This paper recounts the tale of a most vicious dragon that ate thousands of people every day, and of the actions that the king, the people, and an assembly of dragonologists took with respect thereof. (+info)
Yielding the bully pulpit: a conversation with Tommy Thompson. Interview by John K Iglehart.
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In January 2005 Tommy Thompson relinquished the post of secretary of the U.S. Department of Human Services (HHS). Known as being an outspoken defender of his principles throughout his tenure at HHS, Thompson continues that tone in an interview conducted shortly after he left Washington. Topics covered include ways to curb Medicare spending; devote greater attention to preventive health and proper incentives for technology; improve the vaccine infrastructure of the United States and the world; and continue to infuse U.S. foreign policy with what Thompson has termed "medical diplomacy," in an effort to counter the messages of America's enemies. (+info)
Educational governance for the regulation of industry sponsored continuing medical education in interventional and device based therapies.
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The relationship between industry and clinicians in educational programmes needs to be regulated. Industry may be best placed to deliver educational programmes in "craft" related specialties and particularly in areas where device implantation/technology based therapy has a major clinical role. The authors supervise industry sponsored clinical teaching at a purpose built independent teaching facility, and have developed the concept of educational governance to regulate their relationship with their industry sponsor and that concept is presented. (+info)
Grasping the role of technology: a conversation with Ron Dollens. Interview by John K. Iglehart.
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In an interview with Health Affairs founding editor John Iglehart, Ron Dollens outlines the differences between drug and device companies in the current U.S. health care marketplace. He discusses at length the recent Medicare coverage decision regarding implantable cardiac defibrillators, one of his company's major innovations. He sees a growing trend for cost-effectiveness to be considered along with a device's safety and efficacy, and he finds this to be appropriate in an environment characterized by constrained resources. He believes that the United States must find a solution to the problem of uninsurance, if our health care system is to remain competitive in a global economy. (+info)
How changes in the Medicare coverage process have facilitated the spread of new technologies.
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The Medicare coverage decision process can affect the availability and use of new technologies. The Centers for Medicare and Medicaid Services (CMS) has recently made advances in making its coverage decision process speedier, predictable, and more transparent. The CMS recently issued draft Coverage with Evidence Development (CED) guidance to assure that Medicare beneficiaries have access to new technologies through expanded coverage criteria, while gathering information that can be helpful to the doctors who care for them. The CMS continues these efforts with the goal of improving the evidence used for high-quality care, while avoiding unnecessary risks and costs. (+info)
Technological advances in cancer and future spending by the elderly.
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This paper forecasts the consequences of scientific progress in cancer for total Medicare spending between 2005 and 2030. Because technological advance is uncertain, widely varying scenarios are modeled. A baseline scenario assumes that year 2000 technology stays frozen. A second scenario incorporates recent cancer treatment advances and their attendant discomfort. Optimistic scenarios analyzed include the discovery of an inexpensive cure, a vaccine that prevents cancer, and vastly improved screening techniques. Applying the Future Elderly Model, we find that no scenario holds major promise for guaranteeing the future financial health of Medicare. (+info)
Performance evaluation of the CellaVision DM96 system: WBC differentials by automated digital image analysis supported by an artificial neural network.
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We evaluated the CellaVision DM96 (CellaVision AB, Lund, Sweden), an automated digital cell morphology and informatics system for peripheral blood smears. Technologists agreed with 82% of the instrument's preclassifications. Correlation coefficients between final results released from the CellaVision and results obtained by direct microscopy were 0.96 (all neutrophils), 0.94 (lymphocytes), 0.88 (segmented neutrophils), 0.73 (eosinophils), 0.69 (bands), and 0.67 (monocytes). After correction for statistically and clinically insignificant variations, the CellaVision DM96 had 95% sensitivity and 88% specificity for immature myeloid cells. It was 100% sensitive and 94% specific for blasts, and 100% sensitive and 97% specific for unusual WBCs and nucleated RBCs. Advantages of the CellaVision DM96 over direct microscopy include the ability to review slides from a remote location, consultation and quality control on a cell-by-cell basis, and potential labor savings. (+info)
The impact of legislation on future technology development.
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In this paper I examine some of the factors influencing technology development and attempt to explain whether CLIA '88 enhances the opportunities or exacerbates the problems for U.S.-based technology development. The viewpoint I express is concentrated on the clinical chemistry segment of the diagnostics arena. (+info)