scholarly journals A Rapid Process for Identifying and Prioritizing Technology-Based Tools for Health System Implementation (Preprint)

2018 ◽  
Author(s):  
Emily R Dibble ◽  
Bradley E Iott ◽  
Allen J Flynn ◽  
Darren P King ◽  
Mark P MacEachern ◽  
...  
Keyword(s):  
Decision Making ◽  
Health System ◽  
Review Process ◽  
New Technology ◽  
Rapid Review ◽  
Current Evidence ◽  
Review Panel ◽  
Environmental Scan ◽  
System Leaders ◽  
Evidence Review

BACKGROUND Health system decisions to put new technologies into clinical practice require a rapid and trustworthy decision-making process informed by best evidence. OBJECTIVE This study aimed to present a rapid evidence review process that can be used to inform health system leaders and clinicians seeking to implement new technology tools to improve patient-clinician decision making and patient-oriented outcomes. METHODS The rapid evidence review process we pioneered involved 5 sequential subprocesses: (1) environmental scan, (2) expert panel recruitment, (3) host evidence review panel, (4) analysis, and (5) local validation panel. We conducted an environmental scan of health information technology (IT) literature to identify relevant digital tools in oncology care. We synthesized the recent literature using current evidence review methods, creating visual summaries for use by a national panel of experts. Panelists were taken through a 6-hour modified Delphi process to prioritize tools for implementation. Findings from the rapid evidence review panel were taken to a local validation panel for further rapid review during a 3-hour session. RESULTS Our rapid evidence review process shows promise for informing decision making by reducing the amount of time and resources needed to identify and prioritize adoption of IT tools. Despite evidence of improved patient outcomes, panelists had substantial concerns about implementing patient-reported outcome tracking tools, voicing concerns about liability, lack of familiarity with new technology, and additional time and workflow changes such tools would require. Instead, clinicians favored technologies that did not require clinician involvement. CONCLUSIONS Health system leaders can use the rapid evidence review process presented here to usefully inform local technology adoption, implementation, and use in practice.

scholarly journals Use of EHR-Based Pediatric Quality Measures: Views of Health System Leaders and Parents

2019 ◽  
Vol 35 (2) ◽  
pp. 177-185
Author(s):  
David M. Hartley ◽  
Susannah Jonas ◽  
Daniel Grossoehme ◽  
Amy Kelly ◽  
Cassandra Dodds ◽  
...  
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Health System ◽  
Health Care Quality ◽  
Quality Measures ◽  
Care Quality ◽  
Quality Data ◽  
High Confidence ◽  
System Leaders ◽  
Using Data

Measures of health care quality are produced from a variety of data sources, but often, physicians do not believe these measures reflect the quality of provided care. The aim was to assess the value to health system leaders (HSLs) and parents of benchmarking on health care quality measures using data mined from the electronic health record (EHR). Using in-context interviews with HSLs and parents, the authors investigated what new decisions and actions benchmarking using data mined from the EHR may enable and how benchmarking information should be presented to be most informative. Results demonstrate that although parents may have little experience using data on health care quality for decision making, they affirmed its potential value. HSLs expressed the need for high-confidence, validated metrics. They also perceived barriers to achieving meaningful metrics but recognized that mining data directly from the EHR could overcome those barriers. Parents and HSLs need high-confidence health care quality data to support decision making.

scholarly journals Rapid review of decision-making for place of care and death in older people: lessons for COVID-19

2020 ◽  
Author(s):  
Emily West ◽  
Kirsten Moore ◽  
Nuriye Kupeli ◽  
Elizabeth L Sampson ◽  
Pushpa Nair ◽  
...  
Keyword(s):  
Older Adults ◽  
Decision Making ◽  
Older People ◽  
Data Extraction ◽  
Rapid Review ◽  
Current Evidence ◽  
Key Factors ◽  
Full Data ◽  
Review Of Reviews ◽  
Experience Of Illness

Abstract Introduction The coronavirus pandemic (COVID-19) has affected the functioning and capacity of healthcare systems worldwide. COVID-19 has also disproportionately affected older adults. In the context of COVID-19, decision-making surrounding place of care (PoC) and place of death (PoD) in older adults involves significant new challenges. Aims To explore key factors that influence PoC and PoD decisions in older adults. A secondary aim was to investigate key factors that influence the process and outcome of these decisions in older adults. To apply findings from current evidence to the context of COVID-19. Methods Rapid review of reviews, undertaken using WHO guidance for rapid reviews for the production of actionable evidence. Data extracted was synthesised using narrative synthesis, with thematic analysis and tabulation. Results 10 papers were included for full data extraction. These papers were published between 2005 and 2020. Papers included discussed actual PoD, as well as preferred. Results were divided into papers that explored the process of decision-making, and those that explored decision-making outcomes. Conclusions The process and outcomes of decision-making for older people are affected by many factors—all of which have the potential to influence both patients and caregivers experience of illness and dying. Within the context of COVID-19, such decisions may have to be made rapidly and be reflexive to changing needs of systems and of families and patients.

Blockchain in Supply Chain: Case Study of Lottemart Ciputat

2019 ◽  
Vol 5 (1) ◽  
pp. 38-49 ◽  
Author(s):  
B. K. Handoyo ◽  
M. R. Mashudi ◽  
H. P. Ipung
Keyword(s):  
Decision Making ◽  
Supply Chain ◽  
Supply Chain Management ◽  
Information Asymmetry ◽  
New Technology ◽  
Business Case ◽  
Analysis Method ◽  
Chain Management ◽  
Production Processes

Current supply chain methods are having difficulties in resolving problems arising from the lack of trust in supply chains. The root reason lies in two challenges brought to the traditional mechanism: self-interests of supply chain members and information asymmetry in production processes. Blockchain is a promising technology to address these problems. The key objective of this paper is to present qualitative analysis for blockchain in supply chain as the decision-making framework to implement this new technology. The analysis method used Val IT business case framework, validated by the expert judgements. The further study needs to be elaborated by either the existing organization that use blockchain or assessment by the organization that will use blockchain to improve their supply chain management.

Applications of blockchain in healthcare (Preprint)

2020 ◽  
Author(s):  
Pranav C
Keyword(s):  
Decision Making ◽  
Large Scale ◽  
Review Paper ◽  
New Technology ◽  
Personal Identification ◽  
Healthcare Industry ◽  
Healthcare Organizations ◽  
Paper Briefly ◽  
Blockchain Technology ◽  
Audit Trails

UNSTRUCTURED The word blockchain elicits thoughts of cryptocurrency much of the time, which does disservice to this disruptive new technology. Agreed, bitcoin launched in 2011 was the first large scale implementation of blockchain technology. Also, Bitcoin’s success has triggered the establishment of nearly 1000 new cryptocurrencies. This again lead to the delusion that the only application of blockchain technology is for the creation of cryptocurrency. However, the blockchain technology is capable of a lot more than just cryptocurrency creation and may support such things as transactions that require personal identification, peer review, elections and other types of democratic decision-making and audit trails. Blockchain exists with real world implementations beyond cryptocurrencies and these solutions deliver powerful benefits to healthcare organizations, bankers, retailers and consumers among others. One of the areas where blockchain technology can be used effectively is healthcare industry. Proper application of this technology in healthcare will not only save billions of money but also will contribute to the growth in research. This review paper briefly defines blockchain and deals in detail the applications of blockchain in various areas particularly in healthcare industry.

Effects and utility of an online forward triage tool during the SARS-CoV-2 pandemic: patient perspectives (Preprint)

2020 ◽  
Author(s):  
Janet Michel
Keyword(s):  
Decision Making ◽  
Health System ◽  
Information Source ◽  
Patient Perspectives ◽  
User Friendliness ◽  
Fear And Anxiety ◽  
Mail Address ◽  
Second Wave ◽  
E Mail

BACKGROUND Background: Online forward triage tools (OFTT) or symptom checkers are being widely used during this COVID-19 pandemic. The effects and utility of such tools however, have not been widely assessed. OBJECTIVE Objective: To assess the effects (quantitatively) and the utility (qualitatively) of a COVID-19 OFTT in a pandemic context, exploring patient perspectives as well as eliciting recommendations for tool improvement. METHODS Methods: We employed a mixed-method sequential explanatory study design. Quantitative data of all users of the OFTT between March 2nd, 2020 and May 12th, 2020 were collected. A follow-up survey of people who consented to participation was conducted. Secondly, qualitative data was collected through key informant interviews (n=19) to explain the quantitative findings, as well as explore tool utility, user experience and elicit recommendations. RESULTS Results: An estimate of the effects, (quantitatively) and the utility (qualitatively) of a COVID-19 OFTT in a pandemic context, and recommendations for tool improvement. In the study period, 6,272 users consulted our OFTT; 560 participants consented to a follow-up survey and provided a valid e-mail address. 176 (31.4%) participants returned a complete follow-up questionnaire. 85.2% followed the recommendations given. 41.5% reported that their fear was allayed after using tool and 41.1% would have contacted the GP or visited a hospital had the tool not existed. Qualitatively, seven overarching themes emerged namely i) accessibility of tool, ii) user-friendliness of tool, iii) utility of tool as an information source, iv) utility of tool in allaying fear and anxiety, v) utility of tool in decision making (test or not to test), vi) utility of tool in reducing the potential for onward transmissions (preventing cross infection) and vii) utility of tool in reducing health system burden. CONCLUSIONS Conclusion: Our findings demonstrated that a COVID-19 OFTT does not only reduce the health system burden, but can also serve as an information source, reduce anxiety and fear, reduce cross infections and facilitate decision making (to test or not to test). Further studies are needed to assess the transferability of these COVID-19 OFTT findings to other contexts as the second wave sweeps across Europe.

Impact and paybacks of biomedical research findings in Malaysia 2005–2015

2021 ◽  
Author(s):  
Pei Kuan Lai ◽  
S Nalliah ◽  
CL Teng ◽  
NLP Chen
Keyword(s):  
Decision Making ◽  
Health System ◽  
Capacity Building ◽  
Biomedical Research ◽  
Knowledge Production ◽  
Future Research ◽  
Relevant Research ◽  
Research Findings ◽  
The Impact ◽  
Health System Policy

Background: Impact in research encompasses health, economic, and cultural benefits beyond adding to the knowledge base. Funders are under immense pressure to be accountable for the paybacks from funded research.Aims and objectives: The aim of this study was to look into the impact of funded biomedical research between the years 2005 and 2015 in Malaysia from the aspects of knowledge production, research targeting and capacity building, as well as health system policy and decision making.Methods: This study employed a convergent parallel mixed-methods research design. Biomedical projects related to breast cancer, coronary heart disease, and dengue, funded by the Ministry of Health (MOH), Ministry of Higher Education (MOHE), and Ministry of Science, Technology, and Innovation (MOSTI) between the years 2005 and 2015, were included.Findings: From the questionnaire responses (n=58), on average each funded project managed to produce two outputs and one higher degree student. More than half (61.4%) of the funded projects led to subsequent future research. However, low citations in systematic reviews (10.3%), health policies (6.9%), and clinical practice guidelines (5.2%) were reported. In-depth interviews with the key opinion leaders also saw that most of the local research findings were found to be irrelevant to be adopted into policies by the policymakers.Discussion and conclusions: Paybacks on knowledge production as well as research targeting and capacity building had been achieved, but impact on health system policy and decision making had not been well attained, due to the lack of relevant research findings needed by the policymakers.<br />Key messages<br /><ul><li>Payback on knowledge production was achieved, as there had been a lot of new knowledge generated as captured in academic publications, conference proceedings, policy briefs, technical reports, and research highlights, which is important to advance the frontiers of knowledge.</li><br /><li>Payback on research targeting was achieved, with the current research leading to future study with identification of the knowledge gap and generation of new ideas for new research.</li><br /><li>Payback on capacity building was achieved with the training of researchers, building up research capacity and competencies, production of MSc and PhD graduates, promotion of lecturers, and development of new partnerships and networks.</li><br /><li>Impact on health system policy and decision making was not well attained. There had been a lack of relevant research data and findings being incorporated into policymaking, due to the basic and fundamental nature of most of the funded biomedical research in Malaysia.</li></ul>

scholarly journals Humeral Head Replacement and Reverse Shoulder Arthroplasty for the Treatment of Proximal Humerus Fracturesm

2017 ◽  
Vol 11 (1) ◽  
pp. 1108-1114 ◽  
Author(s):  
Aaron Andrew Frombach ◽  
Kendra Brett ◽  
Peter Lapner
Keyword(s):  
Shoulder Arthroplasty ◽  
New Technology ◽  
Reverse Shoulder Arthroplasty ◽  
Standard Of Care ◽  
The Elderly ◽  
Proximal Humeral Fractures ◽  
Humeral Fractures ◽  
Current Evidence ◽  
Complication Rates ◽  
Surgical Fixation

Acute proximal humeral fractures in the elderly are generally treated non-operatively if alignment is acceptable and in stable fracture patterns. When operative treatment is indicated, surgical fixation is often difficult or impossible to obtain. Hemiarthroplasty has long been the standard of care. However, with its reliance on tuberosity healing, functional outcomes and patient satisfaction are often poor. Reverse shoulder arthroplasty has emerged as a new technology for treating proximal humeral fractures but the indications for its use remain uncertain. While not conclusive, the evidence suggests that reverse shoulder arthroplasty yields more consistent results, with improved forward elevation and higher functional outcome scores. The primary advantages of hemiarthroplasty are improved shoulder rotation and shorter operative time. Complication rates do not vary significantly between the two options. Although higher quality trials are needed to further define the role of reverse shoulder arthroplasty, current evidence suggests that this is a reasonable option for surgeons who are highly familiar with its use.

Sign in / Sign up

Export Citation Format

Share Document