Technology Deployment to Improve Clinical Outcomes

作     者：T.M.Judd L.Jacobs M.Jansen B.Birch 

作者机构：clinical technologykaiser permanentebrth boardAtlantaGA30305USA the permanente journalpresidentbrth boardAtlantaGA30305USA iron bow healthcare solutionsAtlantaGAUSA innovation and advanced technologykaiser permanente it0aklandGAUSA 

出 版 物：《中国医疗设备》 (China Medical Devices)

年 卷 期：2016年第31卷第1期

页      面：1-5页

学科分类：0831[工学-生物医学工程（可授工学、理学、医学学位）] 08[工学] 

主　　题：临床医学工程 世界卫生组织 顾问委员会 美国FDA 医疗技术管理 医疗设备 301医院 临床工程 

摘      要：Improved child, newborn, and maternal health(CNM) is a top priority in developing countries. Many factors must be addressed simultaneously to improve clinical outcomes for CNM. A public-private project in Haiti that will deploy the World Health Organization(WHO) evidence-based medicine(EBM) and essential interventions utilizing CNM healthcare technologies(HT), is expected to be a model for improving national health systems. The CNM mortality rates in Haiti are the highest in the western hemisphere with rates similar to those found in Afghanistan and several African countries. Several factors perpetuating this crisis are noted, as well as the most cost-effective interventions proven to decrease CNM mortality rates in low-and middle-income countries. To create major change in health system infrastructure, two strategies are presented, requiring appropriate and leading-edge health technologies(HT), e.g., wireless cellular-network-based Telemedicine(TM):(1) Development of a countrywide network of geographical Community Care Grids to facilitate implementation of frontline interventions;(2) The construction of a central hospital(called Bethesda Referral and Teaching Hospital-BRTH NGO) that will provide secondary and tertiary care for communities throughout the country, including helping local hospitals and clinics practice EBM care. We believe that these strategies-supported by HT will fast track improvement in CNM mortality rates throughout the country and that in a relatively short period of time Haiti s health care system will be among the leaders in the region. Primary factors contributing to the CNM crisis, all addressed by TM:(1) Limited access: demographics, geography, cost, transportation;(2) Inadequate health care facilities: less than 20 NICU beds for 10 million population; BRTH to provide 80 bed NICU and 40 bed PICU in 225 bed hospital;(3) Health care practitioners: inadequate numbers and training;(4) Low % of skilled attendants now at deliveries;(5) Low % of