Early economic evaluation of the digital gait analysis system for fall prevention–Preliminary analysis of the GaitSmart system

Objective: To develop an early economics evaluation (EEE) to assess the cost-effectiveness of the GS in reducing the RoF and FoF. Methods: A cost-effectiveness analysis (CEA) with a return on investment (RoI) estimation was performed. CEA used the most relevant parameters, such as increased gait speed and decreased FoF, to estimate the reduction in the RoF, the impact on health care resources used and financial implications for the National Health System in the United Kingdom. Outcomes were measured as incremental cost-effectiveness ratio per quality-adjusted life years (QALYs) gained based on the reduction of the RoF and FoF. Uncertainties around the main parameters used were evaluated by probabilistic sensitivity analysis. Results: The CEA results showed that the GS is a dominant strategy over the standard of care to improve the movements of older persons who have suffered a fall or are afraid of falling (incremental QALYs based on FoF = 0.77 and QALYs based on RoF = 1.07, cost of FoF = -£4479.57 and cost of RoF = -£2901.79). By implementing the GS, the ROI results suggest that every pound invested in the GS could result in cost savings of £1.85/patient based on the RoF reduction and £11.16/patient based on the FoF reduction. The probability of being cost saving based on the number of iterations were 79.4 percent (based on FoF) and 100 percent (based on RoF). Conclusion: The EEE supports the main hypothesis that the GS is an effective intervention to avoid falls and is potentially cost saving

Adrenal lesions found incidentally: how to improve clinical and cost-effectiveness

Introduction Adrenal incidentalomas are lesions that are incidentally identified while scanning for other conditions. While most are benign and hormonally non-functional, around 20% are malignant and/or hormonally active, requiring prompt intervention. Malignant lesions can be aggressive and life-threatening, while hormonally active tumours cause various endocrine disorders, with significant morbidity and mortality. Despite this, management of patients with adrenal incidentalomas is variable, with no robust evidence base. This project aimed to establish more effective and timely management of these patients. Methods We developed a web-based, electronic Adrenal Incidentaloma Management System (eAIMS), which incorporated the evidence-based and National Health Service–aligned 2016 European guidelines. The system captures key clinical, biochemical and radiological information necessary for adrenal incidentaloma patient management and generates a pre-populated outcome letter, saving clinical and administrative time while ensuring timely management plans with enhanced safety. Furthermore, we developed a prioritisation strategy, with members of the multidisciplinary team, which prioritised high-risk individuals for detailed discussion and management. Patient focus groups informed process-mapping and multidisciplinary team process re-design and patient information leaflet development. The project was partnered by University Hospital of South Manchester to maximise generalisability. Results Implementation of eAIMS, along with improvements in the prioritisation strategy, resulted in a 49% reduction in staff hands-on time, as well as a 78% reduction in the time from adrenal incidentaloma identification to multidisciplinary team decision. A health economic analysis identified a 28% reduction in costs. Conclusions The system’s in-built data validation and the automatic generation of the multidisciplinary team outcome letter improved patient safety through a reduction in transcription errors. We are currently developing the next stage of the programme to proactively identify all new adrenal incidentaloma cases

Analysis of Barriers to the Deployment of Health Information Systems: a Stakeholder Perspective

© 2018 The Author(s). This paper argues that the cross-analysis of barriers with stakeholders provides a richer picture than analyzing the barriers on their own, as most of the literature in this area does. To test this hypothesis, we used the data from 33 interviews across 19 different types of stakeholders that were involved in a telemedicine system for the Chronically-ill Patient. Our findings show encouraging results. For instance, it was found that the group of stakeholders who are directly related to the governance and policy-making identified most of the barriers. This finding may imply that this group is more aware of the challenges when implementing HIS, or it may suggest that this group poses more resistance due to the current economic and Organizational models in health care. It was also found that some barriers are cited by all stakeholders whereas others not, suggesting that some barriers may be more relevant than others

Economic evaluation of an investment in medical websites and medical web-based services.

Healthcare is a unique and complex economic sector much different from any other. It is a sector highly institutionalized, under great government influence, and facing crucial resource allocation issues that threaten the stability of healthcare systems and the survivability of healthcare units worldwide. Evaluation of the processes, interventions and Information Technology (IT) use in healthcare systems is a pressing since the emerging e-Health applications carry a strong potential for solving efficiency and resource allocation problems. Especially nowadays, the increasingly popular medical websites, with the plethora of web medical applications that they offer, are forming a promising emerging market which enables better efficiency and the further evolution of the healthcare systems. Through understanding the factors that lead people to use medical websites and by evaluating the new technological initiatives in healthcare, the road towards better efficiency and cost effectiveness may become shorter. The main thrust of this research is to examine ways of evaluating an investment in the medical websites and apply methods that are well-established and successfully used in other economic sectors To achieve the aims of this research a comprehensive investigation of the extant literature performed and showed that until now evaluation methods like Cost-Benefit Analysis and Return on Investment were used in healthcare with main purpose to evaluate medical treatments, treatment processes and enhance medical education rather than focusing on evaluating processes and technological changes and interventions in healthcare and apply in healthcare sector what was successfully used in other economic sectors such as business and manufacturing. Moreover this research investigated the factors that contribute to the success and the survivability of the medical websites and provided some forecasting and key performance indicators for medical websites. In order to fulfil the aims of this research, a sample of medical web sites was used to form a rich dataset that was analysed using regression modelling. The medical websites were evaluated from the perspective of a medical virtual enterprise that provides medical advices/content and medical applications using a unique feature selection based methodology employing the use of novel tools. Furthermore a novel crowd-sourcing methodology was implemented, tested first in a Willingness to Pay online survey setting, utilising innovative tools and the power of the social networks for the identification of the perceived value of the medical web-based services The results of this research show that the factors that can have great impact on the business excellence and survivability of the medical websites seem to be the current status of the medical website, the category in which it is classified according to its content, the nature of the organization that supports the website, the source of its funding, as well as its presence in search engines and social networks. Finally These results showed that an investment on a successful medical website can be proved to be quite beneficial and profitable, not just for the public/private organization or the individual investor(s) who develops or owns it, but also sufficiently satisfactory for a great number of the Internet users/ patients

Economic evaluation of an investment in medical websites and medical web-based services.

Healthcare is a unique and complex economic sector much different from any other. It is a sector highly institutionalized, under great government influence, and facing crucial resource allocation issues that threaten the stability of healthcare systems and the survivability of healthcare units worldwide. Evaluation of the processes, interventions and Information Technology (IT) use in healthcare systems is a pressing since the emerging e-Health applications carry a strong potential for solving efficiency and resource allocation problems. Especially nowadays, the increasingly popular medical websites, with the plethora of web medical applications that they offer, are forming a promising emerging market which enables better efficiency and the further evolution of the healthcare systems. Through understanding the factors that lead people to use medical websites and by evaluating the new technological initiatives in healthcare, the road towards better efficiency and cost effectiveness may become shorter. The main thrust of this research is to examine ways of evaluating an investment in the medical websites and apply methods that are well-established and successfully used in other economic sectors To achieve the aims of this research a comprehensive investigation of the extant literature performed and showed that until now evaluation methods like Cost-Benefit Analysis and Return on Investment were used in healthcare with main purpose to evaluate medical treatments, treatment processes and enhance medical education rather than focusing on evaluating processes and technological changes and interventions in healthcare and apply in healthcare sector what was successfully used in other economic sectors such as business and manufacturing. Moreover this research investigated the factors that contribute to the success and the survivability of the medical websites and provided some forecasting and key performance indicators for medical websites. In order to fulfil the aims of this research, a sample of medical web sites was used to form a rich dataset that was analysed using regression modelling. The medical websites were evaluated from the perspective of a medical virtual enterprise that provides medical advices/content and medical applications using a unique feature selection based methodology employing the use of novel tools. Furthermore a novel crowd-sourcing methodology was implemented, tested first in a Willingness to Pay online survey setting, utilising innovative tools and the power of the social networks for the identification of the perceived value of the medical web-based services The results of this research show that the factors that can have great impact on the business excellence and survivability of the medical websites seem to be the current status of the medical website, the category in which it is classified according to its content, the nature of the organization that supports the website, the source of its funding, as well as its presence in search engines and social networks. Finally These results showed that an investment on a successful medical website can be proved to be quite beneficial and profitable, not just for the public/private organization or the individual investor(s) who develops or owns it, but also sufficiently satisfactory for a great number of the Internet users/ patients

The Emergence of Open School Education: The Case of Open Discovery Space Portal

Nowadays, open schooling is considered an education paradigm with increasing popularity, which focuses on the learners and offers more freedom in education outside of the physical and other types of barriers such as accessibility, flexibility, affordability and availability of teacher/tutors, classrooms, schools and educational institutions. The main elements that define Open Schooling are flexible learning, based on fully exploring the potential of ICT to improve education and training systems quality and efficiency, aligning them with the current trends on ICT in education, distant learning and life-long training. The aim of this paper is to present the current status of Open Schooling mainly in the EU, but also globally, and to identify the future trends in the field by analysing the data from the use of Open Discovery Space Platform as an Open School initiative case study. In this study, various portals, initiatives, and actors/stakeholders active on Open Schooling and Open Education are identified, classified into categories according to their content, services, and positioning in the EU school education landscape. Moreover, these open school innovation services are studied, resulting in a comprehensive overview of the current status of Open School initiatives and a discussion of the future trends in the field.peerReviewe