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PubMed2001

Barriers that impede the adoption of pediatric information technology.

BACKGROUND: Information technology (IT) is a critical but underused component of health care. Many factors contribute to the inconsistent adoption of IT. OBJECTIVE: To review the literature to better elucidate barriers that are likely to affect the adoption of IT by pediatric professionals. DATA SOURCES: Manuscripts were found using a MEDLINE search combining the terms medicine, information systems, and technology transfer. I also obtained references cited by relevant articles. Finally, I explored the Internet using http://www.google.com and http://www.northernlight.com. STUDY SELECTION: Articles discussing barriers or factors affecting the adoption of IT were considered for inclusion. Articles unrelated to clinical IT were excluded. DATA SYNTHESIS: A variety of barriers exist that affect the adoption of useful technologies. Situational barriers include challenges imposed by the current national health environment, financial and legal risks associated with technology purchasing and use, and access to technology. The most significant barrier is that pediatric health care practitioners may lack the knowledge or training to use IT effectively. CONCLUSIONS: Although some barriers exist that may be challenging to overcome, other barriers, such as the lack of knowledge about the uses of IT, are imminently solvable. Efforts to overcome these barriers should begin in earnest and should include educating stakeholders in the care of children and adolescents, as well as improving the knowledge about various technologies available to support pediatric and adolescent health care.

Biomedical Technology↗
PubMed2004

Improvements in medical care and technology and reductions in traffic-related fatalities in Great Britain.

Great Britain has one of the lowest levels of traffic-related fatalities in the industrialized world with a current total of about 3500 fatalities per year. Large reductions have occurred over the last 20-30 years and the government has targets of achieving another 40% reduction by 2010. This paper analyzes some of the factors that have been statistically significant in helping to achieve those reductions with a focus on improvements in medical care and technology. Using a cross-sectional time-series of regional data a fixed effects negative binomial (NB) model is estimated which includes three proxies of medical care and technology changes. These are the average length of inpatient stay in the hospital, the per-capita level of National Health Service (NHS) staff, and number of people per-capita waiting for hospital treatment. All are statistically significant with the expected sign showing that improvements in medical technology have reduced total fatalities with less of an impact from changes in medical care. Other variables are also found to be significant, including the percent of elderly people in the population, per-capita expenditure on alcohol, motorway capacity, and average vehicle age. The latter shows a surprisingly unexpected effect, with more older vehicles in a region leading to fewer fatalities. Models evaluating effects on serious and slight injuries are also estimated and serve to confirm the expected effects of medical care and technology.

Accidents, Traffic↗
PubMed2002

Technology in the birthing room.

The use of technology is not benign. As with any health care intervention, there are associated risks and benefits. The practitioner needs to constantly consider the benefits of the technology versus the naturalistic birth experience. The use of technology should optimize birth outcomes while maintaining a balance that provides for the best possible human birth experience. Technology, however, does have merit in the birth setting, regardless of location, but its use should be evaluated on an individual, as needed, basis. The most common technological advances currently available for assessment and maternal/fetal care during birth include electronic fetal monitoring, ultrasonography, blood pressure screening, maternal/fetal pulse oximetry, and infusion pumps. All obstetrical care providers must be familiar with the forms of technology currently available and be aware of emerging technologies for use during the birthing process.

Biomedical Technology↗
PubMed2004

Using health technology assessment to put pharmaceutical care on the political agenda.

Pharmaceutical care is a widely accepted strategy in the world of pharmacy, as well as a topic of interest in pharmacy practice research. Most people in the field would agree that it is unfortunate that so little is known about pharmaceutical care outside the world of pharmacy. There is also wide agreement that the further development of pharmaceutical care requires that policymakers become aware of, accept and ultimately support it. Although attempts have been made, we have not yet managed to capture the attention and support of policymakers, including politicians. In this article we argue that the way to get the attention of policymakers/politicians is by changing the way we communicate with them, as a means of overcoming some of the barriers we normally meet when introducing pharmaceutical care. We suggest that one possible way of getting their attention and subsequent support is by gaining a better understanding of the way policymakers work in general and then adjusting our argumentation for pharmaceutical care to better fit into their rationality and work habits. In this article, we elaborate on this idea and discuss how proponents of pharmaceutical care can use 'health technology assessment' to argue their case.

Biomedical Technology↗
PubMed2001

Artificial organs and vanishing boundaries.

With the first clinical use of the artificial kidney over 5 decades ago, we entered into a new era of medicine-that of substitutive and replacement therapy. Yet it took nearly another 15 years until chronic treatment was possible and nearly another 15 years until widespread treatment was possible due to government support. The history of development and clinical use of other artificial organ technologies such as the artificial heart and heart valves, the artificial lung, artificial blood, joint replacements, the artificial liver, the artificial pancreas, immunologic, metabolic, and neurologic support, neurocontrol, and tissue substitutes have followed similar long development paths. Despite their relatively long time to be put into clinical use, the contributions of artificial organ technologies to the betterment of mankind have been unquestionably a major success. For example, modern day surgery would not be possible without heart-lung support, and the technologies for heart support have led to the development of various minimally invasive technologies. The powerful impact that artificial organ technologies presently has on our lives is seen through the statistic that in the U.S.A. nearly 1 in 10 persons is living with an implanted medical device. With the aging of our population and the improvements in technologies, these numbers will only increase.

Animals↗
PubMed2006

[What incentives foster hospital use in the National Health Service?].

BACKGROUND: Geographic variations in medical practice have been widely described and different underlying causes have been proposed. Basically, when evidence about effectiveness is strong variations are lower and, probably, it reflects patient needs differences; nevertheless, when either uncertainty or ignorance about effectiveness dominates, medical decision making is particularly sensitive to supply. In this paper we argue about the factors (incentives) influencing hospital utilization in the Spanish National Health Service (sNHS). MATERIAL AND METHOD: We have compared both sNHS utilization rates and those in MEDICARE (US Federal Health System for elderly and handicapped population). RESULTS: 1) Utilization rates in Spain were lower than in MEDICARE for most of the conditions and procedures under study. However, knee or hip replacement and cholecystectomy rates were similar; 2)unlike what happened in MEDICARE, supply, as total beds per 1,000 inhabitants, showed either negative or no correlation with utilization rates; however, those populations which get more interventions get more of whatever the surgery performed; 3)High tech hospitals, in terms of tertiary and teaching hospitals, perform less < > interventions; on the other hand, < > utilization rates were closed to those in MEDICARE. CONCLUSIONS: Differences between both Health Care Systems suggest a different structure of incentives working under variations. Here in Spain, instead of supply, < > is becoming the alternative explanation. If true, < > hypothesis entails a model of National Health Service focused on technology instead of patient needs.

Aged↗
PubMedDate not supplied

Breaking down barriers. Information technology and rural health.

Fifty years ago, the number of beds was the only significant difference between rural and urban hospitals. Health care was a relatively "low tech" business. Hospitals in less-populated areas were able to provide the same services as their big-city counterparts. However, beginning in the 1960s, rapid advances in technology started to put rural hospitals at a disadvantage.

Biomedical Technology↗
PubMed2005

Designing and Evaluating Home-Based, Just-in-Time Supportive Technology.

At MIT, a multi-disciplinary team of researchers is studying how to create pervasive computing environments for the home. We are developing technologies and design strategies that use context-aware sensing to empower people with information by presenting it at precisely the right time and place. Contrary to many visions of future home environments in the literature, we advocate an approach that uses technology to teach as opposed to using technology primarily for automated control. We have constructed a "living laboratory" that will provide a unique, flexible infrastructure for scientifically studying the power of pervasive computing for motivating learning and behavior change in the home. This facility, called the PlaceLab, is being used to study technology for creating homes that are supportive.

Biomedical Technology↗
PubMed2006

Ethics in the use of new medical technologies for neurosurgery: "Islamic viewpoint".

It is very clear from developments in technology and its global expansion that we cannot survive the 21st century with 20th century ethics. The developments in technology, especially those in the field of medicine have a direct and fast effect on human life expectation and survival. Thus, this issue has to be seen and studied in the context of ethics. In this paper, ethical principles in the application of new medical technologies in neurosurgery from an Islamic viewpoint will be given.

Biomedical Technology↗