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PubMed1999

Maximizing the value of milk through separation technologies.

Milk is the source of a wide range of proteins that deliver nutrition to the most promising new food products today. Isolated milk proteins are natural, trusted food ingredients with excellent functionality. Separation technologies provide the basis for adding value to milk through the production of proteins that provide the food industry with ingredients to meet specific needs, not possible with milk itself or with other ingredients. The major milk proteins, casein and whey protein, can be isolated by manipulating their compositional and physical properties and then by using various separation technologies to recover the proteins. Additionally, they can be processed in various ways to create a wide range of ingredients with diverse functional characteristics. These ingredients include milk protein concentrate, milk protein isolate, casein, caseinate, whey protein concentrate, whey protein isolate, hydrolysates, and various milk fractions. Within each of these ingredient categories, there is further differentiation according to the functional and nutritional requirements of the finished food. Adding value to milk by expanding from consumer products to ingredients often requires different technologies, marketing structure and distribution channels. The worldwide market for both consumer products and ingredients from milk continues to grow. Technology often precedes market demand. Methods for the commercial production of individual milk components now exist, and in the future as clinical evidence develops, the opportunity for adding value to dairy products as functional foods with health benefits may be achieved. The research and development of today will be the basis of those value-added milk products for tomorrow.

Animals↗
PubMed2006

Systematic review: impact of health information technology on quality, efficiency, and costs of medical care.

BACKGROUND: Experts consider health information technology key to improving efficiency and quality of health care. PURPOSE: To systematically review evidence on the effect of health information technology on quality, efficiency, and costs of health care. DATA SOURCES: The authors systematically searched the English-language literature indexed in MEDLINE (1995 to January 2004), the Cochrane Central Register of Controlled Trials, the Cochrane Database of Abstracts of Reviews of Effects, and the Periodical Abstracts Database. We also added studies identified by experts up to April 2005. STUDY SELECTION: Descriptive and comparative studies and systematic reviews of health information technology. DATA EXTRACTION: Two reviewers independently extracted information on system capabilities, design, effects on quality, system acquisition, implementation context, and costs. DATA SYNTHESIS: 257 studies met the inclusion criteria. Most studies addressed decision support systems or electronic health records. Approximately 25% of the studies were from 4 academic institutions that implemented internally developed systems; only 9 studies evaluated multifunctional, commercially developed systems. Three major benefits on quality were demonstrated: increased adherence to guideline-based care, enhanced surveillance and monitoring, and decreased medication errors. The primary domain of improvement was preventive health. The major efficiency benefit shown was decreased utilization of care. Data on another efficiency measure, time utilization, were mixed. Empirical cost data were limited. LIMITATIONS: Available quantitative research was limited and was done by a small number of institutions. Systems were heterogeneous and sometimes incompletely described. Available financial and contextual data were limited. CONCLUSIONS: Four benchmark institutions have demonstrated the efficacy of health information technologies in improving quality and efficiency. Whether and how other institutions can achieve similar benefits, and at what costs, are unclear.

Biomedical Technology↗
PubMed1990

The alignment of technology and structure through roles and networks.

This paper outlines a role-based approach for conceptualizing and investigating the contention in some previous research that technologies change organizational and occupational structures by transforming patterns of action and interaction. Building on Nadel's theory of social structure, the paper argues that the microsocial dynamics occasioned by new technologies reverberate up levels of analysis in an orderly manner. Specifically, a technology's material attributes are said to have an immediate impact on the nonrelational elements of one or more work roles. These changes, in turn, influence the role's relational elements, which eventually affect the structure of an organization's social networks. Consequently, roles and social networks are held to mediate a technology's structural effects. The theory is illustrated by ethnographic and sociometric data drawn from a comparative field study of the use of traditional and computerized imaging devices in two radiology departments.

Age Factors↗
PubMed1991

MRI: update on technology diffusion and acquisition.

Over the past three years, magnetic resonance imaging (MRI) has become accepted as a valuable diagnostic tool, and its applications continue to expand. During this time, the number of units installed in the United States doubled. By 1990 about 2,000 MRI units were in place in the United States and nearly 20 percent of the MRI-installed base was mobile, according to a research study conducted by the Hadley Hart Group (Chicago) and Drew Consultants, Inc. (Concord, MA). With the introduction of the prospective payment system, many hospitals were hesitant to spend limited capital on new technology, such as MRI. At the same time, freestanding diagnostic imaging centers were on the rise. Some hospitals and entrepreneurs who foresaw the potential of MRI in health care pioneered its use in the clinical setting. Hospitals began to examine new partnership arrangements and alternative forms of financing, so that they too could offer MRI services. By the end of 1988, the majority of hospitals offering MRI services did not own their own unit and about 40 percent of the hospitals offering MRI services were in a mobile configuration according to the Hadley Hart Group. While the technology has been diffused into 100-bed hospitals via mobile service vendors in some parts of the country, many medium-sized and large hospitals also have entered the MRI services market in this fashion. In the larger hospitals, the patient demand or need for the service often would justify acquisition of MRI, but the expense of the technology, and in many areas restrictive state health planning policies, modified purchase of MRI systems by hospitals. Mobile service vendors offered hospitals a way to startup MRI services in a limited fashion without a major capital expenditure and its associated risk. As hospitals gain experience with mobile MRI and achieve or exceed their early utilization projections, administrators are reevaluating the need to expand services to a full-time fixed site. Early fixed-site MRI providers have been constantly upgrading their MRI capability while planning on adding more units. The technology itself has continued to improve, primarily through the implementation of new software that permits new techniques such as MR angiography (MRA) to be performed. Units are available in a wide price range, price usually reflecting both the field strength (0.5 tesla units cost less) as well as the additional capabilities beyond routine imaging (MRA, spectroscopy).(ABSTRACT TRUNCATED AT 400 WORDS)

Data Collection↗
PubMed1990

Rotec Theory: planning tool to position hospitals on the technology curve.

The mission statement of a prominent California hospital has been revised as part of a strategic planning process less than two years before the hospital began experiencing substantial financial difficulties. When the "red numbers" began to appear, management was quick to blame changing demographic patterns and the competitive environment. Those were not the only problems. A major contributing factor that management failed to recognize was a delay in how quickly the hospital moved to adopt high technology or new medical procedures. In a few short years, it had changed from being the first community hospital to implement state-of-the-art programs to one that was slow to introduce technology. In retrospect, the hospital's mission statement did not address the role of technology and therefore it could not detect the movement away from one of its critical success factors. The Rotec Theory was developed to assist this hospital to understand the economics of technology on its current and planned operations.

Cost-Benefit Analysis↗
PubMed1990

Technology as culprit and benefactor.

Technologies can be viewed as a mixed blessing: rising health care costs versus improved diagnosis, treatment, and health status. This article briefly discusses the influence of key factors on the demand for technology and its utilization. These factors include rising health expenditures, changes in populations, and the development of cost containment strategies. Resulting shifts in incentives and utilization are examined. Because of the difficult and complex issues associated with the increasing use of medical technologies, hard choices will need to be made about quality of life, technology assessment, and the allocation of health resources to the terminally ill.

Diffusion of Innovation↗
PubMed1993

Building a strategic technology management program.

Strategic technology management decisions are one of the best opportunities for healthcare providers to positively meet clinical needs, patient expectations and competitiveness goals. Technology management must not be treated as an event (annual capital budgeting) but as a well-thought-out, long-range business plan. A strategic technology management team should be formed that includes all the key strategic business areas, plus ad hoc members from the clinical and biomedical engineering areas. Current and future needs should be assessed and the performance of the plan monitored. A plan will help achieve buy-in from clinicians and reduce unwarranted expenditures on technology.

Budgets↗
PubMedDate not supplied

Technology in radiology: advances in diagnostic imaging & therapeutics.

Nearly 100 years from its birth, radiology continues to grow as though still in adolescence. Although some radiologic technologies have matured more than others, new applications and techniques appear regularly in the literature. Radiology has evolved from purely diagnostic devices to interventional technologies. New contrast agents in MRI, X ray and ultrasound enable physicians to make diagnoses and plan therapies with greater precision than ever before. Techniques are less and less invasive. Advances in computer technology have given supercomputer-like power to high-end nuclear medicine and MRI systems. Imaging systems in most modalities are now designed with upgrades in mind instead of "planned obsolescence." Companies routinely upgrade software and other facets of their products, sometimes at no additional charge to existing customers. Hospitals, radiology groups and imaging centers will face increasing demands to justify what they do according to patient outcomes and management criteria. Did images make the diagnosis or confirm it? Did the images determine optimal treatment strategies or confirm which strategies might be appropriate? Third-party payers, especially the government, will view radiology in those terms. The diagnostic imaging and therapy systems of today require increasingly sophisticated technical support for maintenance and repair. Hospitals, radiology groups and imaging centers will have to determine the most economic and effective ways to guarantee equipment up-time. Borrowing from the automotive industry, some radiology manufacturers have devised transtelephonic software systems to facilitate remote troubleshooting. To ensure their fiscal viability, hospitals continue to acquire new imaging and therapy technologies for competitive and access-to-services reasons.(ABSTRACT TRUNCATED AT 250 WORDS)

Diagnostic Imaging↗
PubMed1994

Adopting information technology in hospitals: the relationship between attitudes/expectations and behavior.

The purpose of this field study was to measure the influence of three factors on the adoption of information technology in a health care setting--namely, attitudes toward using the technology, subjective norms or beliefs about others' expectations, and perceived voluntariness. Approximately 77 percent of the variance of intent to use the technology was explained by three attitude variables (beliefs related to perceived relative advantage and compatibility with previous work patterns as well as result demonstrability), and one variable associated with subjective norms (influence of a senior policymaker, the director of nursing). Use of this model may provide insights for administrators managing the process of information technology implementation in health care.

Alberta↗
PubMed1995

Technology management in an information age.

Healthcare spending in this country is approaching 15% of the gross national product (GNP) while 1.4 million more Americans have become uninsured in the past 12 months. Although we spend nearly twice what some industrialized nations spend, an increasing number of people do not have access to our healthcare system. To complicate matters, healthcare reform legislation has stalled, leaving hospitals without a clear sense of direction. Yet, even without federal mandates, hospitals need to be more cost effective. Reform will occur regardless of whether it is driven by legislation, private payers, or marketplace competition. Successful hospitals in the post reform era will maintain or raise their quality standards while reducing operating expenses. The key question is: How can one do more with less? The answer, of course, is better resource management. To achieve real gains, however, it will be important to think of these resources in new ways. Typically hospitals have focused on managing human and capital resources, and many have undertaken initiatives to improve productivity and preserve financial reserves. But to be successful in the new era, you must define resources in non-traditional ways, then develop new strategies to manage them. This article suggests that technology is a resource that can be managed. A straightforward method for identifying a manageable, representative set of core technologies will be described. Once this informational baseline is established, the costs associated with a hospital's technology infrastructure can be estimated and summarized. Then, "if you can measure it, you can manage it." A template for a four-phase technology management program is proposed.

Health Resources↗
PubMed1995

Introducing new mechanical ventilation technology: the hospital perspective.

The introduction of innovative mechanical ventilation technology requires a careful assessment of the cost-benefit relationship of the new technology. Justification for purchase can be sometimes be made on the basis of improved patient safety and physiologic response. Improved patient outcome is much more difficult to demonstrate. It is clear in today's health-care environment that outcome-based research is needed before new technology is introduced to the marketplace, if that new technology is to become part of the average community-hospital complement of mechanical ventilators.

Capital Expenditures↗
PubMed1991

Technology assessment and the evaluation of implanted medical devices.

Technology assessment is attracting new attention and funding as concern about costs and effectiveness of health care grows. This article provides a general overview of technology assessment and relates recent trends and future prospects specifically to the use and evaluation of implanted medical devices. In the next decade we may expect to see renewed interest in technology assessment as pressure to control health care costs continues and as a different focus of evaluation emerges that emphasizes patient preferences and quality of life in addition to traditional measures of safety, efficacy, and cost-effectiveness. These pressures and forces will act to increase the visibility and importance of proper assessment of medical technology, and the field may more nearly achieve its early promise as a tool to make medical care more rational.

Community Participation↗
PubMed1998

Is wireless technology ready to roll?

For years, health care organizations have been slow to accept wireless technology. But as more organizations are finding that the technology can improve care and save money, they're jumping on the wireless bandwagon. Some pioneering providers are even deploying multiple wireless technology applications. Their success is providing a road map for others to follow and building confidence in the emerging technology.

Costs and Cost Analysis↗
PubMed1998

Technology assessment, coverage decisions, and conflict: the role of guidelines.

As pressure grows for health plans to be accountable for increasing quality of care within a cost-control environment, coverage of new technologies becomes a particularly challenging issue. For a number of reasons, health plans have adopted evidence-based methods for guiding technology decisions. The implementation of these methods has not been free of controversy, and conflicts have arisen between plans and proponents of technologies who often use the political and legal arena in an attempt to secure coverage. Unless these conflicts are resolved, the healthcare system may have difficulty meeting cost and quality objectives. Technology assessment and coverage process guidelines and flexible coverage approaches may be possible ways of resolving these conflicts.

Conflict of Interest↗
PubMed1984

Changes in business communications: innovative uses of new media and technologies.

An overview of communication technologies and concepts for intra- and inter-business communication, including local area networks, electronic mail and tele-conferencing, illustrates the wide spectrum of methods which challenge traditional forms of business communication such as correspondence and telephone. It is shown how the application of these technologies, in concert with the computer and new storage media, allows integration of communication, data management and recordkeeping functions. The systematic application of electronic technologies and recognition of the advantages of graphics for effective communication lead to the stimulation of graphic forms of communication. Technologies and methods of graphic communication are discussed, and the impact of these new approaches on the work environment in the office is explained.

Data Display↗
PubMed1988

The high price of technology: factors affecting hip implant costs.

As the cost of new technology for hip implants escalates, financial managers are finding an increasing amount of the DRG payment is spent on the technology itself and not nursing care, maintenance, or overhead. Four factors affect the cost and quality of hip implant prosthetics--the materials, design, fixation, and instrumentation--and must be considered in the cost and quality issues associated with selecting a prosthetic device. Financial managers must be sensitive to quality issues associated with new technological advances in hip implants, and they must be able to communicate the financial impact of this new technology to the physicians who use it and the third-party payers who pay for it.

Ancillary Services, Hospital↗
PubMed1999

[The use of "sous vide" technology in the packaging of chilled and ready to serve food].

As chilled precooked dishes show limited to 3-5 days shelf life several additional factors have to be applied to extend it up to 21 or even 42 days as is sometimes allowed for sous vide technology products. Those factors comprise high hygienic standards for raw materials and premises as well as technological steps and parameters that efficiently destroy microbial contamination, and do not allow for recontamination or bacterial growth. Such steps include precooking which also means pasteurisation in high vacuum or anaerobic atmosphere in sealed pouches, blast chilling, low temperature storage parameters as well as high temperature of reheating process and quick serving procedures. Paper specifies parameters for each technological steps and presents microbiological requirements for final products. Sous vide technology allows for good quality and high nutritional value in soups, meats in sauces and stewed vegetables. It is used for individual consumer in chilled "ready to eat" line dishes in supermarkets and supplies such dishes for catering units.

Food↗
PubMedDate not supplied

[Medical technology and health. A lot of crunching but few nuts?].

The present work pretend to describe the development achieved in the field of health technology assessment and to propose a set of criteria to evaluate them, with the intention that it will lead to the development of health programs and policy with a tendency to maximize effectiveness, efficiency and quality, within a frame of increasing needs and scarce technical and economic resources for health care. For this work, a comprehensive review was carried out about the background of health technology adoption in our country, and the context by which to evaluate the accessibility and utilization of the health technology. In the section for technology assessment, it is propose a method to evaluate based upon the natural history of disease, that is, the traditional form of health assessment is restricted to a cross section in time (vertical evaluation), and in this study the authors propose a model with a horizontal approach, that should offer as its main virtues the development of guidelines with regards to prevention, diagnosis and treatment, in addition to cost containment, in support to a more effective and higher quality medical practice.

Developing Countries↗