4,432 research outputs found
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Digital Orthopaedics: A Glimpse Into the Future in the Midst of a Pandemic.
BackgroundThe response to COVID-19 catalyzed the adoption and integration of digital health tools into the health care delivery model for musculoskeletal patients. The change, suspension, or relaxation of Medicare and federal guidelines enabled the rapid implementation of these technologies. The expansion of payment models for virtual care facilitated its rapid adoption. The authors aim to provide several examples of digital health solutions utilized to manage orthopedic patients during the pandemic and discuss what features of these technologies are likely to continue to provide value to patients and clinicians following its resolution.ConclusionThe widespread adoption of new technologies enabling providers to care for patients remotely has the potential to permanently change the expectations of all stakeholders about the way care is provided in orthopedics. The new era of Digital Orthopaedics will see a gradual and nondisruptive integration of technologies that support the patient's journey through the successful management of their musculoskeletal disease
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Equivalent Mid-Term Results of Open vs Endoscopic Gluteal Tendon Tear Repair Using Suture Anchors in Forty-Five Patients.
BackgroundLittle is known about the relative efficacy of open (OGR) vs endoscopic (EGR) gluteal tendon repair of gluteal tendon tears in minimizing pain and restoring function. Our aim is to compare these 2 surgical techniques and quantify their impact on clinical outcomes.MethodsAll patients undergoing gluteal tendon tear repair at our institution between 2015 and 2018 were retrospectively reviewed. Pain scores, limp, hip abduction strength, and the use of analgesics were recorded preoperatively and at last follow-up. The Hip disability and Osteoarthritis Outcome Score Junior and Harris Hip Score Section1 were obtained at last follow-up. Fatty degeneration was quantified using the Goutallier-Fuchs Classification (GFC). Statistical analysis was conducted using one-way analysis of variance and t-tests.ResultsForty-five patients (mean age 66, 87% females) met inclusion criteria. Average follow-up was 20.3 months. None of the 10 patients (22%) undergoing EGR had prior surgery. Of 35 patients (78%) undergoing OGR, 12 (27%) had prior hip replacement (75% via lateral approach). The OGRs had more patients with GFC ≥2 (50% vs 11%, P = .02) and used more anchors (P = .03). Both groups showed statistical improvement (P ≤ .01) for all outcomes measured. GFC >2 was independently associated with a worst limp and Harris Hip Score Section 1 score (P = .05). EGR had a statistically higher opioid use reduction (P < .05) than OGR. Other comparisons between EGR and OGR did not reach statistical significance.ConclusionIn this series, open vs endoscopic operative approach did not impact clinical outcomes. More complex tears were treated open and with more anchors. Fatty degeneration adversely impacted outcomes. Although further evaluation of the efficacy of EGR in complex tears is indicated, both approaches can be used successfully
Influence of Information System on Emergency Department Shift Leaders’ Mobility
Emergency departments are hospital units for patients, who need emergency and acute care. Due to the state of patients, shift leader nurses and physicians need to do important decisions concerning patients’ treatment and care, quickly and efficiently. To be able to do that, they have to get needed information easily and efficiently. That is called knowledge-based leadership. When knowledge-based leadership is successful, the organisations’ information and knowledge are processed in a way, that they may be exploited in a best possible way.
Unfortunately, nowadays the situation is not ideal in emergency departments, even though a lot of money has been invested in new information systems. Staff dissatisfaction with existing information systems have been reported and can be seen on staff satisfaction. On the other hand, there is not much research on how the information systems impact on shift leader nurses’ and physicians’ work.
A quasi-experimental study was done in the years 2015 – 2016 in emergency departments in three central hospitals in Finland exploring the movement patterns of the shift leader professionals before and after implementation of a new information system in on unit, called intervention unit. Data was collected with Bluetooth beacons installed in different hospital rooms and corridors and with smartphones carried by shift leader nurses and physicians. Improving the knowledge management of leaders with new information systems, it is expected, that it decreases the effort needed to seek information to support decision-making. However, the result was not so unambiguous. The movement patterns changed, but they changed also in control units.
A new information system can influence on hospital leader shift personnel mobility. Unfortunately, the lack of data made it impossible to count and compare actual walked distances. There should be more data – that is – from every day, every shift and every shift leader professional around the clock. Only that way, the comparison would be reliable. The mobility data from hospitals was already collected, when this thesis was written, so collecting the data was not part of this thesis.
Keywords: information system evaluation, indoor positioning, Bluetooth beaco
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Visualizing pain data for wheelchair users: A ubiquitous approach
Copyright @ 2005 Rinton PressWe describe a wireless enabled solution for the vizualisation of pain data. Our approach uses pain drawings to record spatial location and type of pain and enables data collection with appropriate time stamping, thus providing a means for the seldom-recorded (but often attested) time-varying nature of pain, with consequential impact on monitoring the effectiveness of patient treatment regimes. Moreover, since the implementation platform of our solution is that of a Personal Digital Assistant (PDA), data collection takes place ubiquitously, providing back pain sufferers with mobility problems (such as wheelchair users) with a convenient means of logging their pain data and of seamlessly uploading it to a hospital server using WiFi technology. Stakeholder results show that, notwithstanding problems related to PDA data input, our approach is generally perceived to be an easy to use and convenient solution to the challenges of
anywhere/anytime data collection
Design criteria for Indoor Positioning Systems in hospitals using technological, organizational and individual perspectives
This dissertation considers three different studies that handle Indoor Positioning Systems (IPS) in hospitals. Study 1 uses the Reasoned Action Approach by questioning hospital visitors and employees about their intention to use IPS in hospitals. Study 2 reviews IPS in hospitals. Study 3 is based on the results of the first two studies. It handles expert interviews that were conducted with different hospitals and IPS developers to evaluate the determined propositions. Then, the insights were used to conduct and evaluate experiments by testing an ultrasound-based IPS for hospitals
Asthma Prevalence: Focus on Prevention Management in Community Settings
Asthma prevalence continues to increase across the United States of America, affecting more than 43.1 million people and projected to affect over 50 million people by 2025. Asthma prevalence differs by demographic characteristics, such as race, ethnicity, socio-economic status, education, age and gender. Poor quality of life is common among people who suffer from asthma, in addition to school and work absenteeism. In 2008, children 5-17 years old with at least one reported asthma attack missed 10.5 million school days in the past year (CDC, 2010). Healthcare use for asthma is high and disparities remain in asthma healthcare use and reimbursement. In community settings, reimbursement for asthma education and prevention has been problematic due to current reimbursement mechanisms (Bodenheimer et al. (2003); Halterman (2010); CDC (2011) and Laster et al. 2010) that do not go far enough in assisting low-income communities manage their asthma medically nor have uniform standards for billable services associated with asthma management provided by both healthcare professionals and public health workers. A change in reimbursement policy is advocated and the evidence for the effectiveness of community health workers in asthma management is examined
The Changing Roles of Community Health Workers
Community Health Workers (CHWs) have been gaining attention from policymakers because of their unique role in addressing health disparities and socioeconomic drivers of disease, and because of their potential integration into the health care delivery system. To date, there has been limited research specifically describing the variation in CHWs’ roles and relationships, and how that variation relates to management, to financing, to health system integration, and to the competencies CHWs should have in different contexts. This report provides a snapshot of the varied landscape of CHW programs to better understand how CHWs are integrating with the health system both in terms of the structural elements of these programs, and the relational elements of CHW-health system interaction that make integrated models succeed. Authors suggest that there is no blueprint for success; rather, there are certain unifying structural elements of various integration types, and certain useful mechanisms that enable the preservation of the CHW concept
Supporting active and healthy aging with advanced robotics integrated in smart environment
The technological advances in the robotic and ICT fields represent an effective solution to address specific societal problems to support ageing and independent life. One of the key factors for these technologies is the integration of service robotics for optimising social services and improving quality of life of the elderly population. This chapter aims to underline the barriers of the state of the art, furthermore the authors present their concrete experiences to overcome these barriers gained at the RoboTown Living Lab of Scuola Superiore Sant'Anna within past and current projects. They analyse and discuss the results in order to give recommendations based on their experiences. Furthermore, this work highlights the trend of development from stand-alone solutions to cloud computing architecture, describing the future research directions
Advancing Community Health Worker Practice and Utilization: The Focus on Financing
There is a growing interest in the use of community health workers in various roles in the US health care system. These workers go by various titles and names -- including promotora and community health advisor -- but all assist members of the communities they serve. As the role of these workers becomes more accepted and desirable in the overall system of care, they face the challenges of moving from being an exceptional add-on to the system to being more a part of the mainstream. Issues such as educational preparation, formal credentialing, licensure and compensation are all part of this process. In particular, various organizations are interested in but challenged by the need for sustainable financing of the CHW position. It is time to explore and develop viable financing arrangements that go beyond short-term grants.To address these concerns, this research was undertaken to study sustainable financing mechanisms for community health workers. The focus is on existing and emerging funding, reimbursement and payment policies for community health workers. The study seeks to identify promising examples and models of payment programs for community health workers generally in the United States. To the authors' knowledge, this is the first national project with this exclusive focus.The audiences for this report include community health workers, directors of programs that employ or work with community health workers, and administrators of public and private coverage programs such as health plans, insurance companies and state Medicaid programs seeking options for improving health care access and quality at the same or lower costs. Businesses, non-profit organizations and consumers exploring the possibilities of using the services community health workers could provide might also be interested in the findings
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