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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.
Examines the management of health care technology in 8 countries: Australia, Canada, France, Germany, the Netherlands, Sweden, the U.K & the U.S. Six technologies (or sets of technologies) -- including evaluation & management efforts & how the technologies diffused -- are presented & compared: treatments for coronary artery disease, imaging technologies (CT & MRI scanning), laparoscopic surgery, treatments for end-stage renal disease, neonatal intensive care, & breast cancer screening. Extensive bibliography for each country. Charts & tables.
This background paper is part of a larger study on International Differences in Health Care Technology and Spending, which consists of a series of back- ground papers. International Health Statistics: What the numbers mean for the United States was published in November 1993, and International Comparisons of Administrative Costs in Health Care appeared in September 1994. An additional background paper will report on lessons for the United States from a comparison; of hospital financing and spending in seven countries.
Based on careful analysis of burden of disease and the costs ofinterventions, this second edition of 'Disease Control Priorities in Developing Countries, 2nd edition' highlights achievable priorities; measures progresstoward providing efficient, equitable care; promotes cost-effectiveinterventions to targeted populations; and encourages integrated effortsto optimize health. Nearly 500 experts - scientists, epidemiologists, health economists,academicians, and public health practitioners - from around the worldcontributed to the data sources and methodologies, and identifiedchallenges and priorities, resulting in this integrated, comprehensivereference volume on the state of health in developing countries.
To explore how the use of technology can facilitate progress toward globally recognized health priorities, the Forum on Publicâ€"Private Partnerships for Global Health and Safety organized a public workshop. Participants identified and explored the major challenges and opportunities for developing and implementing digital health strategies within the global, country, and local context, and framed the case for cross-sector and cross-industry collaboration, engagement, and investment in digital health strategies. This publication summarizes the presentations and discussions from the workshop.
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.
All too frequently, the largest effective barrier to interdisciplinary communication is jargon. The symposium whose proceedings appear in the following pages sought, of course, to eliminate unnecessary and obscurantist jargon; but it sought also to do something far more ambitious - to confront the intellectual issues that are attached to the use of the word "evaluation" in medicine and health services. To this end a carefully selected group of experts in medicine, epidemiology, and health econom ics was invited to present papers. They were selected for their reputations either as conceptualizers or as empirical evaluators, or - the rarest breed of expert - as both. The context was to be empirical. Three procedures were selected that had been subject to evaluation but that posed rather different types of problem. The first was the treatment of renal failure by dialysis of various kinds. This has a relatively long history of evaluation, with a large literature, and particularly raises broad policy is sues within the health services of Western societies as to - the size of programmes to be provided; the type, location, and mix of treatments; the selection of patients to receive treatment; and the measurement of the success of various strategies. The second was the treatment of duodenal ulcer by a new species of drug - the hista mine Hrreceptor antagonists (specifically, cimetidine).