ABSTRACT
Linezolid is identified as an effective drug with which to treat patients failing multidrug-resistant (MDR)-tuberculosis (TB) treatment. However, cost and safety are the concerns. In India, the average price of a 600-mg pill of linezolid is less than one US dollar, much cheaper than most of the third-line drugs. A prospective study of 29 MDR-TB treatment failure patients (16 with laboratory-proven extensively drug-resistant (XDR)-TB and the remaining 13 with MDR-TB with resistance to any quinolone but sensitive to injectables) was carried out in Delhi, India. All patients received daily unsupervised therapy with linezolid, one injectable agent, one fluoroquinolone and two or more other drugs. Patients received a median of six anti-mycobacterial agents. Besides linezolid, capreomycin, moxifloxacin, levofloxacin and amoxycillin-clavulanic acid were used in 41.4%, 58.6%, 41.4%, and 79.3% of patients. Out of a total of 29 patients, 89.7% patients achieved sputum smear and culture conversion; 72.4% showed interim favourable outcome; 10.3% died, 6.8% failed and 10.3% patients defaulted. Linezolid had to be stopped in three (10.3%) patients due to adverse reactions. The outcome of treatment of 16 XDR-TB patients was comparable to the other 13 MDR-TB patients. Linezolid is an effective, cheap and relatively safe drug for patients failing MDR-TB treatment, including those with confirmed XDR-TB.
Subject(s)
Acetamides/administration & dosage , Acetamides/economics , Drug Costs , Extensively Drug-Resistant Tuberculosis/drug therapy , Extensively Drug-Resistant Tuberculosis/economics , Oxazolidinones/administration & dosage , Oxazolidinones/economics , Acetamides/adverse effects , Adolescent , Adult , Anti-Bacterial Agents/administration & dosage , Anti-Bacterial Agents/adverse effects , Anti-Bacterial Agents/economics , Anti-Infective Agents/administration & dosage , Anti-Infective Agents/adverse effects , Anti-Infective Agents/economics , Antitubercular Agents/administration & dosage , Antitubercular Agents/adverse effects , Antitubercular Agents/economics , Drug Therapy, Combination , Female , Fluoroquinolones/administration & dosage , Fluoroquinolones/adverse effects , Fluoroquinolones/economics , Humans , India , Linezolid , Male , Middle Aged , Oxazolidinones/adverse effects , Prospective Studies , Treatment Outcome , Young AdultABSTRACT
This paper presents an overview of the healthcare systems in Southeast Asia, with a focus on the healthcare informatics development and deployment in seven countries, namely, Singapore, Cambodia, Malaysia, Thailand, Laos, the Philippines and Vietnam. Brief geographic and demographic information is provided for each country, followed by a historical review of the national strategies for healthcare informatics development. An analysis of the state-of-the-art healthcare infrastructure is also given, along with a critical appraisal of national healthcare provisions.
Subject(s)
Medical Informatics/organization & administration , Telemedicine/organization & administration , Asia, Southeastern , Cross-Cultural Comparison , Decision Support Systems, Clinical/organization & administration , Delivery of Health Care/organization & administration , Hospital Information Systems/organization & administration , Humans , Medical Informatics/methods , Medical Records Systems, Computerized/organization & administration , Telemedicine/methodsABSTRACT
Recent healthcare trends clearly show significant investment by healthcare institutions into various types of wired and wireless technologies to facilitate and support superior healthcare delivery. This trend has been spurred by the shift in the concept and growing importance of the role of health information and the influence of fields such as bio-informatics, biomedical and genetic engineering. The demand is currently for integrated healthcare information systems; however for such initiatives to be successful it is necessary to adopt a macro model and appropriate methodology with respect to wireless initiatives. The key contribution of this paper is the presentation of one such integrative model for mobile health (m-health) known as the Wi-INET Business Model, along with a detailed Adaptive Mapping to Realisation (AMR) methodology. The AMR methodology details how the Wi-INET Business Model can be implemented. Further validation on the concepts detailed in the Wi-INET Business Model and the AMR methodology is offered via a short vignette on a toolkit based on a leading UK-based healthcare information technology solution.
Subject(s)
Hospital Communication Systems/organization & administration , Information Systems/organization & administration , Humans , Organizational InnovationABSTRACT
Healthcare institutions globally are currently having major problems accessing and maintaining the large amounts of data that are continuously being generated. Examination of the clinical procedures relating to patient management reveals that many of these activities are repetitive. Workflow Management Systems (WFMS) can automate these repeated activities. Moreover, the introduction of WFMS would enable healthcare institutions to face this challenge of transforming large amounts of medical data into contextually relevant clinical information and knowledge. In order to emphasise the dynamic connection between healthcare, workflow and internet technologies, the intelligence continuum is introduced.
Subject(s)
Delivery of Health Care , Efficiency, Organizational , Internet , Aged, 80 and over , Delivery of Health Care/methods , Hospital Information Systems/statistics & numerical data , Humans , Medical Informatics/methods , Medical Records , Patient Care Management/methods , WorkforceABSTRACT
The notion of incorporating knowledge management (KM) in the healthcare sector has recently witnessed a lot of interest, both from healthcare practitioners and scholars. Because KM for healthcare has just started to appear on the radar of healthcare stakeholders, there exists very limited research (particularly empirical data) to guide healthcare stakeholders, both from an academic and organizational perspective. This paper attempts to contribute to the adoption of KM in the clinical and healthcare sectors by collecting and analyzing data on technological, organizational and managerial perspectives on KM in these sectors. This paper provides an analysis of a case study which looks at current practices towards healthcare information management.
ABSTRACT
The objective of this paper is to examine the Knowledge Management(KM) paradigm in the context of UK paramedics' assessment and treatment of patients with suspected acute myocardial infarction (MI) or ;heart attack' We outline the role of thrombolytic therapy and other aspects of emergency cardiac care and discuss how contemporary KM tools and techniques can be used to support the development and retention of key clinical skills and knowledge in this emerging field of parcice.
ABSTRACT
The objective of this paper is to examine the efficacy of the Knowledge Management (KM) paradigm for a web-based patient administration system (PAS) for cardiovascular disease (CVD). We discuss the role of contemporary information and communication technologies (ICTs) for the management of electrocardiographic information and how this can act as a foundation for a KM-based system.
ABSTRACT
Knowledge Management (KM) has made a significant impact on the global healthcare sector. However, it is important to address the link between knowledge, information and engineering. Knowledge Engineering (KE) is often only a small part of a KM-based project, yet some KM practitioners favour wholly KE-biased Knowledge Management projects, disregarding a more necessary holistic stance. This paper analyses some current achievements in the KM field and provides a benchmark from which academics and practitioners can attempt to attain "Total Knowledge Management for Healthcare" (TKMh).
ABSTRACT
The objective of this paper is to determine the future for Knowledge Management (KM) applications that focus on healthcare processes. This is achieved by tracing the evolution of KM by examining how different sectors have formulated industry-specific KM applications, then discussing the key constraints that these sectors have faced whilst formulating industry specific KM applications. It then details how these constraints can impede the coming of age of KM applications for healthcare. The results of several case studies on the future of healthcare KM applications are presented. This paper thus attempts to contribute to the adoption of KM in healthcare by looking at how practitioners can overcome stumbling blocks in KM healthcare applications.
