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PubMed2001

Science and technology: new drivers in health care.

During the next year, Healthcare Leadership and Management Report will intensify its coverage of the use of science and technology to improve readiness, and financial and operational performance in hospitals and health systems. We will do this through a series of case studies from organizations that have had success in implementing programs that exploit technology, explaining the nuts and bolts of how the success was achieved. Look for a regular science and technology column beginning in January.--Lee Reeder, editor.

Biomedical Technology↗
PubMed2002

Information extraction from biomedical text.

Information extraction is the process of scanning text for information relevant to some interest, including extracting entities, relations, and events. It requires deeper analysis than key word searches, but its aims fall short of the very hard and long-term problem of full text understanding. Information extraction represents a midpoint on this spectrum, where the aim is to capture structured information without sacrificing feasibility. One of the key ideas in this technology is to separate processing into several stages, in cascaded finite-state transducers. The earlier stages recognize smaller linguistic objects and work in a largely domain-independent fashion. The later stages take these linguistic objects as input and find domain-dependent patterns among them. There are now initial efforts to apply this technology to biomedical text. In other domains, the technology plateaued at about 60% recall and precision. Even if applications to biomedical text do no better than this, they could still prove to be of immense help to curatorial activities.

Abstracting and Indexing↗
PubMed2005

Decisions to adopt new technologies at the hospital level: insights from Israeli medical centers.

OBJECTIVES: New medical technologies have been identified as the leading cause of increasing health-care expenditures. Adoption of a new technology is one of the most important decisions in medical centers. The objectives of this study were to map and describe the function of hospital decision-makers within the area of new technology assessment and adoption, and to examine relevant considerations, sources of information, and decision-making processes in the adoption of a new technology. METHODS: A questionnaire was mailed to hospital executives and referred to (i) the considerations for and against adoption of a new technology, (ii) the decision-making process, (iii) information sources used in the decision-making process. RESULTS: The most frequent criteria favoring adoption included increased cost-effectiveness, increased efficacy, and decrease in complication rates. An increase in complication rates or side effects and decreased efficacy were the top ranked criteria against adoption. The final decision-making responsibility varied among technologies; the medical director frequently made the final decision when a new device was involved, but this responsibility decreased when a new drug or a new procedure was considered, Participation in scientific meetings, opinions of local experts, medical journals, and Food and Drug Administration clearance documents were the most important information sources used in the decision-making process. However, these were not necessarily the optimal sources of information. Significant barriers in adoption decision-making are lack of timely data regarding the safety of the new technology, its cost-effectiveness, and efficacy. CONCLUSION: To improve the adoption decisions, hospitals must develop criteria upon which the decision-making will be based.

Biomedical Technology↗
PubMed2005

Medical technology management: bridging the gap between theory and practice.

New medical technologies that offer to improve upon or completely replace existing ones are continuously appearing. These technologies are forcing healthcare policymakers to consistently evaluate new treatment options. However, emerging medical technology has been viewed as a significant factor in increasing the cost of healthcare. The abundance of new medical alternatives, combined with scarcity of resources, has led to priority setting, rationing, and the need for further technology management and assessment. Economic evaluation of medical technologies is a system of analysis within the framework of health technology assessment to formally compare the costs and consequences of alternative healthcare interventions. EEMT can be used by many healthcare entities, including national policymakers, manufacturers, payers and providers, as a tool to aid in resource allocation decisions. In this paper we discuss the historical evolution and potential of EEMT, the practical limitations hindering more extensive implementation of these types of studies, current efforts at improvement, and the ethical issues influencing ongoing development. The Medical Technologies Administration in Israel's Ministry of Health is given as an example of an entity that has succeeded in practically implementing EEMT to optimize healthcare resource allocation.

Biomedical Technology↗
PubMedDate not supplied

Telemedicine: an emerging health care technology.

Telemedicine uses advanced telecommunication technologies to exchange health information and provide health care services across geographic, time, social, and cultural barriers. All telemedicine applications require the use of the electronic transfer of information. Telemedicine encompasses computer technologies using narrow and high bandwidths for specific types of information transmission, broadcast video, compressed video, full motion video, and even virtual reality. There are many types of common medical devices that have been adapted for use with telemedicine technology, and many clinical services can be provided via telemedicine to patients who live in physician shortage areas. The greatest challenges for telemedicine in the twenty-first century are financing, safety standards, security, and infrastructure.

Biomedical Technology↗
PubMed2003

Assessment and validation of imaging methods and technologies.

In summary, the group identified many challenges and opportunities facing those wishing to conduct rigorous assessment and validation of imaging technologies. Specific needs and recommendations were outlined by the group. Overall, it was felt that the field has made great progress in the past several years, and that the future is promising.

Biomedical Technology↗
PubMed2005

The burgeoning disorder of technophilia.

Andreas Laupacis and William Evans have deftly accomplished the difficult task of synthesizing the major issues at hand. Their comments are timely, reflecting society's increasing preoccupation with rapid access to diagnostic imaging. Paradoxically, the recent CIHI report on medical imaging records a steady increase in scanners, without the expected reduction in wait times. The role of private facilities is unclear, and the value of screening asymptomatic patients is unproven. There are few clear guidelines for ordering images. New intraoperative, functional and molecular imaging technologies will further strain the system. This array of challenges should be urgently tackled by a decisive panel of national experts, who would in turn supervise consultants working full-time on guideline development.

Attitude of Health Personnel↗
PubMed1999

Ethical issues in the economic assessment of health care technologies.

This paper challenges traditional views which oppose health economics and medical ethics by arguing that economic assessment is a necessary complement to medical ethics and can help to improve public participation and democratic processes in choices about resource allocation for health care technologies. In support of this argument, four points are emphasized: (1) Most current biomedical ethical debates implicitly deal with economic issues of resource allocation. (2) Clinical decisions, which usually respect the Hippocratic code of ethics, are nevertheless influenced by economic incentives and constraints. (3) Economic assessment is concerned with both efficiency and equity and potential trade-offs between the two, which means that ethical judgements are always embedded in welfare economics. (4) The real debate is not between economics on the one side and medical ethics on the other. Rather it is between different ethical conceptions of social justice and the contrasting approaches they entail to reconciling individual interests and preferences with collective goods and welfare.

Bioethical Issues↗