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Technology and Health Care is intended to serve as a forum for the presentation of original articles and technical notes, observing rigorous scientific standards. Furthermore, upon invitation, reviews, tutorials, discussion papers and minisymposia are featured.
The following types of contributions and areas are considered:
1. Original articles:
Technology development in medicine: New concepts, procedures and devices associated with the use of technology in medical research and clinical practice are presented to a readership with a widespread background in engineering and/or medicine.
Significance of medical technology and informatics for healthcare: The appropriateness, efficacy and usefulness deriving from the application of engineering methods, devices and informatics in medicine and with respect to public health are discussed.
2. Technical notes:
Short communications on novel technical developments with relevance for clinical medicine.
3. Reviews and tutorials (upon invitation only):
Tutorial and educational articles for persons with a primarily medical background on principles of engineering with particular significance for biomedical applications and vice versa are presented.
4. Minisymposia (upon invitation only):
Under the leadership of a Special Editor, controversial issues relating to healthcare are highlighted and discussed by various authors.
Abstract: This paper is a contribution on financial sustainability of hospital biobanks and data warehouses for biospecimens. It aims to discuss new venues for cost models in addition to conventional cost recovery models. It follows the first paper issues on economics of biobanking by Huttin and Liebman, where adaptive platforms where already suggested for biobanks in translational medicine. A case study approach is proposed in order to identify the type of cost drivers that will be needed for optimization of resource allocation in hospital biobanks. It can help the collaboration with designers of ontologies for adaptive platforms, with new data elements…on costs and their measurement in different organizational structures.
Abstract: BACKGROUND: The management and the monitoring of the operating rooms on the part of the general management have the objective of optimizing their use and maximizing the internal safety. The expenses owed to their safe use represent, besides reimbursements coming from the surgical activity, important factors for the analysis of the medical facility. OBJECTIVE: Given that it is not possible to reduce the safety, it is necessary to develop supporting systems with the aim to enhance and optimize the use of the rooms. METHODS: The developed analysis model of the operating rooms in…this study is based on the specific performance indicators and allows the effective monitoring of both the parameters that influence the safety (environmental, microbiological parameters) and those that influence the efficiency of the usage (employment rate, delays, necessary formalities, etc.). This allows you to have a systematic dashboard on hand for all of the OTs and, thus, organize the intervention schedules and more appropriate improvements. RESULTS: A monitoring dashboard has been achieved, accessible from any platform and any device, capable of aggregating hospital information. The undertaken organizational modifications, through the use of the dashboard, have allowed for an average annual savings of 29.52 minutes per intervention and increase the use of the ORs of 5%. The increment of the employment rate and the optimization of the operating room have allowed for savings of around $299,88 for every intervention carried out in 2013, corresponding to an annual savings of $343 362,60. CONCLUSIONS: Integration dashboards, as the one proposed in this study as a prototype, represent a governance model of economically sustainable healthcare systems capable of guiding the hospital management in the choices and in the implementation of the most efficient organizational modifications.
Abstract: BACKGROUND: Ferric Carboxymaltose (FCM), Iron Sucrose (IS) and Oral Iron (OI) are alternative treatments for preoperative anaemia. OBJECTIVE: To compare the cost implications, using a cost-minimization analysis, of three alternatives: FCM vs. IS vs. OI for treating iron-deficient anaemia before surgery in patients with colon cancer. METHODS: Data from 282 patients with colorectal cancer and anaemia were obtained from a previous study. One hundred and eleven received FCS, 16 IS and 155 OI. Costs of intravenous iron drugs were obtained from the Spanish Regulatory Agency. Direct and indirect costs were obtained from the…analytical accounting unit of the Hospital. In the base case mean costs per patient were calculated. Sensitivity analysis and probabilistic Monte Carlo simulation were performed. RESULTS: Total costs per patient were 1827® in the FCM group, 2312® in the IS group and 2101® in the OI group. Cost savings per patient for FCM treatment were 485® compared to IS and 274® compared to OI. A Monte Carlo simulation favoured the use of FCM in 84.7% and 84.4% of simulations when compared to IS and OI, respectively. CONCLUSIONS: FCM infusion before surgery reduced costs in patients with colon cancer and iron-deficiency anaemia when compared with OI and IS.
Keywords: Cost-minimization analysis, ferric carboxymaltose, iron sucrose, iron deficiency, colorectal neoplasia
Abstract: BACKGROUND: Each year, hospitals lose a considerable amount of time and money due to misplaced mobile assets. In addition the assets which remain in departments that frequently use them depreciate early, while other assets of the same type in different departments are rarely used. A real time locating system can prevent these losses when used with appropriate asset sharing policies. OBJECTIVE: This research quantifies the amount of time a medium size hospital saves by using real time locating system and proposes an asset selection rule to eliminate the asset usage imbalance problem. METHODS:…The asset selection rule proposed is based on multi objective optimization techniques. The effectiveness of this rule on asset to patient time and asset utilization rate variance performance measures were tested using discrete event simulation method. RESULTS: Results show that the proposed asset selection rule improved the usage balance significantly. Sensitivity analysis showed that the proposed rule is robust to changes in demand rates and user preferences. CONCLUSIONS: Real time locating systems enable saving considerable amount of time in hospitals, and they can still be improved by integrating decision support mechanisms. Combining tracking technology and asset selection rules helps improve healthcare services.
Keywords: Real time locating system, RTLS, healthcare asset management, hospital asset tracking
Abstract: With the development in science, methods of communication are also improved, replacing old ones with new advanced ways in an attempt to make data transfer more secure, safer for health, and time as well as cost efficient. One of such methods is Visible Light Communication, as the name implies data is transferred through a light equipment such as incandescent or florescent bulb having speed of 10 Kb/s or LEDs approaching speed of 500 Mb/s . VLC uses visible light between 384 and 789 THz [2,3]. Though range is limitation of VLC, however data transfer up-to distance of 1…to 2 km although at lower transfer rate has been reached. The VLC system comprises of light source like LED and receiver equipment, however, with advancement, now LEDs are used for both sending and receiving data. LED remains on all the time, and there is no change in brightness level during the whole process, making it safe for eyes. Currently, VLC system is facing some serious technical challenges before it could be applied in daily life.
Abstract: With the increasing incidences of cerebrovascular disease, as well as the morbidity and mortality associated with it, it is of no surprise that there have been much global governmental interest in the primary prevention of this disorder; or at least in the secondary and tertiary prevention and rehabilitation of individuals who have suffered disabilities arising from a recent cerebrovascular attack. Developers and clinicians have not considered one of the key areas in Stroke prevention and management, which is that of secondary prevention, and in particular that of tapping onto smartphone technologies for stroke rehabilitation. There has been much interest in…the development of devices for rehabilitation of stroke patients instead. One of the concerns with regards to conventional bio and mechanical sensors are the costs involved in development, as well as the costs involved when stroke survivors and their caregivers are required to purchase the devices for monitoring and rehabilitation. In view of the current limitations, the S3 Rehab application, which makes use of the smartphone build in sensors, has been conceptualized and has been developed for the two major platforms (Apple and Android platforms). The authors believe that by tapping onto these sensors and by programming a smartphone application that is specifically catered for rehabilitation, it would keep costs minimal for researchers, patients and caregivers. Whilst there is a growing interest in wearable devices and sensors, it is important for developers and researchers to be cognizant that certain interventions, such as rehabilitation could still be done through a smartphone device, instead of investing in new research and development. There are various untapped potential in the smartphone that researchers and developers need to be cognizant of.
Keywords: Smartphone, mobile phone, applications, neurology, stroke, rehabilitation, sensors
Abstract: BACKGROUND: Conventional procedures for contact lens disinfection, based on solutions with aggressive chemical ingredients, not only affect microorganisms but operate likewise damaging towards the epithelial eye surface. OBJECTIVE: The aim of this study was to evaluate the applicability of an alternative or complementary disinfection procedure for contact lenses based on irradiation within the visible wavelength range. METHODS: Suspensions of S. auricularis, B. subtilis and E. coli were exposed to 405 nm irradiation, for determining the disinfection efficacy. Surviving rates were analyzed by membrane filtration as well as a semi-quantitative analysis using DipSlides.…RESULTS: A significant antibacterial effect of the 405 nm irradiation is verifiable for all probed bacteria. Using S. auricularis, there has been no colony forming after an irradiation exposure of 2 hours. CONCLUSION: The hitherto existing results give reason for the assumption that violet LEDs integrated in contact lens cases will provide a subsidiary disinfection activity and maybe even offer the reduction of chemical ingredients in lens cleaning solutions to become gentler to the eye. In addition the danger of a rerise of the germ concentration after the completion of the disinfection procedure will be reduced.