The Viral Spread of Health Care Financialization: Big Finance, Big Data, and Big Law

Five major technological changes will herald a new era in health care delivery around the World: digitalization of the personal health record, sharing of health care digital data across different platforms, applications and institutions, delivery of patient services via the internet, use of the digital media and social networking as a medium for education and preventive medicine and introduction of smart applications as counselors to prevent medical errors. The implications of such changes are huge. Saudi Arabia is not isolated from such important developments. This article explores the future of health care delivery with a special focus on the experience of a tertiary care center in Saudi Arabia that has led the wave in such changes regionally.

Recommendations of the American Academy of Nursing Conference participants

In addition to extending health insurance coverage, the Affordable Care Act of 2010 aims to improve quality of care and contain costs. To this end, the act allowed introduction of bundled payments for a range of services, proposed the creation of accountable care organizations (ACOs), and established the Centers for Medicare and Medicaid Innovation to test new care delivery and payment models. The ACO program began April 1, 2012, along with demonstration projects for bundled payments for episodes of care in Medicaid. Yet even before many components of the Affordable Care Act are fully in place, the Medicare ESRD Program has instituted legislatively mandated changes for dialysis services that resemble many of these care delivery reform proposals. The ESRD program now operates under a fully bundled, case-mix adjusted prospective payment system and has implemented Medicare's first-ever mandatory pay-for-performance program: the ESRD Quality Incentive Program. As ACOs are developed, they may benefit from the nephrology community's experience with these relatively novel models of health care payment and delivery reform. Nephrologists are in a position to assure that the ACO development will benefit from the ESRD experience. This article reviews the new ESRD payment system and the Quality Incentive Program, comparing and contrasting them with ACOs. Better understanding of similarities and differences between the ESRD program and the ACO program will allow the nephrology community to have a more influential voice in shaping the future of health care delivery in the United States.

Changing Image of Dental Practice

Big Law, Big Data. Special Issue - Comparative Law It is often claimed in the media and in political and academic debates that more law nurtures more research, which in turn should generate more information. However, the question researchers are left with is: What does this mean for comparative law and its methods? This paper takes the context of European consumer sales law as an example of the web of rules applicable at both European and national level. In this context, the main idea behind this article is that looking at law and research as data to be built upon and used in further analysis can revolutionise the way in which legal research is understood. This is because current research methods in European consumer sales law fall short of systematically analysing the essential weaknesses of the current regulation system. In this contribution, I argue that the volume of regulation in European consumer law is large enough for it to be considered Big Data and analysed in a way that can harness its potential in this respect. I exemplify this claim with a case-study consisting in the setting up of a Convergence Index that maps the converging effect of harmonizing policies adopted by the European legislator in the field of

Impact of Telemedicine Modalities on Equitable Access to Ambulatory Gastroenterology Care

Legal Governance of Brain Data Derived from Artificial Intelligence

The Managed Care Environment: Current and Future Trends

The extensive uptake of telehealth has considerably transformed health care delivery since the beginning of the COVID-19 pandemic and has imposed tremendous challenges to its large-scale implementation and adaptation. Given the shift in paradigm from telehealth as an alternative mechanism of care delivery to telehealth as an integral part of the health system, it is imperative to take a systematic approach to identifying barriers to, opportunities for, and the overall impact of telehealth implementation amidst the current pandemic. In this work, we apply a human factors framework, the Systems Engineering Initiative for Patient Safety model, to guide our holistic analysis and discussion of telehealth implementation, encompassing the health care work system, care processes, and outcomes.

Background:The aim of this study was to determine the impact of important social and technological trends on health care delivery, in the context of developing “Iran’s Health System Reform Plan by 2025”.Methods:A detailed review of the national and international literature was done to identify the main trends affecting health system. To collect the experts’ opinions about important trends and their impact on health care delivery, Focus Group Discussions (FGDs) and semi-structured in-depth interviews techniques were used. The study was based on the STEEP model. Final results were approved in an expert’s panel session.Results:The important social and technological trends, affecting health system in Iran in the next 15 years are demographic transition, epidemiologic transition, increasing bio-environmental pollution, increasing slums, increasing private sector partnership in health care delivery, moving toward knowledge-based society, development of information and communication technology, increasing use of high technologies in health system, and development of traditional and alternative medicine. The opportunities and threats resulting from the above mentioned trends were also assessed in this study.Conclusion:Increasing healthcare cost due to some trends like demographic and epidemiologic transition and uncontrolled increase in using new technologies in health care is one of the most important threats that the health system will be facing. The opportunities that advancement in technology and moving toward knowledge-based society create are important and should not be ignored.

Contemporary issues in nursing: patient safety, decision-making and social support in challenging economic times

This edited volume of original chapters brings together researchers from around the world who are exploring the facets of health care organization and delivery that are sometimes marginal to mainstream patient safety theories and methodologies but offer important insights into the socio-cultural and organizational context of patient safety. By examining these critical insights or perspectives and drawing upon theories and methodologies often neglected by mainstream safety researchers, this collection shows we can learn more about not only the barriers and drivers to implementing patient safety programmes, but also about the more fundamental issues that shape notions of safety, alternate strategies for enhancing safety, and the wider implications of the safety agenda on the future of health care delivery. In so doing, A Socio-cultural Perspective on Patient Safety challenges the taken-for-granted assumptions around fundamental philosophical and political issues upon which mainstream orthodoxy relies. The book draws upon a range of theoretical and empirical approaches from across the social sciences to investigate and question the patient safety movement. Each chapter takes as its focus and question a particular aspect of the patient safety reforms, from its policy context and theoretical foundations to its practical application and manifestation in clinical practice, whilst also considering the wider implications for the organization and delivery of health care services. Accordingly, the chapters each draw upon a distinct theoretical or methodological approach to critically explore specific dimensions of the patient safety agenda. Taken as a whole, the collection advances a strong, coherent argument that is much needed to counter some of the uncritical assumptions that need to be described and analyzed if patient safety is indeed to be achieved.

Partnerships between medical schools and their clinical associates, which we describe in this article as academic clinical partnerships (ACPs), are powerful economic and social actors through their roles as major employers and procurers of goods and services. A broad spectrum of effects extending beyond the tripartite mission shapes the social contract between ACPs and the communities they serve. The authors present a model for identifying and measuring effects across this spectrum and illustrate the model's application with reference to specific case studies set in the United Kingdom. This model categorizes effects into five different domains: economic, human capital, social capital, knowledge, and place. These different effects express themselves along a spatial scale that varies from the very local to the global. The authors describe the theoretical background for each domain, as well as the methods required to identify and measure effects. These methods range from a quantitative economic impact analysis using extended input-output models to qualitative methods to capture social capital and place effects. The authors demonstrate how leaders in academic medicine can use the model to build a holistic picture of the societal effects of ACPs. Evidence of impact is of value to ACP leaders in engaging with both national and local stakeholders, and the approach is likely transferable to different countries.

Byline: James. Antony The Health Care has an over-inclusive definition for This will hurt a huge number of victims of even minor illnesses and their families, because of the wide prevalence of stigma. There is no mention about the huge resource-mobilization that is required to realize various promises that the Bill is holding out. Without penal provisions that would force them to act, Government functionaries are unlikely to extend various promised services to concerned beneficiaries. Nor could patients and their families seek relief through courts of Law. A better approach to realize various objectives of the Bill is to have a precise and restrictive definition for That way, vast majority of victims of illness in the country would not be required to face problems. Enforcement of the Law will be easy and such an elaborate machinery, with Health Review Commission and District Health Boards, would not be required. Also, issues like Competence and Advance Directive will not be relevant any more. It is undesirable to have too many controls on the professional functioning of psychiatrists. By strengthening the State Health Authorities properly, all good objectives envisaged in the Bill can be achieved. The Mental Health Care Bill-2013 has already been cleared by the Parliamentary Standing Committee. Unfortunately, they have cleared it without remedying many defects and retaining many counter-productive provisions. In its present form, the Bill would have a negative impact on the future delivery of health care in the whole country. Unless health professionals in India take some effective action collectively and cure many serious deficiencies in this Bill, at least at this late stage, its repercussions on the future practice of psychiatry in this entire country would be terrible. The purported objective of the new Law is to provide remedy all inadequacies in the field of health and protect persons. For this, the primary strategy adopted by the authors of the Bill is to have an over-inclusive definition for mental illness. The one given in chapter I, section 1[r], of the Bill is a very broad one and is more like definitions given in textbooks or classification manuals. [sup][1] Based on this sweeping definition, the figure is just mind-boggling: On a modest estimate, at least 15% of the population or over 19,50,00,000-[195 million] persons in the country have a mental illness! Even persons with minor ailments are to be deemed as having mental illness, as per the proposed Law! Further, in chapter II section 3[2] the Bill advocates to follow internationally accepted medical standards for case-finding. [sup][1] These two positions taken in the Bill, namely an over-inclusive definition along with its liberal method of case-finding, makes one think that the authors of the Bill believe that just by bringing in more persons into the mental illness-group, their plight would improve! But unfortunately, this stand is diametrically opposite to that of the well-established position of professionals as well as policy-makers all over the world, on this issue. The widely accepted stand in this field is that a tag of mentally ill should be given only to the least number of persons! Such a restrictive view about illness is taken by thoughtful people all over the world based on their awareness about various stigma-related issues in the field of mental-health. Even in these modern times, once a person gets the label of mental patient he is treated as an outcast not just by the public, but even by governments! For the victim, that label would destroy his very sense of identity deep inside. And the family would go to any length, just to avoid others knowing it! They would keep away from institutions and even doctors who are known to treat illnesses! …

The field of clinical informatics (CI), and specifically the electronic health record, has been identified as a key facilitator to achieve a sustainable evidence-based health care system for the future.International graduate medical education (GME) programs have been challenged to ensure that their trainees are provided with appropriate skills to deliver effective and efficient health care in an evolving environment. This study explored how international emergency medicine (EM) specialist training standards address competencies and training in relevant areas of CI. A list of categories of CI competencies relative to EM was developed following a thematic review of published references documenting CI curriculum and competencies. Publicly available documents outlining core content, curriculum, and competencies from international organizations responsible for specialty GME and/or credentialing in EM for Australasia, Canada, Europe, the United Kingdom, and the United States were identified. These EM training standards were reviewed to identify inclusion of topics related to the relevant categories of CI competencies. A total of 23 EM curriculum documents were included in the review. Curricula content related to critical appraisal/evidence-based medicine, leadership, quality improvement, and privacy/security were included in all EM curricula. The CI topics related to fundamental computer skills, computerized provider order entry, and patient-centered informatics were only included in the EM curricula documents for the United States and were absent for the other jurisdictions. There is variation in the CI-related content of the international EM specialty training standards reviewed. Given the increasing importance of CI in the future delivery of health care, organizations responsible for training and credentialing specialist emergency physicians must ensure that their training standards incorporate relevant CI content, thus ensuring that their trainees gain competence in essential aspects of CI.