Health Care Opinion Leaders' Views on Delivery System Innovation and Improvement

Presents survey results on healthcare experts' views on strategies and models for fostering coordination and integration, such as accountable care systems, medical homes, and bundled payments; priorities among reform provisions; and market concerns

Trumping communitarianism: crime control and forensic DNA typing and databasing in Singapore

Liberalism and communitarianism have figured prominently in discussions of how to govern forensic DNA practices (forensic DNA typing and databasing). Despite the prominence of these two political philosophies and their underlying values, no studies have looked at the governance of forensic DNA practices in a nondemocratic country governed by a communitarian logic. To fill this lacuna in the literature, this article considers Singapore as an authoritarian state governed by a communitarian philosophy. The article highlights basic innovations and technologies of forensic DNA practices and articulates a liberal democratic version of “biolegality” as described by Michael Lynch and Ruth McNally. It goes on to consider briefly various (political) philosophies (liberalism and communitarianism) and law enforcement models (due process and crime control models). The main part of the article records the trajectory, and hence biolegal progress, of forensic DNA practices in Singapore and compares it with trajectories in England and the United States. The article concludes that Singapore's forensic DNA practices are organized according to the crime control model and therefore safety and the war against crime and terrorism trump individual rights and legal principles such as privacy, bodily integrity, proportionality, presumption of innocence. and onus of proof

Financial Regulation and Transparency of Information: first steps on new land

This article examines the relationship between the level of regulation and transparency of financial institutions from 37 countries and the impacts of the subprime crisis on the stock market, through a regulation and transparency index. Furthermore, with the objective of detecting reasons for the success of some emerging economies in avoiding the crisis, empirical evidence for the presence of market discipline in the Brazilian banking industry is shown. The results are that a higher degree of regulation and transparency is related to higher returns and lower volatility in the stock market during the subprime crisis. Moreover, one of the main reasons for the apparent success of the Brazilian case in facing the crisis is the combination of a strong regulation of the financial system and the presence of market discipline.

Health Insurance Exchanges in Health Care Reform: Legal and Policy Issues

Examines the role of health insurance exchanges in a reformed healthcare system, reviews past experiences with exchanges, compares the House and Senate bills' approaches to the exchanges' design and function, and discusses the policy issues they raise

Artificial Intelligence and Patient-Centered Decision-Making

Advanced AI systems are rapidly making their way into medical research and practice, and, arguably, it is only a matter of time before they will surpass human practitioners in terms of accuracy, reliability, and knowledge. If this is true, practitioners will have a prima facie epistemic and professional obligation to align their medical verdicts with those of advanced AI systems. However, in light of their complexity, these AI systems will often function as black boxes: the details of their contents, calculations, and procedures cannot be meaningfully understood by human practitioners. When AI systems reach this level of complexity, we can also speak of black-box medicine. In this paper, we want to argue that black-box medicine conflicts with core ideals of patient-centered medicine. In particular, we claim, black-box medicine is not conducive for supporting informed decision-making based on shared information, shared deliberation, and shared mind between practitioner and patient

Lost in Translation: Piloting a Novel Framework to Assess the Challenges in Translating Scientific Uncertainty From Empirical Findings to WHO Policy Statements.

BACKGROUND:Calls for evidence-informed public health policy, with implicit promises of greater program effectiveness, have intensified recently. The methods to produce such policies are not self-evident, requiring a conciliation of values and norms between policy-makers and evidence producers. In particular, the translation of uncertainty from empirical research findings, particularly issues of statistical variability and generalizability, is a persistent challenge because of the incremental nature of research and the iterative cycle of advancing knowledge and implementation. This paper aims to assess how the concept of uncertainty is considered and acknowledged in World Health Organization (WHO) policy recommendations and guidelines. METHODS:We selected four WHO policy statements published between 2008-2013 regarding maternal and child nutrient supplementation, infant feeding, heat action plans, and malaria control to represent topics with a spectrum of available evidence bases. Each of these four statements was analyzed using a novel framework to assess the treatment of statistical variability and generalizability. RESULTS:WHO currently provides substantial guidance on addressing statistical variability through GRADE (Grading of Recommendations Assessment, Development, and Evaluation) ratings for precision and consistency in their guideline documents. Accordingly, our analysis showed that policy-informing questions were addressed by systematic reviews and representations of statistical variability (eg, with numeric confidence intervals). In contrast, the presentation of contextual or "background" evidence regarding etiology or disease burden showed little consideration for this variability. Moreover, generalizability or "indirectness" was uniformly neglected, with little explicit consideration of study settings or subgroups. CONCLUSION:In this paper, we found that non-uniform treatment of statistical variability and generalizability factors that may contribute to uncertainty regarding recommendations were neglected, including the state of evidence informing background questions (prevalence, mechanisms, or burden or distributions of health problems) and little assessment of generalizability, alternate interventions, and additional outcomes not captured by systematic review. These other factors often form a basis for providing policy recommendations, particularly in the absence of a strong evidence base for intervention effects. Consequently, they should also be subject to stringent and systematic evaluation criteria. We suggest that more effort is needed to systematically acknowledge (1) when evidence is missing, conflicting, or equivocal, (2) what normative considerations were also employed, and (3) how additional evidence may be accrued

Medicaid's Role in the Health Benefits Exchange: A Road Map for States

Examines issues for integrating Medicaid into the administration, operation, and coverage continuum of insurance exchanges. Discusses eligibility, enrollment, and outreach; contracting, standards, and requirements; benefits design; and infrastructure

A National Dialogue on Health Information Technology and Privacy

Increasingly, government leaders recognize that solving the complex problems facing America today will require more than simply keeping citizens informed. Meeting challenges like rising health care costs, climate change and energy independence requires increased level of collaboration. Traditionally, government agencies have operated in silos -- separated not only from citizens, but from each other, as well. Nevertheless, some have begun to reach across and outside of government to access the collective brainpower of organizations, stakeholders and individuals.The National Dialogue on Health Information Technology and Privacy was one such initiative. It was conceived by leaders in government who sought to demonstrate that it is not only possible, but beneficial and economical, to engage openly and broadly on an issue that is both national in scope and deeply relevant to the everyday lives of citizens. The results of this first-of-its-kind online event are captured in this report, together with important lessons learned along the way.This report served as a call to action. On his first full day in office, President Obama put government on notice that this new, more collaborative model can no longer be confined to the efforts of early adopters. He called upon every executive department and agency to "harness new technology" and make government "transparent, participatory, and collaborative." Government is quickly transitioning to a new generation of managers and leaders, for whom online collaboration is not a new frontier but a fact of everyday life. We owe it to them -- and the citizens we serve -- to recognize and embrace the myriad tools available to fulfill the promise of good government in the 21st Century.Key FindingsThe Panel recommended that the Administration give stakeholders the opportunity to further participate in the discussion of heath IT and privacy through broader outreach and by helping the public to understand the value of a person-centered view of healthcare information technology

Sustainable Development Report: Blockchain, the Web3 & the SDGs

This is an output paper of the applied research that was conducted between July 2018 - October 2019 funded by the Austrian Development Agency (ADA) and conducted by the Research Institute for Cryptoeconomics at the Vienna University of Economics and Business and RCE Vienna (Regional Centre of Expertise on Education for Sustainable Development).Series: Working Paper Series / Institute for Cryptoeconomics / Interdisciplinary Researc

Sustainable Development Report: Blockchain, the Web3 & the SDGs

This is an output paper of the applied research that was conducted between July 2018 - October 2019 funded by the Austrian Development Agency (ADA) and conducted by the Research Institute for Cryptoeconomics at the Vienna University of Economics and Business and RCE Vienna (Regional Centre of Expertise on Education for Sustainable Development).Series: Working Paper Series / Institute for Cryptoeconomics / Interdisciplinary Researc