Business Commons^™

Examining The Regulatory Value Of Multi-Route Mammalian Acute Systemic Toxicity Studies, Troy Seidle, Pilar Prieto, Anna Bulgheroni

Troy Seidle, PhD

Regulatory information requirements for pesticides call for submission of acute systemic toxicity data for up to three different exposure routes (oral, dermal, inhalation) for both active ingredients and formulated products. Similar multi-route testing is required in the European Union and elsewhere for industrial chemicals. To determine the value of acute toxicity testing by more than one route, oral-dermal and oralinhalation concordances among regulatory classifications were examined for large data sets of chemicals and pesticide active ingredients. Across all sectors examined, oral acute toxicity classifications for pure active substances were more severe than those derived from dermal data in more than …

An Evaluation Of The Us High Production Volume (Hpv) Chemical-Testing Programme: A Study In (Ir)Relevance, Redundancy And Retro Thinking, Andrew Nicholson, Jessica Sandler, Troy Seidle

Troy Seidle, PhD

Under the US Environmental Protection Agency (EPA) High Production Volume (HPV) Challenge Programme, chemical companies have volunteered to conduct screening-level toxicity tests on approximately 2800 widely-used industrial chemicals. Participating companies are committed to providing available toxicity information to the EPA and presenting testing proposals for review by the EPA and posting on the EPA Web site as public information. People for the Ethical Treatment of Animals (PETA) and a coalition of animal protection organisations have reviewed all the test plans submitted by the participating chemical companies for compliance with the original HPV framework, as well as with animal welfare guidelines …

Humane Society International’S Global Campaign To End Animal Testing, Troy Seidle

Troy Seidle, PhD

The Research & Toxicology Department of Humane Society International (HSI) operates a multifaceted and science-driven global programme aimed at ending the use of animals in toxicity testing and research. The key strategic objectives include: a) ending cosmetics animal testing worldwide, via the multinational Be Cruelty-Free campaign; b) achieving near-term reductions in animal testing requirements through revision of product sector regulations; and c) advancing humane science by exposing failing animal models of human disease and shifting science funding toward human biology-based research and testing tools fit for the 21st century. HSI was instrumental in ensuring the implementation of the March 2013 …

Health Professionals’ Roles In Animal Agriculture, Climate Change, And Human Health, Aysha Z. Akhtar, Michael Greger, Hope Ferdowsian, Erica Frank

Michael Greger, MD, FACLM

What we eat is rapidly becoming an issue of global concern. With food shortages, the rise in chronic disease, and global warming, the impact of our dietary choices seems more relevant today than ever. Globally, a transition is taking place toward greater consumption of foods of animal origin, in lieu of plantbased diets. With this transition comes intensification of animal agriculture that in turn is associated with the emergence of zoonotic infectious diseases, environmental degradation, and the epidemics of chronic disease and obesity. Health professionals should be aware of these trends and consider them as they promote healthier and more …

E-Coaching For Weight Loss, Jennifer Warren

Jennifer Warren

Massteri: Promoting Translational Research And Entrepreneurship At The University Of Massachusetts Medical School, Melissa J. Moore, Celia A. Schiffer, Anastasia Khvorova, Anita Ballesteros, Cynthia Fuhrmann, Jean A. King, Margaret Koziel, Thomas Mccullough, Linda Plano

Celia A. Schiffer

MassTERi is a faculty-led initiative to foster entrepreneurship among UMass Medical School students, postdocs and faculty, and facilitate translation of UMMS discoveries into drugs, products, technologies and companies. The mission of MassTERi is to; foster a culture of entrepreneurship at UMass Medical School and facilitate dynamic partnerships with industry; bridge the gap between UMMS discoveries and their development into drugs, products, technologies and companies; educate and nurture the next generation of translational scientists and entrepreneurs; benefit the public good through development and commercialization of new therapies and creation of high-value life science jobs. We will present information about MassTERi and …

Predicting Patients’ Use Of Provider-Delivered E-Health: The Role Of Facilitating Conditions, E. Vance Wilson, Nancy K. Lankton

Nancy K. Lankton

This chapter presents a new rational-objective (R-O) model of e-health use that accounts for effects of facilitating conditions as well as patients’ behavioral intention. An online questionnaire measured patients’ behavioral intention to use a new e-health application as well as proxy measures of facilitating conditions that assess prior use of and structural need for health services. A second questionnaire administered three months later collected patients’ self-reported use of e-health during the intervening period. The new model increased predictions of patients’ e-health use (measured in R2) by more than 300% over predictions based upon behavioral intention alone, and all measured factors …

Physician Clinical Alignment And Integration: A Community Academic Hospital Approach, Debbie Salas-Lopez Md, Mph, Sandra Jarva-Weiss Jd, Brian A. Nestor Do, Mba, Thomas V. Whalen Md

Debbie Salas-Lopez MD, MPH, FACP

An overwhelming need for change in the U.S. healthcare delivery system, coupled with the need to improve clinical and financial outcomes, has prompted hospitals to direct renewed efforts toward achieving high quality and cost-effectiveness. Additionally, with the dawn of accountable care organizations and increasing focus on patient expectations, hospitals have begun to seek physician partners through clinical alignment. Contrary to the unsuccessful alignment strategies of the 1990s, today's efforts are more mutually beneficial, driven by the need to achieve better care coordination, increased access to infrastructure, improved quality, and lower costs. In this article, we describe a large, academic, tertiary …

Electronic Health Record (Ehr) Adoption: Failure Or Success?, Madison Ngafeeson

Madison Ngafeeson

Electronic Health Record (EHR) is hailed as a health information technology with great potential to significantly boost healthcare outcomes, reduce medical errors, increase legibility and minimize healthcare costs. The implementation of EHRs is expected to be completely mandatory in the United States by 2015. While evidence of EHR system implementation in research goes back over fifteen years ago, and is continually increasingly being adopted, it would seem be a good time to pause and take critical look down the years. Can it be said that EHR implementation has been a success, or, perhaps a failure? This study explores the subject …

Examining Success In Health Information Technology Implementation Research, Madison Ngafeeson

Madison Ngafeeson

The implementation of health information systems (IS) is rapidly increasing. In the United States, $70 billion will be invested by the government to facilitate the adoption of the electronic health record over a ten-year period. However, IS acceptance is not success. We use content analysis to investigate the success component.

Meaningful Use And Meaningful Curricula: A Survey Of Health Informatics Programs In The U.S., Kai Koong, Madison Ngafeeson, Lai Lui

Madison Ngafeeson

The introduction of the US government’s Meaningful Use criteria carries with it many implications including the training curriculum of healthcare personnel. This study examines 108 health informatics degree programmes across the USA. First, the courses offered are identified and classified into generic classes. Next, these generic groupings are mapped to two important frameworks: the Learning to Manage Health Information (LMHI) academic framework; and the Meaningful Use criteria policy framework. Results suggest that while current curricula seemed acceptable in addressing Meaningful Use Stage 1 objective, there was insufficient evidence that these curricula could support Meaningful Use Stage 2 and Stage 3. …

An Exploratory Study Of User Resistance In Healthcare It, Madison Ngafeeson, Vishal Midha

Madison Ngafeeson

The US healthcare system is clearly experiencing a major transition. By 2015, the healthcare sector is expected to have migrated from a paper record system to a completely electronic health record (EHR) system. The adoption and use of these systems are expected to increase legibility, reduce costs, limit medical errors and improve the overall quality of healthcare. Hence, the US government is investing $70 billion over a 10-year period to facilitate the transition to an electronic system. However, early reports show that physicians and nurses among other health professionals continue to resist the full use of the system. This paper …

Depicting Estimates Using The Intercept In Meta-Regression Models: The Moving Constant Technique, Blair T. Johnson Dr., Tania B. Huedo-Medina Dr.

Blair T. Johnson

In any scientific discipline, the ability to portray research patterns graphically often aids greatly in interpreting a phenomenon. In part to depict phenomena, the statistics and capabilities of meta-analytic models have grown increasingly sophisticated. Accordingly, this article details how to move the constant in weighted meta-analysis regression models (viz. “meta-regression”) to illuminate the patterns in such models across a range of complexities. Although it is commonly ignored in practice, the constant (or intercept) in such models can be indispensible when it is not relegated to its usual static role. The moving constant technique makes possible estimates and confidence intervals at …

Rate Setting And Disclosure In Continuing Care Retirement Communities (Ccrcs), Seth C. Anderson, Jeffrey E. Michelman, Raymond M. Johnson, Kristi Quick

Jeffrey E Michelman

By 2026, the population of Americans age 65 and older will double to 71.5 million. According to a recent study by Metlife, et al., there are five important issues that impact both current and future retirees: Increased longevity with Americans living longer; Changing economic factors such as increased health care costs; A growing skills shortage in many industries; Different beliefs about work among the aging Baby Boomer generation; and Financial resources available for retirement. All five of these factors affect both the ways seniors plan for retirement and the ways that organizations providing services to seniors must respond. Continuing care …

Adoption Of The Icd-10 Standard In The United States: The Time Is Now, Alberto Coustasse, David P. Paul Iii

Alberto Coustasse, DrPH, MD, MBA, MPH

The United States is facing a revolution in the health care system soon when the present coding system (International Classification of Diseases, Ninth Revision) will be replaced with what has for some years been the international standard: International Statistical Classification of Diseases, 10th Revision (ICD-10). The ICD-10 system will provide a tremendous opportunity for better capturing information in the increasingly complex delivery of health care. Although the transition to ICD-10 will undoubtedly result in substantial short-term costs, the long-term benefits make the transition imperative.

Physicians, Patients, And Facebook: Could You? Would You? Should You?, Joy Peluchette, Katherine Karl, Alberto Coustasse

Alberto Coustasse, DrPH, MD, MBA, MPH

This paper investigates the opinions of physicians and patients regarding the use of Facebook to communicate with one another about health-related issues. We analyzed 290 comments posted on online discussion boards and found that most (51.7%) were opposed to physicians being Facebook “friends” with patients and many (42%) were opposed to physicians having any kind of Facebook presence. The primary reasons for this opposition were concerns about privacy and the need to maintain professional boundaries in the physician-patient relationship. Others expressed concerns about HIPAA violations. Some believed it was acceptable for physicians to use Facebook as long as they were …

Expanding Technology In The Icu: The Case For The Utilization Of Telemedicine, Stacie Deslich, Alberto Coustasse

Alberto Coustasse, DrPH, MD, MBA, MPH

Introduction: Telemedicine has been utilized in various healthcare areas to achieve better patient outcomes, lower costs of providing services, and increase patient access to care. Tele-intensive care unit (ICU) technology has been introduced as a way to provide effective ICU services to patients with reduced access, as well as to decrease costs and improve patient care. Materials and Methods: The methodology for this qualitative study was a literature search and review of case studies. The search was limited to sources published in the last 10 years (2003–2013) in the English language. In total, 55 references were used for this research …

The Balanced Scorecard Framework-A Case Study Of Patient And Employee Satisfaction: What Happens When It Does Not Work As Planned?, Andrea Lorden, Alberto Coustasse, Karan P. Singh

Alberto Coustasse, DrPH, MD, MBA, MPH

Background: The successful utilization of the balanced scorecard (BSC) framework in health care has been demonstrated in the literature. Given these successes, a financially struggling hospital implemented a BSC framework intervention which attempted a culture change centered upon patient satisfaction which it hoped would translate to improved financial stability. Despite the evidence of BSC successes, the intervention, entitled Route 99, did not succeed in this hospital. Purpose: This case study was conducted to identify learnable lessons and confounding factors associated with the successes and failures of Route 99. Metrics for patient satisfaction and employee satisfaction were examined as reflections of …

Impact Of Radio-Frequency Identification (Rfid) Technologies On The Hospital Supply Chain: A Literature Review, Alberto Coustasse, Shane Tomblin, Chelsea Slack

Shane Tomblin

Supply costs account for more than one-third of the average operating budget and constitute the second largest expenditure in hospitals. As hospitals have sought to reduce these costs, radio-frequency identification (RFID) technology has emerged as a solution. This study reviews existing literature to gauge the recent and potential impact and direction of the implementation of RFID in the hospital supply chain to determine current benefits and barriers of adoption. Findings show that the application of RFID to medical equipment and supplies tracking has resulted in efficiency increases in hospitals with lower costs and increased service quality. RFID technology can reduce …

Mindfulness At Work: Antecedents And Consequences Of Employee Awareness And Absent-Mindedness, Jochen Reb, Jayanth Narayanan, Zhi Wei Ho

Jochen Reb

The present study examines antecedents and consequences of two aspects of mindfulness in a work setting: employee awareness and employee absent-mindedness. Using two samples, the study found these two aspects of mindfulness to be beneficially associated with employee well-being, as measured by emotional exhaustion, job satisfaction, and psychological need satisfaction, and with job performance, as measured by task performance, organizational citizenship behaviors, and deviance. These results suggest a potentially important role of mindfulness at the workplace. The study also found that organizational constraints and organizational support predicted employee mindfulness, pointing to the important role that the organizational environment may play …

The Influence Of Mindful Attention On Value Claiming In Distributive Negotiations: Evidence From Four Laboratory Experiments, Jochen Reb, Jayanth Narayanan

Jochen Reb

We examined the effect of mindful attention on negotiation outcomes in distributive negotiations across four experiments. In Studies 1 and 2, participants who performed a short mindful attention exercise prior to the negotiation claimed a larger share of the bargaining zone than the control condition participants they negotiated with. Study 3 replicated this finding using a different manipulation of mindful attention. Study 4 again replicated this result and also found that mindful negotiators were more satisfied with both the outcome and the process of the negotiation. We discuss theoretical and practical implications, limitations, and future directions.

Regulation Of Over-The-Counter Derivatives: A Comparative Study Of Proposals In Singapore And Hong Kong, Chao-Hung Christopher Chen

Christopher Chao-hung CHEN

This chapter identifies some of the potential legal and policy issues involved in the future regulation of over-the-counter (OTC) derivatives. First, regulators must be cautious in the regulation and solvency of some mammoth clearing- houses. Second, Singapore and Hong Kong both face challenges in the areas of global regulatory cooperation and extra-territorial regulatory effects. Third, the exact scope of a clearing obligation determines whether there is any regulatory competition or room for regulatory arbitrage in the future. Fourth, there are legal definition problems with the term ‘derivative’ and its sub-categories that must be addressed. Fifth, there are potential privacy and …

The Public Health Impacts Of Concentrated Animal Feeding Operations On Local Communities, Michael Greger, Gowri Koneswaran

Michael Greger, MD, FACLM

Large-scale farm animal production facilities, also known as concentrated animal feeding operations (CAFOs), release a significant amount of contaminants into the air and water. Adverse health effects related to exposure to these contaminants among CAFO workers have been welldocumented; however, less is known about their impact on the health of residents in nearby communities. Epidemiological research in this area suggests that neighboring residents are at increased risk of developing neurobehavioral symptoms and respiratory illnesses, including asthma. Additional research is needed to better understand community-scale exposures and health outcomes related to the management practices and emissions of CAFOs.

The Long Haul: Risks Associated With Livestock Transport, Michael Greger

Michael Greger, MD, FACLM

The Food and Agriculture Organization (FAO) of the United Nations describes live animal transport as “ideally suited for spreading disease,” given that animals may originate from different herds or flocks and are “confined together for long periods in a poorly ventilated stressful environment.” Given the associated “serious animal and public health problems,” the Federation of Veterinarians of Europe has called for the replacement of the long-distance transportation of live animals for slaughter as much as possible to a “carcass-only trade.” In the United States, more than 50 million live cattle, sheep, and pigs and an unknown number of the more …

Impact Of Radio-Frequency Identification (Rfid) Technologies On The Hospital Supply Chain: A Literature Review, Alberto Coustasse, Shane Tomblin, Chelsea Slack

Alberto Coustasse, DrPH, MD, MBA, MPH

Supply costs account for more than one-third of the average operating budget and constitute the second largest expenditure in hospitals. As hospitals have sought to reduce these costs, radio-frequency identification (RFID) technology has emerged as a solution. This study reviews existing literature to gauge the recent and potential impact and direction of the implementation of RFID in the hospital supply chain to determine current benefits and barriers of adoption. Findings show that the application of RFID to medical equipment and supplies tracking has resulted in efficiency increases in hospitals with lower costs and increased service quality. RFID technology can reduce …

A Review Of Radio Frequency Identification Technologies And Impacts On The Hospital Supply Chain: 2002–2012, Alberto Coustasse, Shane Tomblin, Chelsea Slack

Shane Tomblin

Supply costs are the second largest expenditure in hospitals, accounting for more than one third of the average operating budget. RFID technology can reduce these costs, improve patient safety, and supply chain management by increasing the ability to track and locate equipment, as well as monitoring theft prevention, distribution management, and patient billing. Findings of this study have shown that the application of RFID on medical equipment and supplies have resulted in efficiency increase in healthcare with lower costs and increased quality services. Even though the cost of RFID implementation is decreasing, the total expenditures are still significant and the …

Interdisciplinary Research And Publication Opportunites In Information Systems And Health Care, E. Vance Wilson, Nancy K. Lankton

Nancy K. Lankton

Healthcare is a large and growing industry that is experiencing major transformation in its information technology base. IS confronted similar transformations in other industries and developed theories and methods that should prove useful in healthcare applications. In turn, IS may benefit from incorporating knowledge from health informatics, a discipline that studies IT within medical and healthcare contexts. Despite the benefits, it is often a struggle for interdisciplinary researchers in IS and healthcare to publish their work, especially in journals directed toward IS audiences. In this paper, we outline strategies and resources to help ease this publication bottleneck. As a part …

The Ins And Outs Of Change Of Shift Handoffs Between Nurses: A Communication Challenge, John S. Carroll, Michele Williams, Theresa M. Gallivan

Michele Williams

Background: Communication breakdowns have been identified as a source of problems in complex work settings such as hospital-based healthcare. Methods: The authors conducted a multi-method study of change of shift handoffs between nurses, including interviews, survey, audio taping and direct observation of handoffs, posthandoff questionnaires, and archival coding of clinical records. Results: The authors found considerable variability across units, nurses and, surprisingly, roles. Incoming and outgoing nurses had different expectations for a good handoff: incoming nurses wanted a conversation with questions and eye contact, whereas outgoing nurses wanted to tell their story without interruptions. More experienced nurses abbreviated their reports …

Hospital Costs And Clinical Characteristics Of Continuous Renal Replacement Therapy Patients: A Continuous Ethical Dilemma, Alberto Coustasse

Alberto Coustasse, DrPH, MD, MBA, MPH

This study describes the clinical characteristics and examines hospital costs involved in the care of 117 patients undergoing Continuous Renal Replacement Therapy (CRRT) between January 1999 and August 2002. The majority (70.9%) of the patients undergoing CRRT expired in the hospital. Statistically significant differences were found with respect to the length of stay for discharge status and gender; and with respect to costs for surgery versus no surgery and gender. Significant differences were also found between discharge status and gender, age, and cardiovascular surgery. The results of this study raise economic and ethical questions related to the cost/benefit of CRRT …

Importance Of New Technologies For Diabetes Monitoring, David P. Paul Iii, Joey Preast, Zach Garrett, Alberto Coustasse

Alberto Coustasse, DrPH, MD, MBA, MPH

Diabetes and its ramifications and treatments are presented, followed by discussion of the importance of communication between patient and clinician. Improved communication approaches, including telephone consultations, blood glucose communications to a provider with feedback, and active electronic diaries on smartphones for both type 1 and type 2 diabetes mellitus, are reviewed.