Heather Towery and Michael Hough
Digital transformation holds promise for addressing one of the biggest challenges in health care – misdiagnosis. About 30 per cent of health spending in 2009, i.e. roughly $750bn…
Abstract
Purpose
Digital transformation holds promise for addressing one of the biggest challenges in health care – misdiagnosis. About 30 per cent of health spending in 2009, i.e. roughly $750bn, was wasted on unnecessary services, excessive administrative costs, fraud and other problems. Moreover, inefficiencies cause needless suffering, states the Institute of Medicine. Leveraging emerging digital technologies in this sector stands to save thousands of lives and billions of dollars. Digital technology is being applied to this field owing to the great demand for a solution. Misdiagnosis is causing a major hemorrhaging hundreds of billions of dollars in the health industry – an estimated 10-20 per cent of cases are misdiagnosed, sometimes resulting in death or permanent disability, according to studies cited by the National Center for Policy Analysis. Additionally, experts believe as many as 31 per cent of all breast cancer cases are misdiagnosed, according to the New England Journal of Medicine, and 90,000 women are misdiagnosed with invasive breast cancer, according to Susan G. Komen.
Design/methodology/approach
Digital technology is being applied to this field owing to the great demand for a solution. Misdiagnosis is causing a major hemorrhaging hundreds of billions of dollars in the health industry – an estimated 10-20 percent of cases are misdiagnosed, sometimes resulting in death or permanent disability, according to studies cited by the National Center for Policy Analysis. Additionally, experts believe as many as 31 percent of all breast cancer cases are misdiagnosed, according to the New England Journal of Medicine, and 90,000 women are misdiagnosed with invasive breast cancer, according to Susan G. Komen.
Findings
Advance Medical’s experience is that 39 per cent of a self-selecting group of medical advocacy seekers are misdiagnosed. Directly related to this challenge, a major battleground where the war on escalating healthcare costs is being fought is in the space of utilization management tools, which help ensure insurers are paying for the right care. These tools depend on the doctor making the right diagnosis and that the treatment matches the diagnosis. But these tools are broken. Instead of checking accuracy of diagnosis (e.g. the right test was done and interpreted accurately), they are at best checking to see if the “box was checked” for any testing being done. The solution is to not only to ensure that the diagnosis is correct by having it reviewed independently but also to use technology to aid diagnosis and the physician’s overall job. Using tools such as patient portals and data management technology can aid doctors to not burn out from sorting through data but rather using healthcare technology to reduce physician exhaustion and thus misdiagnosis.
Originality/value
New and old tools hold promise for addressing one of the costliest and most able-to-be-impacted challenges in health care – misdiagnosis. Because of misdiagnosis, the health industry is hemorrhaging hundreds of billions of dollars and causing patients undue stress and negative medical impact. Not only does misdiagnosis have a strong effect on the economy and the solvency of the US health care system, it also has a profound effect on the people who are being misdiagnosed, as well as their families and loved ones.
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MICHAEL HOUGH and ROSS I. HARROLD
A societal and educational analysis established the perspective that Australian teachers are working in a context of societal change, with concomitant pressures on their…
Abstract
A societal and educational analysis established the perspective that Australian teachers are working in a context of societal change, with concomitant pressures on their traditional approaches and methods. Further education was seen as a major method of assisting teachers to meet these pressures, and the study addressed the problem of developing policies to induce significant numbers of teachers to undertake further education.
Extends the notion of informality into the area of illegality, looking at how illegal crack vendors in New York use informality to reduce and pass risk to others. Focuses on the…
Abstract
Extends the notion of informality into the area of illegality, looking at how illegal crack vendors in New York use informality to reduce and pass risk to others. Focuses on the techniques used to avoid detection and arrest and the methods of placing risk of imprisonment on smaller, lower‐income dealers. Suggests that this process of exploitation only makes sense when seen in the broader context of inequality in US society where some have nothing to lose by going to jail.
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Jennifer Jane Barton, Tanya Meade, Steven Cumming and Anthony Samuels
– The purpose of this paper is to examine the predictors of self-harm in male inmates.
Abstract
Purpose
The purpose of this paper is to examine the predictors of self-harm in male inmates.
Design/methodology/approach
Male inmates with and without a background of self-harm (i.e. suicidal and non-suicidal) were compared across two distal (static and trait) and two proximal (environmental and current/state psychological) domains. The factors from the four domains which may accurately classify self-harm history were also examined.
Findings
The two groups were significantly different across the four domains, particularly on psychological characteristics. The self-harm group was associated with childhood trauma, violent offences, institutional misconducts and lower levels of social support significantly more than the non-self-harm group. Being single, childhood abuse, impulsivity, antisocial personality disorder and global psychopathology were the five key predictors that contributed to 87.4 per cent of all cases being correctly classified.
Practical implications
The high levels of psychiatric morbidity and childhood trauma in the self-harm group indicated a need for interventions that address emotional and interpersonal difficulties and optimization of adaptive coping skills. Also, interventions may require a focus on the behavioural functions.
Originality/value
A novel approach was taken to the grouping of the variables. A comprehensive range of variables, was assessed simultaneously, including some not previously considered indicators, and in an understudied population, Australian male inmates. The lower levels of agreeableness, conscientiousness and generalized anxiety disorder which distinguished the self-harm and non-self-harm group, were newly identified for self-harm.