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1.
PLoS One ; 15(4): e0227593, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32294089

RESUMO

Genomic editing technologies are developing rapidly, promising significant developments for biomedicine, agriculture and other fields. In the present investigation, we analyzed and compared the process of innovation for six genomic technologies: viral vectors, RNAi, TALENs, meganucleases, ZFNs and CRISPR/Cas including the profile of the main research institutions and their funders, to understand how innovation evolved and what institutions influenced research trajectories. A Web of Science search of papers on viral vectors RNAi, CRISPR/Cas, TALENs, ZFNs and meganucleases was used to build a citation network of 16,746 papers. An analysis of network clustering combined with text mining was performed. For viral vectors, a long-term process of incremental innovation was identified, which was largely publicly funded in the United States and the European Union. The trajectory of RNAi research included clusters related to the study of RNAi as a biological phenomenon and its use in functional genomics, biomedicine and pest control. A British philanthropic organization and a US pharmaceutical company played a key role in the development of basic RNAi research and clinical application respectively, in addition to government and academic institutions. In the case of CRISPR/Cas research, basic science discoveries led to the technical improvements, and these two in turn provided the information required for the development of biomedical, agricultural, livestock and industrial applications. The trajectory of CRISPR/Cas research exhibits a geopolitical division of the investigation efforts between the US, as the main producer and funder of basic research and technical improvements, and Chinese research institutions increasingly leading applied research. Our results reflect a change in the model for financing science, with reduced public financing for basic science and applied research on publicly funded technological developments in the US, and the emergence of China as a scientific superpower, with implications for the development of applications of genomic technologies.


Assuntos
Pesquisa Biomédica/tendências , Tecnologia Biomédica/tendências , Organização do Financiamento/tendências , Edição de Genes/tendências , Invenções/tendências , Pesquisa Biomédica/economia , Pesquisa Biomédica/métodos , Pesquisa Biomédica/organização & administração , Tecnologia Biomédica/economia , Tecnologia Biomédica/métodos , Tecnologia Biomédica/organização & administração , Sistemas CRISPR-Cas , China , Organização do Financiamento/economia , Organização do Financiamento/métodos , Edição de Genes/economia , Edição de Genes/métodos , Vetores Genéticos , Invenções/economia , Liderança , Política , Interferência de RNA , Estados Unidos , Vírus/genética
2.
Soins ; 65(842): 26-28, 2020.
Artigo em Francês | MEDLINE | ID: mdl-32245554

RESUMO

In the Île-de-France region, the medico-social sector is implementing a project to develop digital tools in institutions. With the support of the regional health agency, this project will lead to the selection of publishers by the end of 2019 who will offer the institutions business tools tailored to their needs, secure and interoperable to be part of the e-track programme.


Assuntos
Tecnologia Biomédica/organização & administração , Participação dos Interessados , França , Humanos
4.
Surgery ; 167(3): 535-539, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31862172

RESUMO

The Stanford Biodesign Innovation process, which identifies meaningful clinical needs, develops solutions to meet those needs, and plans for subsequent implementation in clinical practice, is an effective training approach for new generations of healthcare innovators. Continued success of this process hinges on its evolution in response to changes in healthcare delivery and an ever-increasing demand for economically viable solutions. In this article, we provide perspective on opportunities for value-driven innovation in surgery and relate these to value-related teaching elements currently integrated in the Stanford Biodesign process.


Assuntos
Tecnologia Biomédica/organização & administração , Invenções , Determinação de Necessidades de Cuidados de Saúde , Especialidades Cirúrgicas/organização & administração , Tecnologia Biomédica/métodos , Análise Custo-Benefício , Custos de Cuidados de Saúde , Humanos , Satisfação do Paciente , Garantia da Qualidade dos Cuidados de Saúde , Especialidades Cirúrgicas/economia , Especialidades Cirúrgicas/métodos , Estados Unidos
7.
BMC Health Serv Res ; 19(1): 648, 2019 Sep 06.
Artigo em Inglês | MEDLINE | ID: mdl-31492139

RESUMO

BACKGROUND: Commissioning innovative health technologies is typically complex and multi-faceted. Drawing on the negotiated order perspective, we explore the process by which commissioning organisations make their decisions to commission innovative health technologies. The empirical backdrop to this discussion is provided by a case study exploring the commissioning considerations for a new photoplethysmography-based diagnostic technology for peripheral arterial disease in primary care in the UK. METHODS: The research involved an empirical case study of four Clinical Commissioning Groups (CCGs) involved in the commissioning of services in primary and secondary care. Semi-structured in-depth interviews (16 in total) and two focus groups (a total of eight people participated, four in each group) were conducted with key individuals involved in commissioning services in the NHS including (i) senior NHS clinical leaders and directors (ii) commissioners and health care managers across CCGs and (iii) local general practitioners. RESULTS: Commissioning of a new diagnostic technology for peripheral arterial disease in primary care involves high levels of protracted negotiations over funding between providers and commissioners, alliance building, conflict resolution and compromise of objectives where the outcomes of change are highly contingent upon interventions made across different care settings. Our evidence illustrates how reconfigurations of inter-organisational relations, and of clinical and related work practices required for the successful implementation of a new technology could become the major challenge in commissioning negotiations. CONCLUSIONS: Innovative health technologies such as the diagnostic technology for peripheral arterial disease are commissioned in care pathways where the value of such technology is realised by those delivering care to patients. The detail of how care pathways are commissioned is complex and involves high degrees of uncertainty concerning such issues as prioritisation decisions, patient benefits, clinical buy-in, value for money and unintended consequences. Recent developments in the new care models and integrated care systems (ICSs) in the UK offer a unique opportunity for the successful commissioning arrangements of innovative health technologies in primary care such as the new diagnostic technology for peripheral arterial disease.


Assuntos
Tecnologia Biomédica/estatística & dados numéricos , Medicina Geral/estatística & dados numéricos , Invenções , Tecnologia Biomédica/organização & administração , Difusão de Inovações , Grupos Focais , Medicina Geral/organização & administração , Clínicos Gerais/organização & administração , Clínicos Gerais/estatística & dados numéricos , Administração de Serviços de Saúde , Humanos , Negociação , Atenção Primária à Saúde/organização & administração , Atenção Primária à Saúde/estatística & dados numéricos , Medicina Estatal
8.
Cad Saude Publica ; 35(suppl 2): e00071518, 2019 Aug 15.
Artigo em Português | MEDLINE | ID: mdl-31432894

RESUMO

One of the main challenges for modern health systems is to guarantee equitable access to technologies with proven quality, safety, efficacy, and cost-effectiveness, as well as to ensure that their use is based on high-quality scientific evidence. Health technology assessment (HTA) is one of the most widely used strategies in the world to support decisions on health technologies. The article analyzes how HTA systems are organized in Brazil and Canada and discusses the implications for planning the incorporation of technologies in Brazil, considering the challenges posed by the regionalization process and the establishment of healthcare networks. This is an exploratory comparative study based on secondary data. The results show that both countries have fragmented HTA systems with different levels of maturity. The systems are characterized by multiple organizations working in the field of HTA, the scope of activities, and the concentration of activities in national agencies/bodies. Both systems have weaknesses, but the Brazilian case presents a series of factors (insufficient resources, impact of court rulings, heavy dependence on foreign technologies, and incipient regional HTA processes and planning) that make the scenario more complex. The article argues that the regionalized structure for planning the incorporation of technologies in Canada can serve as an interesting experience for the Brazilian system, despite the different contexts in the two countries.


Assuntos
Internacionalidade , Programas Nacionais de Saúde/organização & administração , Avaliação da Tecnologia Biomédica/métodos , Tecnologia Biomédica/organização & administração , Brasil , Canadá , Política de Saúde , Humanos , Regionalização/organização & administração
9.
Gac. sanit. (Barc., Ed. impr.) ; 33(4): 325-332, jul.-ago. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-187988

RESUMO

Objetivo: Analizar la eficiencia técnica por tipo de propiedad y gestión de los hospitales generales del Sistema Nacional de Salud español (2010-2012) y sus variables explicativas hospitalarias y regionales. Método: Se estudian 230 hospitales combinando el análisis envolvente de datos y modelos transversales de regresión lineal multinivel de efectos fijos. Con el análisis envolvente de datos se miden la eficiencia técnica global, pura y de escala, y con los modelos multinivel, las variables explicativas de eficiencia. Resultados: El índice medio de eficiencia técnica global de los hospitales sin personalidad jurídica es inferior al de los hospitales con personalidad jurídica (0,691 y 0,876 en 2012). Existe una importante variabilidad en eficiencia técnica pura (ETP) por formas de gestión directa, indirecta y mixta. Un 29% de la variabilidad en la ETP es atribuible a diferencias entre comunidades autónomas. La dotación de personalidad jurídica del hospital aumenta en 11,14 puntos la ETP. Por otra parte, la mayoría de las formas de gestión alternativas al modelo tradicional aumentan en porcentajes variables la ETP. En el ámbito regional, según el escenario considerado, la insularidad y la renta media por hogar son variables explicativas de la ETP. Discusión: Tener personalidad jurídica favorece la eficiencia técnica. El marco de regulación y gestión de los hospitales, más que la propiedad pública o privada, parecen explicar la eficiencia técnica. Las características regionales explican de forma relevante la variabilidad en la ETP


Objective: To analyze technical efficiency by type of property and management of general hospitals in the Spanish National Health System (2010-2012) and identify hospital and regional explanatory variables. Method: 230 hospitals were analyzed combining data envelopment analysis and fixed effects multilevel linear models. Data envelopment analysis measured overall, technical and scale efficiency, and the analysis of explanatory factors was performed using multilevel models. Results: The average rate of overall technical efficiency of hospitals without legal personality is lower than hospitals with legal personality (0.691 and 0.876 in 2012). There is a significant variability in efficiency under variable returns (TE) by direct, indirect and mixed forms of management. The 29% of the variability in TE es attributable to the Region. Legal personality increased the TE of the hospitals by 11.14 points. On the other hand, most of the forms of management (different to those of the traditional hospitals) increased TE in varying percentages. At regional level, according to the model considered, insularity and average annual income per household are explanatory variables of TE. Discussion: Having legal personality favours technical efficiency. The regulatory and management framework of hospitals, more than public or private ownership, seem to explain technical efficiency. Regional characteristics explain the variability in TE


Assuntos
Humanos , Sistemas Nacionais de Saúde/organização & administração , Tecnologia Biomédica/organização & administração , Eficiência Organizacional/tendências , Espanha , Análise Multinível , Parcerias Público-Privadas/organização & administração , Hospitais Privados/organização & administração , Administradores Hospitalares/tendências , Hospitais Públicos/organização & administração
11.
Healthc Manage Forum ; 32(6): 303-306, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31248283

RESUMO

Implementation of reimbursement decisions is important to payers and manufacturers, however, evidence shows that it is highly variable. An economic framework is available to assess its value that has been successfully applied and which has developed over time to produce a more realistic representation of the real world. The framework incorporates the value of information, technology diffusion, and the interaction between the two, to generate a value of implementation. While potentially complex to apply, simple analyses are possible and qualitative lessons identified from its associated literature. Six lessons are identified which highlight the importance of considering pricing, population size, technology diffusion, evidence generation, and cost-effectiveness. Consideration of these issues would help payers and manufacturers to work together in a combined effort to increase the implementation of new technologies and generate greater value to society.


Assuntos
Tecnologia Biomédica/economia , Tomada de Decisões , Mecanismo de Reembolso/economia , Tecnologia Biomédica/organização & administração , Análise Custo-Benefício/economia , Análise Custo-Benefício/métodos , Difusão de Inovações , Financiamento da Assistência à Saúde , Humanos , Mecanismo de Reembolso/organização & administração , Avaliação da Tecnologia Biomédica/economia , Avaliação da Tecnologia Biomédica/métodos
12.
IEEE Pulse ; 10(3): 15-18, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31135346

RESUMO

Access to health care has long been considered to be a human right. It was formally declared in 1946 when the heads of states wrote the constitution of the World Health Organization (WHO). But more than 70 years after the fact, the global community still has yet to achieve it.


Assuntos
Atenção Primária à Saúde , Tecnologia Biomédica/história , Tecnologia Biomédica/organização & administração , Tecnologia Biomédica/normas , História do Século XX , História do Século XXI , Humanos , Atenção Primária à Saúde/história , Atenção Primária à Saúde/organização & administração , Atenção Primária à Saúde/tendências , Organização Mundial da Saúde
13.
BMC Med ; 17(1): 68, 2019 03 27.
Artigo em Inglês | MEDLINE | ID: mdl-30914045

RESUMO

Blockchain is a shared distributed digital ledger technology that can better facilitate data management, provenance and security, and has the potential to transform healthcare. Importantly, blockchain represents a data architecture, whose application goes far beyond Bitcoin - the cryptocurrency that relies on blockchain and has popularized the technology. In the health sector, blockchain is being aggressively explored by various stakeholders to optimize business processes, lower costs, improve patient outcomes, enhance compliance, and enable better use of healthcare-related data. However, critical in assessing whether blockchain can fulfill the hype of a technology characterized as 'revolutionary' and 'disruptive', is the need to ensure that blockchain design elements consider actual healthcare needs from the diverse perspectives of consumers, patients, providers, and regulators. In addition, answering the real needs of healthcare stakeholders, blockchain approaches must also be responsive to the unique challenges faced in healthcare compared to other sectors of the economy. In this sense, ensuring that a health blockchain is 'fit-for-purpose' is pivotal. This concept forms the basis for this article, where we share views from a multidisciplinary group of practitioners at the forefront of blockchain conceptualization, development, and deployment.


Assuntos
Tecnologia Biomédica , Redes de Comunicação de Computadores , Assistência à Saúde/tendências , Sistemas de Informação Administrativa , Informática Médica , Tecnologia Biomédica/métodos , Tecnologia Biomédica/organização & administração , Tecnologia Biomédica/tendências , Redes de Comunicação de Computadores/organização & administração , Redes de Comunicação de Computadores/normas , Redes de Comunicação de Computadores/provisão & distribução , Redes de Comunicação de Computadores/tendências , Data Warehousing/métodos , Data Warehousing/tendências , Assistência à Saúde/métodos , Assistência à Saúde/organização & administração , Processamento Eletrônico de Dados/métodos , Processamento Eletrônico de Dados/organização & administração , Processamento Eletrônico de Dados/tendências , Utilização de Equipamentos e Suprimentos/organização & administração , Utilização de Equipamentos e Suprimentos/tendências , Ensaios de Triagem em Larga Escala/normas , Humanos , Sistemas de Informação Administrativa/normas , Sistemas de Informação Administrativa/tendências , Informática Médica/métodos , Informática Médica/organização & administração , Informática Médica/tendências , Registros Médicos/normas
15.
Br J Nurs ; 28(3): 204-205, 2019 Feb 14.
Artigo em Inglês | MEDLINE | ID: mdl-30746983

RESUMO

Emeritus Professor Alan Glasper, from the University of Southampton, discusses the recently published NHS Long Term Plan's proposals for developing the use of digital technology to enhance patient care.


Assuntos
Tecnologia Biomédica/organização & administração , Medicina Estatal/organização & administração , Humanos , Reino Unido
16.
J Am Acad Orthop Surg ; 27(1): e9-e16, 2019 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-30320732

RESUMO

Despite the wealth of innovation in the orthopaedic sciences, few technologies translate to clinical use. By way of a 2-day symposium titled "AAOS/ORS Translating Orthopaedic Technologies into Clinical Practice: Pathways from Novel Idea to Improvements in Standard of Care Research Symposium," key components of successful commercialization strategies were identified as a passionate entrepreneur working on a concept aimed at improving patient outcomes and decreasing the cost and burden of disease; a de-risking strategy that has due recognition of the regulatory approval process and associated costs while maximizing the use of institutional, state, and federal resources; and a well thought-out and prepared legal plan and high quality, protected intellectual property. Challenges were identified as a lack of education on the scale-up and commercialization processes; few opportunities to network, get feedback, and obtain funding for early stage ideas; disconnect between the intellectual property and the business model; and poor adoption of new technologies caused in part by un-optimized clinical trials. By leveraging the network of professional orthopaedic societies, there exists an opportunity to create an enlightened community of musculoskeletal entrepreneurs who are positioned to develop and commercialize technologies and transform patient care.


Assuntos
Tecnologia Biomédica/organização & administração , Contrato de Risco/organização & administração , Ortopedia , Transferência de Tecnologia , Tecnologia Biomédica/economia , Tecnologia Biomédica/legislação & jurisprudência , Contrato de Risco/legislação & jurisprudência , Organização do Financiamento , Obtenção de Fundos , Humanos , Propriedade Intelectual , Mentores , Cultura Organizacional , Papel do Médico , Rede Social
17.
Acad Med ; 94(4): 528-534, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30520807

RESUMO

The process of translating academic biomedical advances into clinical care improvements is difficult, risky, expensive, and poorly understood. Notably, many clinicians who identify health care problems do not have the time or expertise to solve the problems, and many academic researchers are unaware of important gaps in clinical care to which their expertise may apply.Recognizing an opportunity to connect people who can identify health care problems with those who can solve them, the Yale Center for Biomedical Innovation and Technology (CBIT) was established in 2014 to educate and enhance the impact of health care innovators. The authors review other health care innovation centers and describe best practices borrowed by Yale CBIT, which tailored its activities and approach to its unique ecosystem.In four years, Yale CBIT has affected over 3,000 people and established a health care innovation cycle as an efficient strategy to guide translational research. Yale CBIT has created or supported graduate and undergraduate courses, clinical immersion programs for industry partners, and large health care hackathon events. Over 200 projects have been submitted to CBIT for mentorship, and some of those projects have been commercialized and raised millions of dollars of follow-on funding.The authors present Yale CBIT as one model of accelerating the impact of academic medicine on clinical practice and outcomes. The project advising strategy is intended to be a template to maximize the efficiency of biomedical innovation and ultimately improve the outcomes and experiences of future patients.


Assuntos
Sucesso Acadêmico , Tecnologia Biomédica/organização & administração , Invenções/tendências , Tecnologia Biomédica/tendências , Humanos
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