Communicating the Value Contributions of Pathology and Laboratory Medicine (PaLM) to Healthcare Administrators, Evidence of Value from a Multiple Cases Study

Hospital administrators were interviewed to explore their perceptions of the strategic alignment of PaLM value-based activities (VBAs). Hospital based PaLM leaders were interviewed to explore their communication of the VBAs. This study identified a misalignment between the assessments utilized by healthcare administrators for PaLM services and the value contributions of laboratorians. PaLM leaders offered insight into the laboratory’s value chain. Three themes emerged from the data: PaLM VBAs, PaLM communication efforts, and PaLM VBA strategic alignment. Together these findings suggest that hospital laboratorians offer untapped value in healthcare, and hospital administrators failing to recognize this value miss opportunities to improve value and capture cost savings. Suggestions to improve the communication of PaLM VBAs and the perceptions of hospital administrators are made

SUPPORTING THE THERAPIST IN ONLINE THERAPY

In the last decade, eSupport (Internet-reliant therapy) has gained substantial attention, both in research and practice. Several studies in psychology show that structured eSupport (e.g. Computerized Cognitive Behavioural Therapy), is promising both with regard to therapeutic efficacy and cost-effectiveness. However, the transition from face-to-face therapy to eSupport creates new challenges for therapists, such as lack of (traditional) structure and access to secondary information (e.g. body language) about their patients. In this paper, a design science research approach has been employed in the context of eSupport. Drawing on the knowledge base of face-to-face conversations, face-to-face therapy, and pragmatic IS theory, a framework for patient indicators has been designed. The design has been justified through both (i) descriptive evaluations based on the selected knowledge base, and (ii) experiences collected in a stakeholder-centric design process, including experimental evaluation of an eSupport platform that implement the indicator framework. The framework was designed to allow new indicators to be ?plugged in? dynamically and inserted into tailorable lists. New indicators can be created either through specialization of an indicator base class, or by configuring metadata for generic indicators that tap into an action log. Indicator values are cached, both to boost performance and to support trend analysis of patient indicators. We conclude that the indicator framework serves to improve support for therapists: It offers structure and access to both primary and secondary information in new ways. In doing so, it meets some of the key challenges that therapists encounter in the transition to eSupport

Responding to COVID – 19: Insight Into Capability Re-Configuration of Healthcare Service Ecosystems? The Use Case of Hospitalization at Home

An effective Healthcare Service Ecosystem must emphasize the notion of well-being co-creation which entails a dynamic interplay of actors, in face of the challenges, with their ability to use the available resource pools, at the different system levels. An appropriate response, largely avoiding any crisis, depends on a society's resilience and the related response of actors in the reconfiguration of resources. Originally considered luxury and for the fortunate few who could afford the learning curve, Hospitalization-at-Home (HaH) recently approached a new normal with a positive impact to health outcomes. Nowadays, hospitals have had to reconfigure their health services to reduce the workload of caregivers during the COVID-19 outbreak. We show an example of how HaH can be a viable re-configuration of Healthcare Service Ecosystems and a use case for capability reconfiguration. Our use case can be a lesson for the adaptation of technology for patient empowerment allowing patients to interact with their care ecosystem while at their home

Taking equity into consideration in economic evaluations of health interventions and other priority-setting tools

Priority setting in Health is a complex task that needs to be based on explicit criteria. While economic evaluations fulfil these requirements, the still remain further shortcomings in the current theory and practice of economic evaluation. One of them, which has attracted the interest of health economists and other professionals, refers to the equity dimension of health. A large amount of the literature reviewed in this paper addresses methodological solutions for addressing distributional concerns in economic evaluations. Yet, even though most authors agree with the general aim of reducing health inequalities, practical implementation issues that should inform policy are far from clear. This document will be followed by recommendations on further research [Abstr. p. 4] [Contents] 1. - Introduction. - 2. - Economic evaluations : 2.1 Different types. 2.2 Methodological and practical issues. 2.3 Shortcomings regarding the equity dimension. - 3. - Equity : 3.1 Rationale and definition. 3.2 Different types and practical implementation issues. 3.3 Measures of inequity. 3.4 Which principle(s) should prevail ? - 4. - Priority setting and equity concerns : 4.1 Equity weighted utility gains. 4.2 Cost-value analysis. 4.3 Frameworks for equitable allocation decisions. - 5 - Recommendations for future research. - 6 Conclusio

A model not a prophet:Operationalising patient-level prediction using observational data networks

Improving prediction model developement and evaluation processes using observational health data

A model not a prophet:Operationalising patient-level prediction using observational data networks

Improving prediction model developement and evaluation processes using observational health data

Workplace-based assessment in Chinese medicine: a case study viewing Competency- Based Medical Education through a Practice Theory Lens

This thesis explores how workplace-based assessment (WBA) was being conducted in three institutions in different Western countries training students to be practitioners of Chinese Medicine. While competency-based medical education (CBME) as a curriculum model is being globalised, the literature on its application to WBA shows a tension between standardization and authenticity and between atomization and holism. The aim of this thesis was to understand how the constructs of CBME were being enacted and how they might be constraining or enabling WBA in these institutions. Using a multiple embedded case-study design I explored WBA through data gathered from the relevant accreditation documents in each country, institutional documents and interviews with managers and clinical supervisors. My analysis revealed that the different stakeholders manifested quite different stories of assessment. In the accreditation and institutional documents the discourse of measurement predominated; in contrast, while the managers were leaning towards standardization and objectivity, they were also aware of a more complex assessment culture. For the clinical supervisors the psychometric grades being enacted could not be seen as a legitimate measure of objectivity as the authentic and holistic constructs of CBME dominated. The thesis draws on Schatzki’s ‘practice turn’ as an interpretive lens. By viewing WBA as a socio-cultural-material, embodied and interactive phenomenon I show that it was the inter-relationships between institutionalized and disciplinary discourses; between standardized and personalized competencies; between educational and practitioner identities; and the entanglement of artefacts and spatio-temporal arrangements, that enabled or constrained how WBA was enacted. Through this analysis I argue that an understanding of how different assemblances lead to different enactments opens up possibilities of how to develop legitimate and workable assessment processes not just for Chinese medicine but any health profession

Decoding Data Products through the Lens of Work System Theory

Data products are seen as important levers in repurposing the large volumes of data that are captured in organizations and in satisfying the increasing demand for analytics. Despite the increasing popularity of the data product concept, it remains unclear how data can be productized. This article proposes work system theory to study the implications data products have for how organizations manage their data. Adopting a multimethod approach involving case studies and focus groups, we identify three types of data products and analyze how organizations coordinate their resources to build work systems around each data product type. Our findings contribute to the ongoing discourse on scaling data and analytics capabilities to repurpose and consume data effectively