Virtual Medicine, Virtual Disease, Real Consequences

2022 ◽  
pp. 19-32
Author(s):  
Alistair Fyfe
Keyword(s):  
Decision Making ◽  
Patient Care ◽  
Common Ground ◽  
Healthcare Delivery ◽  
Mass Scale ◽  
Medical Decision ◽  
The Us ◽  
The Common ◽  
Virtual Medicine ◽  
Perfect Storm

This chapter investigates the hypothesis that the COVID-19 pandemic was the perfect storm due to the misalignment of competing elements of the US healthcare system, the economic commoditization of disease, the economic commoditization of healthcare delivery, and inadequate data to inform medical decision making on a mass scale. The culmination of a decades-long devolution away from patient care to healthcare or more appropriately sick-care created a system that was unable to quickly find the common ground needed to deal with the pandemic known as COVID-19.

A Framework for Modelling the Electronic Medical Record

1993 ◽  
Vol 32 (02) ◽  
pp. 109-119 ◽  
Author(s):  
W. A. Nowlan ◽  
S. Kay ◽  
C. A. Goble ◽  
T. J. Howkins ◽  
A. L. Rector
Keyword(s):  
Decision Making ◽  
Patient Care ◽  
Medical Record ◽  
Electronic Medical Record ◽  
Medical Decision ◽  
Distributed Information ◽  
Aggregated Data ◽  
Direct Observations ◽  
Clinical Workstation ◽  
Specific Implementation

Abstract:This paper presents a model for an electronic medical record which satisfies the requirements for a faithful and structured record of patient care set out in a previous paper in this series. The model underlies the PEN & PAD clinical workstation, and it provides for a permanent, completely attributable record of patient care and the process of medical decision making. The model separates the record into two levels: direct observations of the patient and meta-statements about the use of observations in decision making and the clinical dialogue. The model is presented in terms of “descriptions” formulated in the Structured Meta Knowledge (SMK) formalism, but many of its features are more general than the specific implementation. The use of electronic medical records based on the model for decision support and the analysis of aggregated data are discussed along with potential use of the model in distributed information systems.

Teleconsultation – collaborative work and opportunities for learning across organizational boundaries

2008 ◽  
Vol 14 (7) ◽  
pp. 377-380 ◽  
Author(s):  
Line Lundvoll Nilsen ◽  
Anne Moen
Keyword(s):  
Decision Making ◽  
Patient Care ◽  
Information Exchange ◽  
Medical Decision Making ◽  
Collaborative Work ◽  
Medical Decision ◽  
Medical Problems ◽  
Organizational Boundaries ◽  
Opportunities For Learning ◽  
Communicative Process

Over a period of five months we observed teleconsultations between general practitioners (GPs) in community care and specialists in hospitals in two Norwegian health regions (A and B). In total, 47 teleconsultations between GPs and specialists were recorded. In region A, teleconsultations were organized when needed to discuss specific medical problems. In region B, teleconsultations took place during the specialists' daily morning meeting. The teleconsultations lasted for 5–40 min. There were three categories of talk. In the first two there was information exchange for patient updates and practical organization of the service. The third category, consultation, was the communicative process in which the GP and the specialist engaged in collaborative work, primarily discussing medical problems related to decision-making in patient care. Regular use of teleconsultation opens access to different repertoires of knowledge and experience, and brings knowledge to the point of patient care and medical decision-making.

scholarly journals NÅR HJEMME ER UDE: Betydningen og skabelsen af hjem i naturen blandt homesteadere i Oregon, USA

2009 ◽  
Author(s):  
Gry Skrædderdal Jakobsen
Keyword(s):  
Social Interaction ◽  
Common Ground ◽  
Personal Control ◽  
Modern World ◽  
Life Styles ◽  
The Us ◽  
The Common

Based on fi eldwork among homesteaders in the US Pacifi c Northwest, this article explores particular ways in which home is created and sustained in the light of the homesteaders’ ideals of becoming one with nature. The article focuses on how construction of houses is guided by such ideals and shows how the merging of home and nature is also taking place at a mundane level in social interaction. When building a house the homesteaders are seeking to discard standard urban ideas about which materials to use and how to furnish houses. In a long debate about how to deal with the fact that rats have entered the common kitchen, naturalisation and humanisation of both people and animals are employed in order to create a common ground. In sum the article argues that the homesteaders’ practises are serving both their effort to stand out from “mainstream” or “suburban” America as part of an ideological project to establish alternative ways of living, and that they also express a more existential struggle to create spaces of harmony and personal control in a modern world characterised by consumerism and globalisation. Keywords: Nature, U.S.A., alternative life styles, home.  

An Investigation of Medical Decision Making BIAS Using Patient Penal Status

2005 ◽  
Vol 49 (11) ◽  
pp. 1004-1008
Author(s):  
Stephane Timothee ◽  
Marc L Resnick
Keyword(s):  
Decision Making ◽  
Medical Care ◽  
Prescription Drugs ◽  
Medical Decision Making ◽  
Information Sources ◽  
Medical Decision ◽  
Decision Making Process ◽  
The Us ◽  
Patient Variables ◽  
To Receive

When providing medical care, doctors are constantly required to make complex decisions based on a wide variety of information sources. As the US health care system becomes more complex with managed care, new regulations for prescription drugs, and other factors, it will become easier for bias to be introduced into the decision making process. This study investigates medical treatment decisions and seeks to identify paths through which bias can be introduced. Patient penal status was used as a proxy for patient variables that in theory should not affect care decisions but in practice often do. The results of the study show that penal patients are less likely to receive required and recommended treatments and that these differences are not due to differences in race, age, or gender of the prisoner population. Additional research is needed to identify the organizational or contextual factors that lead to differences in the provision of medical care.

scholarly journals Shared Decision Making: A Fundamental Tenet in a Conceptual Framework of Integrative Healthcare Delivery

2013 ◽  
Vol 8 ◽  
pp. IMI.S12783 ◽  
Author(s):  
Alyssa T. Brooks ◽  
Leanne Silverman ◽  
Gwenyth R. Wallen
Keyword(s):  
Decision Making ◽  
Conceptual Framework ◽  
Shared Decision Making ◽  
Care Delivery ◽  
Healthcare Delivery ◽  
Shared Decision ◽  
Open Communication ◽  
Holistic Treatment ◽  
The Us ◽  
Care Systems

With the increased usage of complementary and alternative medicine (CAM) in the US comes a need for evidence-based and integrated care systems which encourage open communication between patients and providers. This paper introduces a conceptual framework for integrative care delivery, with shared decision making being the “connecting force” between holistic treatment and improved health outcomes for patients.

scholarly journals Improving Shared Medical Decision-Making Through Enhancing Family-Centered Healthcare Delivery in the ICU

CHEST Journal ◽  
2016 ◽  
Vol 150 (4) ◽  
pp. 623A
Author(s):  
Chaitanya Mandapakala ◽  
Amaraja Kanitkar ◽  
Ravinder Bhanot ◽  
Sarah Lee
Keyword(s):  
Decision Making ◽  
Medical Decision Making ◽  
Healthcare Delivery ◽  
Medical Decision ◽  
Family Centered

scholarly journals Influence of response shift and disposition on patient-reported outcomes may lead to suboptimal medical decisions: a medical ethics perspective

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Iris D. Hartog ◽  
Dick L. Willems ◽  
Wilbert B. van den Hout ◽  
Michael Scherer-Rath ◽  
Tom H. Oreel ◽  
...  
Keyword(s):  
Decision Making ◽  
Patient Care ◽  
Patient Reported Outcomes ◽  
Medical Decision Making ◽  
Response Shift ◽  
Cost Effective ◽  
Medical Decision ◽  
Medical Decisions ◽  
Patient Reports ◽  
Patient Reported

Abstract Background Patient-reported outcomes (PROs) are frequently used for medical decision making, at the levels of both individual patient care and healthcare policy. Evidence increasingly shows that PROs may be influenced by patients’ response shifts (changes in interpretation) and dispositions (stable characteristics). Main text We identify how response shifts and dispositions may influence medical decisions on both the levels of individual patient care and health policy. We provide examples of these influences and analyse the consequences from the perspectives of ethical principles and theories of just distribution. Conclusion If influences of response shift and disposition on PROs and consequently medical decision making are not considered, patients may not receive optimal treatment and health insurance packages may include treatments that are not the most effective or cost-effective. We call on healthcare practitioners, researchers, policy makers, health insurers, and other stakeholders to critically reflect on why and how such patient reports are used.

Debates in Dysphagia Management: How Do You Use Evidence-Based Practice in Your Dysphagia Patient Care?

2011 ◽  
Vol 20 (4) ◽  
pp. 121-123
Author(s):  
Jeri A. Logemann
Keyword(s):  
Decision Making ◽  
Patient Care ◽  
Clinical Outcomes ◽  
Clinical Judgment ◽  
Clinical Decision Making ◽  
Evidence Based Practice ◽  
Clinical Decision ◽  
Evidence Based ◽  
Clinical Method ◽  
Do So

Evidence-based practice requires astute clinicians to blend our best clinical judgment with the best available external evidence and the patient's own values and expectations. Sometimes, we value one more than another during clinical decision-making, though it is never wise to do so, and sometimes other factors that we are unaware of produce unanticipated clinical outcomes. Sometimes, we feel very strongly about one clinical method or another, and hopefully that belief is founded in evidence. Some beliefs, however, are not founded in evidence. The sound use of evidence is the best way to navigate the debates within our field of practice.

Sign in / Sign up

Export Citation Format

Share Document