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Issues in Healthcare > Lecture 5/Chapter 5 > Flashcards

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
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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
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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
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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
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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
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6
Q

health informatics

A
  • application of information science
  • improves efficiency, accuracy, and reliability -> minimize errors
  • requires the use of IT
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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
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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
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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
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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
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11
Q

telemedicine vs telehealth

A
  • telemedicine- practice medicine over distances
  • telemedicine is synchronous or asynchronous
  • telehealth involves a variety of caregivers
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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
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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)
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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
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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
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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

Issues in Healthcare (15 decks)

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