Pub Date : 2023-10-17DOI: 10.1007/s44250-023-00045-7
Theodore J. Witek, David Klein
Abstract The prospect of an innovative laboratory device capable of an array of testing from a tiny amount of blood caught the intense attention of both the medical and investment community. The device, however, was never properly validated, with several false and misleading claims made by its founder. This venture in the business of science went very badly for the firm Theranos with ensuing criminal convictions. Using public domain reports from trial testimony provided a unique opportunity to distill facts for key learnings for future stakeholders in the business of science. Several lessons related to basic governance unfolded during the trial’s testimony and are the basis for this brief case study. These include (1) a board make-up that had a suboptimal understanding of the technology, (2) advisors that did not sufficiently engage, (3) management/employee trust was tarnished and (4) investors failing to perform optimal diligence prior to funding. These lessons are particularly important for the physician-scientist and health executive who may find themselves at the interface of health and commerce. Points to consider in such ventures are discussed toward fostering the avoidance of these breakdowns.
{"title":"Governance basics for the physician-scientist considering business ventures. Lessons from Theranos","authors":"Theodore J. Witek, David Klein","doi":"10.1007/s44250-023-00045-7","DOIUrl":"https://doi.org/10.1007/s44250-023-00045-7","url":null,"abstract":"Abstract The prospect of an innovative laboratory device capable of an array of testing from a tiny amount of blood caught the intense attention of both the medical and investment community. The device, however, was never properly validated, with several false and misleading claims made by its founder. This venture in the business of science went very badly for the firm Theranos with ensuing criminal convictions. Using public domain reports from trial testimony provided a unique opportunity to distill facts for key learnings for future stakeholders in the business of science. Several lessons related to basic governance unfolded during the trial’s testimony and are the basis for this brief case study. These include (1) a board make-up that had a suboptimal understanding of the technology, (2) advisors that did not sufficiently engage, (3) management/employee trust was tarnished and (4) investors failing to perform optimal diligence prior to funding. These lessons are particularly important for the physician-scientist and health executive who may find themselves at the interface of health and commerce. Points to consider in such ventures are discussed toward fostering the avoidance of these breakdowns.","PeriodicalId":72826,"journal":{"name":"Discover health systems","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135995523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Migrants and refugees are likely to be under-immunised according to the host country's national immunisation schedule and may remain under-immunised post-resettlement for various reasons. In Australia and Aotearoa New Zealand, primary health care professionals including general practitioners and nurses provide the majority of routine and catch-up immunisations for migrants and refugees. However, immunisation service delivery for migrants and refugees is complex, with evidence that unmet training needs for immunisation providers, particularly in the development of catch-up plans, is a significant barrier to immunisation service delivery for this group. Targeted professional development opportunities for immunisation providers are essential to improve their awareness, confidence, and capability to improve immunisation service delivery for migrants and refugees. We developed an educational program to support learning for immunisation providers and equip them with the requisite knowledge and confidence to improve immunisation service delivery for refugees and migrants. The development of the multi-module online educational program drew on evidence-based web design principles, adult learning theories, and its content aimed to complement general immunisation training and align with the continuing professional development standards of Australian and New Zealand general practice and nursing colleges. Input from experts and feedback from a few selected providers in Australia and New Zealand added to the robustness of the program. This program has the potential to improve the understanding and capacity of immunisation providers, to improve vaccination experiences and increase overall vaccine uptake among migrants and refugees.
{"title":"Designing an online educational program to improve immunisation service delivery for migrants and refugees in Australia and New Zealand","authors":"Abela Mahimbo, Preeti Tiwari, Ikram Abdi, Holly Seale, Nadia Charania, Anita E. Heywood","doi":"10.1007/s44250-023-00043-9","DOIUrl":"https://doi.org/10.1007/s44250-023-00043-9","url":null,"abstract":"Abstract Migrants and refugees are likely to be under-immunised according to the host country's national immunisation schedule and may remain under-immunised post-resettlement for various reasons. In Australia and Aotearoa New Zealand, primary health care professionals including general practitioners and nurses provide the majority of routine and catch-up immunisations for migrants and refugees. However, immunisation service delivery for migrants and refugees is complex, with evidence that unmet training needs for immunisation providers, particularly in the development of catch-up plans, is a significant barrier to immunisation service delivery for this group. Targeted professional development opportunities for immunisation providers are essential to improve their awareness, confidence, and capability to improve immunisation service delivery for migrants and refugees. We developed an educational program to support learning for immunisation providers and equip them with the requisite knowledge and confidence to improve immunisation service delivery for refugees and migrants. The development of the multi-module online educational program drew on evidence-based web design principles, adult learning theories, and its content aimed to complement general immunisation training and align with the continuing professional development standards of Australian and New Zealand general practice and nursing colleges. Input from experts and feedback from a few selected providers in Australia and New Zealand added to the robustness of the program. This program has the potential to improve the understanding and capacity of immunisation providers, to improve vaccination experiences and increase overall vaccine uptake among migrants and refugees.","PeriodicalId":72826,"journal":{"name":"Discover health systems","volume":"59 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136209454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-09DOI: 10.1007/s44250-023-00034-w
Huda Jaffar, Gaurav Kumar, Anfal Atif, Amna Iqbal
Abstract Despite the growing burden of cancer, it remains a low priority in healthcare planning and budgeting in South Asian low- and middle-income countries (LMICs). Mass public awareness about cancer signs and symptoms and encouragement to seek help is an important step towards early diagnosis. Due to scarcity of resources in South Asia, the scale of awareness campaigns is limited, and provision of drugs and curative services take precedence over preventative measures. Several misconceptions and superstitious beliefs regarding the treatment of breast cancer with homeopathic medicine and unconventional religious peers provide a challenge to awareness campaigns. Along with that, shortage of staff and transportation add to the difficulties of conducting these campaigns. Interventions such as role plays, weekly clinics providing counseling for the disease, and measures such as pamphlets and presentations have been considered useful. This review assesses the challenges faced by breast cancer awareness campaigns and the interventions that could help in bringing mortality rates lower.
{"title":"Effectiveness of breast cancer campaigns in South Asia","authors":"Huda Jaffar, Gaurav Kumar, Anfal Atif, Amna Iqbal","doi":"10.1007/s44250-023-00034-w","DOIUrl":"https://doi.org/10.1007/s44250-023-00034-w","url":null,"abstract":"Abstract Despite the growing burden of cancer, it remains a low priority in healthcare planning and budgeting in South Asian low- and middle-income countries (LMICs). Mass public awareness about cancer signs and symptoms and encouragement to seek help is an important step towards early diagnosis. Due to scarcity of resources in South Asia, the scale of awareness campaigns is limited, and provision of drugs and curative services take precedence over preventative measures. Several misconceptions and superstitious beliefs regarding the treatment of breast cancer with homeopathic medicine and unconventional religious peers provide a challenge to awareness campaigns. Along with that, shortage of staff and transportation add to the difficulties of conducting these campaigns. Interventions such as role plays, weekly clinics providing counseling for the disease, and measures such as pamphlets and presentations have been considered useful. This review assesses the challenges faced by breast cancer awareness campaigns and the interventions that could help in bringing mortality rates lower.","PeriodicalId":72826,"journal":{"name":"Discover health systems","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135095375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-26DOI: 10.1007/s44250-023-00041-x
Beat Hofer, Markus Kittler, Kris Laukens
Abstract Background Deep learning (DL) has the potential to transform surgical practice, altering workflows and changing the roles of practitioners involved. However, studies have shown that introducing such change requires user acceptance. Following the development and presentation of a visual prototype for planning facial surgery interventions, the project aimed to understand the utility of DL, the implied workflow and role changes it would entail, and the potential barriers to its adoption in practice. Method This paper presents a multi-year case study providing insights from developing and introducing a visual prototype. The prototype was co-developed by facial surgeons, DL experts, and business process engineers. The study uses project data involving semi-structured interviews, workgroup results, and feedback from an external practitioner audience exposed to the prototype regarding their views on adopting DL tools in practice. Findings The surgeons attested a high utility to the application. However, the data also highlights a perceived need to remain in control, be able to intervene, and override surgical workflows in short intervals. Longer intervals without opportunities to intervene were seen with skepticism, suggesting that the practitioners’ acceptance of DL requires a carefully designed workflow in which humans can still take control of events. Conclusion Deep learning can improve and accelerate facial surgery intervention planning. Models from the business and management literature partially explain the acceptance of new technologies. Perceived ease of use seems less relevant than the perceived usefulness of new technology. Involving algorithms in clinical decision-making will change workflows and professional identities.
{"title":"How deep learning influences workflows and roles in virtual surgical planning","authors":"Beat Hofer, Markus Kittler, Kris Laukens","doi":"10.1007/s44250-023-00041-x","DOIUrl":"https://doi.org/10.1007/s44250-023-00041-x","url":null,"abstract":"Abstract Background Deep learning (DL) has the potential to transform surgical practice, altering workflows and changing the roles of practitioners involved. However, studies have shown that introducing such change requires user acceptance. Following the development and presentation of a visual prototype for planning facial surgery interventions, the project aimed to understand the utility of DL, the implied workflow and role changes it would entail, and the potential barriers to its adoption in practice. Method This paper presents a multi-year case study providing insights from developing and introducing a visual prototype. The prototype was co-developed by facial surgeons, DL experts, and business process engineers. The study uses project data involving semi-structured interviews, workgroup results, and feedback from an external practitioner audience exposed to the prototype regarding their views on adopting DL tools in practice. Findings The surgeons attested a high utility to the application. However, the data also highlights a perceived need to remain in control, be able to intervene, and override surgical workflows in short intervals. Longer intervals without opportunities to intervene were seen with skepticism, suggesting that the practitioners’ acceptance of DL requires a carefully designed workflow in which humans can still take control of events. Conclusion Deep learning can improve and accelerate facial surgery intervention planning. Models from the business and management literature partially explain the acceptance of new technologies. Perceived ease of use seems less relevant than the perceived usefulness of new technology. Involving algorithms in clinical decision-making will change workflows and professional identities.","PeriodicalId":72826,"journal":{"name":"Discover health systems","volume":"60 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134958465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-19DOI: 10.1007/s44250-023-00040-y
Oluwatosin A. Momodu, Ronnie D. Horner, Jihong Liu, Elizabeth Crouch, Brian Chen
Abstract Objective To examine the accuracy of gestational weight gain (GWG) reported on birth certificates (BCs) in comparison with electronic medical records (EMRs), the gold standard. Methods BC data and EMR data were from a random sample of pregnant women who enrolled in CenteringPregnancy program, a type of group-based prenatal care, at three obstetric clinics in South Carolina between 2015 and 2019 (n = 206). Retrospective review of EMR data on patients’ prepregnancy BMI and GWG according to 2009 Institute of Medicine guidelines was conducted. Analyses involved summarizing the variables by their mean and mean differences per data source, and then calculating percent-weighted agreement and kappa statistics. Results The mean values of BMI, delivery weight and total weight gain were similar between BC and EMRs. Data correlation for variables was high for both data sources (height: r = 0.94, prepregnancy weight: r = 0.93, prepregnancy BMI: r = 0.92, delivery weight: r = 0.96, total weight gain: r = 0.60). The BCs slightly underestimated the proportion of women in the normal-weight BMI category but overestimated the proportion in the overweight BMI category. Additionally, BCs slightly overestimated women with inadequate GWG and underestimated those with excessive GWG. Overall, the BC and EMR data were in agreement regarding prepregnancy BMI (weighted-agreement = 90%, Kappa = 0.78) and GWG categories (weighted-agreement = 84%, Kappa = 0.63). Conclusion BC estimates of prepregnancy BMI and GWG categories were similar to those recorded in the EMRs. The South Carolina BC database is a valid database for gestational weight and can provide reasonable estimates for the state in the evaluation of the CenteringPregnancy program.
{"title":"Validation of gestational weight gain records on South Carolina birth certificate data","authors":"Oluwatosin A. Momodu, Ronnie D. Horner, Jihong Liu, Elizabeth Crouch, Brian Chen","doi":"10.1007/s44250-023-00040-y","DOIUrl":"https://doi.org/10.1007/s44250-023-00040-y","url":null,"abstract":"Abstract Objective To examine the accuracy of gestational weight gain (GWG) reported on birth certificates (BCs) in comparison with electronic medical records (EMRs), the gold standard. Methods BC data and EMR data were from a random sample of pregnant women who enrolled in CenteringPregnancy program, a type of group-based prenatal care, at three obstetric clinics in South Carolina between 2015 and 2019 (n = 206). Retrospective review of EMR data on patients’ prepregnancy BMI and GWG according to 2009 Institute of Medicine guidelines was conducted. Analyses involved summarizing the variables by their mean and mean differences per data source, and then calculating percent-weighted agreement and kappa statistics. Results The mean values of BMI, delivery weight and total weight gain were similar between BC and EMRs. Data correlation for variables was high for both data sources (height: r = 0.94, prepregnancy weight: r = 0.93, prepregnancy BMI: r = 0.92, delivery weight: r = 0.96, total weight gain: r = 0.60). The BCs slightly underestimated the proportion of women in the normal-weight BMI category but overestimated the proportion in the overweight BMI category. Additionally, BCs slightly overestimated women with inadequate GWG and underestimated those with excessive GWG. Overall, the BC and EMR data were in agreement regarding prepregnancy BMI (weighted-agreement = 90%, Kappa = 0.78) and GWG categories (weighted-agreement = 84%, Kappa = 0.63). Conclusion BC estimates of prepregnancy BMI and GWG categories were similar to those recorded in the EMRs. The South Carolina BC database is a valid database for gestational weight and can provide reasonable estimates for the state in the evaluation of the CenteringPregnancy program.","PeriodicalId":72826,"journal":{"name":"Discover health systems","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135061069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-05DOI: 10.1007/s44250-023-00039-5
Elisabeth Presterl, M. Diab-Elschahawi, Carolina Lohfert-Praetorius, Siegfried Gierlinger, Herwig Wetzlinger, Walter Zingg
{"title":"Customising hospitals for the future: a perspective focusing on infection prevention and control","authors":"Elisabeth Presterl, M. Diab-Elschahawi, Carolina Lohfert-Praetorius, Siegfried Gierlinger, Herwig Wetzlinger, Walter Zingg","doi":"10.1007/s44250-023-00039-5","DOIUrl":"https://doi.org/10.1007/s44250-023-00039-5","url":null,"abstract":"","PeriodicalId":72826,"journal":{"name":"Discover health systems","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48320994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-04DOI: 10.1007/s44250-023-00038-6
A. Nashwan, S. H. Ahmed, T. Shaikh, Summaiyya Waseem
{"title":"Impact of natural disasters on health disparities in low- to middle-income countries","authors":"A. Nashwan, S. H. Ahmed, T. Shaikh, Summaiyya Waseem","doi":"10.1007/s44250-023-00038-6","DOIUrl":"https://doi.org/10.1007/s44250-023-00038-6","url":null,"abstract":"","PeriodicalId":72826,"journal":{"name":"Discover health systems","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42044391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-08DOI: 10.1007/s44250-023-00035-9
P. Alfille, C. Bean, Gennadiy Fuzaylov
{"title":"Smart phone based medical record software for short term surgical missions","authors":"P. Alfille, C. Bean, Gennadiy Fuzaylov","doi":"10.1007/s44250-023-00035-9","DOIUrl":"https://doi.org/10.1007/s44250-023-00035-9","url":null,"abstract":"","PeriodicalId":72826,"journal":{"name":"Discover health systems","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42294277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-08DOI: 10.1007/s44250-023-00036-8
K. Chakhunashvili, Davit G. Chakhunashvili, E. Kvirkvelia, N. Kiknadze
{"title":"Comparative analysis of a private telehealth clinic and country-wide COVID-19 patient management results","authors":"K. Chakhunashvili, Davit G. Chakhunashvili, E. Kvirkvelia, N. Kiknadze","doi":"10.1007/s44250-023-00036-8","DOIUrl":"https://doi.org/10.1007/s44250-023-00036-8","url":null,"abstract":"","PeriodicalId":72826,"journal":{"name":"Discover health systems","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42879675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-01DOI: 10.1007/s44250-023-00033-x
Ntsako P. Maluleke, K. Khoza-Shangase
{"title":"Embracing videoconferencing interview applications beyond COVID-19: scoping review-guided implications for family centered services in South Africa","authors":"Ntsako P. Maluleke, K. Khoza-Shangase","doi":"10.1007/s44250-023-00033-x","DOIUrl":"https://doi.org/10.1007/s44250-023-00033-x","url":null,"abstract":"","PeriodicalId":72826,"journal":{"name":"Discover health systems","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48351631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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