June 2015 – AQuAS Blog

Telemedicine: 18 ways to prevent excess pilots

25 Jun

Tino Martí, Health economist

Telemedicine services, like any other high value technological innovations tend to work well in controlled environments, such as a laboratory, where the most decisive variables are preset. These experiments are called ‘pilots’ and lead up to the spread of innovation. Pilots often present Hawthorne effect features, such as the result bias displayed when the observed is conscious of being observed and adopts the best behaviour accordingly. Under the spotlight, everything works well, but when the project expands, it often fails. The phenomenon is so common that the health authorities have abused the pilots as a means of implementation and currently there’s a lot of talk on pilotitis.

But what makes a project to exceed the pilot phase and become habitual? And what are the features of the projects that reach a large scale implementation? With these questions in mind and relying on the European Commission’s support, the Momentum project was launched in 2012. Its aim was to develop a guide to the successful implementation of telemedicine in Europe and last week they published the provisional list of 18 critical success factors identified by analyzing cases of success in telemedicine, understood as the relationship between professionals and patients who are not in the same place. These factors cover the following blocks: Continue reading →

Can unnecessary hospitalizations be avoided?

18 Jun

Jordi Varela, Editor of the blog “Advances in Clinical Management“

It is said that the best savings in health is in avoidable hospitalisation that doesn’t occur, especially since the use of a hospital bed is the most expensive health resource of all the health offers, but also because if one person, let’s imagine an elderly one with several chronic conditions, can avoid being admitted in hospital, his/her health will suffer less compromising situations. For this reason, all health systems are very active in trying to launch all kinds of measures to reduce the admission of chronic and frail patients.

Dr. Sara Purdy, family physician and Senior Consultant at the University of Bristol, published under the auspices of the King’s Fund, in late 2010, an analysis of what actions reduce the unnecessary hospital admissions and which ones do not. The work of Dr. Purdy is focused only on organisational actions such as home hospitalisation or case management, and, in contrast, does not include strictly clinical factors such as the impact of a new drug for asthma conditions.

Continue reading →

How does participation become effective? Successes, benefits and risks

11 Jun

Marta Millaret, Communication and Documentation Unit, Agència de Qualitat i Avaluació Sanitàries de Catalunya (AQuAS)

To continue the analysis of the participation of citizens in health policies, a careful and wise consideration of who participates, for what reasons and from which location, is required. Let’s go a little further: The 2012 report from the Belgian Health Care Knowledge Centre and the report from the Australian Commission on Safety and Quality in Healthcare, 2010, deal with these issues. An article published in “The Milbank Quarterly” magazine and another one published in the “Health Policy” journal also shed light and shadows on the issue. Let’s see it in terms of successes, benefits and risks.

(Image courtesy of nonicknamephoto at FreeDigitalPhotos.net) Continue reading →

Participation: squaring the circle of heterogeneity

4 Jun

Marta Millaret, Communication and Documentation Unit, Agència de Qualitat i Avaluació Sanitàries de Catalunya (AQuAS)

Beyond the cliché that says that participation is the important thing, the actual times suggest a thorough discussion of the issues, the controversies and the challenges that new participatory models with the promise of participation on the horizon, is on the table in many different areas, not only health.

What’s involved in participation?

It was 1969, when, Arnstein presented eight levels of participation, from low to high in the article “A ladder of citizen participation”.

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Reference: Vancouver Community Network Continue reading →