ICU Telemedicine and the Value of Qualitative Research for Organizational Innovation.
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ABSTRACT:
SUBMITTER: Lee JT
PROVIDER: S-EPMC6467316 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Background: The progress and innovation in telemedicine within the Middle Eastern countries have not been heavily monitored. Therefore, the present study aims to analyze the scholarly work conducted in the Arab world, using reproducible statistical and scientometric techniques. Methods: An electronic search of Web of Science (core database) had been conducted through use of an extensive search strategy comprising of keywords specific to the Arab region, EMRO countries, telehealth, medical conditions, and disorders. A total yield of 1,630 search results were processed, indexed through July 7, 2020. CiteSpace (5.7.R1, Drexel University, Pennsylvania, USA) is a Java-based application, a user-friendly tool for conducting scientometric analyses. Results: The present analyses found a lack of innovation in the field of digital health in the Arab countries. Many gaps in research were found in Arab countries, which will be discussed subsequently. Digital health research was clustered around themes of big data and artificial intelligence; a lack of progress was seen in telemedicine and digital health. Furthermore, only a small proportion of these publications had principal or corresponding authors from Arab countries. A clear disparity in digital health research in the Arab world was evident after comparing these insights with our previous investigation on telemedicine research in the global context. Conclusion: Telemedicine research is still in its infancy in the Middle Eastern countries. Recommendations include diversification of the research landscape and interdisciplinary collaborations in this area.
| S-EPMC8521801 | biostudies-literature
Project description:ICU telemedicine uses audiovisual conferencing technology to provide critical care from a remote location. Research is needed to best define the optimal use of ICU telemedicine, but efforts are hindered by methodological challenges and the lack of an organized delivery approach. We convened an interdisciplinary working group to develop a research agenda in ICU telemedicine, addressing both methodological and knowledge gaps in the field. To best inform clinical decision-making and health policy, future research should be organized around a conceptual framework that enables consistent descriptions of both the study setting and the telemedicine intervention. The framework should include standardized methods for assessing the preimplementation ICU environment and describing the telemedicine program. This framework will facilitate comparisons across studies and improve generalizability by permitting context-specific interpretation. Research based on this framework should consider the multidisciplinary nature of ICU care and describe the specific program goals. Key topic areas to be addressed include the effect of ICU telemedicine on the structure, process, and outcome of critical care delivery. Ideally, future research should attempt to address causation instead of simply associations and elucidate the mechanism of action in order to determine exactly how ICU telemedicine achieves its effects. ICU telemedicine has significant potential to improve critical care delivery, but high-quality research is needed to best inform its use. We propose an agenda to advance the science of ICU telemedicine and generate research with the greatest potential to improve patient care.
| S-EPMC3130530 | biostudies-literature
Project description:In organizational psychology the positive effects of democratically structured enterprises on their employees are well documented. However, the longstanding viability as well as economic success of democratic enterprises in a capitalistic market environment has long been contested. For instance, this has given rise to widespread endorsement of the "degeneration thesis" and the so-called "iron law of oligarchy". By reviewing 77 qualitative studies that examined 83 democratic enterprises (including 15 studies on nine enterprises of the Mondragon Cooperative Cooperation network) within the last 50 years, the present systematic review provides evidence that such enterprises are able to economically survive and prosper. The majority of studied enterprises (63.5%) either resisted pressures toward degeneration or subsequently regenerated after undergoing degenerative processes. Only 9.5% fully degenerated in accordance with the degeneration thesis and the "iron law of oligarchy", while 27.0% of the democratic enterprises showed diverse and mixed forms of degeneration tendencies, indicating that the notion of an "iron law" needs to be revised. Within the nine investigated cases of Mondragon not one single enterprise or group fully degenerated. Three cases showed degenerative tendencies, another three one degeneration tendencies and simultaneously regeneration, one case fully resisted degeneration tendencies (retention) and two cases regenerated. Further, this systematic review provides an overview of organizational and external conditions, non-/democratic or non-/participative practices and psychological phenomena that contribute to the degeneration, regeneration, or resistance to degeneration (i.e., retention). The described examples of such practices may help practitioners to implement and maintain democratic structures and processes in contemporary organizations.
| S-EPMC9672673 | biostudies-literature
Project description:ObjectiveThe role of cost-effectiveness analysis (CEA) in incentivizing innovation is controversial. Critics of CEA argue that its use for pricing purposes disregards the 'value of innovation' reflected in new drug development, whereas supporters of CEA highlight that the value of innovation is already accounted for. Our objective in this article is to outline the limitations of the conventional CEA approach, while proposing an alternative method of evaluation that captures the value of innovation more accurately.MethodThe adoption of a new drug benefits present and future patients (with cost implications) for as long as the drug is part of clinical practice. Incidence patients and off-patent prices are identified as two key missing features preventing the conventional CEA approach from capturing 1) benefit to future patients and 2) future savings from off-patent prices. The proposed CEA approach incorporates these two features to derive the total lifetime value of an innovative drug (i.e., the value of innovation).ResultsThe conventional CEA approach tends to underestimate the value of innovative drugs by disregarding the benefit to future patients and savings from off-patent prices. As a result, innovative drugs are underpriced, only allowing manufacturers to capture approximately 15% of the total value of innovation during the patent protection period. In addition to including the incidence population and off-patent price, the alternative approach proposes pricing new drugs by first negotiating the share of value of innovation to be appropriated by the manufacturer (>15%?) and payer (<85%?), in order to then identify the drug price that satisfies this condition.ConclusionWe argue for a modification to the conventional CEA approach that integrates the total lifetime value of innovative drugs into CEA, by taking into account off-patent pricing and future patients. The proposed approach derives a price that allows manufacturers to capture an agreed share of this value, thereby incentivizing innovation, while supporting health-care systems to pursue dynamic allocative efficiency. However, the long-term sustainability of health-care systems must be assessed before this proposal is adopted by policy makers.
| S-EPMC4826462 | biostudies-literature
Project description:BackgroundA recent report from the British Nuffield Council on Bioethics associated 'emerging biotechnologies' with a threefold challenge: 1) uncertainty about outcomes, 2) diverse public views on the values and implications attached to biotechnologies and 3) the possibility of creating radical changes regarding societal relations and practices. To address these challenges, leading international institutions stress the need for public involvement activities (PIAs). The objective of this study was to assess the state of PIA reports in the field of biomedical research.MethodsPIA reports were identified via a systematic literature search. Thematic text analysis was employed for data extraction.ResultsAfter filtering, 35 public consultation and 11 public participation studies were included in this review. Analysis and synthesis of all 46 PIA studies resulted in 6 distinguishable PIA objectives and 37 corresponding PIA methods. Reports of outcome translation and PIA evaluation were found in 9 and 10 studies respectively (20% and 22%). The paper presents qualitative details.DiscussionThe state of PIAs on biomedical research and innovation is characterized by a broad range of methods and awkward variation in the wording of objectives. Better comparability of PIAs might improve the translation of PIA findings into further policy development. PIA-specific reporting guidelines would help in this regard. The modest level of translation efforts is another pointer to the "deliberation to policy gap". The results of this review could inform the design of new PIAs and future efforts to improve PIA comparability and outcome translation.
| S-EPMC4254603 | biostudies-literature
Project description:ObjectiveThe concept of shifting from volume (i.e., billing for as many patients and services as possible) to value (i.e., reducing costs while improving quality) has been a key underpinning of the development of accountable care organizations (ACOs), yet the cultural change necessary to make this shift has been previously unexplored.Data sources/study settingPrimary data collected through site visits to four private sector ACOs.Study designCross-sectional, semi-structured interview study with analysis done at the ACO level to learn about ACO development.Data collectionOne hundred and forty-eight interviews recorded and transcribed verbatim followed by rigorous qualitative analysis using a grounded theory approach.Principal findingsThe importance of shifting organizational culture from volume to value was emphasized across sites and interviewees, particularly when defining an ACO; describing the shift in organizational focus to value; and discussing how to create value by emphasizing quality over volume. Value was viewed as more than cost-benefit, but rather encapsulated a paradigmatic cultural change in the way care is provided.ConclusionsWe found that moving from volume to value is central to the culture change required of an ACO. Our findings can inform future efforts that aim to create a more effective value-based health care system.
| S-EPMC6232497 | biostudies-literature
Project description:Despite the ubiquity of textual data, so far few researchers have applied text mining to answer organizational research questions. Text mining, which essentially entails a quantitative approach to the analysis of (usually) voluminous textual data, helps accelerate knowledge discovery by radically increasing the amount data that can be analyzed. This article aims to acquaint organizational researchers with the fundamental logic underpinning text mining, the analytical stages involved, and contemporary techniques that may be used to achieve different types of objectives. The specific analytical techniques reviewed are (a) dimensionality reduction, (b) distance and similarity computing, (c) clustering, (d) topic modeling, and (e) classification. We describe how text mining may extend contemporary organizational research by allowing the testing of existing or new research questions with data that are likely to be rich, contextualized, and ecologically valid. After an exploration of how evidence for the validity of text mining output may be generated, we conclude the article by illustrating the text mining process in a job analysis setting using a dataset composed of job vacancies.
| S-EPMC5975701 | biostudies-literature
Project description:The aim of the study is to identify the factors that influence innovation activities associated with business management, known in the academic world as organizational innovation. Data was gathered by administering a survey on the managers or owners of hotels in the province of Santa Elena, Ecuador. Three components of organizational innovation were analyzed: methods of organizing job positions, work organization practices and management of external relations; all of which were tested with both internal variables (individual and structural characteristics) and variables external to the firms.
| S-EPMC6727002 | biostudies-literature
Project description:Fungal metabolites were extracted with a hydroalcoholic solution and partitioned between EtOAc. Analysis was done using Q-Exactive. In addition, Hydroalcoholic extracts from medicinal plants were also analyzed.
2024-03-25 | MSV000094397 | MassIVE
Project description:Given the complexity of high-acuity health care, designing an effective clinical note template can be beneficial to both document patient care and clarify how telemedicine is used. We characterized documented interactions via a standardized note template between bedside intensive care unit (ICU) providers and teleintensivists in 2 Veterans Health Administration ICU telemedicine support centers. All ICUs linked to support centers and providing care from October 2012 through September 2014 were considered. Interactions were assessed based on initiation site, bedside initiator, contact type, and patient care change. Of 14?511 ICU admissions with teleintensivist access, teleintensivist interaction was documented in 21.6% (N?=?3136). In particular, contacts were primarily initiated by bedside staff (74.4%), use increased over time, and of contacts resulting in changes in patient care, most were initiated by a bedside nurse (84.3%). Given this variation, future research necessitates inclusion of utilization in evaluation of Tele-ICU and patient outcomes.
| S-EPMC7651918 | biostudies-literature