Biomedical subjects
Publications and source records attributed to R Tallon.
In this series on health technology assessment, not only will technology design, scientifically validated therapeutic efficacy and relative cost efficiency be evaluated, but also the medical ethical challenges of technology introduction will be explored. Ideally, these considerations can form the foundation for a technology assessment team's discussions.
Technology assessment performed on the wide range of clinical support systems available highlights the potential difficulties encountered when already utilized clinical therapies become subject to careful scientific scrutiny. The technology assessment committee must look beyond tacitly accepted indications for technology use and instead focus their evaluations on current, published clinical outcomes research. Where this latter clinical research is lacking, the technology assessment committee's goal is to balance the best available evidence of clinical safety and efficacy of a technology against the relative costs of that therapy.
Comprehensive, objective plans of clinical care that reflect the optimal diagnosis and treatment must be developed. Standardized plans of patient care that are centered around a specific disease entity meet outcomes management and maximize health delivery quality. This integration is embodied in the philosophy of disease state management.
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International demands for optimizing the quality and cost effectiveness of health care requires the rethinking of traditional wound care paradigms. This essay defines cost effectiveness as the comparative measure of costs to achieve a given clinical outcome. Among some of the issues that need to be addressed are having more studies that compare the cost effectiveness of wound care modalities, defining what an acceptable outcome for a prescribed treatment program is, deciding who should define the significant outcome, and measuring the values of each therapy.
Critical paths and clinical algorithms are an adjunct for quality management of an average person's health problems. A critical path attempts to achieve continuous quality improvement by aligning actions of the care team. Critical paths are difficult to construct for chronically ill patients with comorbidities. Therefore, clinicians are challenged to consider key elements of critical paths: describing normalcy, identifying variances, creating differential diagnoses, handling individual responses to care, managing continuity of care, communicating among team members, discerning chronic disease dilemmas, and developing a common pathway model. Continuity of care and cost effectiveness can be the result of close attention to aspects of critical pathways. Medicine is frequently described as art blended with science. Nowhere is the art of medicine more apparent than in the management of wounds. The challenge of wound care has taxed the ingenuity of countless caregivers from the days when therapeutic armaments consisted of only salves, balms, and poultices to the present plethora of high-tech therapies. Unfortunately, the treatment of patients with wounds for the most part has been relegated to a little-appreciated segment of an equally unappreciated and "unattractive" category of chronic disease.