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Monitoring is a major component of management of chronic diseases such as diabetes, cardiovascular disease, arthritis and depression. Yet poor monitoring means healthcare costs are rising. This book discusses how monitoring principles adopted in other spheres such as clinical pharmacology and evidence-based medicine can be applied to chronic disease in the global setting. With contributions from leading experts in evidence-based medicine, it is a ground-breaking text for all involved in delivery of better and more effective management of chronic illnesses.
Drawing on the work of the Roundtable on Evidence-Based Medicine, the 2007 IOM Annual Meeting assessed some of the rapidly occurring changes in health care related to new diagnostic and treatment tools, emerging genetic insights, the developments in information technology, and healthcare costs, and discussed the need for a stronger focus on evidence to ensure that the promise of scientific discovery and technological innovation is efficiently captured to provide the right care for the right patient at the right time. As new discoveries continue to expand the universe of medical interventions, treatments, and methods of care, the need for a more systematic approach to evidence development and application becomes increasingly critical. Without better information about the effectiveness of different treatment options, the resulting uncertainty can lead to the delivery of services that may be unnecessary, unproven, or even harmful. Improving the evidence-base for medicine holds great potential to increase the quality and efficiency of medical care. The Annual Meeting, held on October 8, 2007, brought together many of the nation's leading authorities on various aspects of the issues - both challenges and opportunities - to present their perspectives and engage in discussion with the IOM membership.
This volume, developed by the Observatory together with OECD, provides an overall conceptual framework for understanding and applying strategies aimed at improving quality of care. Crucially, it summarizes available evidence on different quality strategies and provides recommendations for their implementation. This book is intended to help policy-makers to understand concepts of quality and to support them to evaluate single strategies and combinations of strategies.
In 1996, the Institute of Medicine (IOM) released its report Telemedicine: A Guide to Assessing Telecommunications for Health Care. In that report, the IOM Committee on Evaluating Clinical Applications of Telemedicine found telemedicine is similar in most respects to other technologies for which better evidence of effectiveness is also being demanded. Telemedicine, however, has some special characteristics-shared with information technologies generally-that warrant particular notice from evaluators and decision makers. Since that time, attention to telehealth has continued to grow in both the public and private sectors. Peer-reviewed journals and professional societies are devoted to telehealth, the federal government provides grant funding to promote the use of telehealth, and the private technology industry continues to develop new applications for telehealth. However, barriers remain to the use of telehealth modalities, including issues related to reimbursement, licensure, workforce, and costs. Also, some areas of telehealth have developed a stronger evidence base than others. The Health Resources and Service Administration (HRSA) sponsored the IOM in holding a workshop in Washington, DC, on August 8-9 2012, to examine how the use of telehealth technology can fit into the U.S. health care system. HRSA asked the IOM to focus on the potential for telehealth to serve geographically isolated individuals and extend the reach of scarce resources while also emphasizing the quality and value in the delivery of health care services. This workshop summary discusses the evolution of telehealth since 1996, including the increasing role of the private sector, policies that have promoted or delayed the use of telehealth, and consumer acceptance of telehealth. The Role of Telehealth in an Evolving Health Care Environment: Workshop Summary discusses the current evidence base for telehealth, including available data and gaps in data; discuss how technological developments, including mobile telehealth, electronic intensive care units, remote monitoring, social networking, and wearable devices, in conjunction with the push for electronic health records, is changing the delivery of health care in rural and urban environments. This report also summarizes actions that the U.S. Department of Health and Human Services (HHS) can undertake to further the use of telehealth to improve health care outcomes while controlling costs in the current health care environment.
"Nurses play a vital role in improving the safety and quality of patient car -- not only in the hospital or ambulatory treatment facility, but also of community-based care and the care performed by family members. Nurses need know what proven techniques and interventions they can use to enhance patient outcomes. To address this need, the Agency for Healthcare Research and Quality (AHRQ), with additional funding from the Robert Wood Johnson Foundation, has prepared this comprehensive, 1,400-page, handbook for nurses on patient safety and quality -- Patient Safety and Quality: An Evidence-Based Handbook for Nurses. (AHRQ Publication No. 08-0043)." - online AHRQ blurb, http://www.ahrq.gov/qual/nurseshdbk/
This User’s Guide is intended to support the design, implementation, analysis, interpretation, and quality evaluation of registries created to increase understanding of patient outcomes. For the purposes of this guide, a patient registry is an organized system that uses observational study methods to collect uniform data (clinical and other) to evaluate specified outcomes for a population defined by a particular disease, condition, or exposure, and that serves one or more predetermined scientific, clinical, or policy purposes. A registry database is a file (or files) derived from the registry. Although registries can serve many purposes, this guide focuses on registries created for one or more of the following purposes: to describe the natural history of disease, to determine clinical effectiveness or cost-effectiveness of health care products and services, to measure or monitor safety and harm, and/or to measure quality of care. Registries are classified according to how their populations are defined. For example, product registries include patients who have been exposed to biopharmaceutical products or medical devices. Health services registries consist of patients who have had a common procedure, clinical encounter, or hospitalization. Disease or condition registries are defined by patients having the same diagnosis, such as cystic fibrosis or heart failure. The User’s Guide was created by researchers affiliated with AHRQ’s Effective Health Care Program, particularly those who participated in AHRQ’s DEcIDE (Developing Evidence to Inform Decisions About Effectiveness) program. Chapters were subject to multiple internal and external independent reviews.
v. 1. Research findings -- v. 2. Concepts and methodology -- v. 3. Implementation issues -- v. 4. Programs, tools and products.
Remote health monitoring using wearable sensors is an important research area involving several key steps: physiological parameter sensing and data acquisition, data analysis, data security, data transmission to caregivers, and clinical intervention, all of which play a significant role to form a closed loop system. Subject-specific behavioral and clinical traits, coupled with individual physiological differences, necessitate a personalized healthcare delivery model for around-the-clock monitoring within the home environment. Cardiovascular disease monitoring is an illustrative application domain where research has been instrumental in enabling a personalized closed-loop monitoring system, which has been showcased in this book. Health Monitoring Systems: An Enabling Technology for Patient Care provides a holistic overview of state-of-the-art monitoring systems facilitated by Internet of Things (IoT) technology. The book lists out the details on biomedical signal acquisition, processing, and data security, the fundamental building blocks towards an ambulatory health monitoring infrastructure. The fundamentals have been complimented with other relevant topics including applications which provide an in-depth view on remote health monitoring systems. Key Features: Presents examples of state-of-the-art health monitoring systems using IoT infrastructure Covers the full spectrum of physiological sensing, data acquisition, processing, and data security Provides relevant example applications demonstrating the benefits of technological advancements aiding disease prognosis This book serves as a beginner’s guide for engineering students of electrical and computer science, practicing engineers, researchers, and scientists who are interested in having an overview of pervasive health monitoring systems using body-worn sensors operating outside the hospital environment. It could also be recommended as a reference for a graduate or master’s level course on biomedical instrumentation and signal processing.
Evidence-Based Practice: An Implementation Guide for Healthcare Organizations was created to assist the increasing number of hospitals that are attempting to implement evidence-based practice in their facilities with little or no guidance. This manual serves as a guide for the design and implementation of evidence-based practice systems and provides practice advice, worksheets, and resources for providers. It also shows institutions how to achieve Magnet status without the major investment in consultants and external resources.
The Evidence-Based Nursing Series is co-published with SigmaTheta Tau International (STTI). The series focuses on implementingevidence-based practice in nursing and midwifery and mirrors theremit of Worldviews on Evidence-Based Nursing, encompassingclinical practice, administration, research and publicpolicy. Evaluating the Impact of Implementing Evidence-BasedPractice considers the importance of approaches to evaluate theimplementation of evidence-based practice. Outcomes of evidence-based practice can be wide ranging andsometimes unexpected. It is therefore important to evaluatethe success of any implementation in terms of clinical outcomes,influence on health status, service users and health policy andlong-term sustainability, as well as economic impacts. This, the third and final book in the series, looks at how best toidentify, evaluate and assess the outcomes of implementation ,reflecting a wide range of issues to consider and addresswhen planning and measuring outcomes. An informative, practical resource for an internationalreadership Providing critical evaluation of models and approaches tomeasuring outcomes Explores the importance of measuring successfulimplementation Examines outcomes in terms of long-term sustainability Addresses economic impacts and influence on healthpolicy Provides practice-based examples Written by a team of internationally respected authors