scholarly journals Quality and Safety in eHealth: The Need to Build the Evidence Base (Preprint)

2019 ◽  
Author(s):  
Elizabeth Borycki
Keyword(s):  
Health Informatics ◽  
Improve Patient Safety ◽  
Health Technology ◽  
Evidence Base ◽  
Evidence Based ◽  
Quality And Safety ◽  
Design Development ◽  
Health Technologies ◽  
Safety Science ◽  
Improve Patient

UNSTRUCTURED Research in the area of health technology safety has demonstrated that technology may both improve patient safety and introduce new types of technology-induced errors. Thus, there is a need to publish safety science literature to develop an evidence-based research base, on which we can continually develop new, safe technologies and improve patient safety. The aim of this viewpoint is to argue for the need to advance evidence-based research in health informatics, so that new technologies can be designed, developed, and implemented for their safety prior to their use in health care. This viewpoint offers a historical perspective on the development of health informatics and safety literature in the area of health technology. I argue for the need to conduct safety studies of technologies used by health professionals and consumers to develop an evidence base in this area. Ongoing research is necessary to improve the quality and safety of health technologies. Over the past several decades, we have seen health informatics emerge as a discipline, with growing research in the field examining the design, development, and implementation of different health technologies and new challenges such as those associated with the quality and safety of technology use. Future research will need to focus on how we can continually extend safety science in this area. There is a need to integrate evidence-based research into the design, development, and implementation of health technologies to improve their safety and reduce technology-induced errors.

scholarly journals Quality and Safety in eHealth: The Need to Build the Evidence Base

10.2196/16689 ◽  
2019 ◽  
Vol 21 (12) ◽  
pp. e16689 ◽  
Author(s):  
Elizabeth Borycki
Keyword(s):  
Health Informatics ◽  
Improve Patient Safety ◽  
Health Technology ◽  
Evidence Base ◽  
Evidence Based ◽  
Quality And Safety ◽  
Design Development ◽  
Health Technologies ◽  
Safety Science ◽  
Improve Patient

Research in the area of health technology safety has demonstrated that technology may both improve patient safety and introduce new types of technology-induced errors. Thus, there is a need to publish safety science literature to develop an evidence-based research base, on which we can continually develop new, safe technologies and improve patient safety. The aim of this viewpoint is to argue for the need to advance evidence-based research in health informatics, so that new technologies can be designed, developed, and implemented for their safety prior to their use in health care. This viewpoint offers a historical perspective on the development of health informatics and safety literature in the area of health technology. I argue for the need to conduct safety studies of technologies used by health professionals and consumers to develop an evidence base in this area. Ongoing research is necessary to improve the quality and safety of health technologies. Over the past several decades, we have seen health informatics emerge as a discipline, with growing research in the field examining the design, development, and implementation of different health technologies and new challenges such as those associated with the quality and safety of technology use. Future research will need to focus on how we can continually extend safety science in this area. There is a need to integrate evidence-based research into the design, development, and implementation of health technologies to improve their safety and reduce technology-induced errors.

Strategies to Improve Patient Safety: The Evidence Base Matures

2013 ◽  
Vol 158 (5_Part_1) ◽  
pp. 350 ◽  
Author(s):  
Robert M. Wachter ◽  
Peter Pronovost ◽  
Paul Shekelle
Keyword(s):  
Patient Safety ◽  
Improve Patient Safety ◽  
Evidence Base ◽  
Improve Patient

A Three-Decade Perspective on Anesthesia Safety

2006 ◽  
Vol 72 (11) ◽  
pp. 985-989 ◽  
Author(s):  
William L. Lanier
Keyword(s):  
Improve Patient Safety ◽  
Mortality Rates ◽  
Hospital Environment ◽  
Quality And Safety ◽  
Road Map ◽  
Anesthesia Safety ◽  
Safety Improvement ◽  
Modern Medical Practice ◽  
Improve Patient ◽  
Current Report

Modern medical practice, and particularly that within the hospital environment, has been under intense scrutiny in an attempt to improve patient safety and optimize outcomes. Anesthesiology has been cited as among the most successful specialties effecting improvements. According to the Institute of Medicine's 1999 report, To Err is Human, “… anesthesiology has successfully reduced anesthesia mortality rates from two deaths per 10,000 anesthetics administered, to one death per 200,000 to 300,000 anesthetics administered.” The current report reviews representative highlights from 30 years of progress in improving anesthesiology safety and offers a speculative synthesis of the factors critical to past and future successes. The seven identified points include 1) the emergence of a champion and his allies, 2) initial efforts to identify and quantify broad-reaching problems, 3) research addressing intellectually “amusing” problems of relevance to practitioners, 4) reaching out to others with focused expertise in problem prevention and problem solving, 5) sharing the responsibility for quality and safety improvement with other specialties, 6) expanding buy-in and participation within the anesthesia community, and 7) preparing for the future. The factors provide not only an accounting of anesthesiologists’ successes, but also a road map for other groups and specialties desiring to emulate the anesthesiologists’ experience.

scholarly journals Health technology assessment in Finland

2009 ◽  
Vol 25 (S1) ◽  
pp. 102-107 ◽  
Author(s):  
Marjukka Mäkelä ◽  
Risto P. Roine
Keyword(s):  
Decision Making ◽  
Health Technology Assessment ◽  
Technology Assessment ◽  
Health Technology ◽  
Evidence Based ◽  
Policy Makers ◽  
Health Technologies ◽  
Based Medicine ◽  
Special Responsibility ◽  
Made In

Since the 1990s, health policy makers in Finland have been supportive of evidence-based medicine and approaches to implement its results. The Finnish Office for Health Technology Assessment (Finohta) has grown from a small start in 1995 to a medium-sized health technology assessment (HTA) agency, with special responsibility in providing assessments to underpin national policies in screening. External evaluations enhanced the rapid growth. In the Finnish environment, decision making on health technologies is extremely decentralized, so Finohta has developed some practical tools for implementing HTA findings. The Managed Uptake of Medical Methods program links the hospital districts to agree on introduction of technologies. The Ohtanen database provides Finnish-language summaries of major assessments made in other countries.

KNOW ESSENTIALS: A tool for informed decisions in the absence of formal HTA systems

2011 ◽  
Vol 27 (2) ◽  
pp. 139-150 ◽  
Author(s):  
Joseph L. Mathew
Keyword(s):  
Decision Making ◽  
Developing Countries ◽  
Literature Search ◽  
Health Technology ◽  
Local Context ◽  
Evidence Based ◽  
Resource Limited Settings ◽  
Health Technologies ◽  
Resource Limited ◽  
Interim Measure

Background: Most developing countries and resource-limited settings lack robust health technology assessment (HTA) systems. Because the development of locally relevant HTA is not immediately viable, and the extrapolation of external HTA is inappropriate, a new model for evaluating health technologies is required.Objectives: The aim of this study was to describe the development and application of KNOW ESSENTIALS, a tool facilitating evidence-based decisions on health technologies by stakeholders in settings lacking formal HTA systems.Methods: Current HTA methodology was examined through literature search. Additional issues relevant to resource-limited settings, but not adequately addressed in current methodology, were identified through further literature search, appraisal of contextually relevant issues, discussion with healthcare professionals familiar with the local context, and personal experience. A set of thirteen elements important for evidence-based decisions was identified, selected and combined into a tool with the mnemonic KNOW ESSENTIALS. Detailed definitions for each element, coding for the elements, and a system to evaluate a given health technology using the tool were developed.Results and Conclusions: Developing countries and resource-limited settings face several challenges to informed decision making. Models that are relevant and applicable in high-income countries are unlikely in such settings. KNOW ESSENTIALS is an alternative that facilitates evidence-based decision making by stakeholders without formal expertise in HTA. The tool could be particularly useful, as an interim measure, in healthcare systems that are developing HTA capacity. It could also be useful anywhere when rapid evidence-based decisions on health technologies are required.

HEALTH TECHNOLOGY ASSESSMENT AND EVIDENCE-BASED POLICY MAKING: QUEENSLAND DEPARTMENT OF HEALTH EXPERIENCE

2014 ◽  
Vol 30 (6) ◽  
pp. 595-600 ◽  
Author(s):  
Hong Ju ◽  
Kaye Hewson
Keyword(s):  
Resource Allocation ◽  
Health Technology Assessment ◽  
Technology Assessment ◽  
Policy Making ◽  
Health Technology ◽  
Evidence Based ◽  
Health Technologies ◽  
Queensland Department ◽  
Department Of Health ◽  
Evidence Based Policy

Background: Evidence-based policy making is increasingly used for better resource allocation. Queensland Department of Health has developed a new model to introduce innovative health technologies through a health technology assessment (HTA) program.Structure: A state-wide committee and several sub-committees at health service district level were established to oversee the HTA program and to monitor the uptake of technologies. The committees are supported by a multidisciplinary secretariat comprising staff with key HTA skills.Process: The process starts with HTA applications, which are then shortlisted according to prespecified criteria. A due diligence process adopting a rapid evidence assessment approach is used to evaluate the applications. Based on the assessment, recommendations are made using a deliberative decision-making process guided by well-recognized tools. With positive recommendation, a technology is piloted in constrained local setting before its system-wide diffusion.Outcome: The HTA program has assisted health administrators in prioritizing their health technology agendas. It has gained trust and wide support from policy makers and is increasingly used to support funding allocations, indicating the increasing awareness of and confidence in the program.Conclusions: The HTA program is a valuable process to assist evidence-based policy development and to guide better resource allocation.

scholarly journals How innovation can be defined, evaluated and rewarded in health technology assessment

2022 ◽  
Vol 12 (1) ◽  
Author(s):  
Juan Carlos Rejon-Parrilla ◽  
Jaime Espin ◽  
David Epstein
Keyword(s):  
Health Technology Assessment ◽  
Technology Assessment ◽  
Unmet Need ◽  
Health Technology ◽  
Evidence Base ◽  
Added Value ◽  
Future Research ◽  
Health Technologies ◽  
Assessment Systems ◽  
Degree Of Innovation

Abstract Background What constitutes innovation in health technologies can be defined and measured in a number of ways and it has been widely researched and published about. However, while many countries mention it as a criterion for pricing or reimbursement of health technologies, countries differ widely in how they define and operationalise it. Methods We performed a literature review, using a snowballing search. In this paper, we explore how innovation has been defined in the literature in relation to health technology assessment. We also describe how a selection of countries (England, France, Italy, Spain and Japan) take account of innovation in their health technology assessment frameworks and explore the key methodologies that can capture it as a dimension of value in a new health technology. We propose a way of coming to, and incorporating into health technology assessment systems, a definition of innovation for health technologies that is independent of other dimensions of value that they already account for in their systems, such as clinical benefit. We use Spain as an illustrative example of how innovation might be operationalised as a criterion for decision making in health technology assessment. Results The countries analysed here can be divided into 2 groups with respect to how they define innovation. France, Japan and Italy use features such as severity, unmet need and therapeutic added value as indicators of the degree of innovation of a health technology, while England, Spain consider the degree of innovation as a separate and additional criterion from others. In the case of Spain, a notion of innovation might be constructed around concepts of `step-change’, `convenience’, `strength of evidence base’ and `impact on future research & development’. Conclusions If innovation is to be used as operational criteria for adoption, pricing and reimbursement of health technologies, the concept must be clearly defined, and it ought to be independent from other value dimensions already captured in their health technology assessment systems.

scholarly journals Methods for Addressing Technology-induced Errors: The Current State

2016 ◽  
Vol 25 (01) ◽  
pp. 30-40 ◽  
Author(s):  
J. W. Dexheimer ◽  
C. Hullin Lucay Cossio ◽  
Y. Gong ◽  
S. Jensen ◽  
J. Kaipio ◽  
...  
Keyword(s):  
Information Technology ◽  
Risk Management ◽  
Patient Safety ◽  
Health Informatics ◽  
Error Reporting ◽  
Evidence Based ◽  
Quality And Safety ◽  
Research Areas ◽  
Current State ◽  
The World

SummaryObjectives: The objectives of this paper are to review and discuss the methods that are being used internationally to report on, mitigate, and eliminate technology-induced errors.Methods: The IMIA Working Group for Health Informatics for Patient Safety worked together to review and synthesize some of the main methods and approaches associated with technology-induced error reporting, reduction, and mitigation. The work involved a review of the evidence-based literature as well as guideline publications specific to health informatics.Results: The paper presents a rich overview of current approaches, issues, and methods associated with: (1) safe HIT design, (2) safe HIT implementation, (3) reporting on technology-induced errors, (4) technology-induced error analysis, and (5) health information technology (HIT) risk management. The work is based on research from around the world. Conclusions: Internationally, researchers have been developing methods that can be used to identify, report on, mitigate, and eliminate technology-induced errors. Although there remain issues and challenges associated with the methodologies, they have been shown to improve the quality and safety of HIT. Since the first publications documenting technology-induced errors in healthcare in 2005, we have seen in a short 10 years researchers develop ways of identifying and addressing these types of errors. We have also seen organizations begin to use these approaches. Knowledge has been translated into practice in a short ten years whereas the norm for other research areas is of 20 years.

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