Vertical Integration and Market Structure

Contractual theories of vertical integration derive firm boundaries as an efficient response to market transaction costs. These theories predict a relationship between underlying features of transactions and observed integration decisions. There has been some progress in testing these predictions, but less progress in quantifying their importance. One difficulty is that empirical applications often must consider firm structure together with industry structure. Research in industrial organization frequently has adopted this perspective, emphasizing how scale and scope economies, and strategic considerations, influence patterns of industry integration. But this research has paid less attention to contractual or organizational details, so that these two major lines of research on vertical integration have proceeded in parallel with only rare intersection. We discuss the value of combining different viewpoints from organizational economics and industrial organization.

The Application of Computer Techniques to ECG Interpretation

This book presents some of the latest available information on automated ECG analysis written by many of the leading researchers in the field. It contains a historical introduction, an outline of the latest international standards for signal processing and communications and then an exciting variety of studies on electrophysiological modelling, ECG Imaging, artificial intelligence applied to resting and ambulatory ECGs, body surface mapping, big data in ECG based prediction, enhanced reliability of patient monitoring, and atrial abnormalities on the ECG. It provides an extremely valuable contribution to the field

Telemedicine

Telemedicine is a rapidly evolving field as new technologies are implemented for example for the development of wireless sensors, quality data transmission. Using the Internet applications such as counseling, clinical consultation support and home care monitoring and management are more and more realized, which improves access to high level medical care in underserved areas. The 23 chapters of this book present manifold examples of telemedicine treating both theoretical and practical foundations and application scenarios

Scenario-based system architecting : a systematic approach to developing future-proof system architectures

This thesis summarizes the research results of Mugurel T. Ionita, based on the work conducted in the context of the STW15 - AIMES16 project. The work presented in this thesis was conducted at Philips Research and coordinated by Eindhoven University of Technology. It resulted in six external available publications, and ten internal reports which are company confidential. The research regarded the methodology of developing system architectures, focusing in particular on two aspects of the early architecting phases. These were, first the generation of multiple architectural options, to consider the most likely changes to appear in the business environment, and second the quantitative assessment of these options with respect to how well they contribute to the overall quality attributes of the future system, including cost and risk analysis. The main reasons for looking at these two aspects of the architecting process was because architectures usually have to live for long periods of time, up to 5 years, which requires that they are able to deal successfully with the uncertainty associated with the future business environment. A second reason was because the quality attributes, the costs and the risks of a future system are usually dictated by its architecture, and therefore an early quantitative estimate about these attributes could prevent the system redesign. The research results of this project were two methods, namely a method for designing architecture options that are more future-proof, meaning more resilient to future changes, (SODA method), and within SODA a method for the quantitative assessment of the proposed architectural options (SQUASH method). The validation of the two methods has been performed in the area of professional systems, where they were applied in a concrete case study from the medical domain. The SODA method is an innovative solution to the problem of developing system architectures that are designed to survive the most likely changes to be foreseen in the future business environment of the system. The method enables on one hand the business stakeholders of a system to provide the architects with their knowledge and insight about the future when new systems are created. And on the other hand, the method enables the architects to take a long view and think strategically in terms of different plausible futures and unexpected surprises, when designing the high level structure of their systems. The SQUASH method is a systematic way of assessing in a quantitative manner, the proposed architectural options, with respect to how well they deal with quality aspects, costs and risks, before the architecture is actually implemented. The method enables the architects to reason about the most relevant attributes of the future system, and to make more informed decisions about their design, based on the quantitative data. Both methods, SODA and SQUASH, are descriptive in nature, rooted in the best industrial practices, and hence proposing better ways of developing system architectures

Lean management in healthcare enterprise project: Beatriz Ângelo Hospital's Cardiology Department

Com os sinais de crise, tornou-se imperativo para as organizações focarem-se na redução de desperdício. Como filosofia de gestão, o termo Lean tem como focus a melhoria da produtividade, a eliminação de desperdício e promove actividades que acrescentam valor para o cliente. Este conceito é transversal a todo o tipo de serviços, inclusive no sector da saúde O objectivo deste estudo prende-se com a introdução e análise de práticas de Lean Mangement no Departamento de Cardiologia do Hospital de Loures. Por isso, no 1º capítulo são descritos a origem, os conceitos e as técnicas de Lean Management. No 2º capítulo são apresentados exemplos de como o Lean Management pode ser aplicado e com resultados positivos, nos vários tipos de serviços. A caracterização e modo de financiamento do Hospital de Loures, e por conseguinte o próprio serviço de Cardiologia, são analisados no 3º capítulo. Ao longo do 4º capítulo, é descrita a Metodologia utilizada na análise da Cultura Organizacional e de Liderança do serviço e na implementação de Lean Management no serviço de Cardiologia. No 5º capítulo é realizado o diagnóstico para aceder ao grau de mentalização e preparação dos recursos para a mudança, são identificadas as principais causas de desperdício e os respectivos resultados são discutidos. Das principais conclusões do estudo, que constam no último capítulo, destaca-se como a integração dos princípios de Lean Management permite trazer melhorias no serviço de Cardiologia através de técnicas simples de implementar. Como desenvolvimentos futuros, propõe-se a melhoria continua no serviço de Cardiologia e a expansão deste conceito para outros departamentos e hospitais do país.Signs of "crisis" make it more imperative that organizations focus on reducing waste. Lean as management philosophy sets its focus on improving productivity, eliminating waste and promoting activities that really add value to the client. This concept transcends boundaries, achieving industry's services in general. The purpose of this study is the introduction and analysis of Lean Management in the Department of Cardiology of a Portuguese Hospital. Thus, the first chapter is intended to deepen the knowledge related to the origin, concepts and techniques of Lean Management. The second chapter presents examples of how Lean Management can be applied in transversal services, including various cases of Lean Management applied to Healthcare. The financing analysis of the entity where Cardiology Department belongs to is described in chapter 3. Along forth chapter, the used methodology is described for both analysis of the organizational culture and leadership of the department and analysis of Lean Implementation on Cardiology Department. In the fifth chapter the degree of mindset and readiness of resources for change is assessed, the main causes of waste are presented and its elimination results discussed. From the main conclusions of this study, last chapter, it is highlighted how integrating Lean Management principles in healthcare improves health services and how spreading good practices in its delivery is possible with simple techniques. As future developments it is proposed the department’s continuing improvement and the initiation of this philosophy in other departments and hospitals of the country

HOW CAN ADVERSE EVENTS INFORMATION BE USED TO MORE EFFECTIVELY INFORM CANCER PATIENT CARE?

Due to advances in screening and therapy design, cancer patients are living longer while on or following therapy. Therapy-related adverse events (AEs) are an unintended, but not infrequent, outcome of these treatments. AEs can impact quality of life, adherence to therapy, economic status, and treatment decision-making. This novel qualitative study is the first to undertake a multi-stakeholder evaluation of the impact of AE information on informing cancer patient care in the context of extended survival. The evaluation focuses on a growing subset of cancer patients – those receiving adjuvant therapy. Adjuvant therapies, used to manage many common cancers, lower the risk that the cancer will return. In this setting, mediating the impact of potential acute or delayed adjuvant treatment-related AEs relative to an uncertain potential for tumor recurrence presents important challenges in balancing risks versus benefits. Stakeholder perspectives on generating, disseminating, and/or adjuvant treatment-related AE information were elicited via key informant interviews with patient advocacy, clinical care, regulatory, drug development, and healthcare payer representatives. The stakeholders identified future needs in four key areas: 1) information resources, 2) information integration and implementation, 3) value systems and culture, and 4) alignment and ownership of collective efforts to improve the use of AE information in the adjuvant setting. This study revealed the following novel insights: 1) there is cross-stakeholder agreement that change is needed to improve the use of AE information in the adjuvant setting to improve patient outcome, 2) the directionality of needed changes are similar across stakeholders, although specific priorities varied, and 3) the potential to realize broad systemic progress in the use of adjuvant-related AE information is a challenge that lacks clear ownership. This lack of ownership has adversely impacted resourcing, efficiency, and collective progress and is likely to be a progress-limiting factor in realizing transformational change. To address the system-limiting challenges identified in this research, a proposed approach to incentivize and support stakeholders in forward action is offered. The proposal offers an infrastructure to promote collaborative and independent efforts in fulfillment of the many scientific, economic, communication, social, and implementation challenges identified in this research study.Doctor of Public Healt