June 25, 2012
Debates about the productivity yield of IT are new to health care but not to other sectors of the economy. During the 1970s and 1980s, the computing capacity of the U.S. economy increased more than a hundredfold while the rate of productivity growth fell dramatically to less than half the rate of the preceding 25 years.1 The relationship between the rapid increase in IT use and the simultaneous slowdown in productivity became widely known as the “IT productivity paradox,” and economists debated whether investing billions of dollars in IT was worthwhile. The Nobel laureate economist Robert Solow observed in 1987 that “you can see the computer age everywhere but in the productivity statistics.”
Posted in Journal Articles, READ Portal | Tagged with Cost effectiveness, Health technology, Information technology, Technology | No Comments
May 9, 2012
“Background: Finding measures to enhance the dissemination and implementation of their recommendations has become part of most health technology assessment (HTA) bodies’ preoccupations. The Quebec government HTA organization in Canada observed that some of its projects relied on innovative practices in knowledge production and dissemination. A research was commissioned in order to identify what characterized these practices and to establish whether they could be systematized.
Methods: An exploratory case study was conducted during summer and fall 2010 in the HTA agency in order to determine what made the specificity of its context, and to conceptualize an approach to knowledge production and dissemination that was adapted to the mandate and nature of this form of HTA organization. Six projects were selected. For each, the HTA report and complementary documents were analyzed, and semi-structured interviews were carried out. A narrative literature review of the most recent literature reviews of the principal knowledge into practice frameworks (2005-2010) and of articles describing such frameworks (2000-2010) was undertaken.
Results and discussion: Our observations highlighted an inherent difficulty as regards applying the dominant knowledge translation models to HTA and clinical guidance practices. For the latter, the whole process starts with an evaluation question asked in a problematic situation for which an actionable answer is expected. The objective is to produce the evidence necessary to respond to the decision-maker’s request. The practices we have analyzed revealed an approach to knowledge production and dissemination, which was multidimensional, organic, multidirectional, dynamic, and dependent on interactions with stakeholders. Thus, HTA could be considered as a knowledge mobilization process per se.
Conclusions: HTA’s purpose is to solve a problem by mobilizing the types of evidence required and the concerned actors, in order to support political, organizational or clinical decision-making. HTA relies on the mediation between contextual, colloquial and scientific evidence, as well as on interactions with stakeholders for recommendation making. Defining HTA as a knowledge mobilization process might contribute to consider the different orders of knowledge, the social, political and ethical dimensions, and the interactions with stakeholders, among the essential components required to respond to the preoccupations, needs and contexts of all actors concerned with the evaluation question’s issues.”
Posted in Journal Articles, READ Portal | Tagged with Canada, Decision making, Health technology, Technology | No Comments
March 7, 2012
This TED talk looks at how crowdsourcing can be used to help improve service to patients. Crowdsourcing is “the practice of obtaining needed services, ideas, or content by soliciting contributions from a large group of people and especially from the online community rather than from traditional employees or suppliers (crowdsourcing, 2011. In Merriam-Webster.com. Retrieved May 8, 2011, from http://www.merriam-webster.com/dictionary/crowdsourcing.).”
According to Lucien Engelen (“a technologist and innovator who is working to put patients into the healthcare team”), “you can use your smartphone to find a local ATM, but what if you need a defibrillator? At TEDxMaastricht, Lucien Engelen shows us online innovations that are changing the way we save lives, including a crowdsourced map of local defibrillators.”
To watch the video visit: http://www.ted.com/talks/lucien_engelen_crowdsource_your_health.html.
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January 25, 2012
“Ms. H. is a 35-year-old woman from Japan who has had a cough for 3 weeks. Her physician sends her for an x-ray and CT scan that reveal an advanced lesion, which a biopsy confirms to be non–small-cell lung cancer. She has never smoked. Can anything be done for her?
Had Ms. H.’s cancer been diagnosed before 2004, her oncologist might have offered her a treatment to which about 10% of patients have a response, with the remainder gaining a negligible survival benefit and experiencing clinically significant side effects. But her diagnosis was made in 2011, when her biopsy tissue could be analyzed for a panel of genetic variants that can reliably predict whether the disease will respond to treatment. Her tumor was shown to be responsive to a specific targeted agent, whose administration led to a remission lasting almost a year; her only side effect was a rash.
This scenario illustrates the fundamental idea behind personalized medicine: coupling established clinical–pathological indexes with state-of-the-art molecular profiling to create diagnostic, prognostic, and therapeutic strategies precisely tailored to each patient’s requirements — hence the term “precision medicine.” Recent biotechnological advances have led to an explosion of disease-relevant molecular information, with the potential for greatly advancing patient care. However, progress brings new challenges, and the success of precision medicine will depend on establishing frameworks for regulating, compiling, and interpreting the influx of information that can keep pace with rapid scientific developments. In addition, we must make health care stakeholders aware that precision medicine is no longer just a blip on the horizon — and ensure that it lives up to its promise.”
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November 29, 2011
“Background and Objectives: In the last few years there has been a steady uptake of mobile phone short message service (SMS) reminders to increase medical attendance rates. We undertook a review of studies that assessed the effectiveness of SMS reminders at increasing the uptake of appointments in health care settings.
Methods: We reviewed studies which involved a comparison of appointment attendance rates between patients who did and did not receive SMS reminders published prior to June 2010. We used meta-analysis methods to calculate the overall effect on attendance rates, stratified by study design and clinic type.
Results: The review criteria were met by 18 reports, made up of eight randomized controlled trials (RCTs) and 10 controlled observational studies. Across all studies, there was significant heterogeneity in the estimated effect measure of the relationship between use of SMS reminders and clinic attendance (I2 = 90 percent; p < .01), so a summary effect estimate was not calculated. Stratification by study design showed that the heterogeneity was due to the observational studies. The summary effect from the RCTs was 1.48 (95% CI: 1.23–1.72) with no significant subgroup differences by clinic type (primary care clinics, hospital outpatient clinics), message timing (24, 48, and 72+ hours before the scheduled appointment), and target age group (pediatric, older).
Conclusions: Short message service reminders in health care settings substantially increase the likelihood of attending clinic appointments. SMS reminders appear to be a simple and efficient option for health services to use to improve service delivery, as well as resulting in health benefits for the patients who receive the reminders.”
Click here to read the full article
Posted in Journal Articles, READ Portal | Tagged with Evidence-based, Information technology, Policy, Technology | No Comments
September 12, 2011
On the surface, technology-enabled home health care should be thriving in the United States. The country’s aging population and the transformation of acute illnesses such as heart failure into chronic diseases mean that the number of patients is growing. In addition, new medical-technology devices could help keep patients at home rather than in costly institutions, such as assisted-living facilities or nursing homes—leading to potentially big savings for the health care system.
Instead, the full potential of the technology-enabled home health care market remains to be tapped.
Click here for the full article
Posted in Journal Articles, READ Portal | Tagged with Health services for the aged, Technology | No Comments
July 12, 2011
Tablet technology has become ubiquitous in the hospital setting. Doctors use them to review patient data, demonstrate health concepts, and much more. There are a number of types of tablets available, from consumer models like the iPad to healthcare targeted models like the Toughbook H1. While MDs are lauding the advancement of tablet technologies, there are still a plethora of concerns regarding their use in a healthcare setting. Some of the obvious concerns include privacy issues- if a tablet device leaves the workplace then there is a chance sensitive data could fall into the wrong hands. Other challenges include sanitation issues, like ensuring the devices stay clean in a hospital setting, and gadget overload, faced by many doctors that have too many mobile devices. Despite these concerns, the advantages of tablet technology cannot be ignored. They allow for greater control of patient care through a number of avenues, including the increased ability to monitor patient data remotely and through the ability to look for resources in an easy to access handheld device.
Posted in READ Portal, Reports & Papers | Tagged with Hospitals, Information technology, Technology | No Comments
June 29, 2011
“The objective of the Telehealth Adoption and Benefits Study was to inform Telehealth stakeholders, including funders of Telehealth programs, health system administrators, clinicians and patients, about the evidence of value of Telehealth activities in Canada. The study focused on the quality, access, and productivity benefits being achieved by these Telehealth activities. The benefits were assessed utilizing the Canada Health Infoway (Infoway) Benefits Evaluation Framework.”
“The benefits evaluation process employed a combination of quantitative and qualitative methods. Where it was possible, quantitative methods were used to calculate current benefits and to forecast/extrapolate potential future benefits. Qualitative methods of inquiry were used to gain an in-depth understanding of benefits experienced by users, and to give context and to help interpret the quantitative data.”
“The study found significant and growing utilization of Telehealth — the use of information and communication technologies to extend health care service delivery across distance — all over the country. (The study also found that) the utilization of this Telehealth infrastructure has resulted in a number of access, quality and productivity benefits…”
Posted in READ Portal, Reports & Papers | Tagged with Health technology, Information technology, Technology, Telehealth | No Comments
June 16, 2011
“The use of mobile and wireless technologies to support the achievement of health objectives (mHealth) has the potential to transform the face of health service delivery across the globe. A powerful combination of factors is driving this change. These include rapid advances in mobile technologies and applications, a rise in new opportunities for the integration of mobile health into existing eHealth services, and the continued growth in coverage of mobile cellular networks. According to the International Telecommunication Union (ITU), there are now over 5 billion wireless subscribers; over 70% of them reside in low- and middle- income countries. The GSM Association reports commercial wireless signals cover over 85% of the world’s population, extending far beyond the reach of the electrical grid.
For the first time the World Health Organization’s (WHO) Global Observatory for eHealth (GOe) has sought to determine the status of mHealth in Member States; its 2009 global survey contained a section specifically devoted to mHealth. Completed by 114 Member States, the survey documented for analysis four aspects of mHealth: adoption of initiatives, types of initiatives, status of evaluation, and barriers to implementation. Fourteen categories of mHealth services were surveyed: health call centres, emergency toll-free telephone services, managing emergencies and disasters, mobile telemedicine, appointment reminders, community mobilization and health promotion, treatment compliance, mobile patient records, information access, patient monitoring, health surveys and data collection, surveillance, health awareness raising, and decision support systems.”
Posted in READ Portal, Reports & Papers | Tagged with Health care reform, Health technology, Information technology, Technology | No Comments
June 13, 2011
According to a new report (registration required) from Fitch Ratings, not-for-profit hospitals that utilized information technology achieved higher profits and quality ratings than hospitals that did not employ similar technology.
A synopsis of the report on Modern Healthcare illustrates some of the major findings, such as the fact that technology advanced hospitals were more likely than low-tech hospitals to receive a rating of A- or higher, as well as see greater profit over cost growth and more available cash and investments.
Posted in Mass Media Articles, READ Portal | Tagged with Benchmarking, Economics, Health technology, Hospital administration, Technology | No Comments