Digital transformation in the german healthcare industry : an analysis of the video consultation (teledoctor) and how it can shape the german healthcare industry

The healthcare industry is currently undergoing a digital transformation. Thereby, efficiency and accessibility between physicians and patients shall be improved by innovative care and treatment concepts. One of these innovative concepts is the telemedicine and in particular the video consultation which enables a location independent treatment of patients through information and communication technology. However, this kind of digital medical treatment is currently not properly available in Germany. Therefore, this exploratory study deals with the current status and potential of video consultation in Germany, the challenges and derives potential impacts of the video consultation. The findings reveal that the legal framework of the video consultation, inappropriate reimbursement, acceptance within patients and physicians and no adequate expanded telematic infrastructure are the main challenges that hinder the further development of the video consultation. At the same time, an educated guess showed that a potential size of video consultation based on physicians and patient’s acceptance exists. The video consultation and its connected features will shift the physical based healthcare system to a more online focused and patient centered system which in return will affect all involved stakeholder. Patients will have better access to medical care and physicians will have more efficient practice processes and more flexible working models. In order to adapt to the digital change of society, physicians should provide VC and healthcare insurance companies should support it.A indústria da saúde está, atualmente, a passar por uma transformação digital. Deste modo, a eficiência e a acessibilidade entre médicos e pacientes serão melhoradas através de conceitos inovadores de cuidados e tratamentos. Um destes conceitos inovadores é a telemedicina e, em particular, a videoconferência, que permite um tratamento independente da localização dos doentes através das tecnologias da informação e da comunicação. No entanto, este tipo de tratamento médico digital não está actualmente disponível de forma adequada na Alemanha. Portanto, este estudo exploratório lida com a situação atual e o potencial da consulta por vídeo na Alemanha, os desafios e os potenciais impactos da consulta por vídeo. Os resultados revelam que a estrutura legal da consulta em vídeo, o reembolso inadequado, a aceitação pelos pacientes e médicos e a falta de infraestrutura telemática expandida adequada são os principais desafios que dificultam o desenvolvimento futuro da consulta em vídeo. Ao mesmo tempo, uma suposição esclarecida mostrou que existe um tamanho potencial de consulta por vídeo baseado na aceitação dos médicos e pacientes. A consulta em vídeo e os recursos conectados mudam o sistema de saúde com base física para um sistema mais focado online e centrado no paciente, o que afetará todas as partes interessadas envolvidas. Os pacientes terão melhor acesso aos cuidados médicos e os médicos terão processos práticos mais eficientes e modelos de trabalho mais flexíveis. A fim de se adaptar à mudança digital da sociedade, os médicos devem fornecer VC e as companhias de seguros de saúde devem apoiá-la

Health Information Management Administration

This document addresses a range of current challenges presented by the information management sector of the healthcare industry. The purpose for examining these shortcomings is to identify a new tool with which healthcare information may be handled. A proof of concept for a new software as well as specific functionality requirements for said software have been developed as a response to this challenge. Contents include software specifications, implementation standards, security and privacy protocol, as well as any relevant background information

Globalization and the Paradox of Incorporation and Marginalization: An Exploratory Note on Sub-Saharan Africa

Globalization has of late become the lingua franca of the study of the international political economic system. As its ideological counterpart, globalization has elevated neoliberalism to the status of an international theology. To harness the benefits of a globalizing world economy, conventional wisdom consider the dictums underlying neoliberal policies as “immutable laws” that must be adopted by both the developing and the developed world. Utilizing a structured, focused analysis based on a case study of Sub-Saharan Africa (SSA), this research challenges the orthodox notion that the new international context of development that is instigated by the imperatives of globalization, and is defined by the ideological framework of neoliberalism has universal, redemptive effects. First, the literature is reviewed to show that this new context of development differs, ideologically, from the post-World War II development paradigms. Second, the demands of the new development framework are exposed with the examination of the links between globalization and neoliberalism. Third, with specific examples from different countries within the sub-region, the path, and the psychological processes through which SSA was (is) conditioned to the political economy of globalization are identified. Then, on the basis of a specified theoretical model, the study examines whether SSA has been attaining the benefits presumed to be associated with subscription to the neoliberal policy demands of the new global market discipline. As a litmus test of competing interpretative accounts, our theoretical function reveals that globalization and its associated neoliberal policy framework, in the context of SSA, precipitate a peculiar paradoxical relationship of incorporation and marginalization. The adoption and implementation of neoliberal policies concurrently incorporate and marginalize SSA within the emerging political economy of globalization. The policy implications of this paradox are examined in the wider context of development and poverty alleviation concerns of the sub-region

Improving evidence-based risk-benefit decision-making of medicines for children

Risk-benefit assessment for decision-making based on evidence is a subject of continuing interest. However, randomised clinical trials evidence of risks and benefits are not always available especially for drugs used in children mainly due to ethical concern of children being subjects of clinical trials. This thesis appraises risk-benefit evidence from published trials in children for the case study; assesses the risk-benefit balance of drugs, proposes a framework for risk-benefit evidence synthesis, and demonstrates the extent of its contribution. The review shows trial designs lack safety planning leading to inconsistency safety reporting, and lack of efficacy evidence. The General Practice Research Database (GPRD) data was exploited to synthesise evidence of risks of cisapride and domperidone in children with gastro-oesophageal reflux as a case study. Efficacy data are only available through review evidence. Analysis of prescribing trends does not identify further risk-benefit issues but suggest the lack of evidence has led to inappropriate prescribing in children. Known adverse events are defined from the British National Formulary and quantified. Proportional reporting ratio technique is applied to other clinical events to generate potential safety signals. Signals are validated; and analysed for confirmatory association through covariates adjustment in regressions. The degree of associations between signals and drugs are assessed using Bradford Hill’s criteria for causation. Verified risks are known adverse events with 95% statistical significance, and signals in abdominal pain group and bronchitis and bronchiolitis group. The drugs’ risk-benefit profiles are illustrated using the two verified signals and an efficacy outcome. Sensitivity of input parameters is studied via simulations. The findings are used to hypothetically advise risk-benefit aspects of trial designs. The value of information from this study varies between stakeholders and the keys to communicating risks and benefits lie in presentation and understanding. The generalisability and scope of the proposed methods are discussed

Space life sciences: A status report

The scientific research and supporting technology development conducted in the Space Life Sciences Program is described. Accomplishments of the past year are highlighted. Plans for future activities are outlined. Some specific areas of study include the following: Crew health and safety; What happens to humans in space; Gravity, life, and space; Sustenance in space; Life and planet Earth; Life in the Universe; Promoting good science and good will; Building a future for the space life sciences; and Benefits of space life sciences research