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
M-health
-use of wireless communication devices
26
E-therapy
- interactions with health professionals over the internet
| - a way to fix something
27
innovation*
-creation of a new product, technique, or service
28
diffusion*
- 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
utilization*
-once it is acquired, the use of technology is almost ensured
30
technological imperative
- 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
certificate of need
CON laws required hospitals to seek approval before acquiring major equipment or projects
-must prove the need for government funding
32
research on technology
AHRQ technology assessments are available to medical practitioners, consumers, and others
33
funding for research
national institutes of health (NIH)
34
efficacy
health benefit from the use of technology
35
saftey
benefits must outweigh risks
36
cost effectiveness
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
cost benefit
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
