Lecture 5/Chapter 5 Flashcards
1
Q
learning objectives
A
- role of medical technology in health care delivery
- growing application of information technology and informatics
- aspects of telemedicine and telehealth
- factors driving innovation, dissemination, and utilization of technology
- governments role in technology diffusion
- domestic and global impact of technology
- direction of health technology assessment
- status of medical technology under health care reform
2
Q
medical technology
A
- technology has been a blessing
- reduction in complications and disability
- increased longevity of life
- technology imposes a cost burden on society
- costly research is necessary
3
Q
changes triggered by technology
A
- raised consumer expectations
- changed the organization of medical services -> shorter exams
- driven scope and content of medical training -> people need to operate the equipment
- influenced status of various medical workers
- technology assessment is a growing activity
- raised complex social and ethical concerns
4
Q
what is medical technology
A
- application of scientific knowledge to improve health and efficiencies
- medical science benefited from developments: chemistry, physics, engineering, and pharmacology
- nanomedicine is in its infancy
- nanotechnology manipulated material on the atomic and molecular level
5
Q
information technology and informatics
A
- information technology transforms data into useful information
- 3 categories of IT applications:
- clinical information systems- where history is stored
- administrative information systems- employers, scheduling, lab results
- decision support systems- for the physicians to help make a diagnosis
6
Q
health informatics
A
- application of information science
- improves efficiency, accuracy, and reliability -> minimize errors
- requires the use of IT
7
Q
4 components of EHR
A
- collection and storage of health information on patients over time
- immediate electronic access to person and population level information
- availability of knowledge and decision support
- support of efficient processes for health care delivery
8
Q
electronic health records and systems
A
- benefits and drawbacks of EHR
- EHRs and quality of care
- interoperability
- health information organzations
- adoption of EHRs
- financial incentives under the HITECH act
- confidentiality under the HIPPA law** -> security issues
- smart card technology
9
Q
internet, E-health, M-health, and E-therapy
A
- the internet is often the first source of information a patient consults
- patients satisfied with their physicians rely less on the internet
- E-health
- M-health
- E-therapy
- virtual physicians visits
10
Q
telemedicine, telehealth, and remote monitoring
A
- telemedicine- distance medicine
- telecommunications technology for diagnosis and patient care when separated
- tele-ICU- improve quality of health care, monitors the health care monitor on the patient
11
Q
telemedicine vs telehealth
A
- telemedicine- practice medicine over distances
- telemedicine is synchronous or asynchronous
- telehealth involves a variety of caregivers
12
Q
factors that drive innovation and diffusion
A
- anthro-cultural beliefs and values
- medical specialization
- financing and payment
- technology driven competition
- expenditures on research and development
- supply side controls (rationing*)
- government policy
13
Q
governments role in technology diffusion
A
- regulation of drugs, devices, and biologics
- regulation of drugs and evolution of the approval processes
- drugs from overseas
- securing the supply chain
- regulation of medical devices and equipment
- regulation of biologics
- certificate of need
- research on technology
- funding for research- national institutes of health (NIH)
14
Q
impact of medical technology
A
- impact on quality of care
- impact of quality of life
- impact on health care costs
- impact on access- mobile equipment can improve geographic access
- impact on the structure and processes of health care delivery
- impact on global medical practice
- impact on bioethics- technological change raises ethical and moral issues
15
Q
3 main cost drivers of medical technology
A
- acquiring the new technology and equipment
- trained physicians and technicians to operate the equipment
- special housing and setting requirements
16
Q
assessment of medical technology
A
- technology assessment or health technology assessment (HTA)- examining and reporting properties of a medical technology used in health care
- efficacy**- how well something works
- safety
- cost-effectiveness
- cost-benefit- is there enough benefit to want to spend the money
- cost-effectiveness- can you recover the costs lost of providing the service
- quality adjusted life year (QALY)
17
Q
four assumptions of a cost benefit analysis
A
- problem or condition can be diagnosed
- problem can be controlled or eradicated
- benefit or outcome is assigned a dollar value
- cost of intervention is determined in dollars
18
Q
direction and issues in health technology assessment
A
- private sector initiatives
- need for coordinated effort
- need for standardization
- balance between clinical efficacy and economic worth
19
Q
7 ethical clinical research requirements
A
- social or scientific value improving health or knowledge
- scientifically valid and methodolgically rigorous
- fair selection of subjects in clinical trials
- benefits and knowledge gained outweigh risks
- independent review of methods and findings
- informed, voluntary consent obtained
- subjects privacy protected, able to withdraw, and well being maintained
20
Q
health care reform and medical technology
A
- ACA imposed a 2.3% excise tax on the sale of certain medical devices
- allowed FDA to approve “biosimilars”
- developers of an original reference product are protected by law
- no biosimilar license can be granted until the reference product is licensed for 12 years
21
Q
summary
A
- medical technology has produced many benefits
- medical technology has increase longevity and decreased mortality around the world
- development and diffusion of technology are closely intertwined with its utilization
- health technology assessment has been focused on safety and efficacy
22
Q
examples of medical technology
A
- organic chemistry -> drugs, anesthetics
- physics -> MRI
- computer science and communications -> telemedicine
- nanotechnology -> nanomedicine
23
Q
Confidentiality concerns in EHR
A
- health insurance portability and accountability act, 1996 (HIPAA)
- legal uses of personal medical information:
- health care delivery
- operations
- reimbursement
- organizations must devise methods to safeguard transfer and disclosure of personal health information (PHI)
24
Q
E-health
A
-various types of health care delivered over the internet and access to ones own EHR
25
Q
M-health
A
-use of wireless communication devices
26
Q
E-therapy
A
- interactions with health professionals over the internet
- a way to fix something
27
Q
innovation*
A
-creation of a new product, technique, or service
28
Q
diffusion*
A
- spread of technology into society
- innovation sees rapid diffusion when:
- new technology is beneficial and the benefit can be evaluated
- technology is compatible with the adopters values and needs
- it is reimbursable
29
Q
utilization*
A
-once it is acquired, the use of technology is almost ensured
30
Q
technological imperative
A
- the desire to have state of the art technology available and to use it despite the cost
- because of the technological imperative the US has been foremost in the world in technological innovation and use
- have to have the best no matter the cost
31
Q
certificate of need
A
CON laws required hospitals to seek approval before acquiring major equipment or projects
-must prove the need for government funding
32
Q
research on technology
A
AHRQ technology assessments are available to medical practitioners, consumers, and others
33
Q
funding for research
A
national institutes of health (NIH)
34
Q
efficacy
A
health benefit from the use of technology
35
Q
saftey
A
benefits must outweigh risks
36
Q
cost effectiveness
A
marginal benefits in relation to marginal costs
- can you profit
- optimum point- marginal benefits equal marginal costs
- beyond the optimum point, cost effectiveness is negative
- flat of the curve- marginal benefits are zero
- high intensity care is often wasteful, but legal ramifications play a role in medical decisions*** -> treatment near death is wasteful but very expensive
37
Q
cost benefit
A
benefits in relation to costs when both can be measured in monetary terms
- is anyone gonna want to pay for this service bc of the benefits
- does the patient get a better quality life from it
