Legal Implications of Clinical Investigation

There is an increasing concern among the members of the medical profession with legal rights, obligations and limitations affecting clinical investigation. This is understandable in light of the virtual explosion of clinical investigation within medical science. Clinical investigation is the systematic collection, evaluation and reporting, by or under the supervision of physicians, of data about other human beings for the purpose of advancing scientific medical knowledge. Thus it includes neither investigation relating to animals (even though such investigation may also advance scientific medical knowledge), nor investigation of human beings for purposes unrelated to medical science, nor the trial of unproven procedures in the treatment of patients unless this is also a part of a systematic program of clinical investigation. Nevertheless, clinical investigation need not occur within the physician-patient relationship, which arises when a person seeks and a physician undertakes to furnish medical diagnosis or treatment. For example, a person who volunteers as a subject of clinical investigation does not have a physician-patient relationship with a physician who does not undertake to furnish him any medical benefit

Legal Implications of Clinical Investigation

There is an increasing concern among the members of the medical profession with legal rights, obligations and limitations affecting clinical investigation. This is understandable in light of the virtual explosion of clinical investigation within medical science. Clinical investigation is the systematic collection, evaluation and reporting, by or under the supervision of physicians, of data about other human beings for the purpose of advancing scientific medical knowledge. Thus it includes neither investigation relating to animals (even though such investigation may also advance scientific medical knowledge), nor investigation of human beings for purposes unrelated to medical science, nor the trial of unproven procedures in the treatment of patients unless this is also a part of a systematic program of clinical investigation. Nevertheless, clinical investigation need not occur within the physician-patient relationship, which arises when a person seeks and a physician undertakes to furnish medical diagnosis or treatment. For example, a person who volunteers as a subject of clinical investigation does not have a physician-patient relationship with a physician who does not undertake to furnish him any medical benefit

\u3ci\u3eMedicine Meets Virtual Reality 17\u3c/i\u3e

Chapter, A Virtual Reality Training Program for Improvement of Robotic Surgical Skills, co-authored by Mukul Mukherjee and Nicholas Stergiou, UNO faculty members. Chapter, Consistency of Performance of Robot-Assisted Surgical Tasks in Virtual Reality, co-authored by Mukul Mukherjee and Nicholas Stergiou, UNO faculty members. The 17th annual Medicine Meets Virtual Reality (MMVR17) was held January 19-22, 2009, in Long Beach, CA, USA. The conference is well established as a forum for emerging data-centered technologies for medical care and education. Each year, it brings together an international community of computer scientists and engineers, physicians and surgeons, medical educators and students, military medicine specialists and biomedical futurists. MMVR emphasizes inter-disciplinary collaboration in the development of more efficient and effective physician training and patient care. The MMVR17 proceedings collect 108 papers by conference lecture and poster presenters. These papers cover recent developments in biomedical simulation and modeling, visualization and data fusion, haptics, robotics, sensors and other related information-based technologies. Key applications include medical education and surgical training, clinical diagnosis and therapy, physical rehabilitation, psychological assessment, telemedicine and more. From initial vision and prototypes, through assessment and validation, to clinical and academic utilization and commercialization - MMVR explores the state-of-the-art and looks toward healthcare’s future. The proceedings volume will interest physicians, surgeons and other medical professionals interested in emerging and future tools for diagnosis and therapy; educators responsible for training the next generation of doctors and scientists; IT and medical device engineers creating state-of-the-art and next-generation simulation, imaging, robotics and communication systems; data technologists creating systems for gathering, processing and distributing medical intelligence; military medicine specialists addressing the challenges of warfare and defense health needs; and biomedical futurists and investors who want to understand where the field is headed.https://digitalcommons.unomaha.edu/facultybooks/1233/thumbnail.jp

ITC SOLUTIONS TO ACHIEVE PERFORMANCE AND EFFICIENCY OF HEALTH SERVICES:ONLINE VIRTUAL CLINIC

The digital era modified the way people work, how the information and the informational resources are defined and organized. The organization which holds, uses and correctly reproduces the piece of information, the knowledge, the intellectual capital, becomes a leader in the proper field of activity. Following the actual tendencies in the digital era connected to the exchange of professional information, I can say that the exchange and sharing of digital information in a global multitude of interconnected computers are essential instruments that can contribute to the development and consolidation of the intellectual potential of the organization. This is why, the access of the individuals to information is an actual requirement of the development of the Romanian society in the context of globalization and world implication o contemporary processes and phenomena. The Digital integration eliminates the barriers that traditionally suppress the circuit of the medical information, lets the goods and services circulate to and from Romania by promoting efficiency as final purpose. Performance is needed in the health system, the transformation of the system of medical services by bringing the benefits of the medical science and technology to all individuals from every community. In order to accomplish these expectations it is needed that all the components that form the health system look at it as a whole and subscribe to modern solutions for improvement so that the quality of health should raise to an unprecedented level. Even if health systems differ from country to country from the organizational and financial point of view, they face the same challenges and problems, respectively the supply of medical care of better quality and keeping under control the health expenses. The use of information and communication technology in the field of medical assistance in order to stock, share, transmit and analyze clinical data and knowledge is more necessary than ever.Internet, communication in real time, health system, medical information system, digital integration, virtual medical assistance, virtual clinic, shared medical information

A service oriented approach for guidelines-based clinical decision support using BPMN

Evidence-based medical practice requires that clinical guidelines need to be documented in such a way that they represent a clinical workflow in its most accessible form. In order to optimize clinical processes to improve clinical outcomes, we propose a Service Oriented Architecture (SOA) based approach for implementing clinical guidelines that can be accessed from an Electronic Health Record (EHR) application with a Web Services enabled communication mechanism with the Enterprise Service Bus. We have used Business Process Modelling Notation (BPMN) for modelling and presenting the clinical pathway in the form of a workflow. The aim of this study is to produce spontaneous alerts in the healthcare workflow in the diagnosis of Chronic Obstructive Pulmonary Disease (COPD). The use of BPMN as a tool to automate clinical guidelines has not been previously employed for providing Clinical Decision Support (CDS)

Quality Assurance in Telehealth: Adherence to Evidence-Based Indicators.

Background: Value enhancing telehealth (TH) lacks a robust body of formal clinically focused quality assessment studies. Innovations such as telehealth must always demonstrate that it preserves or hopefully advances quality. Introduction: We sought to determine whether adherence to the evidence-based Choosing Wisely (CW) recommendations (antibiotic stewardship) for acute sinusitis differs for encounters through direct-to-consumer (DTC) telemedicine verses in-person care in an emergency department (ED) or an urgent care (UC) center. Materials and Methods: Study design was a retrospective review. Patients with a symptom complex consistent with acute sinusitis treated through DTC were matched with ED and UC patients, based upon time of visit. Charts were reviewed to determine patient characteristics, chief complaint, final diagnosis, presence or absence of criteria within the CW guidelines, and whether or not antibiotics were prescribed. The main outcome was adherence to the CW campaign recommendations. Results: A total of 570 visits were studied: 190 DTC, 190 ED, and 190 UC visits. The predominant chief complaints were upper respiratory infection (36%), sore throat (25%), and sinusitis (18%). Overall, there was a 67% (95% CI 62.3-71.7) adherence rate with the CW guidelines for sinusitis: DTC visits (71%), ED visits (68%), and UC visits (61%). There was a nonsignificant difference (p = 0.29) in adherence to CW guidelines based upon type of visit (DTC, UC, and ED). Discussion: The challenge is to demonstrate whether or not DTC TH compromises quality. Conclusion: In this study, DTC visits were associated with at least as good an adherence to the CW campaign recommendations as emergency medicine (EM) and UC in-person visits. © Daniel Halpren-Ruder et al

The Medicare Physician Group Practice Demonstration: Lessons Learned on Improving Quality and Efficiency in Health Care

Discusses the experiences of ten large practices earning performance payments for improving the quality and cost-efficiency of health care delivered to Medicare fee-for-service beneficiaries

Predictive Modeling in Action: How 'Virtual Wards' Help High-Risk Patients Receive Hospital Care at Home

Describes a program to reduce hospitalizations by providing multidisciplinary case management and coordinated preventive care at home to chronic disease patients found to be at risk of emergency hospitalization by predictive modeling. Outlines challenges