Design of a multiple criteria decision analysis framework for prioritizing high-impact health technologies in a regional health service

OBJECTIVES

This study aims to develop a framework for establishing priorities in the regional health service of Murcia, Spain, to facilitate the creation of a comprehensive multiple criteria decision analysis (MCDA) framework. This framework will aid in decision-making processes related to the assessment, reimbursement, and utilization of high-impact health technologies.

METHOD

Based on the results of a review of existing frameworks for MCDA of health technologies, a set of criteria was proposed to be used in the context of evaluating high-impact health technologies. Key stakeholders within regional healthcare services, including clinical leaders and management personnel, participated in a focus group (n = 11) to discuss the proposed criteria and select the final fifteen. To elicit the weights of the criteria, two surveys were administered, one to a small sample of healthcare professionals (n = 35) and another to a larger representative sample of the general population (n = 494).

RESULTS

The responses obtained from health professionals in the weighting procedure exhibited greater consistency compared to those provided by the general public. The criteria more highly weighted were "Need for intervention" and "Intervention outcomes." The weights finally assigned to each item in the multicriteria framework were derived as the equal-weighted sum of the mean weights from the two samples.

CONCLUSIONS

A multi-attribute function capable of generating a composite measure (multicriteria) to assess the value of high-impact health interventions has been developed. Furthermore, it is recommended to pilot this procedure in a specific decision context to evaluate the efficacy, feasibility, usefulness, and reliability of the proposed tool.

Transforming healthcare delivery: a descriptive study of a novel provider-to-provider virtual care platform

Introduction

Addressing challenges in access to specialty care, particularly long wait times and geographic disparities, is a pressing issue in the Canadian healthcare system. This study aimed to evaluate the impact and feasibility of provider-to-provider phone consultations between primary care providers (PCPs) and specialists using a novel virtual care platform in Nova Scotia (Virtual Hallway).

Methods

We conducted a cross-sectional survey over 5 months, involving 211 PCPs and 34 specialists across Nova Scotia. The survey assessed the need for formal in-person referrals as well as clinician satisfaction. Statistical methods included descriptive statistics and the one-sample t-test.

Results

We found that 84% of provider-to-provider phone consultations negated the need for an in-person specialist referral. It was also reported that 90% of patients that did require in-person consultation had enhanced care while they awaited an in-person appointment with a specialist. Very high levels of satisfaction were reported among both PCPs and specialists, and there was a noticeable increase in billing volumes related to these consultations as measured by provincial billing codes.

Conclusion

The findings indicate that provider-to-provider phone consultations are feasible, well-accepted and also effective in reducing the need for in-person specialist visits. This approach offers a promising avenue for alleviating waitlist burdens, enhancing the quality of care, and improving the overall efficiency of healthcare delivery.

Management of Point-of-Care Testing (POCT) Services by Community Pharmacists in Osun State Nigeria

Background: Point-of-care testing (POCT) provides important opportunity for community pharmacists to participate in oriented primary patient care. Effective management of these services is required to deliver their currently- underexploited benefits. Objectives: Assessed attitudes and practice, examined management functions deployed and identified factors affecting provision of POCTs by community pharmacists. Methods: A questionnaire-guided cross-sectional survey of 146 randomly-selected community pharmacists was conducted in Osun State Southwestern Nigeria. Study variables were measured on 5-point Likert scales with weighted averages, median scores and ranks used to present item performances. Interquartile ranges were computed to categorize practice scores. Chi square statistic was used to examine association of variables. ANOVA and 2-sample t-test were used to compare means. Results: A response rate of 94.5% was achieved. Respondents had a positive attitude (MWA 3.75) towards provision of POCTs as core component of their practice (MWA 4.58) with potential to contribute significantly to profitability (MWA 4.31). Respondents' median practice score was 3.01(moderate practice) with blood pressure screening (4.77), weight measurement (4.45), and blood glucose screening (4.18) as leading POCTs, while cervical cancer screening (1.09) was least practiced. Management of POCTs was fair (MWA 3.33) with organisation of work as pre-eminent domain (MWA 3.66). Management practices were significantly associated with almost all demographic variables (p< .05). Positive public perception of pharmacists' roles (MWA 4.31) and their improving clinical skills (MWA 4.01) were the leading enablers while the lack of enabling policy framework (MWA 3.80) and poor health information backbone (MWA 3.78) were major challenges to routine adoption of POCTs by respondents. Conclusion: The community pharmacists had positive attitude and moderate practice of POCTs. Management of these services was fair. Improving public perception of pharmacists should be exploited while enabling legal and health information systems should be provided to drive routine adoption of POCTs.

Letter to the Editor: "How Can Biomedical Engineers Help Empower Individuals With Intellectual Disabilities? The Potential Benefits and Challenges of AI Technologies to Support Inclusivity and Transform Lives"

The rapid advancement of Artificial Intelligence (AI) is transforming healthcare and daily life, offering great opportunities but also posing ethical and societal challenges. To ensure AI benefits all individuals, including those with intellectual disabilities, the focus should be on adaptive technology that can adapt to the unique needs of the user. Biomedical engineers have an interdisciplinary background that helps them to lead multidisciplinary teams in the development of human-centered AI solutions. These solutions can personalize learning, enhance communication, and improve accessibility for individuals with intellectual disabilities. Furthermore, AI can aid in healthcare research, diagnostics, and therapy. The ethical use of AI in healthcare and the collaboration of AI with human expertise must be emphasized. Public funding for inclusive research is encouraged, promoting equity and economic growth while empowering those with intellectual disabilities in society.

The nurses' touch: An irreplaceable component of caring

BACKGROUND

Touch is an integral part of human interaction. Health care makes significant use of touch, and for most healthcare professionals, it is indispensable to their practice. An essential and inevitable facet of the nursing profession is the touching of patients during the provision of care. Unfortunately, touch is seldom considered in the nursing framework today.

AIMS

To emphasize the importance of touch in contemporary nursing practice in a highly technological environment.

MATERIALS AND METHODS

A search was conducted on February-May 2022. The initial search identified 84 articles and the final analysis included 38 articles that met the inclusion criteria (touch; touch in health care; touch and nursing; touch and technology; nursing and technology; nursing and caring; touch and caring).

RESULTS

The nurses' touch will always be an irreplaceable component of caring in nursing.

DISCUSSION

There can be no substitute to the expressive touch of a nurse. As the technological revolution in nursing is inevitable, it is imperative that nurses consider how much these technologies impact the nurse-patient relationships.

CONCLUSION

The study emphasized the importance of touch in contemporary nursing practice. The study found that the nurses' touch will always be an irreplaceable component of caring in nursing. The finding will have an impact on nurses and patients situated in highly technological healthcare environments.

Development of a checklist to assess COVID-19 information on orthodontic webpages

OBJECTIVE

To create a COVID-19 information checklist and critique all available webpages of hospitals with an orthodontic department in England.

DESIGN

Cross-sectional analysis.

SETTING

World Wide Web.

METHODS

A 16-item COVID-19 webpage checklist was developed using up-to-date COVID-19 government advice, and the General Dental Council Principles of Ethical Advertising. Presence of advice on managing orthodontic appliance breakages, information on outpatient appointment changes and video consultations was also assessed. The checklist was used to undertake a cross-sectional analysis of all available webpages of hospitals with an orthodontic department in England between September 2020 to October 2020.

RESULTS

A total of 61 webpages were assessed. Of them, 95% had a COVID-19 section on the homepage, including advice on the use of face coverings during hospital visits. Only 18% of websites provided information on orthodontic appliance care and breakages. Four orthodontic department websites stated the department was closed during this study. The mean update interval of the webpages was six weeks (range = 1-28 weeks). Only one webpage fully conformed with the COVID-19 checklist.

CONCLUSION

Availability and completeness of COVID-19 information on webpages of hospitals with an orthodontic department varied, which may be due to the absence of a formal COVID-19 information webpage checklist. The checklist produced in this research may prove valuable to encourage uniform patient support and positive patient experience across orthodontic services. Principles behind the development of the checklist could be adopted during prolonged service disruptions to ensure optimal patient communications. The checklist is equally applicable to primary and secondary care settings.

Public Health Expenditures and Health Outcomes in Pakistan: Evidence from Quantile Autoregressive Distributed Lag Model

OBJECTIVE

The provision of healthcare facilities remains high on the manifesto of various political parties in Pakistan and healthcare spending has witnessed a significant surge in the last two decades that is expected to positively influence health outcomes in the country. Therefore, this research aims to explore the effects of healthcare expenditures on the actual health status of the masses in Pakistan for the period 1995Q1 to 2017Q1.

METHODS

We apply the Quantile Autoregressive Distributed Lag (QARDL) approach for estimation purposes. This is the most recent and emerging estimation technique in time series analysis.

RESULTS

Our findings confirm that public healthcare spending significantly impacts health outcomes in Pakistan both in the short-run and long-run. Public healthcare spending improves life expectancy and reduces death rate and infant mortality.

CONCLUSION

The study concludes that public healthcare is the main focus of the current regime. It is noticed that spending on healthcare significantly contributes to the health outcomes in Pakistan. These efforts by the government significantly promote life expectancy and drop down the mortality ratio in the country. Based on these notable facts, the government should allocate sufficient resources towards the latest healthcare technologies and equipment to optimize health outcomes in the country.

Using technology to enhance medication regimen education after solid organ transplantation

PURPOSE

The design and implementation of a tool that combines clinical teaching with cutting-edge, simplified technology for providing medication education to solid organ transplant (SOT) recipients are described.

METHODS

In a retrospective study of adults who received kidney transplants from February 2015 through May 2017, patients were educated about their medications using a tablet computer application, Medication Regimen Education (MRxEd), that presented concise videos describing the name, indication, dose, adverse effects, and associated interactions of all medications received, as well as special considerations applicable to each agent. Assessment questions were used to reinforce key concepts and identify knowledge gaps.

RESULTS

The digital educational intervention was provided to 282 kidney transplant recipients. Patients were predominantly white (48%) and/or male (63%), with a median age of 51 years (interquartile range, 37-61 years). Patients came from a variety of education backgrounds. Most patients (81%) were educated on dual maintenance immunosuppression (with tacrolimus and mycophenolate) and 3 infection prophylaxis agents (nystatin, sulfamethoxazole-trimethoprim, and valganciclovir). Most patients (90%) correctly answered questions related to medication indications, dosing, and special rules, but many (61%) had difficulty correctly answering questions about adverse effects.

CONCLUSION

An innovative approach for interactive and engaging medication teaching with the MRxEd application enhanced the education process for SOT recipients.