Health Care Science最新文献

On November 11, 2022, the Chinese government released the Scientific and Targeted Prevention and Control Measures to Optimize COVID-19 Response. Since that time, adjusted measures have been implemented throughout China, leading to major shifts in implementation of the national prevention and control strategy. On the basis of the current situation of the epidemic and the evolving SARS-Cov-2 variants, an additional 10 specifications (referred to as “the 10-point measures”) were officially released on December 7, 2022, in an effort to further optimize the prevention and control measures. The latest adjustments pertain to the specification of: precise delineation of high-risk areas, nucleic acid testing scheme, isolation and health monitoring, restriction and lifting of high-risk areas, medicine supply, vaccination rollout among older people, health status of key populations, social functioning, and campus response.

Since the outbreak of the COVID-19 pandemic, under the strong leadership of the Central Committee of the Communist Party of China and President Xi Jinping, China has made firm decisions to prioritize people's lives and health. Efforts have been made to avoid foreign imported infection and domestic rebound of COVID-19 cases; the “dynamic zero COVID” policy has been executed without wavering; and the prevention and control measures have been optimized and improved in response to changing circumstances, actively responding to the impact caused by multiple waves of COVID-19 surge globally. China has made extraordinary efforts to safeguard people's lives and health. Meanwhile, prevention and control measures were timely updated to coordinate with economic and social development. On November 10, the Standing Committee of the Central Political Bureau held a meeting to discuss the latest situation of the COVID-19 pandemic in China. Twenty measures (referred to as “the 20-point measures“) were officially announced to further optimize the COVID-19 response. The latest prevention and control measures involve the requirements and guidance for isolation at home, high-risk area delineation, nucleic acid testing, international inbound flights and travelers, vaccination rollout, medical resource preparedness, and protection for special places and vulnerable population.

In May 2022, the 75th World Health Assembly recognized the need to accelerate national responses to the growing burden of noncommunicable diseases (NCDs) to achieve the goals of the Global Action Plan (GAP) for the Prevention and Control of NCDs. To facilitate this, an implementation roadmap was adopted that urges countries to prioritize the implementation of NCD interventions that are most appropriate to their specific local and regional context. The roadmap will act as an overarching guide for countries to tackle NCDs via three approaches: (i) Accelerate national responses based on local NCD epidemiology, risk factors and identified barriers and enablers; (ii) Prioritize and scale up the implementation of most impactful and feasible interventions according to the local context; and (iii) Ensure timely, reliable and sustained national data on NCD risk factors and mortality for data driven actions and to strengthen accountability [1].

With the end date of 2030 for the NCD-GAP fast approaching, the adaptation of proven interventions is likely the most efficient and effective means by which countries can make inroads into NCD control [2]. While investment in continued research and innovation to support such adaptation processes is vital, prior knowledge and experience with the implementation of NCD interventions highlight a series of common principles that—if leveraged—can provide programs for NCD prevention and management with the strongest chance of success. In this perspective piece we share such key principles emerging from our own experience implementing a multifaceted NCD management intervention—SMARThealth (Systematic Medical Appraisal Referral and Treatment)—across different country contexts.

SMARThealth is a technology-supported, multifaceted primary health care intervention aimed at improving the provision of guideline-based assessment and prevention or management of common NCDs. A central common component of the SMARThealth intervention is a clinical decision support system (CDSS) with context-defined variations in disease focus and approach to health system integration, including workforce strategy [3] (Figure 1).

The intervention was first piloted in Australia as a CDSS embedded in existing patient management information systems and delivered by general practitioners (GPs) [4]. Encouraged by positive outcomes (e.g., improved cardiovascular risk factor screening, namely blood pressure [BP] recording and up-titration of cardiovascular preventive drugs), the CDSS was adapted to the Indian primary health care setting by expanding the platform to include a mobile application that can be used by frontline health workers within rural communities to support early identification, referral, and management for cardiovascular disease. Though the platform was found to be acceptable by the community and health professionals across test sites in rural India,

Computer-assisted orthopedic system (CAOS) is rapidly gaining popularity in the field of precision medicine. However, the cost-effectiveness of CAOS has not been well clarified. We performed this review to summarize and assess the cost-effectiveness analyses (CEAs) with regard to CAOS. Publications on CEA in CAOS have been searched in PubMed and CEA Registry up to May 31, 2022. The Quality of Health Economic Studies (QHES) instrument was used to estimate the quality of studies. Relationships between qualities and potential factors were also examined. There were 15 eligible studies in the present review. Twelve studies evaluated CAOS joint arthroplasties and found that CAOS joint arthroplasties were cost-effective compared to manual methods. Three studies focused on spinal surgery, two of which analyzed the cost-effectiveness of CAOS for patients after spinal fusion, with conflicting results. One study demonstrated that CAOS was cost-effective in spinal pedicle screw insertion. The mean QHES score of CEAs included was 86.1. The potential factors had no significant relationship with the quality of studies. Based on available studies, our review reflected that CAOS was cost-effective in the field of joint arthroplasty. While in spinal surgery, the answer was unclear. Current CEAs represent high qualities, and more CEAs are required in the different disciplines of orthopedics where CAOS is employed.

At present, health-care systems in the United States face enormous challenges in providing quality care, characterized by safe, effective, efficient, patient-centered, timely, and equitable care while containing health-care costs [1, 2]. To understand and address patients' increasingly complicated health-care needs, we need safe access to quality information that is characterized by integrity, reliability, and accuracy [3], and establish mutually beneficial relationships among a multidisciplinary team of professionals [4]. Traditional paper-based clinical workflow produces many issues such as illegible handwriting, inconvenient access, the possibility of computational prescribing errors, inadequate patient hand-offs, and drug administration errors. These problems can lead to medical errors, omissions, and duplications and, ultimately, poor patient outcomes and compromised quality of care [2].

Electronic health records (EHR) is a major achievement in the health information technology [5]. It is deemed a promising solution to improve the interoperability of patients' information across health-care settings and achieve a more cost-effective, safer, and higher quality of care [3, 6]. Electronic medical records (EMR) is a different concept from EHR; thus, the two terms cannot be used interchangeably. The EMR is the official record produced by hospitals and other ambulatory settings that serves as the EHR's data source. EMR is a prerequisite for EHR [7]. EHR refers to systematic documentation of patients' health status and health care in a secured digital format [8]. It indicates that patients' health information can not only be stored but also be transmitted and accessed by authorized interdisciplinary professionals across health-care settings in patients' health-care continuum. In addition, authorized non-health-care professionals, including insurers, the government, and researchers can also have access to patients' health information as well.

With EHR, patients can have greater autonomy over their care, and clinicians may better understand patients' medical history and coordinate care with other interdisciplinary professionals with fewer barriers [2]. EHR can also provide data for a variety of other purposes such as providing data for research, population-based interventions, and reporting quality-related measures [9]. Thus, this technological innovation benefits not only patients but also healthcare providers, administrative officers, researchers, and professionals from a variety of disciplines [10].

The adoption of EHR in the United States started early and was accelerated by laws and regulations. In 2004, US President George W. Bush proposed a plan that most Americans would have EHR by 2014. He stated that computerizing health records could help clinicians avo

COVID-19 Monkey pox, days like these need planning

Healthcare systems face many competing demands and insufficient resources. Service innovations to improve efficiency are important to address this challenge. Innovations can range from new pharmaceuticals, alternate models of care, novel devices, and the use other technologies. Suboptimal implementation can mean lost benefits. This review article aims to highlight the role of implementation science, summarize how settings have leveraged this methodology to promote translation of innovation into practice, and describe our own experience of embedding implementation science into an academic medical center in Singapore. Implementation science offers a range of methods to promote systematic uptake of research findings about innovations and is gaining recognition worldwide as an important discipline for health services researchers. Health systems around the world have tried to promote implementation research in their settings by establishing (1) dedicated centers/programs, (2) offering funding, and (3) building knowledge and capacity among staff. Implementation science is a critical piece in the translational pathway of “evidence to innovation.” The three efforts we describe should be strengthened to integrate implementation science into the innovation ecosystem around the world.