Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Technology”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 919 records · Page 51Linked to original sources
PubMed1990

Clinical technology assessment, cost-effective adoption, and quality management by hospitals in the 1990s.

Technology assessment in the 1990s must become an integral part of a hospital's strategic priority goals, with active participation of physicians and top management. Technology assessment should involve a wide range of criteria and health care consumer expectations, so that the appropriateness, effectiveness, cost-effectiveness, and quality improvement aspects of new technologies are all considered. Mount Carmel Health's Advanced Treatment and Bionics Institute (ATBI), established in 1986, monitors significant developments in new technologies and performs technology and outcomes assessments. ATBI activities, which have facilitated adoption of 35 treatment-based projects, are integrated into the existing QA structure of Mount Carmel hospitals. Through resolution of identified problems, quality care can be promoted, while providing patients innovative medical treatments.

Academies and Institutes↗
PubMed2002

Priority setting for health technology assessment in The Netherlands: principles and practice.

The resources for health technology assessment fall short of that needed to evaluate all health technologies. Therefore, priorities have to be set. In The Netherlands, the Health Care Insurance Board tried to address this issue by developing a more explicit priority setting procedure for the Fund for Investigative Medicine, which is the most important health technology assessment programme in The Netherlands. The procedure provides one of the first examples of the application of theoretical principles for priority setting. The aim is to select those health technologies for assessment that are most relevant for policy-making. To determine the policy relevance of research proposals, different procedures for categorising, scoring, and weighting policy criteria were defined, and different classification strategies were explored. Our first experiences using the priority setting procedure are described by means of an example on low back pain. Subsequently, the procedure has been applied to research proposals submitted to the Fund for Investigative Medicine in 1998 to illustrate how decisions on the funding of health technology assessments can be guided. The results show a different rating of research proposals into one of three predefined categories of policy relevance, high, intermediate and low, implying that decisions about funding can heavily dependent on the selected procedure. Therefore, it seems to be important that the selected procedure reflects the viewpoint of the organisation wishing to set priorities. The different ratings of the research proposals using a more explicit procedure suggest that there may be scope for further development and application of the procedure.

Health Policy↗
PubMed1998

Diffusion of laparoscopic technologies in Denmark.

It has been predicted that minimally invasive therapy will have dramatic consequences for the specialty of general surgery, as demonstrated by the diffusion of laparoscopic cholecystectomy. To investigate the determinants of the diffusion in Denmark of five laparoscopic technologies (cholecystectomy, appendicectomy, surgery for colon cancer, surgery for inguinal hernia and fundoplication), questionnaires on seventeen factors' influence on the adoption (stimulating or impeding) were sent to fifty-nine hospitals. Fifty hospitals (85%) responded. Overall, 98% adopted laparoscopic cholecystectomy in Denmark between 1991 and 1995, whereas the remainder of the technologies were adopted by 7-65% of hospitals performing these operations. Large and specialized hospitals were the earliest adopters. The factors, nature of technology (minimally invasive versus conventional), training (appropriate training courses), competition (between specialties and between hospitals) and media attention have stimulated the diffusion, whereas three budget factors (budget for investment, budget for operation and public regulation) usually had an impeding effect. Stimulating factors prevail for all laparoscopic technologies indicating that some guidance of the adoption and use of new health technologies might be necessary. In Denmark, one of the suggested health policies to secure timely guidance is the establishment of an early warning system.

Denmark↗
PubMed1999

IMIA Working Group 15: technology assessment and quality development in health informatics.

The working group on technology assessment and quality development in health informatics was established as a follow-up to the recommendations made at the IMIA-ISTAHC working conference in 1990. The working group was approved by the IMIA General Assembly at Kyoto, September, 1993. The working group aims to further develop the field of technology assessment and quality development in health informatics, by: promoting consensus development on methodological issues; promoting comprehensive assessment of health care information technologies, for instance by providing expertise; demonstrating the value and importance of assessment of health care information technologies, to health care decision makers, health care providers and developers of information technologies.

Medical Informatics↗
PubMed1988

The role of the universities in assessing technology and disseminating information.

Universities, especially those with medical schools whose academics engage in clinical research, have a vital role in shaping the way in which medical technology is used. Academic clinicians are a bridge between laboratory research, where new technologies are developed, and clinical practice, where these technologies are applied in treating patients. Academic clinicians are particularly suited to doing clinical assessment of medical technologies, and academic clinical departments should devote more time to the assessment and application of technology on a broad scale.

Academic Medical Centers↗
PubMed1988

Data bases for the assessment of medical technologies. Examples from Europe.

The assessment of medical technologies has to answer several questions ranging from safety and effectiveness to complex economical, social, and health policy issues. The type of data needed to carry out such evaluation depends on the specific questions to be answered, as well as on the stage of development of a technology. Basically two types of data may be distinguished: (a) general demographic, administrative, or financial data which has been collected not specifically for technology assessment; (b) the data collected with respect either to a specific technology or to a disease or medical problem. On the basis of a pilot inquiry in Europe and bibliographic research, the following categories of type (b) data bases have been identified: registries, clinical data bases, banks of factual and bibliographic knowledge, and expert systems. Examples of each category are discussed briefly. The following aims for further research and practical goals are proposed: criteria for the minimal data set required, improvement to the registries and clinical data banks, and development of an international clearinghouse to enhance information diffusion on both existing data bases and available reports on medical technology assessments.

Artificial Intelligence↗
PubMed1988

Health care technologies in The Netherlands. Assessment and policy.

This article argues that while health care and government authorities in the Netherlands in the last decades have attempted to rationalize the diffusion of medical technology, much work remains to be done. The authors contend that though a mix of direct government regulation and economic incentives will be needed, regulation by incentive is more effective than regulation by directive in achieving cost effective use of technology. Generally, bureaucratic structures provide only limited opportunities for tight control of the diffusion of medical technologies. The article offers possible future strategies for directing the adoption and use of medical technologies and stresses the importance of reliable information culled from comprehensive technology assessments.

Diffusion of Innovation↗
PubMed1995

The use of technology assessment by hospitals, health maintenance organizations, and third-party payers in the United States.

A case study design was used to determine the reliance on technology assessment of decisionmakers in hospitals, health maintenance organizations (HMOs), and third-party payers. Thirty different organizations were contacted and semistructured interviews conducted. The study found that hospitals, HMOs, and insurers are conducting technology assessments, but the form and sophistication of these analyses range widely. Hospitals are particularly focused on traditional financial analyses ("prudent purchasing") with the exception of pharmacy committees, which generally conduct more sophisticated socio-economic analyses. HMOs and insurers conduct outcome assessments for coverage of expensive or controversial technologies but exclude economics. Technology assessment will become increasingly important in resource allocation decision making and it is in the interest of technology providers to foster better information, a more comprehensive assessment process, and a more efficient assessment system.

Decision Making, Organizational↗
PubMed1991

Estimating the effectiveness of perinatal care technologies by expert opinion.

The majority of technologies in use in perinatal care were organized into 45 technological functions. Forty-six experts from 19 different regions of Brazil and other Latin American countries then selected a "basic package" (BP) of 15 technological functions. Considering the 12 main causes of perinatal mortality in Brazil, the experts estimated the number of preventable deaths, assuming universal coverage by the BP and the additional reductions that could be obtained by gradually adding other technological functions to the BP. A simulation was performed for the 26 states of Brazil to identify regional priorities for the diffusion of technological functions. For most regions, the BP appears to be the most effective intervention, with the potential of reducing perinatal mortality by 33%, followed by "coordination of services and referral of pregnant women" (14%), and "treatment of respiratory conditions" (11.8%).

Attitude of Health Personnel↗
PubMed1994

Increasing physician acceptance of technology assessment through a focused training program.

This paper presents the framework for a one-semester course to give physicians a better understanding of the core concepts of technology assessment, using medical instrumentation technology as a vehicle to stimulate the discussion of technology assessment and its applications. An assessment matrix has been developed as an organizational tool to identify issues in assessment to be addressed under each topic and to identify those issues that are of key importance to particular technologies. At the end of the class, the physician-student should be able to identify major types of medical instrumentation and the instrument's principal application(s), to identify the techniques of technology assessment, and to analyze the economic, ethical, and legal issues that are applicable to instrumentation.

Curriculum↗
PubMed1988

The assessment of technology and quality. A comparative study of certainties and ambiguities.

Though technology assessment and quality assessment have much in common, they differ significantly in emphasis. Technology assessment judges technology itself; quality assessment examines the extent to which a technology is used well in its various settings. This article explores the nature of quality assessment--including the performance of individual practitioners as they care for individual patients and the care received by communities--and examines its interrelationship with technology assessment.

Health Services Research↗
PubMed1988

The technology of mammography. Misunderstood and underutilized.

This article reviews milestones in the technological development of mammography since 1970. Mammography is particularly underutilized as a screening procedure for breast cancer and the reasons for its continued inappropriate and under use are explored. Although there are some known barriers to increased utilization among the female adult population, the majority of barriers reside within the domain of referring physicians. Remedies to address the low referral rates for screening mammography are outlined for federal agencies, radiology groups, mammography equipment companies, medical schools, and philanthropic groups. Until the developers of technological procedures such as mammography appreciate that the application of a technology and its appropriate utilization by professionals and the public are important to consider when the technology is developed, utilization rates may not do justice to the technology's potential.

Adult↗
PubMed1996

Awareness of providers' use of new medical technology among private health care plans in the United States.

In a national survey of medical directors at 231 U.S. private health care plans that cover over two thirds of the privately insured population, we studied whether medical directors are aware when a new technology, such as laser therapy, is being used in procedures for which claims are submitted, the factors alerting them to such use, and the factors prompting them to make a specific coverage decision for the technology. We also examined possible associations between health plans' characteristics (HMO versus indemnity, size, profit status, and time in operation) and their medical directors' awareness of the use of technologies, factors alerting medical directors to their use, and factors prompting specific coverage decisions. The majority of plans were generally not aware that laser technology was being used when it was billed under a general billing code, raising the possibility that less effective or less safe technologies could be introduced rapidly into the treatment of insured populations. Nonprofit and older plans were less likely to be aware that lasers were used in some procedures than for-profit and younger plans.

Analysis of Variance↗
PubMed1998

An early system for the identification and assessment of future health care technology. The Dutch STG Project.

This article is based on the report, Anticipating and Assessing Health Care Technology, written in the Netherlands between 1985-88. The project was carried out because of increasing concern in the Dutch Ministry of Health (STG, then WVC) about the costs and benefits of new technologies for health care. At that time, there were no established models for early identification, so the project was not only the most extensive such effort to that date, but had to develop its own methods. Overseen by a special commission, the project staff identified many future and emerging technologies in health care and assessed selected technologies. Although the actual information produced was quickly dated and the project was discontinued in 1988, it did stimulate the Ministry of Health to ask the Dutch Health Council (Gezondheidsraad) to continuously identify important new technologies. The reports also demonstrated the potential usefulness of such an effort to Dutch policy makers, and probably to those in other countries as well.

Communication↗
PubMed1998

When is the 'right' time to initiate an assessment of a health technology?

There is currently no generally accepted formula for the optimal timing of health technology assessments (HTAs). This paper presents some of the relevant issues and then reviews the existing literature on timing of HTAs. It finds that the literature that specifically addresses these issues is limited. There is a consensus that HTAs should be initiated at an early stage of the development of a new health technology, and repeated during the life cycle of the technology. However, the questions of reliably identifying new technologies at an early stage in their development and of deciding on a detectable critical point for starting evaluation are not resolved. It is proposed that a system of categorization and prioritization of health technologies should be developed to allow decisions to be made as to when a strongly precautionary approach is required and how the limited resources available for HTA could be optimally deployed.

Diffusion of Innovation↗
PubMed2000

Health technology assessment in Greece.

In 1983 a health reform aimed to assure universal coverage and equity in the distribution of services in Greece. The reform implied state responsibility for the financing and delivery of services and a reduction of the private sector. The model was a Bismarckian scheme for social insurance. However, healthcare delivery remains fragmented and uncoordinated and the private sector is getting stronger. The dominant payment system is fee-for-service for the private sector and administered prices and salaries for public hospitals and social insurance funds. The many insurers have their own eligibility requirements, validation procedures, etc. Coverage of services by social security funds, probably among the most comprehensive in Europe, is determined more on historical and political grounds than on efficiency or cost-effectiveness. The system is plagued by problems, including geographical inequalities, overcentralization, bureaucratic management, poor incentives in the public sector, open-ended financing, inefficient use of hospital beds, and lack of cost-effectiveness. There are no specific legal provisions for the control of health technology. Technologies are introduced without standards or formal consideration of needs. There are no current efforts to control health technology in Greece. However, health technology assessment (HTA) has gained increasing visibility. In 1997 a law provided for a new government agency responsible for quality control, economic evaluation of health services, and HTA. The hope is that the new law may introduce evaluation and assessment elements into health policy formulation and assure that cost effectiveness, quality, and appropriate use of health technology will receive more attention.

Delivery of Health Care↗
PubMed2000

Health technology assessment in Ireland.

Ireland's health system is primarily funded from general taxation and is publicly provided, although private health care retains a considerable role. It is a unique structure, a mixture of universal health service free at the point of consumption and a fee-based private system where individuals subscribe to private health insurance that covers some of their medical expenses. The recent history of the Irish health services saw consolidation of existing services and an expansion into new areas to adapt to changing practices and needs. There has also been a drive to extract maximum efficiency so as to maintain the volume and quality of patient services at a time of very tight financial constraints. Introduction of new health technologies continued to accelerate. New technologies tended to spread rapidly before systematic appraisal of their costs and benefits. When the state is involved in funding the public hospital system, acceptance of new technology is a matter for discussion between agencies and the Department of Health and Children. Decisions about spending annual "development funding" have generally not been based on careful assessment of proposals for new technology. In 1995, a healthcare reform put new Public Health Departments in Health Boards in a prime position in Ireland's health services organization. These departments now emphasize evidence-based medicine. While Ireland does not have a national health technology assessment (HTA) program, there are plans to form an advisory group on HTA in 1998. HTA is seen as a significant element of future health policy in Ireland.

Delivery of Health Care↗
PubMed2000

Health technology diffusion rates. Statins, coronary stents, and MRI in England.

OBJECTIVE: To analyze the rates and influences on the adoption of three selected health technologies: statins, coronary stents, and magnetic resonance imaging (MRI). METHODS: A retrospective diffusion study using primary care prescribing data and questionnaire responses from acute hospital trusts in the West Midlands region (population 5.3 million or 10% of England). RESULTS: The selected technologies had markedly different diffusion curves. Statins diffused rapidly soon after launch. Coronary stents were initially used 6 years after first availability, but within 2 years all responding hospitals reported using them. MRI scanners were initially purchased 6 years after first availability with a subsequently slow rate of diffusion, and are still absent from some hospitals. Influences on the adoption of each technology were different. Commercial marketing was reported as a major influence on the diffusion of statins but not at all on MRIs. Cost impact was a major negative influence on the diffusion of MRI scanners and statins, whereas enthusiastic individuals were key to the diffusion of stents. CONCLUSIONS: Influences on adoption and consequent diffusion rates are very different for different health technologies. It is not at all clear that such diffusion patterns relate well to an optimum timing rate. This has important implications for technology gatekeepers in health care.

Anticholesteremic Agents↗