scholarly journals COVID -19 and Cardio Metabolic Practice at MENA Regions. Policy Analysis & Recommendations

2020 ◽  
Keyword(s):  
Policy Analysis ◽  
Health Systems ◽  
Patient Journey ◽  
Health Technologies ◽  
Practice Elements ◽  
Cancer Field ◽  
Systems Practice ◽  
Practice Methods ◽  
Safety Enhancement ◽  
Integration Analysis

Health systems were not expected COVID -19 pandemic which made Pressure on that systems. Practice at Cancer field had different nature at COVID -19. Due to the following (patients type, Diagnosis Process and patient journey) the objective of this research is finding out impact of COVID -19 on cardio metabolic practice. Methods: Integration analysis between International guidelines like (ESC, NHS, WHO) and conducting local survives with local Physicians at previous countries. Results: Periodization criteria was very influencer at practice elements this leaded to medications plans changing through different solutions one of those solutions was health technologies Conclusion: Dynamic prioritization criteria was founded the corner stone for Practice adaption for Safety enhancement through Time reducing plans managed Effective leadership elements through technology solutions .

scholarly journals Barriers to Creating Scalable Business Models for Digital Health Innovation in Public Systems: Qualitative Case Study (Preprint)

2020 ◽  
Author(s):  
Leah Taylor Kelley ◽  
Jamie Fujioka ◽  
Kyle Liang ◽  
Madeline Cooper ◽  
Trevor Jamieson ◽  
...  
Keyword(s):  
Health Care ◽  
Health System ◽  
Health Systems ◽  
Business Models ◽  
Digital Health ◽  
Digital Technologies ◽  
Economic Incentives ◽  
Barriers To Entry ◽  
Health Innovation ◽  
Health Technologies

BACKGROUND Health systems are increasingly looking toward the private sector to provide digital solutions to address health care demands. Innovation in digital health is largely driven by small- and medium-sized enterprises (SMEs), yet these companies experience significant barriers to entry, especially in public health systems. Complex and fragmented care models, alongside a myriad of relevant stakeholders (eg, purchasers, providers, and producers of health care products), make developing value propositions for digital solutions highly challenging. OBJECTIVE This study aims to identify areas for health system improvement to promote the integration of innovative digital health technologies developed by SMEs. METHODS This paper qualitatively analyzes a series of case studies to identify health system barriers faced by SMEs developing digital health technologies in Canada and proposed solutions to encourage a more innovative ecosystem. The Women’s College Hospital Institute for Health System Solutions and Virtual Care established a consultation program for SMEs to help them increase their innovation capacity and take their ideas to market. The consultation involved the SME filling out an onboarding form and review of this information by an expert advisory committee using guided considerations, leading to a recommendation report provided to the SME. This paper reports on the characteristics of 25 SMEs who completed the program and qualitatively analyzed their recommendation reports to identify common barriers to digital health innovation. RESULTS A total of 2 central themes were identified, each with 3 subthemes. First, a common barrier to system integration was the lack of formal evaluation, with SMEs having limited resources and opportunities to conduct such an evaluation. Second, the health system’s current structure does not create incentives for clinicians to use digital technologies, which threatens the sustainability of SMEs’ business models. SMEs faced significant challenges in engaging users and payers from the public system due to perverse economic incentives. Physicians are compensated by in-person visits, which actively works against the goals of many digital health solutions of keeping patients out of clinics and hospitals. CONCLUSIONS There is a significant disconnect between the economic incentives that drive clinical behaviors and the use of digital technologies that would benefit patients’ well-being. To encourage the use of digital health technologies, publicly funded health systems need to dedicate funding for the evaluation of digital solutions and streamlined pathways for clinical integration.

scholarly journals Elements of Trust in Digital Health Systems: Scoping Review (Preprint)

2018 ◽  
Author(s):  
Afua Adjekum ◽  
Alessandro Blasimme ◽  
Effy Vayena
Keyword(s):  
Health Care ◽  
Health Systems ◽  
Scoping Review ◽  
Service Provider ◽  
Digital Health ◽  
Digital Technologies ◽  
Data Access ◽  
Building Blocks ◽  
Sociodemographic Factors ◽  
Health Technologies

BACKGROUND Information and communication technologies have long become prominent components of health systems. Rapid advances in digital technologies and data science over the last few years are predicted to have a vast impact on health care services, configuring a paradigm shift into what is now commonly referred to as digital health. Forecasted to curb rising health costs as well as to improve health system efficiency and safety, digital health success heavily relies on trust from professional end users, administrators, and patients. Yet, what counts as the building blocks of trust in digital health systems has so far remained underexplored. OBJECTIVE The objective of this study was to analyze what relevant stakeholders consider as enablers and impediments of trust in digital health. METHODS We performed a scoping review to map out trust in digital health. To identify relevant digital health studies, we searched 5 electronic databases. Using keywords and Medical Subject Headings, we targeted all relevant studies and set no boundaries for publication year to allow a broad range of studies to be identified. The studies were screened by 2 reviewers after which a predefined data extraction strategy was employed and relevant themes documented. RESULTS Overall, 278 qualitative, quantitative, mixed-methods, and intervention studies in English, published between 1998 and 2017 and conducted in 40 countries were included in this review. Patients and health care professionals were the two most prominent stakeholders of trust in digital health; a third—health administrators—was substantially less prominent. Our analysis identified cross-cutting personal, institutional, and technological elements of trust that broadly cluster into 16 enablers (altruism, fair data access, ease of use, self-efficacy, sociodemographic factors, recommendation by other users, usefulness, customizable design features, interoperability, privacy, initial face-to-face contact, guidelines for standardized use, stakeholder engagement, improved communication, decreased workloads, and service provider reputation) and 10 impediments (excessive costs, limited accessibility, sociodemographic factors, fear of data exploitation, insufficient training, defective technology, poor information quality, inadequate publicity, time-consuming, and service provider reputation) to trust in digital health. CONCLUSIONS Trust in digital health technologies and services depends on the interplay of a complex set of enablers and impediments. This study is a contribution to ongoing efforts to understand what determines trust in digital health according to different stakeholders. Therefore, it offers valuable points of reference for the implementation of innovative digital health services. Building on insights from this study, actionable metrics can be developed to assess the trustworthiness of digital technologies in health care.

scholarly journals Universal Health Coverage

2020 ◽  
Vol 7 (4) ◽  
pp. p14
Author(s):  
Alfred A. Osoro ◽  
Edwine B. Atitwa ◽  
John K. Moturi
Keyword(s):  
Health Care ◽  
Human Resources ◽  
Health Systems ◽  
Universal Health Coverage ◽  
Health Coverage ◽  
Political Commitment ◽  
Equipment And Supplies ◽  
Health Technologies ◽  
Financial Allocation ◽  
Universal Health

Universal Health Coverage has attracted global attention as an ideal vehicle that will drive health care services to the individuals, families, and communities globally. Good health systems are capable of serving the needs of entire populations, including the availability of infrastructure, human resources, health technologies, and medicines. This study seeks to identify the barriers and challenges which have hindered the provision of basic health care to communities and suggest ways of addressing some of them. Literature search reviewed 40 materials which were more relevant. Results revealed that there have been disparities in the provision of healthcare. Challenges in service provision include; lack of political commitment, weak health system resulting from limited financial allocation and poor leadership, lack of adequate number of skilled human resources, equipment and supplies and poor infrastructures. For UHC to be successful, an effective and well-functioning Primary Health Care (PHC) system is essential. Thus health systems can be strengthened through financial allocation; training of skilled and well-motivated healthcare workers. Also provision of right equipment and supplies, equity in resource distribution, improvement of infrastructures to meet the needs of the people is fundamental.

Considering Health-Systems Constraints in Economic Evaluation in Low- and Middle-Income Settings

2019 ◽  
Author(s):  
Anna Vassall ◽  
Fiammetta Bozzani ◽  
Kara Hanson
Keyword(s):  
Economic Evaluation ◽  
Health System ◽  
Health Systems ◽  
New Technologies ◽  
System Thinking ◽  
Health System Strengthening ◽  
Middle Income ◽  
Health Technologies ◽  
Analytical Approaches ◽  
Low And Middle Income

In order to secure effective service access, coverage, and impact, it is increasingly recognized that the introduction of novel health technologies such as diagnostics, drugs, and vaccines may require additional investment to address the constraints under which many health systems operate. Health-system constraints include a shortage of health workers, ineffective supply chains, or inadequate information systems, or organizational constraints such as weak incentives and poor service integration. Decision makers may be faced with the question of whether to invest in a new technology, including the specific health system strengthening needed to ensure effective implementation; or they may be seeking to optimize resource allocation across a range of interventions including investment in broad health system functions or platforms. Investment in measures to address health-system constraints therefore increasingly need to undergo economic evaluation, but this poses several methodological challenges for health economists, particularly in the context of low- and middle-income countries. Designing the appropriate analysis to inform investment decisions concerning new technologies incorporating health systems investment can be broken down into several steps. First, the analysis needs to comprehensively outline the interface between the new intervention and the system through which it is to be delivered, in order to identify the relevant constraints and the measures needed to relax them. Second, the analysis needs to be rooted in a theoretical approach to appropriately characterize constraints and consider joint investment in the health system and technology. Third, the analysis needs to consider how the overarching priority- setting process influences the scope and output of the analysis informing the way in which complex evidence is used to support the decision, including how to represent and manage system wide trade-offs. Finally, there are several ways in which decision analytical models can be structured, and parameterized, in a context of data scarcity around constraints. This article draws together current approaches to health system thinking with the emerging literature on analytical approaches to integrating health-system constraints into economic evaluation to guide economists through these four issues. It aims to contribute to a more health-system-informed approach to both appraising the cost-effectiveness of new technologies and setting priorities across a range of program activities.

scholarly journals A policy analysis of the chronic care policies in Belgium

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
K Danhieux ◽  
M Martens ◽  
E Colman ◽  
R Remmen ◽  
J Van Olmen ◽  
...  
Keyword(s):  
Health Care ◽  
Health Policy ◽  
Policy Analysis ◽  
Integrated Care ◽  
Chronic Diseases ◽  
Health Systems ◽  
Policy Making ◽  
Chronic Care ◽  
Financing System ◽  
Vested Interests

Abstract Introduction Chronic diseases form the largest burden of disease in European countries. Redesign of health systems towards chronic integrated care is needed, with more collaboration between first and second line, between medical and social services and support to prevention and self-management. What are the levers for change in such health systems? This study addresses this knowledge gap, through a policy analysis of barriers and facilitators for change towards chronic integrated care. Methods 26 central level stakeholders were selected, based upon their influence in regulation and policy, financing, health care provision and community representation. Semi-structured face-to-face interviews were held covering assessment of past and current policies and implementation, barriers and opportunities for change. Results Reforms have taken place, such as the stimulation of local initiatives for chronic integrated care projects and the set-up of local care councils. Most stakeholders assessed the current Belgium's implementation of integrated care as low, despite a growing awareness for the need for change. A context factor often mentioned to constrain implementation was a state reform which led to a partial decentralization, fragmentation of decision power and a division of healthcare competences between federal and federated levels. Other barriers were the current financing system, the lack of investments in new models of care and the vested interests of providers. Discussion This analysis shows that chronic care reform in Belgium is constrained by partial decentralization of primary health care, and by the financing system and vested interests. It points to the need for coordination of health policy making and implementation. Disentangling the levels of decision-making and the financial leverage at these levels gives insights for change and change management, for the Belgium health system and other countries with a strong decentralized system. Key messages The current Belgium’s implementation of integrated care was assessed as low, due to different contexts factors such as division of health care competencies between different governmental levels. In a country as Belgium with a strong decentralized health care system coordination of health policy making and implementation is key in order to scale up integrated care for chronic diseases.

HOW CAN HEALTH SYSTEMS PREPARE FOR NEW AND EMERGING HEALTH TECHNOLOGIES? THE ROLE OF HORIZON SCANNING REVISITED

2018 ◽  
Vol 34 (3) ◽  
pp. 254-259 ◽  
Author(s):  
Wija Oortwijn ◽  
Laura Sampietro-Colom ◽  
Fay Habens ◽  
Rebecca Trowman
Keyword(s):  
Health Systems ◽  
Good Practice ◽  
Integrative Approach ◽  
Full Potential ◽  
Health Technologies ◽  
For Profit ◽  
Stage Of Development ◽  
Horizon Scanning ◽  
Policy Forum

Objectives:For many years, several health technology assessment (HTA) agencies scanned the horizon to identify health technologies that were safe, effective and offer value for money. However, there is limited evidence regarding its impact. The role of horizon scanning in preparing health systems for the uptake of new and emerging health technologies was discussed during the 2018 HTA International (HTAi) Global Policy Forum Meeting.Methods:Reflection of the discussion between seventy-two senior representatives from for-profit, not-for-profit organizations, and HTAi leadership. It was informed by a background paper, and presentations from four invited experts and seventeen Policy Forum members.Results:Current horizon scanning systems (HSS) mainly identify health technologies in the late stage of development, aiming to inform topic selection for HTA. Areas for improvement included the need for a clearer definition of the end user(s), purpose, scope, and focus of HSS, the long-term full health system effects, including all relevant stakeholders as early as possible, and considering smart data systems and international collaboration to improve HSS's efficiency. The way in which HSS could be further optimized and better shaped to prepare health systems was also discussed and good practice examples were presented.Conclusions:HSS have not yet reached their full potential in preparing health systems. To improve the current situation, the HTA community could act as convenors, bringing together all relevant stakeholders and providing the information that decision makers need. This would require a new, more integrative approach to define and use HSS and HTA, and requires new skills.

Information technology law and health systems in the European Union

2004 ◽  
Vol 20 (4) ◽  
pp. 498-508
Author(s):  
Elias Mossialos ◽  
Sarah Thomson ◽  
Annemarie Ter Linden
Keyword(s):  
Information Technology ◽  
European Union ◽  
Health Systems ◽  
Health Sector ◽  
Legal Aspects ◽  
Unintended Consequences ◽  
The European Union ◽  
Health Technologies ◽  
Goods And Services ◽  
The Impact

Objectives: This study aims to examine the impact of European Union (EU) law relating to information technology (IT) on health systems.Methods: The study identifies EU directives relating to IT, analyzes them in terms of their impact on the use of IT in health systems, and outlines their implications for health technology assessment (HTA). Analysis is based on a review of literature identified through relevant databases and Internet searches.Results: Developments in IT have serious implications for EU health systems, presenting policy makers with new challenges. The European Commission has adopted a range of legal measures to protect consumers in the “information society” However, as few of them are health-specific, it is not evident that they have implications for health, health systems, or HTA, and they may not be effective in protecting consumers in the health sector.Conclusions: In light of the growing importance of IT in the health sector, legal and nonlegal measures need to be further developed at EU and international level. Where possible, future initiatives should pay attention to the particular characteristics of health goods and services and health systems. Although definitions of HTA usually recognize the importance of evaluating both the indirect, unintended consequences of health technologies and the legal aspects of their application, it seems that, in practice, HTA often overlooks or underestimates legislative matters. Those involved in HTA should be aware of the legal implications of using IT to provide health goods and services and compile, store, transfer, and disseminate health information electronically.

scholarly journals Co-creating and Developing Health Management Theory and Practice: a global opportunity?

2018 ◽  
Vol 11 (2) ◽  
pp. 4-5
Author(s):  
David Briggs
Keyword(s):  
Health Systems ◽  
Health Management ◽  
Theory And Practice ◽  
Management Theory ◽  
Systems Practice ◽  
Research Findings

In recent years much has been made of the need to effectively translate knowledge developed through research into health systems practice. [1] Literature suggests that the acceptance of research findings would be more likely if the research were achieved and disseminated into practice where it occurs in a more collaborative alignment of researchers and practitioners.....

scholarly journals "There’s Not Enough Bodies to Do the Demand:" An Exploration of Key Stakeholder Views on the Role of Health Service Capacity in Shaping Cancer Outcomes in 7 International Cancer Benchmarking Partnership Countries

2020 ◽  
Author(s):  
Maureen Seguin ◽  
Melanie Morris ◽  
Martin McKee ◽  
Ellen Nolte
Keyword(s):  
Health System ◽  
Health Systems ◽  
Cancer Care ◽  
Cancer Survival ◽  
System Capacity ◽  
Multidisciplinary Teams ◽  
Specialist Care ◽  
Cancer Outcomes ◽  
Patient Journey

Background: Differences in cancer survival are shaped by differences in health system capacity in workforce and infrastructure. Part of the International Cancer Benchmarking Partnership (ICBP), this study explored stakeholders’ perceptions of the role of health system capacity necessary for cancer care in influencing cancer survival in 7 high-income countries. Methods: We conducted semi-structured interviews with 79 key informants from national, regional, and local tiers of health systems, professional bodies, patient associations, and academic experts in Australia, Canada, Denmark, Ireland, New Zealand, Norway, and the United Kingdom. Data collection was guided by a conceptual model linking characteristics of health systems and cancer survival along the cancer patient journey, from recognition of symptoms at pre-diagnostic stages through to survivorship or death. Data were analysed using a thematic approach. Results: We identified 3 themes as important in shaping cancer outcomes: primary care and access to diagnostic evaluation, specialist care and access to treatment, and workforce pertaining to diagnostic and treatment phases. Improved infrastructure for diagnosis and treatment had improved cancer outcomes in all jurisdictions. However, this was seen as insufficient if staffing was inadequate. Consolidation of services and greater surgical specialisation was important in some jurisdictions if accompanied by a reconfiguration of services, in particular the creation of specialist multidisciplinary teams, along with supporting capacity in the wider health system. Staff shortages were commonly cited as reasons why some jurisdictions lagged behind others. Conclusion: Continued improvement in cancer outcomes will require sustained investment in plans to deliver and maintain the workforce engaged in cancer care and in the infrastructure on which they depend. However, strategic plans must recognise that systems for cancer care do not work in isolation from the rest of the health system and a whole systems approach is essential if we are to improve outcomes for an ageing, increasingly multimorbid population.

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