Ethical and Professionalism Implications of Physician Employment and Health Care Business Practices: A Policy Paper From the American College of Physicians

2021 ◽  
Author(s):  
Matthew DeCamp ◽  
Lois Snyder Sulmasy
Keyword(s):  
Health Care ◽  
Business Practices ◽  
Policy Paper ◽  
Physician Employment

scholarly journals 人工智能醫學應用的前景與風險

2019 ◽  
Vol 17 (2) ◽  
pp. 79-109
Author(s):  
Robert SPARROW ◽  
Joshua HATHERLEY
Keyword(s):  
Public Health ◽  
Artificial Intelligence ◽  
Health Care ◽  
Healthcare Systems ◽  
Business Practices ◽  
Medical Decisions ◽  
Diagnostic Aid ◽  
Healthcare Settings ◽  
Digital Commons ◽  
Distribution Of Power

LANGUAGE NOTE | Document text in English; abstract also in Chinese.人工智能（ＡＩ）將如何促進人類的醫療保健？如果我們擔心人工智能介入醫療的風險，我們又應該關注什麽呢？本文試圖概述此類問題，並對人工智能介入醫療的風險與希望作一個初步評價。人工智能作為一種研究工具和診斷工具具有巨大的潛力，特別是在基因組學和公共衛生領域中。人工智能在醫療中的廣泛使用可能還會對醫療系統的組織方式和商業實踐產生深刻的影響，而這些影響的方式與程度還沒有被充分認識到。在人工智能醫學的熱情擁護者看來，應用人工智能可以幫助醫生集中精力在對他們和病人而言真正重要的問題上。然而，本文將論證這些樂觀的判斷是基於對現代醫療環境下機構和經濟運行規則的一些不合情理的假設之上。本文將聚焦於如下一 些重要議題：大資料中的隱私、監管和偏見，過分信任機器的風險，透明度問題，醫療專業人士的“去技能化”問題，人工智能重塑醫療保健的方式，以及人工智能對醫療保健中權力分配的影響。其中有兩個關鍵的問題尤其值得哲學家和生命倫理學家的進一步關注。第一，當醫生不僅需要處理人而且需要處理資料的時候，醫療實踐會呈現出什麽樣的形態？第二，在醫療決策權衡中，我們應該给予來自機器的意見以多大的權重？What does Artificial Intelligence (AI) have to contribute to health care? And what should we be looking out for if we are worried about its risks? In this paper we offer a survey, and initial evaluation, of hopes and fears about the applications of artificial intelligence in medicine. AI clearly has enormous potential as a research tool, in genomics and public health especially, as well as a diagnostic aid. It’s also highly likely to impact on the organisational and business practices of healthcare systems in ways that are perhaps under-appreciated. Enthusiasts for AI have held out the prospect that it will free physicians up to spend more time attending to what really matters to them and their patients. We will argue that this claim depends upon implausible assumptions about the institutional and economic imperatives operating in contemporary healthcare settings. We will also highlight important concerns about privacy, surveillance, and bias in big data, as well as the risks of over trust in machines, the challenges of transparency, the deskilling of healthcare practitioners, the way AI reframes healthcare, and the implications of AI for the distribution of power in healthcare institutions. We will suggest that two questions, in particular, are deserving of further attention from philosophers and bioethicists. What does care look like when one is dealing with data as much as people? And, what weight should we give to the advice of machines in our own deliberations about medical decisions?DOWNLOAD HISTORY | This article has been downloaded 119 times in Digital Commons before migrating into this platform.

Mergers may enhance the legitimacy of community health organisations in neoliberal environments

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Veronique Roussy ◽  
Grant Russell ◽  
Charles Livingstone ◽  
Therese Riley
Keyword(s):  
Health Care ◽  
Service Delivery ◽  
Community Health ◽  
Social Model ◽  
Business Practices ◽  
Structured Interviews ◽  
Content Type ◽  
Comprehensive Primary Health Care ◽  
Health And Social Care ◽  
Cognitive Legitimacy

PurposeComprehensive primary health care (PHC) models are seldom implemented in high income countries, in part due to their contested legitimacy in neoliberal policy environments. This article explores how merging affected the perceived legitimacy of independent community health organisations in Victoria, Australia, in providing comprehensive PHC services.Design/methodology/approachA longitudinal follow-up study (2–3 years post-merger) of two amalgamations among independent community health organisations from the state of Victoria, Australia, was conducted. This article explores the perceived effects of merging on (1) the pragmatic, normative and cognitive legitimacy of studied organisations and (2) the collective legitimacy of these organisations in Victoria's health care system. Data were collected through 19 semi-structured interviews with key informants and subjected to template and thematic analyses.FindingsMerging enabled individual organisations to gain greater overall legitimacy as regional providers of comprehensive PHC services and thus retain some capacity to operationalise a social model of health. Normative legitimacy was most enhanced by merging, through acquisition of a large organisational size and adoption of business practices favoured by neoliberal norms. However, mergers may have destabilised the already contested cognitive legitimacy of community health services as a group of organisations and as a comprehensible state-wide platform of service delivery.Practical implicationsOver-reliance on individual organisational behaviour to maintain the legitimacy of comprehensive PHC as a model of organising health and social care could lead to inequities in access to such models across communities.Originality/valueThis study shows that organisations can manage their perceived legitimacy in order to ensure the survival of their preferred model of service delivery.

scholarly journals Seven year overview (2007—2013) of ethical transgressions by registered healthcare professionals in South Africa

2016 ◽  
Vol 21 ◽  
pp. 46-53
Author(s):  
Nico Nortje ◽  
Willem Hoffmann
Keyword(s):  
South Africa ◽  
Health Care ◽  
Health Care Providers ◽  
Health Care Professionals ◽  
Primary Objective ◽  
Regulatory Body ◽  
Research Approach ◽  
Business Practices ◽  
Care Providers ◽  
Dental Practitioners

A move has taken place internationally in the delivery and “consumption” of health care where if clients and patients (health care consumers) hold the opinion that the health care professionals/providers' behaviour has had a negative effect, impact or outcome on them, they may lodge a complaint with the relevant health professional regulatory body. Ethical transgressions of health care providers can generally be clustered into the following three categories: a) Competence and conduct with clients (e.g. abandonment, sexual intimacies, dishonesty, disclosure of information); b) Business practices (e.g. billing, reports, documentation); and c) Professional practice (e.g. referral upon termination, obtaining appropriate potential employment opportunities, nonprofessional relationships).The primary objective of this study was to analyse the ethical transgressions of registered members of the twelve professional boards in the Health Professions Council of South Africa (HPCSA) in the period 2007 to 2013. A mixed methods approach was followed in this study which specifically focused on a historical research approach. The results indicate that the boards with the highest number of transgressions per the registered practitioners were firstly the Medical and Dental practitioners, closely followed by the Optometry and Dispensing Opticians Board. The predominantly complaint made against members of both these boards was for fraudulent conduct (collectively totalling to 85% of all fraudulent cases during the period) and included actions such as charging for non-rendered services, issuing false statements and submitting fraudulent medical aid claims. Cognisance needs to be taken that the South African public will increasingly demand better services and that since they are being better informed via the media of their rights and have access to a broader database of knowledge (rightly or wrongly so the internet) practitioners' opinions will not necessarily be accepted outright and that they (the public) will challenge it accordingly. This raises the concern that practitioners need to take on the responsibility to communicate with their patients/clients in order to educate them and keep them informed. 

scholarly journals Corporate Digital Responsibility Challenges for Sports Betting Companies

2021 ◽  
pp. 202-211
Author(s):  
Peter Jones ◽  
Daphne Comfort
Keyword(s):  
Digital Technologies ◽  
Service Industries ◽  
Sports Betting ◽  
The Other ◽  
Business Practices ◽  
Gambling Industry ◽  
Policy Paper ◽  
The One

The emergence and continuing development of digital technologies is disrupting and reshaping traditional business practices throughout the service industries, and the gambling industry is no exception. On the one hand, digital technologies have opened the door to a landscape of new sports betting opportunities. On the other, the introduction of digital technologies brings responsibility challenges for sports betting companies. This policy paper outlines the features of corporate digital responsibility, provides some simple illustrations of digital responsibility issues in sports betting, and offers reflections on how these responsibilities are being discharged.

scholarly journals Morehouse Choice Accountable Care Organization and Education System (MCACO-ES): Integrated Model Delivering Equitable Quality Care

2019 ◽  
Vol 16 (17) ◽  
pp. 3084 ◽  
Author(s):  
Michelle Brown ◽  
Elizabeth O. Ofili ◽  
Debbie Okirie ◽  
Priscilla Pemu ◽  
Cheryl Franklin ◽  
...  
Keyword(s):  
Health Care ◽  
Education System ◽  
Care Delivery ◽  
Accountable Care Organization ◽  
Performance Outcomes ◽  
Care Organization ◽  
Business Practices ◽  
Accountable Care ◽  
Medicare Beneficiaries ◽  
Integration Model

Accountable Care Organizations (ACOs) seek sustainable innovation through the testing of new care delivery methods that promote shared goals among value-based health care collaborators. The Morehouse Choice Accountable Care Organization and Education System (MCACO-ES), or (M-ACO) is a physician led integrated delivery model participating in the Medicare Shared Savings Program (MSSP) offered through the Centers for Medicare and Medicaid Services (CMS) Innovation Center. The MSSP establishes incentivized, performance-based payment models for qualifying health care organizations serving traditional Medicare beneficiaries that promote collaborative efficiency models designed to mitigate fragmented and insufficient access to health care, reduce unnecessary cost, and improve clinical outcomes. The M-ACO integration model is administered through participant organizations that include a multi-site community based academic practice, independent physician practices, and federally qualified health center systems (FQHCs). This manuscript aims to present a descriptive and exploratory assessment of health care programs and related innovation methods that validate M-ACO as a reliable simulator to implement, evaluate, and refine M-ACO’s integration model to render value-based performance outcomes over time. A part of the research approach also includes early outcomes and lessons learned advancing the framework for ongoing testing of M-ACO’s integration model across independently owned, rural, and urban health care locations that predominantly serve low-income, traditional Medicare beneficiaries, (including those who also qualify for Medicaid benefits (also referred to as “dual eligibles”). M-ACO seeks to determine how integration potentially impacts targeted performance results. As a simulator to test value-based innovation and related clinical and business practices, M-ACO uses enterprise-level data and advanced analytics to measure certain areas, including: 1) health program insight and effectiveness; 2) optimal implementation process and workflows that align primary care with specialists to expand access to care; 3) chronic care management/coordination deployment as an effective extender service to physicians and patients risk stratified based on defined clinical and social determinant criteria; 4) adoption of technology tools for patient outreach and engagement, including a mobile application for remote biometric monitoring and telemedicine; and 5) use of structured communication platforms that enable practitioner engagement and ongoing training regarding the shift from volume to value-based care delivery.

The Ethical Health Lawyer

2005 ◽  
Vol 33 (2) ◽  
pp. 375-379
Author(s):  
Philip L. Pomerance
Keyword(s):  
Health Care ◽  
Medical Equipment ◽  
The United States ◽  
Business Practices ◽  
Health Care Fraud ◽  
Medicare Fraud ◽  
Legal Advice ◽  
History Of ◽  
Federal Laws ◽  
Wrongful Use

Health care may be the most regulated industry in the United States, at least in terms of the volume of State and Federal laws and regulations that affect business practices. Lawyers who counsel health care clients often face a dilemma: is the client seeing legitimate advice about the legal limitations on his or her conduct, or is the client seeking to use the lawyer's skills to evade the law? The history of health care fraud prosecutions involving lawyers and other professional advisors in recent years makes this an issue of more than academic interest. The well publicized case of U.S. v. Anderson, in which health care counsel faced charges as co-defendants for purported kickback violations, the recent prosecution of Ernst & Young for allegedly aiding Medicare fraud on behalf of client hospitals, and the recent indictment and conviction of an in-house lawyer in a national durable medical equipment fraud case, make clear that the wrongful use of legal advice by health care clients can lead to significant criminal and civil charges against attorneys.

Prescription Drug Counterfeiting: Distributors Meet the Challenge

2006 ◽  
Vol 19 (4) ◽  
pp. 230-235
Author(s):  
Anita T. Ducca
Keyword(s):  
Health Care ◽  
Supply Chain ◽  
Prescription Drug ◽  
Radio Frequency Identification ◽  
Business Practices ◽  
Counterfeit Drugs ◽  
Health Care Supply ◽  
Health Care Supply Chain ◽  
Drug Supply Chain ◽  
Past Experiences

The Healthcare Distribution Management Association (HDMA) and its primary full-service health care distributor members, other members of the health care supply chain, and government officials have made considerable progress in the ongoing effort to further secure the nation's prescription drug supply chain. However, all stakeholders must continue to seek additional deterrents. Based on past experiences, effective anticounterfeiting techniques involve 3 crucial components: (1) the approaches must be innovative, (2) every supply chain partner must share the commitment to fight counterfeit drugs, and (3) they include interim measures, particularly those emphasizing preventing criminal counterfeiters from getting into the system. These components are met by the recommendations of the HDMA and its distributor members including the adoption of supply chain technologies, such as radio frequency identification; stricter, uniform distributor licensing standards across the 50 states; and tougher regulation, stronger enforcement, and harsher penalties for the crime of counterfeiting medicine. Also strongly supported are continuous improvements in business practices. The US health care supply chain has evolved, and there have been important changes since the enactment of the Prescription Drug Marketing Act. This article recommends strategies for meeting the challenge of counterfeit drugs.

scholarly journals Technology for Sustainable HRM: An Empirical Research of Health Care Sector

2019 ◽  
Vol 9 (1) ◽  
pp. 2919-2924
Keyword(s):  
Artificial Intelligence ◽  
Health Care ◽  
Decision Making ◽  
Resource Management ◽  
Human Resources ◽  
Human Resource Management ◽  
Human Resource ◽  
Health Care Sector ◽  
Business Practices ◽  
Changing Times

In a highly competitive world of today characterised by VUCA (Volatility Uncertainty Complexity and Ambiguity) environment organizations are striving to achieve excellence with standard business practices. Given the international mantra of cost quality & service companies need to adopt technology in a proactive manner by collaborating with IT department. Traditionally HR and IT have operated as distinct units. But with the changing times there is an urgent need to adopt technology for improving the productivity of human resources thereby contributing to the sustainable organizational development. So a close collaboration between these two departments is called for. Some of the HR professionals assume that technology will fix all their problems i.e. By moving to cloud the outdated HR operating model and disconnected data sourcing issues will get resolved. But HR professionals will be committing a grave mistake if they think that the technology will be a panacea to all HR problems. In other words, the key is about how the technology is applied and not the acquisition of technology. In the prevailing competitive environment there is every need to understand appreciate the behaviour of the employees so that required initiatives could be taken for obtaining outstanding performance from these valuable human resources. In this regard technological tools like HR Analytics(HRA) Artificial Intelligence (AI) come very handy for getting valuable insights into human behaviour. Further application of these tools helps in effective decision making thereby contributing to the accomplishment of organization goals. Application of HRA and AI apart from facilitating decision making also helps in integrating Human Resource with other business activities. The paper focusses on understanding how HR analytics helps in sustainable human resource management by providing insights into elementary HR processes and behaviours. It also correlates well with current HRA/AI trends in general and health care sector in particular. Needless to say this will be a ready reference for any future study into role of data analytics/Artificial intelligence in Human Resource Management.

RFID Technologies and Warehouse Applications

2021 ◽  
pp. 2393-2402
Author(s):  
Alan D. Smith
Keyword(s):  
Health Care ◽  
Supply Chain ◽  
Health Care Systems ◽  
Competitive Environment ◽  
Business Practices ◽  
Care Systems ◽  
Rapid Pace ◽  
Best Business Practices ◽  
Warehouse Operations ◽  
Rfid Applications

RFID is a technology that continues to evolve, improve, and grow. The number of ways the technology can be used to help companies stay efficient increases in a highly competitive environment. For companies that are still looking for ways to improve their supply chain and their warehouse operations, RFID technology is something worth exploring. It can save companies time and money and can be an especially great technology to adopt for companies that are growing at a rapid pace. Case studies comparing large health care systems provider in Pittsburgh, PA with a large manufacturing company, Boeing, located Everett, WA were cited to highlight best business practices of RFID applications to the warehousing function.

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