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Health Provider Action & Media Coverage of IFHP Reform
Open Medicine Blog - 20. Mai 2012 - 7:53
The proposed Interim Federal Health Program cuts (discussed further here) have not only motivated individual physicians to action, but also mobilized groups of health providers nation wide. On May 11, physicians across Canada held protests, an occupation and issued press releases in an effort to catch the Minister responsible, Jason Kenney’s ear. More recently, the Canadian Medical Association, College of Family Physicians of Canada, Royal College of Physicians and Surgeons, Canadian Nurses Association, Canadian Pharmacists Association, Canadian Association of Optometrists, Canadian Association of Social Workers and Canadian Dental Association sent a joint letter to the Minister requesting that the planned IFHP cuts be rescinded. A full list of media coverage is below.
Medical groups slam plan to cut refugee health coverage – Ottawa Citizen (May 18, 2012)
Refugee health reform assailed – CMAJ (May 18, 2012)
Refugee health cuts are bad for all of us – Hamilton Spectator (May 17, 2012)
They aren’t all ‘bogus’ refugees, as portrayed by Kenney – Winnipeg Free Press (May 17, 2012)
Why cutting health care for asylum-seekers makes no sense – Globe and Mail (May 15, 2012)
Canadian doctors occupy government offices over healthcare cuts - Guardian (May 12, 2012)
Doctors fight for refugee health care – Hamilton Spectator (May 12, 2012)
Physicians occupied MP’s office over cuts to refugee health care – Toronto Star (May 11, 2012)
Doctors stage sit-in over refugee health care costs – CBC News (May 11, 2012)
Doctors demand changes to proposed refugee health policy – CBC News (May 11, 2012)
Doctors protest refugee health cuts – CBC News (May 11, 2012)
An attack on vulnerable refugees - Ottawa Citizen (May 9, 2012)
Cuts to refugee health insurance dangerous, inhumane, doctors say – National Post (May 7, 2012)
Doctor worries federal cuts could harm refugee health – CBC News (May 3, 2012)
Kategorien: Information Access, Informationswissen - neue Medien und Informationsquellen
Interim Federal Health, Bill C-31, Jason Kenney & Refugee Health – a Primer
Open Medicine Blog - 20. Mai 2012 - 7:38
Jason Kenney, Minister of Citizenship, Immigration and Multiculturalism, has been a very busy man as of late. In less than five months, he has sought to redefine Canada’s threshold for asylum seekers and to tighten the handshake that welcomes them to their new home. For those in the medical community providing care for and advocating on behalf of refugee patients, these efforts have caused considerable consternation. After a closer inspection of Bill C-31 and the more recent overhaul of the Interim Federal Health Program, it is not a stretch to see why.
Bill C-31 or the Protecting Canada’s Immigration System Act was first introduced to Parliament in February 2012 with the intention of clamping down on ‘bogus’ refugees, speeding up claimant processing times and reducing government costs. Stretching a healthy fifty-six pages, C-31’s most objectionable provisions related to health include:
- Automatic detention of asylum seekers for up to one year without review if deemed to land via an “irregular arrival.”
- An embargo on permanent resident applications and family reunification for five years after arrival.
- Conditional permanent residency with the possibility of a later revocation.
As a group of Ontario based physicians pointed out in a Toronto Star column, prolonged detention of refugee claimants leads to increased risk of suicidal thoughts, post-traumatic stress disorder and self-harm. This comes in addition to incubating infectious diseases and exacerbating chronic ones. Public outcry has led Kenney to amend this portion of the bill, granting review of detention at 14 days and 6 months. But the remainder stays unchanged. Delayed family reunification will still serve to weaken already fragile social supports and health, while revocation of already granted residency will still lead to social isolation, slow improvement of language skills and poor mental health.
In addition to the above reforms, C-31 also builds on the 2010 Conservative led legislation, Bill C-11, or the Balanced Refugee Reform Act. It divides refugee claimants into two categories: those from ‘Designated Countries of Origin’ (or DCOs) and those not. The stated aim of DCO policy is to deter abuse of the refugee system by those who come from countries generally considered ‘safe.’ One would expect a panel of experts to make such a crucial distinction – but not according to Minister Kenney. Bill C-11 contained no parliamentary oversight, but created a panel of public servants to make recommendation to the Minister. C-31 goes one step further, eliminating this provision and granting the Minister unilateral authority to deem which countries are considered ‘safe’ and which are not.
The DCO distinction is not an esoteric one. It has direct and very harsh implications for more recent reforms to refugee health services provided under the Interim Federal Health Program (IFHP). These changes do not require legislative reform; no Parliamentary vote or committee review is required. Their scope (though not their consequences) requires only the approval of Prime Minister Harper's Cabinet.
Like C-31, the stated aim of the IFHP change is cost-savings. It currently costs the Canadian government 84 million dollars annually – the Harper government is aiming for a reduction of 20 million. To achieve their ends they are leaving no category of refugee unaffected, even rolling back services for those who are government sponsored on recommendation from the United Nations High Commission on Refugees (UNHCR).
For these refugees, ironically deemed ‘protected persons’ in government releases, pre-reform benefits equate approximately to those available under most provincial social assistance programs. Post-reform changes will bear little resemblance to this, with health coverage available only for conditions deemed to be of an ‘urgent or essential nature’ or those to ‘prevent or treat a disease that is a risk to public health or a condition of public safety concern.’
What does that mean in practice? A ministry briefer illustrates a few examples. Come Canada Day, a protected person can be assessed for coronary artery disease by a physician, but their statins and anti-hypertensives will not be covered. A protected person will still be able to see a nurse or physician for a diabetic assessment, but will receive no coverage for insulin. For protected persons, many vaccines don’t even meet these new thresholds. All of these examples are significant changes from current policy. For claimants from the newly created DCO category, the news is even worse. Coverage has been completely eliminated for prenatal care, labour & delivery, as well emergency services. Every DCO acute myocardial infarction will go unfunded.
Kenney has defended these reforms on grounds that asylum seekers should not enjoy a level of government funding that Canadians themselves don’t receive. Physician and advocates have responded with both moral and economic arguments. Andre Picard has pointed out that it is exactly the vulnerability of refugees that necessitates broader health services. Dr. Mark Tyndall has also provided a reality check - the real challenge is connecting refugees with unfamiliar preventative services and primary care, not stopping ‘abuse.’ A Hamilton Spectator health provider Op-Ed highlights that according to the Ministry’s own data, refugee claimant’s per capita health costs are only 10% of Canadians, a number that is expected to rise with cuts to prevention.
Jason Kenney’s stated ends are to strengthen Canada’s refugee selection process and to save government dollars. But by choosing a path ignoring evidence contrary to his means and by adopting a hostile stance to those on refugee health’s frontlines, he risks doing just the opposite. Bill C-31 and the IFHP reforms come into force in less than 6 weeks. Minister Kenney, you still have time to change course. July 1st deserves to remain a celebration for Canadians already here and for those that have yet to come.
Kategorien: Information Access, Informationswissen - neue Medien und Informationsquellen
The Politics of Health
Open Medicine Blog - 19. Mai 2012 - 21:18
As the newest member of the Open Medicine blog team, you can expect posts from me that focus on the intersection of health and elected politics. If I had started posting some months ago, you might have seen stories on the 2014 health accord, the health scandals in Alberta/defection of Raj Sherman and the recent ICES report on primary health care reform in Ontario. While I can't always promise to strike an impartial tone, you can look forward to posts that seek clarity in often messy situations.
When not blogging for Open Medicine or Tweeting via @DanyaalRaza, you can find me in the midst of a Family Medicine Global Health & Vulnerable Populations Fellowship at the University of Toronto. My first set of posts will focus on this area - specifically, proposed reform to refugee health care in Canada.
I look forward to hearing your thoughts on each post, and the opportunity to respond to each of your posted comments.
Happy reading,
DR
Kategorien: Information Access, Informationswissen - neue Medien und Informationsquellen
Hygieia’s DIGS Automatic Insulin Titration Device Shows Promise; Company Talks to Medgadget
medgadget - Internet journal of emerging medical technologies - 18. Mai 2012 - 18:33
An experimental new device called Diabetes Insulin Guidance System (DIGS) from Hygieia, Inc. (Ann Arbor, MI) is being developed to automate insulin dosage titration in patients with type I and type II diabetes, based on measurements of blood glucose and analysis of patterns in the obtained data. The company hopes one day to provide patients with an automatically calculated insulin dosage adjustments between doctor visits, in hopes of improving their glycemic control.
The company’s clinical advisory board is packed with diabetes experts such as Martin Abrahamson, MD from Joslin Diabetes Center in Boston, so they obviously know what they are doing. And the latest data seems to confirm that. A recent publication in Diabetes Technology and Therapeutics is quite positive for the technology, as it demonstrated DIGS’ potential to improve blood glucose control for insulin-using patients with type 2 or type 1 diabetes. Over the 12-week intervention period of the study, investigators observed:
Kategorien: Gesundheitswesen - aktuelle Nachrichten, Informationswissen - neue Medien und Informationsquellen, Quellen
UCSD Electronic Wireless Tattoo Receives Grant from the Gates Foundation
medgadget - Internet journal of emerging medical technologies - 18. Mai 2012 - 17:20
Last week, the Bill and Melinda Gates Foundation announced its latest round of grant winners for its Grand Challenges Explorations initiative. Among the recipients is a team from the University of California, San Diego and University of Illinois at Urbana-Champaign that is developing a tiny, flexible fetal monitor. We wrote about the technology behind the device back in August and were able to hear from David Icke, CEO of MC10, the company helping to commercialize it, at both FutureMed in February and at last month’s TEDMED conference.
Described as an electronic “tattoo”, the device is a wearable patch of circuits, sensors, and wireless transmitters that sticks to the skin like a temporary tattoo and is able to stretch and flex with the skin. The researchers hope that the final product will continuously measure and monitor uterine contractions, fetal heart rate and oxygen, and maternal heart rate and body temperature.
Kategorien: Gesundheitswesen - aktuelle Nachrichten, Informationswissen - neue Medien und Informationsquellen, Quellen
NIH Director Francis Collins on Speeding Up Arrival of New Disease Treatments
medgadget - Internet journal of emerging medical technologies - 18. Mai 2012 - 17:16
Francis Collins, Director of the National Institutes of Health, spoke at the last TEDMED about the challenges of converting fundamental research into practical therapeutics. In addition to proposing new approaches like repurposing of drugs and using manufactured human tissue for testing new compounds, he spoke on stage with a 15-year-old boy with Hutchinson–Gilford Progeria, a rare condition that accelerates aging, who had some words for medical researchers everywhere.
Kategorien: Gesundheitswesen - aktuelle Nachrichten, Informationswissen - neue Medien und Informationsquellen, Quellen
Medgadget Interviews Eric Berdinis and Jeff Kiske, Creators of the Kinecthesia Haptic Belt for Blind People
medgadget - Internet journal of emerging medical technologies - 18. Mai 2012 - 17:11
Over the years we have been fortunate to cover numerous student designed medical devices and we are always amazed by the innovation and creativity demonstrated by these teams. In November of last year we covered one such project, the Kinecthesia, a haptic belt which allows the wearer to virtually sense objects ahead, and to the left and right thanks to three motors which vibrate in response to objects in their immediate vicinity. As the name would imply, at the heart of the Kinecthesia is an XBox Kinect 3D camera which is connected to a Beagle Board computing platform that processes the depth data from the device and drives the motors.
Its two student creators, Eric Berdinis and Jeff Kisk, developed the Kinecthesia at Weiss Tech House, a student-run hub of technological innovation at the University of Pennsylvania that supports students in the creation, development and commercialization of innovative technologies. The project is very innovative and reflects a growing trend in hardware hacking and customization which is creeping into a number of fields including health technology.
Kategorien: Gesundheitswesen - aktuelle Nachrichten, Informationswissen - neue Medien und Informationsquellen, Quellen
Studiendekanat-Newsletter: neue Ausgabe online
Medizinische Fakultät Mannheim - Bibliothek - Newsblog - 18. Mai 2012 - 9:21
Ausgabe 17 des Newsletters aus dem Studiendekanat ist erschienen. Themen sind u.a. das Rankingergebnis im CHE, neue Finanzmittel fürs PJ und der Tag der Lehre am 06.07.2012.
Kategorien: Informationswissen - neue Medien und Informationsquellen
The European quality of care pathways (EQCP) study on the impact of care pathways on interprofessional teamwork in an acute hospital setting: study protocol: for a cluster randomised controlled trial and evaluation of implementation processes
Implementation Science - Uptake of research findings into routine healthcare - 18. Mai 2012 - 1:00
Background: Although care pathways are often said to promote teamwork, high-level evidence thatsupports this statement is lacking. Furthermore, knowledge on conditions and facilitators forsuccessful pathway implementation is scarce. The objective of the European Quality of CarePathway (EQCP) study is therefore to study the impact of care pathways on interprofessionalteamwork and to build up understanding on the implementation process. Methods: An international post-test-only cluster Randomised Controlled Trial (cRCT), combined withprocess evaluations, will be performed in Belgium, Ireland, Italy, and Portugal. Teams caringfor proximal femur fracture (PFF) patients and patients hospitalized with an exacerbation ofchronic obstructive pulmonary disease (COPD) will be randomised into an intervention andcontrol group. The intervention group will implement a care pathway for PFF or COPDcontaining three active components: a formative evaluation of the actual teams' performance,a set of evidence-based key interventions, and a training in care pathway-development. Thecontrol group will provide usual care. A set of team input, process and output indicators willbe used as effect measures. The main outcome indicator will be relational coordination. Nextto these, process measures during and after pathway development will be used to evaluate theimplementation processes. In total, 132 teams have agreed to participate, of which 68 wererandomly assigned to the intervention group and 64 to the control group. Based on poweranalysis, a sample of 475 team members per arm is required. To analyze results, multilevelanalysis will be performed.DiscussionResults from our study will enhance understanding on the active components of carepathways. Through this, preferred implementation strategies can be defined.Trail registrationNCT01435538
Kategorien: HTA - Health Technology Updates, Informationswissen - neue Medien und Informationsquellen
Nurses' research utilization two years after graduation--a national survey of associated individual, organizational, and educational factors
Implementation Science - Uptake of research findings into routine healthcare - 18. Mai 2012 - 1:00
Background: Nurses' research utilization (RU) as part of evidence-based practice is strongly emphasized intoday's nursing education and clinical practice. The primary aim of RU is to provide high-qualitynursing care to patients. Data on newly graduated nurses' RU are scarce, but apredominance of low use has been reported in recent studies. Factors associated with nurses'RU have previously been identified among individual and organizational/contextual factors,but there is a lack of knowledge about how these factors, including educational ones, interactwith each other and with RU, particularly in nurses during the first years after graduation.The purpose of this study was therefore to identify factors that predict the probability for lowRU among registered nurses two years after graduation. Methods: Data were collected as part of the LANE study (Longitudinal Analysis of NursingEducation), a Swedish national survey of nursing students and registered nurses. Data onnurses' instrumental, conceptual, and persuasive RU were collected two years aftergraduation (2007, n = 845), together with data on work contextual factors. Data on individualand educational factors were collected in the first year (2002) and last term of education(2004). Guided by an analytic schedule, bivariate analyses, followed by logistic regressionmodeling, were applied. Results: Of the variables associated with RU in the bivariate analyses, six were found to besignificantly related to low RU in the final logistic regression model: work in the psychiatricsetting, role ambiguity, sufficient staffing, low work challenge, being male, and low studentactivity. Conclusions: A number of factors associated with nurses' low extent of RU two years postgraduation werefound, most of them potentially modifiable. These findings illustrate the multitude of factorsrelated to low RU extent and take their interrelationships into account. This knowledge mightserve as useful input in planning future studies aiming to improve nurses', specifically newlygraduated nurses', RU.
Kategorien: HTA - Health Technology Updates, Informationswissen - neue Medien und Informationsquellen
Improving quality of care through improved audit and feedback
Implementation Science - Uptake of research findings into routine healthcare - 18. Mai 2012 - 1:00
Background: The Department of Veterans Affairs (VA) has led the industry in measuring facilityperformance as a critical element in improving quality of care, investing substantial resourcesto develop and maintain valid and cost-effective measures. The External Peer ReviewProgram (EPRP) of the VA is the official data source for monitoring facility performance,used to prioritize the quality areas needing most attention. Facility performance measurementhas significantly improved preventive and chronic care, as well as overall quality; however,much variability still exists in levels of performance across measures and facilities. Audit andfeedback (A&F), an important component of effective performance measurement, can helpreduce this variability and improve overall performance. Previous research suggests that VAMedical Centers (VAMCs) with high EPRP performance scores tend to use EPRP data as afeedback source. However, the manner in which EPRP data are used as a feedback source byindividual providers as well as service line, facility, and network leadership is not wellunderstood. An in-depth understanding of mental models, strategies, and specific feedbackprocess characteristics adopted by high-performing facilities is thus urgently needed.This research compares how leaders of high, low, and moderately performing VAMCs useclinical performance data from the EPRP as a feedback tool to maintain and improve qualityof care. Methods: We will conduct a qualitative, grounded theory analysis of up to 64 interviews using a novelmethod of sampling primary care, facility, and Veterans Integrated Service Network (VISN)leadership at high-, moderate-, and low-performing facilities. We will analyze interviews forevidence of cross-facility differences in perceptions of performance data usefulness andstrategies for disseminating performance data evaluating performance, with particularattention to timeliness, individualization, and punitiveness of feedback delivery.DiscussionMost research examining feedback to improve provider and facility performance lacks adetailed understanding of the elements of effective feedback. This research will highlight theelements most commonly used at high-performing facilities and identify additional featuresof their successful feedback strategies not previously identified. Armed with this information,practices can implement more effective A&F interventions to improve quality of care.
Kategorien: HTA - Health Technology Updates, Informationswissen - neue Medien und Informationsquellen
Five Questions for Dr. Paul Walker of Spectral Diagnostics
medgadget - Internet journal of emerging medical technologies - 17. Mai 2012 - 19:40
Sepsis is a huge problem, costing billions of dollars and hundreds of thousands of lives a year in the US alone. A Toronto, Canada-based startup Spectral Diagnostics Inc. is developing a promising technology to decrease morbidity and mortality of patients with sepsis. The company’s proprietary technology is integrated into Toraymyxin, a hemoperfusion adsorption column which is highly effective in removing circulating endotoxin from the bloodstream. Furthermore, Spectral Diagnostics has also developed the Endotoxin Activity Assay (EAA) – the only FDA cleared, CE marked rapid diagnostic for endotoxemia. According to a company representative, in 2009 interim results of a Phase II study were published in JAMA demonstrating that “Toraymyxin, when added to conventional therapy, significantly reduced 28-day mortality in patients with severe sepsis and septic shock, compared to patients only receiving conventional therapy. Due to these positive results, that trial was terminated early and a Phase III pivotal multicenter study has been launched in the U.S. and Canada.” To find out more about this technology and its future, we had a chance to conduct an interview with Dr. Paul Walker, President and CEO of Spectral Diagnostics.
Dr. Jan Sinnige, Medgadget: Spectral Diagnostics recently started a phase three randomized controlled trial on Polymyxin B Hemoperfusion. What are the expectations according to the phase two results?
Kategorien: Gesundheitswesen - aktuelle Nachrichten, Informationswissen - neue Medien und Informationsquellen, Quellen
FlexLeg Gives Users With Lower-Leg Injuries Increased Mobility (videos)
medgadget - Internet journal of emerging medical technologies - 17. Mai 2012 - 18:30
Ask anyone who’s ever had to spend part of their life hobbling around on crutches, and they’ll probably agree that it’s a chore. Running, let alone anything faster than a brisk walk, is out of the picture, and ascending or descending stairs becomes an adventure.
A new product, called FlexLeg, from a couple of mechanical engineers from Brigham Young University in Utah, seeks to make life with an injured lower leg a little less burdensome. Looking somewhat like the Cheetah Flex-Foot prostheses that Olympic sprinter Oscar Pistorius uses, FlexLeg is a hands-free alternative for people with temporary lower-leg injuries to help them walk with a more natural rhythm than using crutches, and for those always on the go, the ability to even run.
Kategorien: Gesundheitswesen - aktuelle Nachrichten, Informationswissen - neue Medien und Informationsquellen, Quellen
F Cubed’s Pathogen Detector Will Make Swimming Holes Safer This Summer
medgadget - Internet journal of emerging medical technologies - 17. Mai 2012 - 17:47
During our recent tour of Northeast Indiana, we had the opportunity to visit F Cubed (F3), a startup supported by the Innovation Park at Notre Dame. F3 is developing a portable device that allows for rapid detection of DNA of harmful pathogens in under 30 minutes.
We’ve written about a number of similar lab-on-chip detectors, but what sets the F3 system apart is its biochip technology. F3′s biochip, which is smaller than the size of a thumbnail, allows for the detection of multiple pathogens without the use of expensive and complicated optical devices. According to F3,
Kategorien: Gesundheitswesen - aktuelle Nachrichten, Informationswissen - neue Medien und Informationsquellen, Quellen
Using Colonoscopy to Predict Parkinson’s Disease?
medgadget - Internet journal of emerging medical technologies - 17. Mai 2012 - 16:26
Roughly 60,000 people in the United States are diagnosed with Parkinson’s disease each year, according to the Parkinson’s Disease Foundation. In all, more than 1.5 million people in the United States suffer from the condition. Yet thousands of cases go undetected and diagnosing the disease in the early stages remains challenging.
Early diagnosis of Parkinson’s enables the disease to be treated with drugs such as dopamine agonists and monoamine oxidase type-B inhibitors, which can alleviate the condition’s symptoms and postpone the need to begin levodopa therapy. Nevertheless, early diagnosis of Parkinson’s has remained challenging and misdiagnoses are common.
Kategorien: Gesundheitswesen - aktuelle Nachrichten, Informationswissen - neue Medien und Informationsquellen, Quellen
Severely Disabled People Control Robotic Arm Through Thought (video)
medgadget - Internet journal of emerging medical technologies - 17. Mai 2012 - 16:17
We’ve been covering the development of the BrainGate brain-computer interface system for the last seven years, and we’re glad to see that it’s now at a point where severely disabled tetraplegics are able to control a robotic arm in three dimensional space purely by thinking about it.
The system relies on a 96-channel microelectrode array that records the motor cortex neurons responsible for arm movement. Because the implant reads the very neurons that are normally activated during arm movement, the people in the study didn’t require any explicit training or instruction in operating the roboarm. One of the two people in the study, who last moved her arms effectively before a severe stroke 14 years prior, was able to control the robotic hand to pick up a cup and take a drink from it. See yourself in this Nature video:
Kategorien: Gesundheitswesen - aktuelle Nachrichten, Informationswissen - neue Medien und Informationsquellen, Quellen
Device Manufacturing 101: Orthopedic Implants and Instruments
medgadget - Internet journal of emerging medical technologies - 16. Mai 2012 - 22:09
We’re constantly giving you the scoop on the latest in orthopedic devices from our clinical and design perspective, but have you ever wondered about the steps that go into manufacturing these devices? There’s a lot of work in the process that turns an idea into an actual physical product, and often times it’s something we don’t think about.
During our recent trip to Northeast Indiana, we had the opportunity to visit a number of manufacturing sites and learn the high-tech processes and technology that go into producing orthopedic implants and instruments. Here’s how it works!
Kategorien: Gesundheitswesen - aktuelle Nachrichten, Informationswissen - neue Medien und Informationsquellen, Quellen
Neu im Bestand
Medizinische Fakultät Mannheim - Bibliothek - Newsblog - 16. Mai 2012 - 10:26
Gerne weisen wir wieder auf ausgewählte neue Bücher und E-Books hin, die ab sofort in unseren Regalen zur Ausleihe bereit stehen bzw. online verfügbar sind: Tomas Jelinek (Hrsg): Kursbuch Reisemedizin Beratung, Prophylaxe, Reisen mit Erkrankungen. Thieme 2012.Buch und dazugehörige CD-ROM finden Sie im Fachbuchbestand bzw. im Medienschrank unter T5. // zum Online-Katalog Axel Karenberg: Fachsprache [...]
Kategorien: Informationswissen - neue Medien und Informationsquellen
Neue und Top Cochrane Reviews
Medizinische Fakultät Mannheim - Bibliothek - Newsblog - 16. Mai 2012 - 9:00
Neue und überarbeitete Reviews aus der Cochrane Library: Preoperative statin therapy for patients undergoing cardiac surgery Trastuzumab containing regimens for early breast cancer (Podcast) Nicotine receptor partial agonists for smoking cessation (Podcast) Interventions for improving outcomes in patients with multimorbidity in primary care and community settings (Podcast) Helminth therapy (worms) for allergic rhinitis (Podcast) [...]
Kategorien: Informationswissen - neue Medien und Informationsquellen
Modeling technology innovation: How science, engineering, and industry methods can combine to generate beneficial socioeconomic impacts
Implementation Science - Uptake of research findings into routine healthcare - 16. Mai 2012 - 1:00
Background: Government-sponsored science, technology, and innovation (STI) programs support thesocioeconomic aspects of public policies, in addition to expanding the knowledge base. Forexample, beneficial healthcare services and devices are expected to result from investmentsin research and development (R&D) programs, which assume a causal link to commercialinnovation. Such programs are increasingly held accountable for evidence of impact--that is,innovative goods and services resulting from R&D activity. However, the absence ofcomprehensive models and metrics skews evidence gathering toward bibliometrics aboutresearch outputs (published discoveries), with less focus on transfer metrics aboutdevelopment outputs (patented prototypes) and almost none on econometrics related toproduction outputs (commercial innovations). This disparity is particularly problematic forthe expressed intent of such programs, as most measurable socioeconomic benefits resultfrom the last category of outputs. Methods: This paper proposes a conceptual framework integrating all three knowledge-generatingmethods into a logic model, useful for planning, obtaining, and measuring the intendedbeneficial impacts through the implementation of knowledge in practice. Additionally, theintegration of the Context-Input-Process-Product (CIPP) model of evaluation proactivelybuilds relevance into STI policies and programs while sustaining rigor. Results: The resulting logic model framework explicitly traces the progress of knowledge from inputs,following it through the three knowledge-generating processes and their respectiveknowledge outputs (discovery, invention, innovation), as it generates the intended sociobeneficialimpacts. It is a hybrid model for generating technology-based innovations, wherebest practices in new product development merge with a widely accepted knowledgetranslationapproach. Given the emphasis on evidence-based practice in the medical andhealth fields and "bench to bedside" expectations for knowledge transfer, sponsors andgrantees alike should find the model useful for planning, implementing, and evaluatinginnovation processes. Conclusions: High-cost/high-risk industries like healthcare require the market deployment of technologybasedinnovations to improve domestic society in a global economy. An appropriate balanceof relevance and rigor in research, development, and production is crucial to optimize thereturn on public investment in such programs. The technology-innovation process needs acomprehensive operational model to effectively allocate public funds and thereby deliberatelyand systematically accomplish socioeconomic benefits.
Kategorien: HTA - Health Technology Updates, Informationswissen - neue Medien und Informationsquellen
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