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- All Subjects: healthcare
- Creators: Harrington Bioengineering Program
- Creators: Department of Supply Chain Management
- Member of: Theses and Dissertations
- Status: Published
Description
Many developing countries do not have health care systems that can afford technological biomedical devices or supplies to make such devices operational. To fill this void, nonprofit organizations, like Project C.U.R.E., recondition retired biomedical instrumentation so they can send medical supplies to help these developing countries. One of the issues with this is that sometimes the devices are unusable because components or expendable supplies are not available (Bhadelia). This issue has also been shown in the Impact Evaluations that Project C.U.R.E. receives from the clinics that explain the reasons why certain devices are no longer in use. That need underlies the idea on which this honors thesis has come into being. The purpose of this honors project was to create packing lists for biomedical instruments that Project C.U.R.E. recycles. This packing list would decrease the likelihood of important items being forgotten when sending devices. If an extra fuse, battery, light bulb, cuff or transducer is the difference between a functional or a nonfunctional medical device, such a list would be of benefit to Project C.U.R.E and these developing countries. In order to make this packing list, manuals for each device were used to determine what supplies were required, what was necessary for cleaning, and what supplies were desirable but functionally optional. This list was then added into a database that could be easily navigated and could help when packing up boxes for a shipment. The database also makes adding and editing the packing list simple and easy so that as Project C.U.R.E. gets more donated devices the packing list can grow.
ContributorsGraft, Kelsey Anne (Author) / Coursen, Jerry (Thesis director) / Walters, Danielle (Committee member) / Harrington Bioengineering Program (Contributor) / Barrett, The Honors College (Contributor)
Created2018-05
Description
In the medical industry, there have been promising advances in the increase of new types of healthcare to the public. As of 2015, there was a 98% Premarket Approval rate, a 38% increase since 2010. In addition, there were 41 new novel drugs approved for clinical usage in 2014 where the average in the previous years from 2005-2013 was 25. However, the research process towards creating and delivering new healthcare to the public remains remarkably inefficient. It takes on average 15 years, over $900 million by one estimate, for a less than 12% success rate of discovering a novel drug for clinical usage. Medical devices do not fare much better. Between 2005-2009, there were over 700 recalls per year. In addition, it takes at minimum 3.25 years for a 510(k) exempt premarket approval. Plus, a time lag exists where it takes 17 years for only 14% of medical discoveries to be implemented clinically. Coupled with these inefficiencies, government funding for medical research has been decreasing since 2002 (2.5% of Gross Domestic Product) and is predicted to be 1.5% of Gross Domestic Product by 2019. Translational research, the conversion of bench-side discoveries to clinical usage for a simplistic definition, has been on the rise since the 1990s. This may be driving the increased premarket approvals and new novel drug approvals. At the very least, it is worth considering as translational research is directly related towards healthcare practices. In this paper, I propose to improve the outcomes of translational research in order to better deliver advancing healthcare to the public. I suggest Best Value Performance Information Procurement System (BV PIPS) should be adapted in the selection process of translational research projects to fund. BV PIPS has been shown to increase the efficiency and success rate of delivering projects and services. There has been over 17 years of research with $6.3 billion of projects and services delivered showing that BV PIPS has a 98% customer satisfaction, 90% minimized management effort, and utilizes 50% less manpower and effort. Using University of Michigan \u2014 Coulter Foundation Program's funding process as a baseline and standard in the current selection of translational research projects to fund, I offer changes to this process based on BV PIPS that may ameliorate it. As concepts implemented in this process are congruent with literature on successful translational research, it may suggest that this new model for selecting translational research projects to fund will reduce costs, increase efficiency, and increase success. This may then lead to more Premarket Approvals, more new novel drug approvals, quicker delivery time to the market, and lower recalls.
ContributorsDel Rosario, Joseph Paul (Author) / Kashiwagi, Dean (Thesis director) / Kashiwagi, Jacob (Committee member) / Harrington Bioengineering Program (Contributor) / Barrett, The Honors College (Contributor)
Created2016-05
Description
This article summarizes exploratory research conducted on private and public hospital systems in Australia and Costa Rica analyzing the trends observed within supply chain procurement. Physician preferences and a general lack of available comparative effectiveness research—both of which are challenges unique to the health care industry—were found to be barriers to effective supply chain performance in both systems. Among other insights, the ability of policy to catalyze improved procurement performance in public hospital systems was also was observed. The role of centralization was also found to be fundamental to the success of the systems examined, allowing hospitals to focus on strategic rather than operational decisions and conduct value-streaming activities to generate increased cost savings.
ContributorsBudgett, Alexander Jay (Author) / Schneller, Eugene (Thesis director) / Gopalakrishnan, Mohan (Committee member) / Barrett, The Honors College (Contributor) / Department of Supply Chain Management (Contributor) / Department of English (Contributor)
Created2015-05
Description
One of the most prominent biological challenges for the field of drug delivery is the blood-brain barrier. This physiological system blocks the entry of or actively removes almost all small molecules into the central nervous system (CNS), including many drugs that could be used to treat diseases in the CNS. Previous studies have shown that activation of the adenosine receptor signaling pathway through the use of agonists has been demonstrated to increase BBB permeability. For example, regadenoson is an adenosine A2A receptor agonist that has been shown to disrupt the BBB and allow for increased drug uptake in the CNS. The goal of this study was to verify this property of regadenoson. We hypothesized that co-administration of regadenoson with a non-brain penetrant macromolecule would facilitate its entry into the central nervous system. To test this hypothesis, healthy mice were administered regadenoson or saline concomitantly with a fluorescent dextran solution. The brain tissue was either homogenized to measure quantity of fluorescent molecule, or cryosectioned for imaging with confocal fluorescence microscopy. These experiments did not identify any significant difference in the amount of fluorescence detected in the brain after regadenoson treatment. These results contradict those of previous studies and highlight potential differences in injection methodology, time windows, and properties of brain impermeant molecules.
ContributorsWohlleb, Gregory Michael (Author) / Sirianni, Rachael (Thesis director) / Stabenfeldt, Sarah (Committee member) / Barrett, The Honors College (Contributor) / Harrington Bioengineering Program (Contributor)
Created2015-05
Description
Objective: To assess and quantify the effect of state’s price transparency regulations (hereafter, PTR) on healthcare pricing.
Data Sources: I use the Healthcare Cost and Utilization Project’s Nationwide Inpatient Sample (NIS) from 2000 to 2011. The NIS is a 20% sample of all inpatient claims. The Manhattan Institute supplied data on the availability of health savings accounts in each state. State PTR implementation dates were gathered by Hans Christensen, Eric Floyd, and Mark Maffett of University of Chicago’s Booth School of Business by contacting the health department, hospital association, or website controller in each state.
Study Design: The NIS data was collapsed by procedure, hospital, and year providing averages for the dependent variable, Cost, and a host of covariates. Cost is a product of Total Charges within the NIS and the hospital’s Cost to Charge ratio. A new binary variable, PTR, was defined as ‘0’ if the year was strictly less than the disclosure website’s implementation date, ‘1’ for afterwards, and missing for the year of implementation. Then, using multivariate OLS regression with fixed effect modeling, the change in cost from before to after the year of implementation is estimated.
Principal Findings: The analysis estimates the effect of PTR to decrease the average cost per procedure by 7%. Specifications identify within state, within hospital, and within procedure variation, and reports that 78% of the cost decrease is due to within-hospital, within-procedure price discounts. An additional model includes the interaction of PTR with the prevalence of health savings accounts (hereafter, HSAs) and procedure electivity. The results show that PTR lowers costs by an additional 3 percent with each additional 10 percentage point increase in the availability of HSAs. In contrast, the cost reductions from PTR were much smaller for procedures more frequently coded as elective.
Conclusions: The study concludes price transparency regulations can lead to a decrease in a procedure’s costs on average, primarily through price discounts and slightly through lower cost procedures, but not due to patients moving to cheaper hospitals. This implies that hospitals are taking initiative and lowering prices as the competition’s prices become publically available suggesting that hospitals – not patients – are the biggest users of price transparency websites. Hospitals are also finding some ways to provide cheaper alternatives to more expensive procedures. State regulators should evaluate if a better metric other than charge prices, such as expected out-of-pocket payments, would evoke greater patient participation. Furthermore, states with higher prevalence of HSAs experience greater effects of PTR as expected since patients with HSAs have greater incentives to lower their costs. Patients should expect a shift towards plans that offer these types of savings accounts since they’ve shown to have a reduction of health costs on average per procedure in states with higher prevalence of HSAs.
Data Sources: I use the Healthcare Cost and Utilization Project’s Nationwide Inpatient Sample (NIS) from 2000 to 2011. The NIS is a 20% sample of all inpatient claims. The Manhattan Institute supplied data on the availability of health savings accounts in each state. State PTR implementation dates were gathered by Hans Christensen, Eric Floyd, and Mark Maffett of University of Chicago’s Booth School of Business by contacting the health department, hospital association, or website controller in each state.
Study Design: The NIS data was collapsed by procedure, hospital, and year providing averages for the dependent variable, Cost, and a host of covariates. Cost is a product of Total Charges within the NIS and the hospital’s Cost to Charge ratio. A new binary variable, PTR, was defined as ‘0’ if the year was strictly less than the disclosure website’s implementation date, ‘1’ for afterwards, and missing for the year of implementation. Then, using multivariate OLS regression with fixed effect modeling, the change in cost from before to after the year of implementation is estimated.
Principal Findings: The analysis estimates the effect of PTR to decrease the average cost per procedure by 7%. Specifications identify within state, within hospital, and within procedure variation, and reports that 78% of the cost decrease is due to within-hospital, within-procedure price discounts. An additional model includes the interaction of PTR with the prevalence of health savings accounts (hereafter, HSAs) and procedure electivity. The results show that PTR lowers costs by an additional 3 percent with each additional 10 percentage point increase in the availability of HSAs. In contrast, the cost reductions from PTR were much smaller for procedures more frequently coded as elective.
Conclusions: The study concludes price transparency regulations can lead to a decrease in a procedure’s costs on average, primarily through price discounts and slightly through lower cost procedures, but not due to patients moving to cheaper hospitals. This implies that hospitals are taking initiative and lowering prices as the competition’s prices become publically available suggesting that hospitals – not patients – are the biggest users of price transparency websites. Hospitals are also finding some ways to provide cheaper alternatives to more expensive procedures. State regulators should evaluate if a better metric other than charge prices, such as expected out-of-pocket payments, would evoke greater patient participation. Furthermore, states with higher prevalence of HSAs experience greater effects of PTR as expected since patients with HSAs have greater incentives to lower their costs. Patients should expect a shift towards plans that offer these types of savings accounts since they’ve shown to have a reduction of health costs on average per procedure in states with higher prevalence of HSAs.
ContributorsSabol, Joshua Lawrence (Author) / Reiser, Mark (Thesis director) / Ketcham, Jonathan (Committee member) / Dassanayake, Maduranga (Committee member) / Barrett, The Honors College (Contributor) / School of Mathematical and Statistical Sciences (Contributor) / Department of Supply Chain Management (Contributor)
Created2015-05
Description
The global population over the age of 60 is estimated to rise to 23% by 2050 only increase the prevalence of functional neurological disorders and stroke. Increase in cases of functional neurological disorders and strokes will place a greater burden on the healthcare industry, specifically physical therapy. Physical therapy is vital for a patient’s recovery of motor function which is time demanding and taxing on the physical therapist. Wearable robotics have been proven to improve functional outcomes in gait rehabilitation by providing controlled high dosage and high-intensity training. Accurate control strategies for assistive robotic exoskeletons are vital for repetitive high precisions assistance for cerebral plasticity to occur.
This thesis presents a preliminary determination and design of a control algorithm for an assistive ankle device developed by the ASU RISE Laboratory. The assistive ankle device functions by compressing a spring upon heel strike during gait, remaining compressed during mid-stance and then releasing upon initiation of heel-off. The relationship between surface electromyography and ground reactions forces were used for identification of user-initiated heel-off. The muscle activation of the tibialis anterior combined with the ground reaction forces of the heel pressure sensor generated potential features that will be utilized in the revised control algorithm for the assistive ankle device. Work on this project must proceed in order to test and validate the revised control algorithm to determine its accuracy and precision.
This thesis presents a preliminary determination and design of a control algorithm for an assistive ankle device developed by the ASU RISE Laboratory. The assistive ankle device functions by compressing a spring upon heel strike during gait, remaining compressed during mid-stance and then releasing upon initiation of heel-off. The relationship between surface electromyography and ground reactions forces were used for identification of user-initiated heel-off. The muscle activation of the tibialis anterior combined with the ground reaction forces of the heel pressure sensor generated potential features that will be utilized in the revised control algorithm for the assistive ankle device. Work on this project must proceed in order to test and validate the revised control algorithm to determine its accuracy and precision.
ContributorsGaytan-Jenkins, Daniel Rinaldo (Author) / Zhang, Wenlong (Thesis director) / Tyler, Jamie (Committee member) / Harrington Bioengineering Program (Contributor, Contributor) / Barrett, The Honors College (Contributor)
Created2019-05
Description
The purpose of this thesis is to gain a more nuanced understanding of what research is currently going on in the academic realm of supply chain management. This thesis is composed of two parts. The first part contains summaries and personal takeaways from four different supply chain management seminars that were put on by professors who were visiting the ASU campus. These seminars include general topics such as RFID readability, supply chain cash conversion cycles, risk management within the healthcare supply chain, and building trust and trustworthiness in global business. The second part of the thesis will then use a literature review to expand upon the topic of risk management within the healthcare supply chain, and to explore how previous research ties into the current happenings of the industry, as well as its future implications.
ContributorsHemzacek, Noah (Author) / Printezis, Antonios (Thesis director) / Choi, Thomas (Committee member) / Department of Finance (Contributor) / Department of Supply Chain Management (Contributor) / Barrett, The Honors College (Contributor)
Created2018-05
Description
The healthcare industry is currently facing significant changes. One of the changes in the industry is a movement towards patient-focused care, which considers the patient as a person and the impact of care on the person. Patient experience is part of patient-focused care, and has similarities to the marketing term customer experience, which contributes to happier customers and long-term financial growth and success for businesses. This thesis defines current issues in patient experience as it relates to hospital manager decision making. Through secondary research, this thesis demonstrates what patient experience is, the role it plays in healthcare and hospital settings, the pressures on hospitals to increase patient experience performance, how patient experience performance is measured, and what strategies or action drive improvements under current performance measurements. Many studies and articles exist examining each of these issues individually. However, these sources do not comprehensively define patient experience in hospitals with perspective on how this influences hospital strategy and decision-making. Previous works on patient experience from the perspective of hospital strategy do not include considerations for recent industry shifts, most notably the Patient Protection and Affordable Care Act. The collected definitions in this thesis provide guidance of relevant concerns hospital managers consider when formulating organization-wide strategy related to patient experience. This thesis explains how patient experience contributes to the success of hospitals in the short-term, medium-term, and long-term and how patient experience may shift its focus over time. Short-term concerns include specific regulations and definitions from the Centers for Medicare and Medicaid services, responsible for over half of all payments to hospitals. Conforming to CMS standards is a matter of survival for most hospitals in the short-term. Hospitals are adjusting to rules and payment models not in existence just two years ago. First, hospitals will adapt, and then hospitals will strive to optimize under new standards as well as respond to adjustments in the rules over the next several years. After patient experience standards are well established, certain aspects of patient experience will be part of long-term differentiation and success for hospitals. Responding comprehensively to the shift towards improving patient experience is a critical aspect for hospitals to weather the many changes in the healthcare industry. Patient experience will provide better care to patients and better financial health to the hospitals that perform above patient experience standards.
ContributorsWilton, Kara Alexandra (Author) / Ketcham, Jonathan (Thesis director) / Ostrom, Amy (Committee member) / Barrett, The Honors College (Contributor) / W. P. Carey School of Business (Contributor) / Department of Supply Chain Management (Contributor) / Department of Marketing (Contributor)
Created2014-05
Description
Thesis Abstract: Cygnal The healthcare market plays a vital role in how our team worked with innovation space to design a product that fit user needs and could be a sustainable business. Whatever product we design is going to be dictated based off of how the insurance market will pay for it and how much we can charge for our product and services. In fact, the healthcare market is so incredibly unclear with outdated regulations that all of these fraud schemes and inflammatory prices are bound to happen. Stronger government involvement in this instance, I believe would help the issue. In reality, there are so many people taking advantage of the system that you cannot put the blame on anyone exploiting the system. What is clear though, is that they are taking advantage of a system that looks like it was set up to allow them to do so, and in that sense, Medicare is responsible for allowing this market to become warped. The healthcare industry played a vital role in our team for Innovation Space is completing our project. If we do not have a firm understanding on how the insurance market works, how much wheelchair companies are pricing chair components for, and how easily customers can see a financial benefit in switching to our product, it will not survive in the market place. That is why I as the business student am dedicating a lot of time in the final months of our project to make sure that our pricing is accurate, and feasible. The health insurance market, even if it is dysfunctional, will be ultimately paying for our product, and in business if you do not truly know your customer, you are bound to lose him. This paper uncovers why this market is warped and how to do business within it.
ContributorsMefford, Michael James (Author) / Peck, Sidnee (Thesis director) / Boradkar, Prasad (Committee member) / Barrett, The Honors College (Contributor) / Department of Economics (Contributor) / Department of Supply Chain Management (Contributor) / W. P. Carey School of Business (Contributor)
Created2015-05
Description
This paper takes a look at developing a technological start up revolving around the world of health and fitness. The entire process is documented, starting from the ideation phase, and continuing on to product testing and market research. The research done focuses on identifying a target market for a 24/7 fitness service that connects clients with personal trainers. It is a good study on the steps needed in creating a business, and serves as a learning tool for how to bring a product to market.
ContributorsHeck, Kyle (Co-author) / Mitchell, Jake (Co-author) / Korczynski, Brian (Co-author) / Peck, Sidnee (Thesis director) / Eaton, John (Committee member) / Barrett, The Honors College (Contributor) / Department of Finance (Contributor) / Department of Economics (Contributor) / Department of Management (Contributor) / Department of Psychology (Contributor) / Department of Supply Chain Management (Contributor) / School of Accountancy (Contributor) / W. P. Carey School of Business (Contributor)
Created2014-05