Health technology refers to medical equipment, devices, supplies, procedures used for prevention, diagnosis and treatment. Health technologies must be evidence-based through clinical studies, improve health outcomes, and be cost-effective. The Ontario Health Technology Advisory Committee provides advice on new health technologies and assesses whether technologies improve length and quality of life. Health technology assessment evaluates properties, effects and impacts of technologies to inform health policy decisions. It applies scientific methods and considers clinical, economic and social factors.
Evidence based nursing practice is one of most important for perfect and accurate in terms of saving a life.this presentation covers almost all aspect of EBD
Evidence based nursing practice is one of most important for perfect and accurate in terms of saving a life.this presentation covers almost all aspect of EBD
This presentation is an introduction to telemedicine and telehealth. It explains common terminology and the different types of technology used. It concludes with findings from the American Medical Association on national physician use and links to additional resources.
This presentation is an introduction to telemedicine and telehealth. It explains common terminology and the different types of technology used. It concludes with findings from the American Medical Association on national physician use and links to additional resources.
Here are the ways to describe What is Medical Technology and how it works? ; 1. What does it entail? 2. The following is a description of what constitutes a medical device according to the World Health Organization:
Within the field of healthcare, there are three main viewpoints .docxadolphoyonker
Within the field of healthcare, there are three main viewpoints related to the use of financial information. They are the:
1. financial view
2. process view
3. clinical view
1) After reading the materials for the week, discuss the main areas of overlap within the three viewpoints.
2) Does this overlap create potential areas of conflict?
3) If so, as a manager, how would we proactively address these areas before they negatively impacted our department or organization?
APA style
1 – 2 pages
Citation of at least 4 recent studies (within 5 years)
Be sure to cite your references accordingly.
Reading the materials for the week From text book
Gapenski, L. C., & Pink, G. H. (2015). Understanding healthcare financial management (7th ed.). Chicago: Association of University Programs in Health Administration and Health Administration Press. ISBN 9781567937060.:
Financial View
· The financial view is held by those who normally handle finance on a daily basis, such as auditors, accountants, and financial analysts.
· Their strength lies in their ability to interpret data and spot problems before they become too critical.
· One of the key weaknesses is that these individuals are often very good with the minute details but often have a difficult time with the big picture.
Process View
· The process view is normally held by those individuals who are responsible for the financial systems and typically comprise the information technology departments.
· Their strength is the ability to take raw data and turn it into meaningful reports.
· Their weakness lies in not having all information at once. Since there are normally multiple individuals working in this department, each individual may have various pieces of the financial puzzle, but few have the ability to see it all.
Clinical View
· The clinical view is normally held by those who are responsible for the day to day interactions of the patients and are usually the licensed healthcare professionals.
· Their strength lies in their desire to ensure the best possible outcome for the patient and they generally serve as the patients’ advocate.
· Their weakness may actually be the same as their strength. Many clinical individuals want to provide the best for their patients, regardless of cost. Therefore, they may have a difficult time balancing the needs of the patients with the needs of the organization.
There are strengths and weaknesses to each viewpoint. Perhaps the ideal viewpoint would be where these three perspectives overlap. However, it is certainly not an easy task. Being able to see through each one of these lenses requires that the individual manager be in constant communication with other departments. While it may not be possible to fully integrate all three perspectives, being aware of them better prepares the manager to meet both patient and organizational objectives.
(Glossary of Telemedicine and eHealth)
· Teleconsultation: Consultation between a provider and specialist at dist.
Recommending an Evidence-Based Practice ChangeSilifat Jones-.docxaudeleypearl
Recommending an Evidence-Based Practice Change
Silifat Jones-Ibrahim
Walden University
Introduction
My organization has focused on delivery of better healthcare to its clients.
Diversity in healthcare delivery has bee crucial in transforming the healthcare.
The quality of care has been holistic care which is essential in long-term healthcare delivery.
Patient centered care has been important and provide a better patient satisfaction which has been a crucial aspect in improved quality healthcare delivery.
Introduction
The healthcare organization has been growing with a critical focus on the integration of fundamental technology-based changes which have focused on transforming healthcare setting.
IT due diligence in healthcare concentrates on evaluation of necessary technological changes in healthcare with a focus on the underlying costs, benefits, and risks involved in IT function.
Current problem
The changes within the healthcare organization have provided a strong emphasis on the need to ensure there is a focus on the wellbeing of quality service delivery.
Delivery of quality healthcare requires a highly integrated environment that help in ensure that there is better delivery of healthcare across different healthcare organizations.
The hospital has been unable to effectively define a strategy to incorporate technology in healthcare with an intention to improve the quality of care.
Current problem
The integration of technology has ensured that there are new measures in healthcare, which define an improved quality.
The advancing quality of health care is based on technological changes, which are focusing on specific concepts within healthcare.
However, inability to incorporate better healthcare technology within the organization has created a difficult operational environment especially management of patient health information.
Evidence based solutions
According to Mežinska et al. (2015), the most appropriate approach to consider has been to implement a health management system.
The article assert that the system should focus on efficiency in management patient information as well as operations management within the healthcare environment.
Management of healthcare information has become a critical factor which provides a strong consideration on critical processes which help create a reliable system.
Evidence based solutions
The inclusion of health information management systems has integrated vital processes which help identify important concepts which help manage patient information (Williams, 2013).
Electronic health record systems are also able to put in place better patient data protection thus ensuring that patient information does not fall into the wrong hands.
Health information is sensitive information, which can be detrimental to patient wellbeing if exposed (Wei, Lin & Loho-Noya,2013).
Plan for knowledge transfer of this change
A strategic system dev ...
Health technology assessment (HTA) is familiar as technique for gauging the value of specific medical technologies or approaches to care. As Adrian Towse points out, however, HTA has a much broader, ‘macro’ role in contributing to the efficiency of health care systems and supporting universal health coverage. This is particularly crucial in the face of increasing demands and limited budgets.
Challenges and Opportunities Around Integration of Clinical Trials DataCitiusTech
Conducting a Clinical Trial is a complex process, consisting of activities such as protocol preparation, site selection, approval of various authorities, meticulous collection and management of data, analysis and reporting of the data collected
Each activity is benefited from the development of point applications which ease the process of data collection, reporting and decision making. The recent advancements in mobile technologies and connectivity has enabled the generation and exchange of a lot more data than previously anticipated. However, the lack of interoperability and proper planning to leverage this data, still acts as a roadblock in allowing organizations truly harness their data assets. This document will help life sciences IT professionals and decision makers understand challenges and opportunities around clinical data integration
Assignment 1 Legal Aspects of U.S. Health Care System Administrat.docxbraycarissa250
Assignment 1: Legal Aspects of U.S. Health Care System Administration
Due Week 3 and worth 200 points
Prevailing wisdom reinforces the fact that working in U.S. health care administration in the 21st Century requires knowledge of the various aspects of health laws as they apply to dealing with medical professionals. Further, because U.S. health care administrators must potentially interact with many levels of professionals beyond the medical profession, it is prudent that they be aware of any federal, state, and local laws that may be applicable to their organizations. Thus, their conduct is also subject to the letter of the law. They must evaluate the quality of their professional interactions and be mindful of the implications and ramifications of their decisions.
Nearly 65 million surgical operations were performed in 2015 in the U.S. resulting in an estimated 200,000 deaths from complications or other post-operative issues (Ghaferi, Myers, Sutcliffe, & Pronovost, 2016). Ongoing innovation in healthcare can improve patient outcomes. According to the Harvard Business Review article, The Next Wave of Hospital Innovation to Make Patients Safer, over the past several decades, there have been three distinct waves of surgical improvement: technical advancements, standardizing procedures, and high reliability organizing.
Assume the role of a top health administrator at We Care Hospital. You are interested in propelling the hospital to the next level by applying for the Malcolm Baldrige National Quality Award. However, you want to ensure surgical outcomes for patient morbidity and mortality rates. You begin by researching the Surgical Care Improvement Project (SCIP) aimed to improve adherence to quality protocols. You need to ensure the hospital policy is consistent with the law and that the hospital is correctly reporting Sentinel Events to the Joint Commission, a hospital regulatory agency.
Note: You may create and / or make all necessary assumptions needed for the completion of this assignment.
Write a three to four (3-4) page paper in which you:
1. Analyze how standardizing procedures and documenting steps can improve outcomes when performing a complex procedure. Review the peer-reviewed journal article, The Next Wave of Hospital Innovation to Make Patients Safer. Articulate your position as the top administrator concerned about the importance of professional conduct and negligence in SCIP quality guidelines.
2. High Reliability Organizing emphasizes the varying actions that can affect patient safety given that standardized systems ignore the fact that each patient is different. Ascertain the major ramifications when the health care team “fails to rescue” the patient. Identify what hospital policies should be in place and identify previous case laws.
3. Analyze the four (4) elements required of a plaintiff to prove medical negligence.
4. Discuss the overarching duties of the health care governing board in mitigating the effects of medical non- ...
Psychosocial care of coronavirus disease 2019Nursing Path
The novel Coronavirus (nCoV) epidemic in 2019 -2020 has recently emerged. The route of transmission is not totally known, although it is known that it can spread from person to person, and local health care systems may be ill-equipped to handle a large-scale outbreak.
The blood electrolytes—sodium, potassium, chloride, and bicarbonate—help regulate nerve and muscle function and maintain acid-base balance and water balance. ... Thus, having electrolytes in the right concentrations (called electrolyte balance) is important in maintaining fluid balance among the compartments
Hospital infection control programs can help healthcare organizations monitor and improve practices, identify risks and proactively establish policies to prevent the spread of infections
Outcome-based education (OBE) is an educational theory that bases each part of an educational system around goals (outcomes). By the end of the educational experience, each student should have achieved the goal.
Assessment is part of the everyday activities of nursing professionals. Assessment is the only way by which a teacher can know how successful his teaching was and what areas in teaching need improvement.
A mental health disorder characterised by feelings of worry, anxiety or fear that are strong enough to interfere with one's daily activities.
The term "anxiety disorder" refers to specific psychiatric disorders that involve extreme fear or worry, and includes generalized anxiety disorder (GAD), panic disorder and panic attacks, agoraphobia, social anxiety disorder, selective mutism, separation anxiety, and specific phobias.
Selection and organization of learning experienceNursing Path
Curriculum is the educational design of learning experiences for the students. Curricular experiences include course content as well as learning activities. The selection and organization of curricular experiences must also reflect the philosophy of the school. The identifying and organizing of curricular experiences begins with the analysis of curriculum objectives. The most commonly used approach in selecting learning experiences is the logical approach in which the process is treated as content in curriculum development.
Universal health coverage (UHC) means that all people and communities can use the promotive, preventive, curative, rehabilitative and palliative health services they need, of sufficient quality to be effective, while also ensuring that the use of these services does not expose the user to financial hardship.
Pneumonia is an inflammatory condition of the lung affecting primarily the small air sacs known as alveoli. Typically symptoms include some combination of productive or dry cough, chest pain, fever, and trouble breathing.
Swine influenza is an infection caused by any one of several types of swine influenza viruses. Swine influenza virus (SIV) or swine-origin influenza virus (S-OIV) is any strain of the influenza family of viruses that is endemic in pigs
Abortion is the ending of pregnancy by removing an embryo or fetus before it can survive outside the uterus. An abortion that occurs spontaneously is also known as a miscarriage.
The enterobacteriaceae basic properties.ppsx xNursing Path
The Enterobacteriaceae are a large family of Gram-negative bacteria that includes, along with many harmless symbionts, many of the more familiar pathogens, such as Salmonella, Escherichia coli, Yersinia pestis, Klebsiella, and Shigella.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Ocular injury ppt Upendra pal optometrist upums saifai etawah
Health technology
1. 1www.drjayeshpatidar.blogspot.com
HEALTH TECHNOLOGY
DEFINITION:-
Health technologies are evidence-based technologies that provide cost-effective solutions to
health problems.
Health technologies are evidence-based when they meet well-defined specifications and
have been validated through controlled clinical studies or rest on a widely accepted
consensus by experts.
Health technologies are used at every level of the health care system from the simplest to the
most advanced; they form the backbone of the services medicine can offer in the prevention,
diagnosis and treatment of illness and disease.
For the purposes of the Ontario Health Technology Advisory Committee (OHTAC), health
technology includes a wide range of clinical procedures, devices and equipment applied to
the maintenance, restoration and promotion of health, but excludes drugs on the Ontario
Drug Benefit Program or Information Systems/Information Technology related technologies.
Technologies may include new and existing diagnostic and treatment related medical
devices, equipment and supplies and clinical procedures used in any health care
service delivery setting.
Technology encompasses interventions at any stage of health care, including primary
prevention, early detection of disease and risk factors, diagnosis, treatment,
rehabilitation and palliative care.
MISSION
The Mission of EHT is to:
Develop and maintain basic operational frameworks for safe and reliable health
services and technologies;
2. 2www.drjayeshpatidar.blogspot.com
Help Member States complete the basic operational frameworks through project
proposals prepared by Member States;
Develop norms and standards, guidelines, training materials, reference materials and
estimation of burden of disease; and
Focus on diseases of the poor.
Health technologies range from the tongue depressor to magnetic resonance imaging
equipment, from blood transfusion to emergency surgical procedures. Yet access to health
technologies is at the same time one of the most distinct differences between rich and poor
countries - far more so than access to technologies associated with basic medical education.
Young medical doctors educated in Bangladesh may have been taught by the same or
virtually the same textbooks as their colleagues educated in Great Britain. After their
graduation, thanks to internet access, they probably read the same medical journals and
continue to read the same kind of medical literature. And the most important factor for this is
access to health technologies. But the preventive measures, diagnostic procedures and
therapeutic interventions they are able to offer their patients are a long way from being of the
same magnitude and variety. Strong health systems invariably rely heavily on access to and
use of health technologies. Together, they form a dense mesh throughout the health services
into which they are interwoven. A strong mesh of health technologies is one of the most
fundamental prerequisites for the sustainability and self-reliance of health systems.
HEALTH TECHNOLOGIES INCLUDES IN THE FOLLOWING AREAS
Health technologies are everywhere.
o Blood transfusion safety
o Blood products and related biologicals
o Diagnostic imaging
o District hospital surgery
o Laboratory services
o Medical devices and equipment
o Transplantation services
HEALTH TECHNOLOGIES ARE ESSENTIAL WHEN THEY:
3. 3www.drjayeshpatidar.blogspot.com
1. Meet basic needs for health services
2. Have been proven to be cost-efficient
3. Are evidence-based
4. Health technologies are evidence-based when they meet well-defined
5. specifications and have been validated through controlled
6. clinical studies or rest on a widely accepted consensus by experts
HEALTH TECHNOLOGY ASSESSMENT (HTA)
Health Technology Assessment (HTA) applies rigorous, systematic methods of scientific
inquiry to the evaluation and use of new or existing health care technologies.
Vast amounts of practical experience have been accumulated around the world, and a
large body of relevant literature (both on methods and on particular technologies) exists on
the Internet and elsewhere. These resources have been packaged in a manner that will allow
you to develop the knowledge and skills required to manage health care technologies based
on their cost-effectiveness.
OBJECTIVE: To identify possible approaches for solving the problem of variations in the
types and intensity of resource use in implementing economic analyses of new technologies.
HEALTH TECHNOLOGY ASSESSMENT (HTA)
Health technology assessment is the systematic evaluation of properties, effects or other
impacts of health technology.
The main purpose of HTA is to inform policymaking for technology in health care, where
policymaking is used in the broad sense to include decisions made at, e.g., the individual or
patient level, the level of the health care provider or institution, or at the regional, national
and international levels. HTA may address the direct and intended consequences of
technologies as well as their indirect and unintended consequences. HTA is conducted by
interdisciplinary groups using explicit analytical frameworks, drawing from a variety of
methods.
Basic HTA Orientations
4. 4www.drjayeshpatidar.blogspot.com
The impetus for an HTA is not necessarily a technology. Three basic orientations to HTA are
as follows.
1. Technology-oriented assessments: - are intended to determine the characteristics or
impacts of particular technologies. For example, a government agency may want to
determine the clinical, economic, social, professional, or industrial impacts of population-
based cancer screening, cochlear implants, or other particular interventions.
2. Problem-oriented assessments:-focus on solutions or strategies for managing a particular
problem for which alternative or complementary technologies might be used. For example,
clinicians and providers concerned with the problem of diagnosis of dementia may call for
the development of clinical practice guidelines involving some combination or sequence of
clinical history, neurological examination, and diagnostic imaging using various modalities..
3. Project-oriented assessments:-focus on a local placement or use of a technology in a
particular institution, program, or other designated project. For example, this may arise when
a hospital must decide whether or not to purchase a magnetic resonance imaging (MRI) unit,
considering the facilities, personnel, and other resources needed to install and operate an
MRI unit; the hospital's financial status; local market potential for MRI services; competitive
factors; etc. These basic assessment orientations can overlap and complement one another.
Certainly, all three types could draw upon a common body of scientific evidence and other
information. A technology-oriented assessment may address the range of problems for which
the technology might be used and how appropriate the technology might be for different
types of local settings (e.g., inpatient versus outpatient). A problem-oriented assessment,
examining the effects or other impacts of alternative technologies on a given problem, may
incorporate multiple, focused (i.e., on the problem at hand) technology-oriented assessments.
A project-oriented assessment would consider the range of impacts of a technology or its
alternatives in a given setting, as well as the role or usefulness of that technology for various
problems. Although the information used in a project-oriented assessment by a particular
hospital may include findings of pertinent technology- and problem-oriented assessments,
local data collection and analysis may be required to determine what is sensible for that
hospital. Thus, many HTAs will blend aspects of all three basic orientations.
TEN BASIC STEPS OF HTA
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There is great variation in the scope, selection of methods and level of detail in the practice
of HTA. Nevertheless, most HTA activity involves some form of the following basic steps.
1. Identify assessment topics
2. Specify the assessment problem
3. Determine locus of assessment
4. Retrieve evidence
5. Collect new primary data (as appropriate)
6. Appraise/interpret evidence
7. Integrate/synthesize evidence
8. Formulate findings and recommendations
9. Disseminate findings and recommendations
10. Monitor impact
Not all assessment programs conduct all of these steps, and they are not necessarily
conducted in a linear manner. Many HTA programs rely largely on integrative methods of
reviewing and synthesizing data from existing primary data studies (reported in journal
articles or from epidemiological or administrative data sets), and do not collect primary data.
Some assessment efforts involve multiple cycles of retrieving/collecting, interpreting, and
integrating evidence before completing an assessment.
For example, to gain regulatory approval (e.g., by the US FDA) to market a new drugs,
pharmaceutical companies typically sponsor several iterations of new data collection:
preclinical testing in the laboratory and in animals and phase I, II, and III studies in humans;
additional phase IV post marketing studies may be a condition of approval. The steps of
appraising and integrating evidence may be done iteratively, such as when a group of
primarily data studies are appraised individually for quality, then are integrated into a body
of evidence, which in turn is appraised for its overall quality. Depending upon the
circumstances of an HTA, the dissemination of findings and recommendations and
monitoring of impact may not be parts of the HTA itself, although they may be important
responsibilities of the sponsoring program or parent organization.
Another framework for HTA is offered by the European Collaboration for Health
Technology Assessment, as follows.
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• Submission of an assessment request/identification of an assessment need
• Prioritization
• Commissioning
• Conducting the assessment
�Definition of policy question(s)
�Elaboration of HTA protocol
�Collecting background information/determination of the status of the technology
�Definition of the research questions
�Sources of data, appraisal of evidence, and synthesis of evidence for each of:
�Safety
�Efficacy/effectiveness
�Psychological, social, ethical
�Organizational, professional
�Economic
�Draft elaboration of discussion, conclusions, and recommendations
�External review
�Publishing of final HTA report and summary report
• Dissemination
• Use of HTA
• Update of the HTA
PURPOSES OF HTA
HTA can be used in many ways to advise or inform technology-related policy making.
a. Among these are to advise or inform:
1. Regulatory agencies such as the Food and Drug Administration (FDA) about whether
to permit the commercial use (e.g. marketing) of a drug, device or other technology
2. Health care payers, providers, and employers about whether technologies should be
included in health benefits plans or disease management programs, addressing
coverage (whether or not to pay) and reimbursement (how much to pay)
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3. Clinicians and patients about the appropriate use of health care interventions for a
particular patient’s clinical needs and circumstances
4. Health professional associations about the role of a technology in clinical protocols or
practice guidelines
5. Hospitals, health care networks, group purchasing organizations, and other health care
organizations about decisions regarding technology acquisition and management
6. Standards-setting organizations for health technology and health care delivery
regarding the manufacture, use, quality of care, and other aspects of health care
technologies
7. Government health department officials about undertaking public health programs
(e.g., vaccination, screening, and environmental protection programs)
8. Lawmakers and other political leaders about policies concerning technological
innovation, research and development, regulation, payment and delivery of health
care
9. Health care product companies about product development and marketing decisions
10.Investors and companies concerning venture capital funding, acquisitions and
divestitures, and other transactions concerning health care product and service
companies HTA contributes in many ways to the knowledge base for improving the
quality of health care, especially to support development and updating of a wide
spectrum of standards, guidelines, and other health care policies. For example, the
Joint Commission on Accreditation of Healthcare Organizations (JCAHO) and the
National Committee for Quality Assurance (NCQA) set standards for measuring
quality of care and services of hospitals, managed care organizations, long-term care
facilities, hospices, ambulatory care centers, and other health care institutions. Health
professional associations (e.g., American College of Cardiology, American College of
Physicians, American College of Radiology etc.
HEALTH TECHNOLOGY ASSESSMENT PROGRAM (HTA)
HTA is an innovative program that determines if health services used by state
government are safe and effective.
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The primary goals are to make:
Health care safer by relying on scientific evidence and a committee of practicing
clinicians
Coverage decisions of state agencies more consistent
State purchased health care more cost effective
Coverage decision process more open and inclusive by sharing information, holding public
meetings, and publishing decision criteria and outcomes
ONTARIO HEALTH TECHNOLOGY ADVISORY COMMITTEE (OHTAC)
CRITERIA
Several criteria are used to assess whether OHTAC will request a health technology review
and policy appraisal of a technology proposed for review. OHTAC considers first whether a
technology improves health outcomes such as length of life, quality of life and functionality.
OHTAC uses the criteria below to assess whether a health technology improves health
outcomes such as length of life, quality of life and functionality:
1. Technology must improve the net health outcome and/or safety for patients and/or
providers or improve health systems efficiency.
2. Technology must be at least as beneficial as any established alternative. If the
technology is not better but equivalent to an existing technology, it must be shown to
be effective and cost-effective.
3. Technology must be licensed by Health Canada and have received other applicable
licensing or approvals from appropriate governmental or regulatory bodies (e.g. the
Canadian Nuclear Safety Commission).
4. Opinions and evaluations by national or provincial medical associations, consensus
panels, or other technology evaluation bodies are evaluated according to the scientific
quality and strength of the supporting evidence and rationale.
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Preference will be directed to new technologies, rather than technologies that have already
diffused unless a diffused technology is being considered for a new application or significant
issues regarding a diffused technology are considered by OHTAC to warrant assessment.
Other important considerations
Applications for review must be endorsed by a potential purchaser of the technology
such as a hospital, home care program, or long-term care facility who acts as sponsor.
All correspondence concerning the status of the application will be between the
Medical Advisory Secretariat and the sponsor.
The applicant is responsible for ensuring that the materials submitted comply with all
applicable privacy and intellectual property regulation.
The applicant should be aware that the Medical Advisory Secretariat (MAS) might be
required to share submitted materials with experts.
The applicant should be aware that any materials submitted might be subject to
freedom of information requests made to the Ministry of Health and Long-Term Care.
OHTAC will notify the manufacturer(s) of the technology if it prioritizes the technology for
review
Timing of Assessment
There is no single correct time to conduct an HTA. It is conducted to meet the needs of a
variety of policymakers seeking assessment information throughout the lifecycles of
technologies. Investors, regulators, payers, hospital managers and others tend to make
decisions about technologies at particular junctures, and each may subsequently reassess
technologies. Indeed, the determination of a technology's stage of diffusion may be the
primary purpose of an assessment. For insurers and other payers, technologies that are
deemed experimental or investigational are usually excluded from coverage, whereas those
that are established or generally accepted are usually eligible for coverage there are tradeoffs
inherent in decisions regarding the timing for HTA. On one hand, the earlier a technology is
assessed, the more likely its diffusion can be curtailed if it is unsafe or ineffective From
centuries' old purging and bloodletting to the more contemporary autologous bone marrow
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transplantation with high-dose chemotherapy for advanced breast cancer, the list of poorly
evaluated technologies that diffused into general practice before being found to be
ineffective and/or harmful continues to grow. On the other hand, to regard the findings of an
early assessment as definitive or final may be misleading.
An investigational technology may not yet be perfected; its users may not yet be proficient;
its costs may not yet have stabilized; it may not have been applied in enough circumstances
to recognize its potential benefits; and its long-term outcomes may not yet be known
(Mowatt 1997). As one technology assessor concluded about the problems of when-to-
assess: "It's always too early until, unfortunately, it's suddenly too late!” (Buxton 1987).
Further, the "moving target problem" can complicate HTA (Goodman 1996). By the time a
HTA is conducted, reviewed and disseminated, its findings may be outdated by changes in a
technology, in how it is used, or in its technological alternatives for a given problem. Some
payers provide conditional coverage for selected investigational technologies in order to
compile evidence on safety, effectiveness, cost, etc., for making more informed coverage
policies. In these instances, payers cover the use of a technology only under certain
conditions, such as where patients are enrolled in an RCT at certain participating medical
centers. This arrangement offers a way to balance the need for evidence with the demand for
access and financially compensated care. Depending on the type of technology involved, it
further enables refinement of technique or delivery, and building of experience and expertise
among physicians and other providers despite the value of conditional coverage in principle,
some observers have raised practical and ethical concerns about their implementation.
Among these are that:
1. If conditional coverage is initiated after a technology has diffused, some patients
who had expected to get a procedure may be denied it if they are not enrolled in a
trial;
2. Some patients who would be interested in enrolling in a covered trial are not located
near a participating center and are therefore denied access;
3. Patients and physicians who believe in the effectiveness of the technology may be
unwilling to be involved in an RCT, including Some who decide to finance the
technology outside of the trial and therefore diminish enrollment,
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4. The indications for using the technology in the conditional coverage trial may be too
broad or too narrow to properly reflect the potential safety and effectiveness of the
technology; and
5. The technology continues to evolve during the conditional coverage process, to the
point where the trial findings are of diminished relevance
Diethylstilbestrol (DES) to improve pregnancy outcomes
Electronic fetal monitoring during labor without access to fetal scalp sampling
Episiotomy (routine or liberal) for birth
Extra cranial-intracranial bypass to reduce risk of ischemic stroke
Gastric bubble for morbid obesity
Gastric freezing for peptic ulcer disease
Hormone replacement therapy for healthy menopausal women
Hydrolyzing for chronic heart failure
Intermittent positive pressure breathing monitoring
Mammary artery legation for coronary artery disease
Optic nerve decompression surgery for nonarteritic anterior ischemic optic
neuropathy
Quinidine for suppressing recurrences of atrial fibrillation
Radiation therapy for acne
Sleeping face down for healthy babies
Supplemental oxygen for healthy premature babies
Thalidomide for sedation in pregnant women
Thymic irradiation in healthy children
Triparanol (MER-29) for cholesterol reduction
PROPERTIES AND IMPACTS ASSESSED
In general, these include the following.
Technical properties
Safety
Efficacy and/or effectiveness
Economic attributes or impacts
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Social, legal, ethical and/or political impacts
Technical properties: - include performance characteristics and conformity with
specifications for design, composition, manufacturing, tolerances, reliability, ease of use,
maintenance, etc.
Safety: - is a judgment of the acceptability of risk (a measure of the probability of an adverse
outcome and its severity) associated with using a technology in a given situation, e.g., for a
patient with a particular health problem, by a clinician with certain training, and/or in a
specified treatment setting.
Efficacy and effectiveness: -both refer to how well a technology works to improve patient
health, usually based on changes in one or more pertinent health outcomes or "endpoints" as
described below. A technology that works under carefully controlled conditions or with
carefully selected patients under the supervision of its developers does not always work as
well in other settings or as implemented by other practitioners. In HTA, efficacy refers to the
benefit of using a technology for a particular problem under ideal conditions, e.g., within the
protocol of a carefully managed randomized controlled trial, involving patients meeting
narrowly defined criteria, or conducted at a "center of excellence." Effectiveness refers to
the benefit of using a technology for a particular problem under general or routine
conditions, e.g., by a physician in a community hospital for a variety of types of patients.
Clinicians, patients, managers and policymakers are increasingly aware of the practical
implications of differences in efficacy and effectiveness. Researchers delve into registers,
databases (e.g., of third-party payment claims and administrative data) and other
epidemiological and observational data to discern possible associations between the use of
technologies and patient outcomes in general or routine practice settings. The validity of any
findings regarding causal connections between interventions and patient outcomes may be
weakened to the extent that these data are not derived from prospective, randomized,
controlled studies (US Congress, OTA 1994). As discussed below, some newer prospective
trials are designed to incorporate varied groups of patients and settings.
EXPERTISE FOR CONDUCTING HTA
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Given the variety of impacts addressed and the range of methods that may be used in an
assessment, multiple types of experts are needed in HTA. Depending upon the topic and
scope of assessment, these may include a selection of the following:
1. Physicians, nurses, dentists, and other clinicians
2. Managers of hospitals, clinics, nursing homes, and other health care
institutions
3. Radiology technicians, laboratory technicians and other allied health
professionals
4. Biomedical and clinical engineers
5. Pharmacologists
6. Patients and patient affairs representatives
7. Epidemiologists
8. Biostatisticians
9. Economists
10.Lawyers
11.Social scientists
12.Ethicists
13.Decision scientists
14.Computer scientists/programmers
15.Librarians/information specialists
Certain individuals have expertise in more than one area. The set of participants in an
assessment depends upon its purpose, available resources and other factors. For example, the
standing members of a hospital technology assessment committee might include: the chief
executive officer, chief financial officer, physician chief of staff, director of nursing, director
of planning, materials manager and director of biomedical engineering (Sadock 1997; Taylor
1994). Physician specialists and marketing, legal, patient affairs and additional analytical
support staff could be involved as appropriate.
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HEALTH TECHNOLOGIES AND DECISION MAKING:
Health technology has the tremendous potential to change our understanding of disease,
transform the delivery of health-care services, and improve health outcomes. But using such
technology comes at a price. Decisions about whether to purchase and use new technology
should be based on high-quality evidence on its impact on health care and health outcomes.
OECD countries face the challenge of aligning health-care decision making with the best
available evidence. While many countries have invested in the production of health
technology assessment, evidence about its use in decision making is limited.
Health Technologies and Decision Making analyses the barriers to, and facilitators of,
evidence-based decision making in OECD health-care systems. It examines how countries
can successfully manage the opportunities and challenges arising from health-related
technology by optimizing decision-making processes, recognizing the value of innovation,
dealing with uncertainty, and producing and coordinating health technology assessment. The
book also considers the capacity of health systems to respond to the particular challenges of
fast-developing health-related biotechnologies.
The work described in this report, carried out with a group of experts drawn from OECD
countries, examined how improvements could be made to integrate effective and efficient
technologies into health-care systems. Analysis focused on the production of evidence,
primarily in the form of health technology assessment (HTA), and the way that such
evidence is subsequently used in decision making. The way decisions are made and
implemented was also analyzed, including examining the range of policy tools used to put
decisions into actual practice.
The conclusions presented in this report drew on analysis of a survey of how health
technologies are integrated into health systems, focusing on:
How decisions at the national, regional and hospital levels are made.
How evidence (particularly HTA-based evidence) is produced and used in decision
making.
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How aspects of health-care systems facilitate or impede the implementation of decisions.
In order to face the challenge of making appropriate coverage decisions, HCFA has moved
toward the increased use of evidence-based decision-making. We often rely on technology
assessments done by agencies such as the Agency for Health Care Policy and Research
(AHCPR) as well as the advice of the Food and Drug Administration, the National Institutes
of Health, the Department of Veterans Affairs, the Department of Defense, and on many
experts in the medical community and private sector. Obtaining authoritative evidence of the
value of individual services assures that beneficiaries will receive high quality and effective
care.
Health technology includes the following.
a. Drugs: e.g., aspirin, beta-blockers, antibiotics, HMG-CoA reductase inhibitors
(“statins”)
b. Biologics: vaccines, blood products, cellular and gene therapies
c. Devices, equipment and supplies: e.g., cardiac pacemakers, CT scanners,
surgical gloves, diagnostic test kits
d. Medical and surgical procedures: e.g., psychotherapy, nutrition counseling,
coronary angiography, gall bladder removal
e. Support systems: e.g., electronic patient record systems, telemedicine systems,
drug formularies, blood banks, clinical laboratories
f. Organizational and managerial systems: e.g., prospective payment using
diagnosis-related groups, alternative health care delivery configurations,
clinical pathways, total quality management programs
CONCLUSION
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HCFA today must react expeditiously to rapid advances and changes made in medical
science and technology and define and clarify the benefits under the Medicare program. This
is a challenge because, like all health plans, Medicare often faces the dilemma of having
inadequate data to make evidence-based coverage decisions for new technologies and
services. AHCPR thus plays a crucial role in providing needed information on medical
effectiveness and outcomes, which assists in the adoption of appropriate coverage policies.
This, in turn, serves beneficiaries by assuring that they have access to the current beneficial
medical advances, are treated appropriately, and are protected from ineffective and
potentially unsafe services.
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