Who approves/pays for additional monitoring?

Major considerations in the provision of healthcare are availability, affordability, accessibility, and appropriateness, especially in the setting of heart failure where disease burden is growing, developments have been rapid and newer biomarkers, diagnostic and imaging techniques, monitoring systems, devices, procedures, and drugs have all been developed in a relatively short period of time. Many monitoring and diagnostic systems have been developed but the disproportionate cost of conducting trials of their effectiveness has limited their uptake. There are added complexities, in that the utilization of doctors for the supervision of the monitoring results may be optimal in one setting and not in another because of differences in the characteristics of organization of healthcare provision, making even interpretation of the trials we have had, still difficult to interpret. New technologies are continuously changing the approach to healthcare and will reshape the structure of the healthcare systems in the future. Mobile technologies can empower patients and carers by giving them more control over their health and social care needs and reducing their dependence on healthcare professionals for monitoring their health, but a significant problem is the integration of the multitude of monitored parameters with clinical data and the recognition of intervention thresholds. Digital technology can help, but we need to prove its cost/efficacy and how it will be paid for. Governments in many European countries and worldwide are trying to establish frameworks that promote the convergence of standards and regulations for telemedicine solutions and yet simultaneously health authorities are closely scrutinizing healthcare spending, with the objective of reducing and optimizing expenditure in the provision of health services. There are multiple factors to be considered for the reimbursement models associated with the implementation of physiological monitoring yet it remains a challenge in cash-strapped health systems

NH Department of Helath and Human Services Public Health Laboratories Shellfish Program Activites January 2006 – December 2006

The Department of Health and Human Services-New Hampshire Public Health Laboratories (DHHS-NHPHL) has continued to carry out various actions providing laboratory analyses for the routine water quality monitoring, “Red Tide” monitoring, and additional testing after rainfall, excess sewage treatment plant, and emergency events

NH Department of Health and Human Services Public Health Laboratories Shellfish Program 2005

The Department of Health and Human Services-New Hampshire Public Health Laboratories (DHHS-NHPHL) has continued to carry out various actions providing laboratory analyses for the routine water quality monitoring, “Red Tide” monitoring, and additional testing after rainfall, excess sewage treatment plant, and emergency events. Also, a validation study was performed using non-EPA funds to compare results between the traditional Paralytic Shellfish Poison bioassay and a newer developed test allowed for screening use

Timing of Verification Procedures: Monitoring versus Auditing

This paper studies the strategic effect of a difference in timing of verification in an agency model. A principal may choose between two equally efficient verification procedures: monitoring and auditing. Under auditing the principal receives additional information. Due to a double moral hazard problem, there exists a tension between incentives for effort and incentives for verification. Auditing exacerbates this tension and, consequently, requires steeper incentive schemes than monitoring. Hence, auditing is suboptimal if 1) steep incentives structures are costly to implement due to bounded transfers, or 2) steep incentive schemes induce higher rents due to limited liability. verification in an agency model. A principal may choose between two equally efficient verification procedures: monitoring and auditing. Under auditing the principal receives additional information. Due to a double moral hazard problem, there exists a tension between incentives for effort and incentives for verification. Auditing exacerbates this tension and, consequently, requires steeper incentive schemes than monitoring. Hence, auditing is suboptimal if 1) steep incentives structures are costly to implement due to bounded transfers, or 2) steep incentive schemes induce higher rents due to limited liability.timing of verification; double moral hazard; monitoring; auditi

NH Department of Health and Human Services Public Health Laboratories Shellfish Program Activities January 2005 - December 2005

The Department of Health and Human Services-New Hampshire Public Health Laboratories (DHHS-NHPHL) has continued to carry out various actions providing laboratory analyses for the routine water quality monitoring, “Red Tide” monitoring, and additional testing after rainfall, excess sewage treatment plant, and emergency events. Also, a validation study was performed using non-EPA funds to compare results between the traditional Paralytic Shellfish Poison bioassay and a newer developed test allowed for screening use

Protocol of the SOMNIA project : an observational study to create a neurophysiological database for advanced clinical sleep monitoring

Introduction Polysomnography (PSG) is the primary tool for sleep monitoring and the diagnosis of sleep disorders. Recent advances in signal analysis make it possible to reveal more information from this rich data source. Furthermore, many innovative sleep monitoring techniques are being developed that are less obtrusive, easier to use over long time periods and in the home situation. Here, we describe the methods of the Sleep and Obstructive Sleep Apnoea Monitoring with Non-Invasive Applications (SOMNIA) project, yielding a database combining clinical PSG with advanced unobtrusive sleep monitoring modalities in a large cohort of patients with various sleep disorders. The SOMNIA database will facilitate the validation and assessment of the diagnostic value of the new techniques, as well as the development of additional indices and biomarkers derived from new and/or traditional sleep monitoring methods. Methods and analysis We aim to include at least 2100 subjects (both adults and children) with a variety of sleep disorders who undergo a PSG as part of standard clinical care in a dedicated sleep centre. Full-video PSG will be performed according to the standards of the American Academy of Sleep Medicine. Each recording will be supplemented with one or more new monitoring systems, including wrist-worn photoplethysmography and actigraphy, pressure sensing mattresses, multimicrophone recording of respiratory sounds including snoring, suprasternal pressure monitoring and multielectrode electromyography of the diaphragm

Establishing the reach of Cheshire Children's Fund: April 2006 - March 2007

Monitoring and evaluation is a significant and obligatory element of Children’s Fund projects nationwide, with statutory returns made to the Department for Children, Schools and Families. The aim of the additional monitoring work commissioned by Cheshire Children’s Fund and carried out by the Centre for Public Health Research was to provide a more detailed picture of the children who had been referred to services, and for what reasons. This was made possible through the development of a system to track individuals and capture routine service data.Cheshire Children’s Fun