1
|
De Domenico F, Noto G, Cinici MC. Hospital process performance and the adoption of medical devices: An organization-based view. Health Serv Manage Res 2024:9514848241270874. [PMID: 39102280 DOI: 10.1177/09514848241270874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/06/2024]
Abstract
Over the past two decades, there has been a growing scholarly interest in the adoption of technology in healthcare. While numerous studies have delved into the effects of specific technologies on the performance of different organizational units and medical specialties, the findings have often been divergent. Unlike the established literature, our approach focuses on the organization's perspective to analyze how technology impacts process performance in hospital settings. More precisely, we compiled a tailored dataset from 56 healthcare organizations in Italy and conducted a comprehensive analysis of panel data from 2016 to 2019, utilizing Ordinary Least Squares (OLS) regression as our main analytical tool. The data shows a clear relationship between an organization's use of medical devices and its overall process performance. Our research highlights the importance of achieving substantial improvements in process performance by strategically integrating new technologies and devices. Policymakers are encouraged to consider introducing incentives to drive hospitals to invest in innovative technologies. Furthermore, monitoring expenditures on new devices could serve as a valuable metric for assessing the extent of technology adoption within clinical practices.
Collapse
Affiliation(s)
| | - Guido Noto
- Department of Economics, University of Messina, Messina, Italy
| | | |
Collapse
|
2
|
Iskrov G, Raycheva R, Kostadinov K, Gillner S, Blankart CR, Gross ES, Gumus G, Mitova E, Stefanov S, Stefanov G, Stefanov R. Are the European reference networks for rare diseases ready to embrace machine learning? A mixed-methods study. Orphanet J Rare Dis 2024; 19:25. [PMID: 38273306 PMCID: PMC10809751 DOI: 10.1186/s13023-024-03047-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 01/19/2024] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND The delay in diagnosis for rare disease (RD) patients is often longer than for patients with common diseases. Machine learning (ML) technologies have the potential to speed up and increase the precision of diagnosis in this population group. We aim to explore the expectations and experiences of the members of the European Reference Networks (ERNs) for RDs with those technologies and their potential for application. METHODS We used a mixed-methods approach with an online survey followed by a focus group discussion. Our study targeted primarily medical professionals but also other individuals affiliated with any of the 24 ERNs. RESULTS The online survey yielded 423 responses from ERN members. Participants reported a limited degree of knowledge of and experience with ML technologies. They considered improved diagnostic accuracy the most important potential benefit, closely followed by the synthesis of clinical information, and indicated the lack of training in these new technologies, which hinders adoption and implementation in routine care. Most respondents supported the option that ML should be an optional but recommended part of the diagnostic process for RDs. Most ERN members saw the use of ML limited to specialised units only in the next 5 years, where those technologies should be funded by public sources. Focus group discussions concluded that the potential of ML technologies is substantial and confirmed that the technologies will have an important impact on healthcare and RDs in particular. As ML technologies are not the core competency of health care professionals, participants deemed a close collaboration with developers necessary to ensure that results are valid and reliable. However, based on our results, we call for more research to understand other stakeholders' opinions and expectations, including the views of patient organisations. CONCLUSIONS We found enthusiasm to implement and apply ML technologies, especially diagnostic tools in the field of RDs, despite the perceived lack of experience. Early dialogue and collaboration between health care professionals, developers, industry, policymakers, and patient associations seem to be crucial to building trust, improving performance, and ultimately increasing the willingness to accept diagnostics based on ML technologies.
Collapse
Affiliation(s)
- Georgi Iskrov
- Institute for Rare Diseases, 22 Maestro G. Atanasov St., 4017, Plovdiv, Bulgaria.
- Department of Social Medicine and Public Health, Faculty of Public Health, Medical University of Plovdiv, 15A Vasil Aprilov Blvd., 4002, Plovdiv, Bulgaria.
| | - Ralitsa Raycheva
- Institute for Rare Diseases, 22 Maestro G. Atanasov St., 4017, Plovdiv, Bulgaria
- Department of Social Medicine and Public Health, Faculty of Public Health, Medical University of Plovdiv, 15A Vasil Aprilov Blvd., 4002, Plovdiv, Bulgaria
| | - Kostadin Kostadinov
- Institute for Rare Diseases, 22 Maestro G. Atanasov St., 4017, Plovdiv, Bulgaria
- Department of Social Medicine and Public Health, Faculty of Public Health, Medical University of Plovdiv, 15A Vasil Aprilov Blvd., 4002, Plovdiv, Bulgaria
| | - Sandra Gillner
- KPM Center for Public Management, University of Bern, Freiburgstr. 3, 3010, Bern, Switzerland
- Swiss Institute for Translational and Entrepreneurial Medicine (Sitem-Insel), Freiburgstr. 3, 3010, Bern, Switzerland
| | - Carl Rudolf Blankart
- KPM Center for Public Management, University of Bern, Freiburgstr. 3, 3010, Bern, Switzerland
- Swiss Institute for Translational and Entrepreneurial Medicine (Sitem-Insel), Freiburgstr. 3, 3010, Bern, Switzerland
| | - Edith Sky Gross
- EURORDIS - Rare Diseases Europe, 96 Rue Didot, 75014, Paris, France
| | - Gulcin Gumus
- EURORDIS - Rare Diseases Europe, 96 Rue Didot, 75014, Paris, France
| | - Elena Mitova
- Institute for Rare Diseases, 22 Maestro G. Atanasov St., 4017, Plovdiv, Bulgaria
| | - Stefan Stefanov
- Institute for Rare Diseases, 22 Maestro G. Atanasov St., 4017, Plovdiv, Bulgaria
- Department of Epidemiology and Disaster Medicine, Faculty of Public Health, Medical University, 15A Vasil Aprilov Blvd., 4002, Plovdiv, Bulgaria
| | - Georgi Stefanov
- Institute for Rare Diseases, 22 Maestro G. Atanasov St., 4017, Plovdiv, Bulgaria
| | - Rumen Stefanov
- Institute for Rare Diseases, 22 Maestro G. Atanasov St., 4017, Plovdiv, Bulgaria
- Department of Social Medicine and Public Health, Faculty of Public Health, Medical University of Plovdiv, 15A Vasil Aprilov Blvd., 4002, Plovdiv, Bulgaria
| |
Collapse
|
3
|
When Patience is a Failing: The Case for Patient Reported Outcomes Adoption. Int J Radiat Oncol Biol Phys 2023:S0360-3016(23)00091-3. [PMID: 36724856 DOI: 10.1016/j.ijrobp.2023.01.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 01/21/2023] [Indexed: 01/30/2023]
|
4
|
Whyte S, Bray L, Chan HF, Chan RJ, Hunt J, Peltz TS, Dulleck U, Hutmacher DW. Exploring Surgeons', Nurses', and Patients' Information Seeking Behavior on Medical Innovations: The Case of 3D Printed Biodegradable Implants in Breast Reconstruction. ANNALS OF SURGERY OPEN 2022; 3:e176. [PMID: 37601603 PMCID: PMC10431284 DOI: 10.1097/as9.0000000000000176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 05/09/2022] [Indexed: 11/26/2022] Open
Abstract
Objectives To explore information seeking behavior on medical innovations. Background While autologous and alloplastic options for breast reconstruction are well established, it is the advent of the combination of 3D printing technology and the biocompatible nature of a highly porous biodegradable implants that offers new treatment options for the future. While this type of prosthesis is not yet clinically available understanding how patients, surgeons, and nurses take up new medical innovations is of critical importance for efficient healthcare provision. Materials and Methods Using the largest ever combined sample of breast cancer patients (n = 689), specialist surgeons (n = 53), and breast care nurses (n = 101), we explore participants preference for a new surgical treatment concept rooted in 3D printed and biodegradable implant technologies in the context of breast reconstruction. Results We find that patients overwhelmingly favor information from a successful patient of the proposed new technology when considering transitioning. Surgeons and nurses instead favor regulatory body advice, peer-reviewed journals, and witnessing the procedure performed (either in person or online). But while 1 in 4 nurses nominated talking to a successful patient as an information source, not a single surgeon chose the same. Our multinomial logit analysis exploring patient preference (controlling for individual differences) showed statistically significant results for both the type of surgical treatment and choice to undergo reconstruction. Women who underwent a type of mastectomy procedure (compared with lumpectomy patients) were more likely to choose a former patient than a surgeon for seeking information relating to a new breast implant technology. Further, women who chose to undergo a reconstruction procedure, compared with those who did not, where more likely to prefer a surgeon for information relating to a new breast implant technology, rather than a successful patient. For medical professionals, we find no statistically significant relationship between medical professionals' preference and their age, nor the number of other medical professionals they work with daily, nor the average number of breast procedures performed in their practice on a weekly basis. Conclusions As our findings show large variation exists (both within our patient group and compared with medical professionals) in where individuals favor information on new medical innovations, future behavioral research is warranted.
Collapse
Affiliation(s)
- Stephen Whyte
- From the School of Economics and Finance, Queensland University of Technology (QUT), Brisbane, QLD, Australia
- Centre for Behavioural Economics, Society & Technology (BEST), Queensland University of Technology (QUT), Brisbane, QLD, Australia
- Centre in Regenerative Medicine, Queensland University of Technology (QUT), Kelvin Grove, QLD, Australia
- ARC Training Centre for Cell and Tissue Engineering Technologies, Queensland University of Technology (QUT), Brisbane, QLD, Australia
| | - Laura Bray
- Centre for Behavioural Economics, Society & Technology (BEST), Queensland University of Technology (QUT), Brisbane, QLD, Australia
- School of Mechanical, Medical and Process Engineering, Science and Engineering Faculty, Queensland University of Technology (QUT), Brisbane, QLD, Australia
- ARC Training Centre for Cell and Tissue Engineering Technologies, Queensland University of Technology (QUT), Kelvin Grove, QLD, Australia
| | - Ho Fai Chan
- From the School of Economics and Finance, Queensland University of Technology (QUT), Brisbane, QLD, Australia
- Centre for Behavioural Economics, Society & Technology (BEST), Queensland University of Technology (QUT), Brisbane, QLD, Australia
| | - Raymond J. Chan
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
| | - Jeremy Hunt
- Surgical and Orthopedic Research Laboratories, Prince of Wales Clinical School, University of New South Wales, Sydney, NSW, Australia
| | - Tim S. Peltz
- Surgical and Orthopedic Research Laboratories, Prince of Wales Clinical School, University of New South Wales, Sydney, NSW, Australia
| | - Uwe Dulleck
- From the School of Economics and Finance, Queensland University of Technology (QUT), Brisbane, QLD, Australia
- Centre for Behavioural Economics, Society & Technology (BEST), Queensland University of Technology (QUT), Brisbane, QLD, Australia
- Centre in Regenerative Medicine, Queensland University of Technology (QUT), Kelvin Grove, QLD, Australia
- ARC Training Centre for Cell and Tissue Engineering Technologies, Queensland University of Technology (QUT), Brisbane, QLD, Australia
- Centre for Behavioural Economics, Science & Technology (BEST), Queensland University of Technology (QUT), Brisbane, QLD, Australia
- CESifo Ludwig-Maximilians-Universität, Center for Economic Studies, Munich, Germany
- Research School of Economics, Australian National University, Canberra, ACT, Australia
| | - Dietmar W. Hutmacher
- Centre for Behavioural Economics, Society & Technology (BEST). Queensland University of Technology (QUT), Kelvin Grove, QLD, Australia
- ARC Training Centre in Additive Biomanufacturing, Queensland University of Technology, Brisbane, QLD, Australia
- ARC Training Centre for Multiscale 3D Imaging, Modelling and Manufacturing, Queensland University of Technology, Brisbane, QLD, Australia
| |
Collapse
|
5
|
Binci D, Palozzi G, Scafarto F. Toward digital transformation in healthcare: a framework for remote monitoring adoption. TQM JOURNAL 2021. [DOI: 10.1108/tqm-04-2021-0109] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
PurposeDigital transformation (DT) is a priority for the healthcare sector. In many countries, it is still considered in the early stages with an underestimation of its benefits and potentiality. Especially in Italy, little is known about the impact of digitalization – particularly of the Internet of Things (IoT) – on the healthcare sector, for example, in terms of clinician's jobs and patient's experience. Drawing from such premises, the paper aims to focus on an overlooked healthcare area related to the chronic heart diseases field and its relationship with DT. The authors aim at exploring and framing the main variables of remote Monitoring (RM) adoption as a specific archetype of healthcare digitalization, both on patients and medical staff level, by shedding some lights on its overall implementation.Design/methodology/approachThe authors empirically inquiry the RM adoption within the context of the Cardiology Department of the Casilino General Hospital of Rome. To answer our research question, the authors reconstruct the salient information by using induction-type reasoning, direct observation and interviewees with 12 key informants, as well as secondary sources analysis related to the hospital (internal documentation, presentations and technical reports).FindingsAccording to a socio-technical framework, the authors build a model composed of five main variables related to medical staff and patients. The authors classify such variables into an input-process-output (I-P-O) model. RM adoption driver represents the input; cultural digital divide, structure flexibility and reaction to change serve the process and finally, RM outcome stands for the output. All these factors, interacting together, contribute to understanding the RM adoption process for chronic disease management.Research limitations/implicationsThe authors' research presents two main limitations. The first one is related to using a qualitative method, which is less reliable in terms of replication and the interpretive role of researchers. The second limitation, connected to the first one, is related to the study's scale level, which focuses on a mono-centric consistent level of analysis.Practical implicationsThe paper offers a clear understanding of the RM attributes and a comprehensive view for improving the overall quality management of chronic diseases by suggesting that clinicians carefully evaluate both hard and soft variables when undertaking RM adoption decisions.Social implicationsRM technologies could impact on society both in ordinary situations, by preventing patient mobility issues and transport costs, and in extraordinary times (such as a pandemic), where telemedicine contributes to supporting hospitals in swapping in-person visits with remote controls, in order to minimize the risk of coronavirus disease (COVID-19) contagion or the spread of the virus.Originality/valueThe study enriches the knowledge and understanding of RM adoption within the healthcare sector. From a theoretical perspective, the authors contribute to the healthcare DT adoption debate by focusing on the main variables contributing to the DT process by considering both medical staff and patient's role. From a managerial perspective, the authors highlight the main issues for RM of chronic disease management to enable the transition toward its adoption. Such issues range from the need for awareness of the medical staff about RM advantages to the need for adapting the organizational structure and the training and education process of the patients.
Collapse
|
6
|
Residential Solar Water Heater Adoption Behaviour: A Review of Economic and Technical Predictors and Their Correlation with the Adoption Decision. ENERGIES 2021. [DOI: 10.3390/en14206630] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The successful deployment of the solar water heater (SWH) in the residential sector relies on the household’s bounded rational decision-makers to accept this system. The decision is shaped by a wide spectrum of predictors that form heterogeneous behaviour. Over the past years, research has employed a wide range of these predictors to understand their role in the decision and predict the behaviour and diffusion rate of SWHs. This review primarily identifies economic and technical predictors of 100 quantitative and qualitative studies on the residential SWH adoption decision. For the identified predictors, their characteristics and popularity are explored in a structured and coherent framework. The review further investigates the correlation between the identified predictors and the adoption decision from 97 of the 100 initially reviewed studies. The outcome of the research revealed 123 (56 economic and 67 technical) predictors that were classified into seven categories. ‘Financial incentives’ and ‘perceived attitude towards government policies’ are among the most popular economic predictors, whereas ‘house type’ and ‘knowledge of SWH’ were the most frequent technical factors in the research. Analysing the correlation between 99 predictors and the decision also unfolded that certain attitudinal attributes have a stronger influence on the residential SWH take-up than some common factors (e.g., electricity cost, technical variables).
Collapse
|
7
|
Powers B, Smith CD, Arroyo N, Francis DO, Fernandes-Taylor S. How Do Academic Otolaryngologists Decide to Implement New Procedures Into Practice? Otolaryngol Head Neck Surg 2021; 167:253-261. [PMID: 34546818 DOI: 10.1177/01945998211047434] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To identify barriers and facilitators to adoption of a new surgical procedure via an implementation science framework to characterize associated socioemotional, clinical, and decision-making processes. STUDY DESIGN Qualitative study with a semistructured interview approach. SETTING Large tertiary care referral center. METHODS Academic otolaryngologists with at least 2 years of practice were identified and interviewed. Transcripts were thematically coded and separated into steps in the clinical pathway. Synthesis of major themes characterized facilitators and barriers to uptake of a new surgical technique. RESULTS Of 22 otolaryngologists, 19 were interviewed (85% male). They had a median 18 years of practice (interquartile range, 7.8-26.3), and 65% were subspecialty trained. In the decision to implement a new procedure, improving patient outcomes and addressing unmet clinical needs facilitated adoption, whereas costs and adopting profit-driven technologies without improved outcomes were barriers. In patient consults, establishing trust facilitated implementation of new techniques; barriers included participants' hesitation to communicate about the unknowns of a new procedure. Intraoperatively, little change to existing workflow or improved efficiency facilitated adoption, while a substantial learning curve for the new procedure was a barrier. Achieving favorable outcomes and patient satisfaction sustained implementation of new procedures. Too few referrals or indications for the new procedure hindered implementation. CONCLUSION Our study demonstrates that innovation in otolaryngology is often an individual iterative process that providers pursue to improve patients' outcomes. Although models for the oversight of surgical innovation emphasize the need for evidence, obtaining sufficient numbers of providers and patients to generate evidence remains a challenge in specialty surgical practice.
Collapse
Affiliation(s)
- Bethany Powers
- Department of Surgery, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Cara Damico Smith
- Department of Surgery, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Natalia Arroyo
- Department of Surgery, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - David O Francis
- Department of Surgery, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | | |
Collapse
|
8
|
Lin X, Lu L, Pan J. Hospital market competition and health technology diffusion: An empirical study of laparoscopic appendectomy in China. Soc Sci Med 2021; 286:114316. [PMID: 34416527 DOI: 10.1016/j.socscimed.2021.114316] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 06/07/2021] [Accepted: 08/13/2021] [Indexed: 12/16/2022]
Abstract
The evidence about the role of hospital market competition on health technology diffusion in developing countries is scarce. In this study, we examined the association between hospital market competition and the diffusion of health technologies in China's healthcare system. Laparoscopic appendectomy, a minimally invasive surgery for patients with acute appendicitis, was selected as a representative of cost-effective health technology. The inpatient discharge dataset linked to the annually hospital administrative data and to the demographic and socioeconomic data were used. A total of 261,922 patients who were diagnosed with acute appendicitis and had received either open appendectomy or laparoscopic appendectomy at 820 hospitals in Sichuan, China between 2017 and 2019 were included in our analyses. Our outcome measure was the use of laparoscopic appendectomy during hospitalization. We accounted for the endogeneity of hospital competition measures using the Herfindahl-Hirschman Index calculated by predicted patient flows. Controlling for the observable patient, hospital and region characteristics, multivariate logistic regression was performed to model the association between hospital competition and the diffusion of laparoscopic appendectomy. The rapid diffusion of laparoscopic appendectomy over the study period and the substantial variation in use across regions and hospitals were observed. The regression results showed that laparoscopic appendectomy diffused faster in the markets where hospitals faced more competition. Our findings suggest that the diffusion of laparoscopic appendectomy is not only driven by medical factors but also nonmedical factors like hospital market competition. Our study provides new evidence on the association between market structure and technology diffusion in China's hospital market and offers the implications of appropriate technologies diffusion in health for policymakers.
Collapse
Affiliation(s)
- Xiaojun Lin
- HEOA Group, West China School of Public Health and West China Fourth Hospital, Sichuan University, China; Institute for Healthy Cities and West China Research Center for Rural Health Development, Sichuan University, China.
| | - Liyong Lu
- HEOA Group, West China School of Public Health and West China Fourth Hospital, Sichuan University, China; Institute for Healthy Cities and West China Research Center for Rural Health Development, Sichuan University, China.
| | - Jay Pan
- HEOA Group, West China School of Public Health and West China Fourth Hospital, Sichuan University, China; Institute for Healthy Cities and West China Research Center for Rural Health Development, Sichuan University, China.
| |
Collapse
|
9
|
Grossi A, Hoxhaj I, Gabutti I, Specchia ML, Cicchetti A, Boccia S, de Waure C. Hospital contextual factors affecting the implementation of health technologies: a systematic review. BMC Health Serv Res 2021; 21:407. [PMID: 33933068 PMCID: PMC8088675 DOI: 10.1186/s12913-021-06423-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 04/19/2021] [Indexed: 12/05/2022] Open
Abstract
Background To keep a high quality of assistance it is important for hospitals to invest in health technologies (HTs) that have the potential of improving health outcomes. Even though guidance exists on how HTs should be introduced, used and dismissed, there is a surprising gap in literature concerning the awareness of hospitals in the actual utilization of HTs. Methods We performed a systematic literature review of qualitative and quantitative studies aimed at investigating hospital contextual factors that influence the actual utilization of HTs. PubMed, Scopus, Web of Science, Econlit and Ovid Medline electronic databases were searched to retrieve articles published in English and Italian from January 2000 to January 2019. The quality of the included articles was assessed using the Critical Appraisal Skills Programme checklist for qualitative studies, Newcastle-Ottawa Scale for the cross-sectional studies and the Mixed Methods Appraisal Tool for mixed method studies. Results We included 33 articles, which were of moderate to high methodological quality. The included articles mostly addressed the contextual factors that impact the implementation of information and communication technologies (ICTs). Overall, for all HTs, the hospital contextual factors were part of four categories: hospital infrastructure, human resource management, financial resources and leadership styles. Conclusion Our systematic review reported that the contextual factors influencing the HTs utilization at hospital level are mainly explored for ICTs. Several factors should be considered when planning the implementation of a new HTs at hospital level. A potential publication bias might be present in our work, since we included articles published only in English and Italian Language, from January 2000 to January 2019. There remains a gap in the literature on the facilitators and barriers influencing the implementation and concrete utilization of medical and surgical HTs, suggesting the need for further studies for a better understanding. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-021-06423-2.
Collapse
Affiliation(s)
- Adriano Grossi
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Largo Francesco Vito, 1, 00168, Rome, Italy
| | - Ilda Hoxhaj
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Largo Francesco Vito, 1, 00168, Rome, Italy.
| | - Irene Gabutti
- Graduate School of Health Economics and Management (ALTEMS), Faculty of Economics, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Maria Lucia Specchia
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Largo Francesco Vito, 1, 00168, Rome, Italy.,Clinical Governance Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Americo Cicchetti
- Graduate School of Health Economics and Management (ALTEMS), Faculty of Economics, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Stefania Boccia
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Largo Francesco Vito, 1, 00168, Rome, Italy.,Department of Woman and Child Health and Public Health - Public Health Area, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Chiara de Waure
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| |
Collapse
|
10
|
Vadia R, Stargardt T. Impact of Guidelines on the Diffusion of Medical Technology: A Case Study of Cardiac Resynchronization Therapy in the UK. APPLIED HEALTH ECONOMICS AND HEALTH POLICY 2021; 19:243-252. [PMID: 32970307 PMCID: PMC7902577 DOI: 10.1007/s40258-020-00610-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 09/02/2020] [Indexed: 06/11/2023]
Abstract
INTRODUCTION Research on clinical practice guidelines as a determinant of the diffusion of medical technology remains sparse. We aim to evaluate the impact of guidelines on the awareness of medical technology, as a proxy of its use, with the example of cardiac resynchronization therapy (CRT) in the United Kingdom (UK). METHODS We measured clinician awareness based on Google searches performed for CRT that corresponded with actual CRT implant numbers provided by the European Heart Rhythm Association (EHRA). We identified the guideline recommendations published by the National Institute of Health and Care Excellence (NICE) within the UK, the European Society of Cardiology (ESC) at the European level, and the American College of Cardiology Foundation/American Heart Association in the United States (US). We specified a dynamic moving average model, with Google searches as the dependent variable and guideline changes as the independent variables. RESULTS One guideline change published by NICE in 2007 and two changes released by the US guidelines in 2005 and 2012 were significantly correlated with the Google searches (p = 0.08, p = 0.02, and p = 0.02, respectively). Guideline changes by the ESC had no significant impact. Changes recommending CRT in place of a conventional pacemaker, in patients with atrial fibrillation, and restricting CRT due to contraindication, remained universally uninfluential. CONCLUSION The factors associated with a lack of awareness (as a proxy for technology diffusion) in our case study were: a lack of strong clinical evidence that resulted in the moderate strength of a recommendation, a lack of recognition of any externally published recommendation by NICE, and the frequent release of guidelines with minor changes targeting small patient groups. At least in our case, in the absence of NICE guidelines, the US guidelines received more attention than their non-UK European counterparts, even if the former were released after the latter.
Collapse
Affiliation(s)
- Rucha Vadia
- Hamburg Center for Health Economics, University of Hamburg, Esplanade 36, 20354, Hamburg, Germany.
- Abbott, Health Economics & Reimbursement, Da Vincilaan 11, 1935, Zaventem, Belgium.
| | - Tom Stargardt
- Hamburg Center for Health Economics, University of Hamburg, Esplanade 36, 20354, Hamburg, Germany
| |
Collapse
|
11
|
Morrell ALG, Morrell Junior AC, Mendes JMF, Morrell AG, Morrell A. Robotic TAPP inguinal hernia repair: lessons learned from 97 cases. Rev Col Bras Cir 2021; 48:e20202704. [PMID: 33533825 PMCID: PMC10683431 DOI: 10.1590/0100-6991e-20202704] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 09/17/2020] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES minimally invasive inguinal hernia repair has proven advantages over open procedures including less pain and earlier return to normal activity. Robotic surgery adds ergonomics, a three-dimensional high definition camera and articulating instruments overcoming some laparoscopic limitations. We aimed to report the outcomes of the early experience of over 97 robotic inguinal hernia repairs performed by a referred surgical group in Brazil. METHODS a review of a prospective mantined database was conducted in patients submitted to robotic transabdominal preperitoneal (TAPP) inguinal hernia repairs between March 2016 and February 2020. Descriptive statistics were performed. Surgical outcomes data and patient follow-ups are reported. RESULTS retrospective chart review identified 97 patients submitted to robotic TAPP inguinal hernia repair. Mean age was 36.4 years, with median BMI of 26.9 kg/m2. Mean console time was 58 min (range 40-150) and patients were discharged within 24 hours of their stay in a majority of cases. Mesh was placed in all procedures and there were no conversion rates. Complications were low grade and no recurrence was seen after a mean follow-up of 642 days. CONCLUSION this study represents to-date the first brazilian case series of robotic TAPP inguinal hernia repair. Our results encourage that robotic assisted TAPP inguinal hernia repair appears to be technically feasible and safe in experienced hands, with good outcomes achieving high health-related quality of life and low recurrence rates in the short and long term.
Collapse
Affiliation(s)
- Andre Luiz Gioia Morrell
- - Instituto Morrell, Cirurgia Robótica e Minimamente Invasiva do Aparelho Digestivo - São Paulo - SP - Brasil
- - Sociedade Beneficente Israelita Brasileira Hospital Albert Einstein, Cirurgia Geral e Aparelho Digestivo Minimamente Invasiva e Robótica - São Paulo - SP - Brasil
- - Rede D'Or Hospital São Luiz, Cirurgia Robótica e Minimamente Invasiva do Aparelho Digestivo - São Paulo - SP - Brasil
- - Vila Nova Star - Rede D'Or Hospital São Luiz, Cirurgia Robótica e Minimamente Invasiva do Aparelho Digestivo - São Paulo - SP - Brasil
- - Hospital Alemão Oswaldo Cruz, Cirurgia Geral e do Aparelho Digestivo Minimamente Invasiva e Robótica - São Paulo - SP - Brasil
- - Grupo Leforte, Cirurgia Robótica e Minimamente Invasiva do Aparelho Digestivo - São Paulo - SP - Brasil
| | - Alexander Charles Morrell Junior
- - Instituto Morrell, Cirurgia Robótica e Minimamente Invasiva do Aparelho Digestivo - São Paulo - SP - Brasil
- - Sociedade Beneficente Israelita Brasileira Hospital Albert Einstein, Cirurgia Geral e Aparelho Digestivo Minimamente Invasiva e Robótica - São Paulo - SP - Brasil
- - Rede D'Or Hospital São Luiz, Cirurgia Robótica e Minimamente Invasiva do Aparelho Digestivo - São Paulo - SP - Brasil
- - Vila Nova Star - Rede D'Or Hospital São Luiz, Cirurgia Robótica e Minimamente Invasiva do Aparelho Digestivo - São Paulo - SP - Brasil
- - Grupo Leforte, Cirurgia Robótica e Minimamente Invasiva do Aparelho Digestivo - São Paulo - SP - Brasil
| | - Jose Mauricio Freitas Mendes
- - Sociedade Beneficente Israelita Brasileira Hospital Albert Einstein, Cirurgia Geral e Aparelho Digestivo Minimamente Invasiva e Robótica - São Paulo - SP - Brasil
- - Rede D'Or Hospital São Luiz, Cirurgia Robótica e Minimamente Invasiva do Aparelho Digestivo - São Paulo - SP - Brasil
- - Hospital Alemão Oswaldo Cruz, Cirurgia Geral e do Aparelho Digestivo Minimamente Invasiva e Robótica - São Paulo - SP - Brasil
| | - Allan Gioia Morrell
- - Instituto Morrell, Cirurgia Robótica e Minimamente Invasiva do Aparelho Digestivo - São Paulo - SP - Brasil
- - Rede D'Or Hospital São Luiz, Cirurgia Robótica e Minimamente Invasiva do Aparelho Digestivo - São Paulo - SP - Brasil
- - Vila Nova Star - Rede D'Or Hospital São Luiz, Cirurgia Robótica e Minimamente Invasiva do Aparelho Digestivo - São Paulo - SP - Brasil
- - Grupo Leforte, Cirurgia Robótica e Minimamente Invasiva do Aparelho Digestivo - São Paulo - SP - Brasil
| | - Alexander Morrell
- - Instituto Morrell, Cirurgia Robótica e Minimamente Invasiva do Aparelho Digestivo - São Paulo - SP - Brasil
- - Sociedade Beneficente Israelita Brasileira Hospital Albert Einstein, Cirurgia Geral e Aparelho Digestivo Minimamente Invasiva e Robótica - São Paulo - SP - Brasil
- - Rede D'Or Hospital São Luiz, Cirurgia Robótica e Minimamente Invasiva do Aparelho Digestivo - São Paulo - SP - Brasil
- - Vila Nova Star - Rede D'Or Hospital São Luiz, Cirurgia Robótica e Minimamente Invasiva do Aparelho Digestivo - São Paulo - SP - Brasil
- - Hospital Alemão Oswaldo Cruz, Cirurgia Geral e do Aparelho Digestivo Minimamente Invasiva e Robótica - São Paulo - SP - Brasil
- - Grupo Leforte, Cirurgia Robótica e Minimamente Invasiva do Aparelho Digestivo - São Paulo - SP - Brasil
| |
Collapse
|
12
|
Ex P, Vogt V, Busse R, Henschke C. The reimbursement of new medical technologies in German inpatient care: What factors explain which hospitals receive innovation payments? HEALTH ECONOMICS, POLICY, AND LAW 2020; 15:355-369. [PMID: 31159902 DOI: 10.1017/s1744133119000124] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Most hospital payment systems based on diagnosis-related groups (DRGs) provide payments for newly approved technologies. In Germany, they are negotiated between individual hospitals and health insurances. The aim of our study is to assess the functioning of temporary reimbursement mechanisms. We used multilevel logistic regression to examine factors at the hospital and state levels that are associated with agreeing innovation payments. Dependent variable was whether or not a hospital had successfully negotiated innovation payments in 2013 (n = 1532). Using agreement data of the yearly budget negotiations between each German hospital and representatives of the health insurances, the study comprises all German acute hospitals and innovation payments on all diagnoses. In total, 32.9% of the hospitals successfully negotiated innovation payments in 2013. We found that the chance of receiving innovation payments increased if the hospital was located in areas with a high degree of competition and if they were large, had university status and were private for-profit entities. Our study shows an implicit self-controlled selection of hospitals receiving innovation payments. While implicitly encouraging safety of patient care, policy makers should favour a more direct and transparent process of distributing innovation payments in prospective payment systems.
Collapse
Affiliation(s)
- Patricia Ex
- TU Berlin, Department of Health Care Management, Technische Universität Berlin, 10623Berlin, Germany
| | - Verena Vogt
- TU Berlin, Department of Health Care Management, Technische Universität Berlin, 10623Berlin, Germany
| | - Reinhard Busse
- TU Berlin, Department of Health Care Management, Technische Universität Berlin, 10623Berlin, Germany
| | - Cornelia Henschke
- TU Berlin, Department of Health Care Management, Technische Universität Berlin, 10623Berlin, Germany
| |
Collapse
|
13
|
Mithas S, Hofacker CF, Bilgihan A, Dogru T, Bogicevic V, Sharma A. Information technology and Baumol's cost disease in healthcare services: a research agenda. JOURNAL OF SERVICE MANAGEMENT 2020. [DOI: 10.1108/josm-11-2019-0339] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeThis paper advances a research agenda for service researchers at the intersection of healthcare and information technologies to improve access to quality healthcare at affordable prices. The article reviews key trends to provide an agenda for research focusing on strategies, governance and management of key service processes.Design/methodology/approachThis paper synthesizes literature in information systems, service management, marketing and healthcare operations to suggest a research agenda. The authors draw on frameworks such as the interpretive model of technology, technology acceptance model, assemblage theories and Baumol's cost disease to develop their arguments.FindingsThe paper situates strategy-related service management questions that service providers and consumers face in the context of emerging healthcare and technology trends. It also derives implications for governance choices and questions related to that.Research limitations/implicationsThe paper discusses service management challenges and concludes with an agenda for future research that touches on governance and service management issues.Practical implicationsThis paper provides implications for healthcare service providers and policymakers to understand new trends in healthcare delivery, technologies and facilities management to meet evolving customer needs.Social implicationsThis paper provides implications for managing healthcare services that touch on many social and societal concerns.Originality/valueThis conceptual paper provides background and review of the work at the intersections of information systems, marketing and healthcare operations to draw implications for future research.
Collapse
|
14
|
Taylor CO, Tarczy-Hornoch P. Personalized Medicine Implementation with Non-traditional Data Sources: A Conceptual Framework and Survey of the Literature. Yearb Med Inform 2019; 28:181-189. [PMID: 31419830 PMCID: PMC6697507 DOI: 10.1055/s-0039-1677916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
OBJECTIVES With the explosive growth in availability of health data captured using non-traditional sources, the goal for this work was to evaluate the current biomedical literature on theory- driven studies investigating approaches that leverage non- traditional data in personalized medicine applications. METHODS We conducted a literature assessment guided by the personalized medicine unsolicited health information (pUHl) conceptual framework incorporating diffusion of innovations and task-technology fit theories. RESULTS The assessment provided an oveiview of the current literature and highlighted areas for future research. In particular, there is a need for: more research on the relationship between attributes of innovation and of societal structure on adoption; new study designs to enable flexible communication channels; more work to create and study approaches in healthcare settings; and more theory-driven studies with data-driven interventions. CONCLUSION This work introduces to an informatics audience an elaboration on personalized medicine implementation with non-traditional data sources by blending it with the pUHl conceptual framework to help explain adoption. We highlight areas to pursue future theory-driven research on personalized medicine applications that leverage non-traditional data sources.
Collapse
Affiliation(s)
| | - Peter Tarczy-Hornoch
- Department of Biomedical Informatics and Medical Education, University of Washington, Seattle, Washington, USA
| |
Collapse
|
15
|
Schultz C, Graw J, Salomo S, Kock A. How Project Management and Top Management Involvement Affect the Innovativeness of Professional Service Organizations—An Empirical Study on Hospitals. PROJECT MANAGEMENT JOURNAL 2019. [DOI: 10.1177/8756972819857893] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study investigates how top management involvement and project management professionalization affect firm innovativeness. We focus on hospitals as representative of professional service organizations characterized by pluralistic individual and organizational interests. A multiyear analysis of project management survey and objective performance data of 90 hospitals indicates that top management involvement in innovation projects reduces hospital innovativeness, and project management professionalization increases hospital innovativeness. However, increasing project management professionalization simultaneously strengthens top management involvement’s effectiveness. The results contribute to our understanding of potential interactions and different effects of project management efforts at different organizational levels in professional service organizations.
Collapse
Affiliation(s)
- Carsten Schultz
- Department for Technology Management, Kiel University, Germany
| | - Jan Graw
- Department for Technology Management, Kiel University, Germany
| | - Søren Salomo
- Department of Technology and Innovation Management, Technische Universität Berlin, Germany
| | - Alexander Kock
- Department of Technology and Innovation Management, Technische Universität Darmstadt, Germany
| |
Collapse
|
16
|
Maggio MG, Maresca G, De Luca R, Stagnitti MC, Porcari B, Ferrera MC, Galletti F, Casella C, Manuli A, Calabrò RS. The Growing Use of Virtual Reality in Cognitive Rehabilitation: Fact, Fake or Vision? A Scoping Review. J Natl Med Assoc 2019; 111:457-463. [PMID: 30739728 DOI: 10.1016/j.jnma.2019.01.003] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 01/07/2019] [Accepted: 01/08/2019] [Indexed: 12/30/2022]
Abstract
OBJECTIVE This review aims to evaluate the role of Virtual Reality (VR) in cognitive rehabilitation of different neurological diseases, and the accessibility to healthcare systems providing this type of treatment. METHOD OF RESEARCH Studies performed between 2003 and 2017 and fulfilling the selected criteria were found on PubMed, Scopus, Cochrane and Web of Sciences databases. The search combined the terms VR rehabilitation with different neurological disease. RESULTS Our findings showed that neurological patients performed significant improvement in many cognitive domains (executive and visual-spatial abilities; speech, attention and memory skills) following the use of VR training. CONCLUSIONS This review supports the idea that rehabilitation through new VR tools could positively affect neurological patients' outcomes, by boosting motivation and participation so to get a better response to treatment. In particular, VR can be used to enhance the effects of conventional therapies, promoting longer training sessions and a reduction in overall hospitalization time.
Collapse
Affiliation(s)
| | | | | | | | - Bruno Porcari
- IRCCS Centro Neurolesi "Bonino-Pulejo", Messina, Italy
| | | | | | | | | | | |
Collapse
|
17
|
Modeling predictors of acceptance and use of electronic medical record system in a resource limited setting: Using modified UTAUT model. INFORMATICS IN MEDICINE UNLOCKED 2019. [DOI: 10.1016/j.imu.2019.100182] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
|
18
|
Felgner S, Ex P, Henschke C. Physicians' Decision Making on Adoption of New Technologies and Role of Coverage with Evidence Development: A Qualitative Study. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2018; 21:1069-1076. [PMID: 30224111 DOI: 10.1016/j.jval.2018.03.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Revised: 02/09/2018] [Accepted: 03/08/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVES To foster value-based pricing and coverage with evidence development in Germany, certain new diagnostic and treatment methods have been subject to a benefit assessment since 2016 to determine their reimbursement. Although this is a paradigm shift, the German approach is limited to some few specific technologies for which reimbursement is requested. As physicians encounter this regulatory instrument, the aim of the study was to understand physicians' decision making regarding the adoption of new medical technologies and to identify their perspectives on the evidence base and financing with additional reimbursement systems. METHODS From April to August 2017, semistructured interviews with chief and senior physicians of vascular surgery and cardiology in inpatient care in Germany were conducted (N = 23). The interviews were carried out by one researcher in one-to-one appointments or via telephone. Data were analyzed inductively to identify factors and generate thematic categories using qualitative content analysis. RESULTS We identified 52 factors in eight categories influencing physicians' adoption of new technologies. The evidence base for new technologies was criticized (e.g., lack of available studies). Physicians' knowledge of the regulation of market approval and innovation payments varied. They recommended the utilization of new technologies in certain specialist centers and the facilitation of observational studies. CONCLUSIONS Physicians saw the need for the new approach and supported its aim. However, its design and implementation appeared to be questionable from their medical perspective. The provision of summarized information on the benefit of technologies might be a possibility to assist physicians' decision making.
Collapse
Affiliation(s)
- Susanne Felgner
- Department of Health Care Management, Technische Universität Berlin, Berlin, Germany.
| | - Patricia Ex
- Department of Health Care Management, Technische Universität Berlin, Berlin, Germany
| | - Cornelia Henschke
- Department of Health Care Management, Technische Universität Berlin, Berlin, Germany
| |
Collapse
|
19
|
Harvey G, Llewellyn S, Maniatopoulos G, Boyd A, Procter R. Facilitating the implementation of clinical technology in healthcare: what role does a national agency play? BMC Health Serv Res 2018; 18:347. [PMID: 29743068 PMCID: PMC5944036 DOI: 10.1186/s12913-018-3176-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Accepted: 05/01/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Accelerating the implementation of new technology in healthcare is typically complex and multi-faceted. One strategy is to charge a national agency with the responsibility for facilitating implementation. This study examines the role of such an agency in the English National Health Service. In particular, it compares two different facilitation strategies employed by the agency to support the implementation of insulin pump therapy. METHODS The research involved an empirical case study of four healthcare organisations receiving different levels of facilitation from the national agency: two received active hands-on facilitation; one was the intended recipient of a more passive, web-based facilitation strategy; the other implemented the technology without any external facilitation. The primary method of data collection was semi-structured qualitative interviews with key individuals involved in implementation. The integrated-PARIHS framework was applied as a conceptual lens to analyse the data. RESULTS The two sites that received active facilitation from an Implementation Manager in the national agency made positive progress in implementing the technology. In both sites there was a high level of initial receptiveness to implementation. This was similar to a site that had successfully introduced insulin pump therapy without facilitation support from the national agency. By contrast, a site that did not have direct contact with the national agency made little progress with implementation, despite the availability of a web-based implementation resource. Clinicians expressed differences of opinion around the value and effectiveness of the technology and contextual barriers related to funding for implementation persisted. The national agency's intended roll out strategy using passive web-based facilitation appeared to have little impact. CONCLUSIONS When favourable conditions exist, in terms of agreement around the value of the technology, clinician receptiveness and motivation to change, active facilitation via an external agency can help to structure the implementation process and address contextual barriers. Passive facilitation using web-based implementation resources appears less effective. Moving from initial implementation to wider scale-up presents challenges and is an issue that warrants further attention.
Collapse
Affiliation(s)
- Gill Harvey
- Adelaide Nursing School, University of Adelaide, Adelaide, SA, 5005, Australia. .,Alliance Manchester Business School, University of Manchester, Booth Street East, Manchester, M13 9SS, UK.
| | - Sue Llewellyn
- Alliance Manchester Business School, University of Manchester, Booth Street East, Manchester, M13 9SS, UK
| | - Greg Maniatopoulos
- Institute of Health & Society, Newcastle University, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK
| | - Alan Boyd
- Alliance Manchester Business School, University of Manchester, Booth Street East, Manchester, M13 9SS, UK
| | - Rob Procter
- Department of Computer Science, University of Warwick, Warwick, CV4 7AL, UK
| |
Collapse
|
20
|
Borsci S, Uchegbu I, Buckle P, Ni Z, Walne S, Hanna GB. Designing medical technology for resilience: integrating health economics and human factors approaches. Expert Rev Med Devices 2017; 15:15-26. [PMID: 29243500 DOI: 10.1080/17434440.2018.1418661] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
INTRODUCTION The slow adoption of innovation into healthcare calls into question the manner of evidence generation for medical technology. This paper identifies potential reasons for this including a lack of attention to human factors, poor evaluation of economic benefits, lack of understanding of the existing healthcare system and a failure to recognise the need to generate resilient products. Areas covered: Recognising a cross-disciplinary need to enhance evidence generation early in a technology's life cycle, the present paper proposes a new approach that integrates human factors and health economic evaluation as part of a wider systems approach to the design of technology. This approach (Human and Economic Resilience Design for Medical Technology or HERD MedTech) supports early stages of product development and is based on the recent experiences of the National Institute for Health Research London Diagnostic Evidence Co-operative in the UK. Expert commentary: HERD MedTech i) proposes a shift from design for usability to design for resilience, ii) aspires to reduce the need for service adaptation to technological constraints iii) ensures value of innovation at the time of product development, and iv) aims to stimulate discussion around the integration of pre- and post-market methods of assessment of medical technology.
Collapse
Affiliation(s)
- Simone Borsci
- a Surgery and Cancer , National Institute for Health Research Diagnostic Evidence Cooperative of London, Imperial College London, St Mary's Hospital , London , UK
| | - Ijeoma Uchegbu
- a Surgery and Cancer , National Institute for Health Research Diagnostic Evidence Cooperative of London, Imperial College London, St Mary's Hospital , London , UK
| | - Peter Buckle
- a Surgery and Cancer , National Institute for Health Research Diagnostic Evidence Cooperative of London, Imperial College London, St Mary's Hospital , London , UK
| | - Zhifang Ni
- a Surgery and Cancer , National Institute for Health Research Diagnostic Evidence Cooperative of London, Imperial College London, St Mary's Hospital , London , UK
| | - Simon Walne
- a Surgery and Cancer , National Institute for Health Research Diagnostic Evidence Cooperative of London, Imperial College London, St Mary's Hospital , London , UK
| | - George B Hanna
- a Surgery and Cancer , National Institute for Health Research Diagnostic Evidence Cooperative of London, Imperial College London, St Mary's Hospital , London , UK
| |
Collapse
|