radiation oncology. There are many advantages, such as decreased travel time and potential cost savings; however, there continues to be challenges with veterans having access to devices and the Internet as well as understanding how to use telehealth equipment. The lessons learned from this assessment of the VA telehealth system for cancer care can be adopted and integrated into other health systems. In the future, there needs to be evaluation of how telehealth can be further incorporated into oncology, satisfaction of veterans using telehealth services, overcoming telehealth barriers, and defining metrics of success.

The Special Perils of Being Old and Sick in Prison

2020 ◽  
Vol 32 (5) ◽  
pp. 276-284
Author(s):  
William J. Jefferson
Keyword(s):  
United States ◽  
Health Care ◽  
Medical Care ◽  
Health Care Providers ◽  
The United States ◽  
United States Constitution ◽  
Care Providers ◽  
Medical Practitioners ◽  
Medical Needs ◽  
Access To Medical Care

The United States Supreme Court declared in 1976 that deliberate indifference to the serious medical needs of prisoners constitutes the unnecessary and wanton infliction of pain…proscribed by the Eighth Amendment. It matters not whether the indifference is manifested by prison doctors in their response to the prisoner’s needs or by prison guards intentionally denying or delaying access to medical care or intentionally interfering with treatment once prescribed—adequate prisoner medical care is required by the United States Constitution. My incarceration for four years at the Oakdale Satellite Prison Camp, a chronic health care level camp, gives me the perspective to challenge the generally promoted claim of the Bureau of Federal Prisons that it provides decent medical care by competent and caring medical practitioners to chronically unhealthy elderly prisoners. The same observation, to a slightly lesser extent, could be made with respect to deficiencies in the delivery of health care to prisoners of all ages, as it is all significantly deficient in access, competencies, courtesies and treatments extended by prison health care providers at every level of care, without regard to age. However, the frailer the prisoner, the more dangerous these health care deficiencies are to his health and, therefore, I believe, warrant separate attention. This paper uses first-hand experiences of elderly prisoners to dismantle the tale that prisoner healthcare meets constitutional standards.

Nurse Practitioner Challenges to the Orthodox Structure of Health Care Delivery: Regulation and Restraints on Trade

1985 ◽  
Vol 11 (2) ◽  
pp. 195-225
Author(s):  
Karla Kelly
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Health Care Delivery ◽  
Nurse Practitioners ◽  
Nurse Practitioner ◽  
Allied Health ◽  
Care Delivery ◽  
The United States ◽  
Care Providers ◽  
Allied Health Care

AbstractUntil recently, physicians have been the primary health care providers in the United States. In response to the rising health care costs and public demand of the past decade, allied health care providers have challenged this orthodox structure of health care delivery. Among these allied health care providers are nurse practitioners, who have attempted to expand traditional roles of the registered nurse.This article focuses on the legal issues raised by several major obstacles to the expansion of nurse practitioner services: licensing restrictions, third party reimbursement policies, and denial of access to medical facilities and physician back-up services. The successful judicial challenges to discriminatory practices against other allied health care providers will be explored as a solution to the nurse practitioners’ dilemma.

Patients' Perceptions of Different Information Exchange Mechanisms: An Exploratory Study in the United States

2020 ◽  
Vol 59 (04/05) ◽  
pp. 162-178
Author(s):  
Pouyan Esmaeilzadeh
Keyword(s):  
United States ◽  
Health Care ◽  
Health Information ◽  
Health Care Providers ◽  
Information Exchange ◽  
The United States ◽  
Exchange Mechanism ◽  
Care Providers ◽  
Security Risks ◽  
Direct Exchange

Abstract Background Patients may seek health care services from various providers during treatment. These providers could serve in a network (affiliated) or practice separately (unaffiliated). Thus, using secure and reliable health information exchange (HIE) mechanisms would be critical to transfer sensitive personal health information (PHI) across distances. Studying patients' perceptions and opinions about exchange mechanisms could help health care providers build more complete HIEs' databases and develop robust privacy policies, consent processes, and patient education programs. Objectives Due to the exploratory nature of this study, we aim to shed more light on public perspectives (benefits, concerns, and risks) associated with the four data exchange practices in the health care sector. Methods In this study, we compared public perceptions and expectations regarding four common types of exchange mechanisms used in the United States (i.e., traditional, direct, query-based, patient-mediated exchange mechanisms). Traditional is an exchange through fax, paper mailing, or phone calls, direct is a provider-to-provider exchange, query-based is sharing patient data with a central repository, and patient-mediated is an exchange mechanism in which patients can access data and monitor sharing. Data were collected from 1,624 subjects using an online survey to examine the benefits, risks, and concerns associated with the four exchange mechanisms from patients' perspectives. Results Findings indicate that several concerns and risks such as privacy concerns, security risks, trust issues, and psychological risks are raised. Besides, multiple benefits such as access to complete information, communication improvement, timely and convenient information sharing, cost-saving, and medical error reduction are highlighted by respondents. Through consideration of all risks and benefits associated with the four exchange mechanisms, the direct HIE mechanism was selected by respondents as the most preferred mechanism of information exchange among providers. More than half of the respondents (56.18%) stated that overall they favored direct exchange over the other mechanisms. 42.70% of respondents expected to be more likely to share their PHI with health care providers who implemented and utilized a direct exchange mechanism. 43.26% of respondents believed that they would support health care providers to leverage a direct HIE mechanism for sharing their PHI with other providers. The results exhibit that individuals expect greater benefits and fewer adverse effects from direct HIE among health care providers. Overall, the general public sentiment is more in favor of direct data transfer. Our results highlight that greater public trust in exchange mechanisms is required, and information privacy and security risks must be addressed before the widespread implementation of such mechanisms. Conclusion This exploratory study's findings could be interesting for health care providers and HIE policymakers to analyze how consumers perceive the current exchange mechanisms, what concerns should be addressed, and how the exchange mechanisms could be modified to meet consumers' needs.

scholarly journals Patient Suffering in Chronic Digestive Diseases: Will Primary Care-Specialist Collaboration With Effective Interactive Communication and Integrative Medicine in the Plan of Care Improve Quality of Life?

2020 ◽  
Vol 7 (6) ◽  
pp. 989-993
Author(s):  
Andrew Thomas ◽  
Annie Thomas
Keyword(s):  
Quality Of Life ◽  
Primary Care ◽  
Health Care ◽  
Health Care Providers ◽  
The United States ◽  
Care Providers ◽  
Physician Visits ◽  
Digestive Diseases ◽  
Care Specialist

Acute and chronic digestive diseases are causing increased burden to patients and are increasing the United States health care spending. The purpose of this case report was to present how nonconfirmatory and conflicting diagnoses led to increased burden and suffering for a patient thus affecting quality of life. There were many physician visits and multiple tests performed on the patient. However, the primary care physician and specialists could not reach a confirmatory diagnosis. The treatment plans did not offer relief of symptoms, and the patient continues to experience digestive symptoms, enduring this burden for over 2 years. The central theme of this paper is to inform health care providers the importance of utilizing evidence-based primary care specialist collaboration models for better digestive disease outcomes. Consistent with patient’s experience, the authors propose to pilot/adopt the integrative health care approaches that are proven effective for treating digestive diseases.

Pediatric Collections: Vaping: Effects and Solutions

2020 ◽  
Author(s):  
Keyword(s):  
Public Health ◽  
United States ◽  
Health Care ◽  
Health Care Providers ◽  
Electronic Cigarettes ◽  
The United States ◽  
Care Providers ◽  
Tobacco Products ◽  
Pediatric Health ◽  
Pediatric Health Care

Electronic cigarettes are the tobacco products most commonly used by youths in the United States. The use of e-cigarettes, also known as vaping or JUULing, is a public health epidemic. This collection offers reviews and research to assist pediatric health care providers in identifying and treating adolescent use and exposure to e-cigarettes. https://shop.aap.org/pediatric-collections-vaping-effects-and-solutions-paperback/

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