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- Creators: Kashiwagi, Dean
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
Emerging Information Technology, Storage and Evaluation within Healthcare: A Discerning IMT Analysis
Description
The introduction of novel information technology within contemporary healthcare settings presents a critical juncture for the industry and thus lends itself to the importance of better understanding the impact of this emerging "health 2.0" landscape. Simply, how such technology may affect the healthcare system is still not fully realized, despite the ever-growing need to adopt it in order to serve a growing patient population. Thus, two pertinent questions are posed: is HIT useful and practical and, if so, what is the best way to implement it? This study examined the clinical implementation of specific instances of health information technology (HIT) so as to weigh its benefits and risks to ultimately construct a proposal for successful widespread adoption. Due to the poignancy of information analysis within HIT, Information Measurement Theory (IMT) was used to measure the effectiveness of current HIT systems as well as to elucidate improvements for future implementation. The results indicate that increased transparency, attention to patient-focused approaches and proper IT training will not only allow HIT to better serve the community, but will also decrease inefficient healthcare expenditure.
ContributorsMaietta, Myles Anthony (Author) / Kashiwagi, Dean (Thesis director) / Kashiwagi, Jacob (Committee member) / Barrett, The Honors College (Contributor) / Department of Psychology (Contributor) / School of Life Sciences (Contributor)
Created2015-05
Description
Exercise is a great boon to both the health of individuals and the national as a whole. Exercise provides a wide range of significant and well established benefits to both physical and psychological health, with many benefits that are still being discovered. The effects of exercise on health are somewhat unique, as exercise is one of a limited number of ways to improve health that is not harm a reduction strategy, but instead increases health through direct benefit, rather than increasing health by decreasing damage and harm. Support is also given to the proposal that individuals are in best position to determine the intensity of exercise and to choose primary activities to participate in, in order to provide near maximum physical and psychological benefit, with the understanding that frequency of exercise is of the upmost importance for benefit. The accessibility of exercise and the tremendous health benefit of exercise, makes exercise a huge asset in reducing the exorbitant health care spending and improving mediocre health outcomes in this country; a reasonable goal as numerous countries have better health the United States, even though the United States spends the more than any other country on health.
ContributorsRael, Ashur Scott (Author) / Kashiwagi, Dean (Thesis director) / Kashiwagi, Jacob (Committee member) / Barrett, The Honors College (Contributor) / Department of Chemistry and Biochemistry (Contributor) / School of Film, Dance and Theatre (Contributor)
Created2015-05
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
Prenatal care is a widely administered preventative care service, and its adequate use has been shown to decrease poor infant and maternal health outcomes. Today however, in the United States, preterm birth rates remain among the highest in the industrialized world, with low socioeconomic women having the highest risk of preterm births. This group of women also face the greatest barriers to access adequate prenatal care in the United States. This paper explores the viability of short message service to help bridge gaps in prenatal care for low socioeconomic women in the United States and provides areas for further research.
ContributorsMiles, Kelly Nicole (Author) / Ketcham, Jonathan (Thesis director) / Santanam, Raghu (Committee member) / Barrett, The Honors College (Contributor) / W. P. Carey School of Business (Contributor) / Department of Marketing (Contributor) / Department of Finance (Contributor)
Created2014-05
Description
Homelessness is a pervasive in American society. The causes of homelessness are complex, but health and homelessness are inextricably linked. Student-run free clinics care for underserved populations, including people experiencing homelessness, but they have multiple agendas—to provide care but also to give students hands-on experience. It is plausible that these two agendas may compete and give patients sub-par quality of care.
This study examines patient care in the SHOW free clinic in Phoenix, Arizona, which serves adults experiencing homelessness. This study asks two questions: First, do clinicians in Phoenix’s SHOW free clinic discuss with patients how to pay for and where to access follow-up services and medications? Second, how do the backgrounds of patients, measured by scales based on the Gelberg-Anderson behavioral model for vulnerable populations, correlate with patient outcomes, including number of unmet needs in clinic, patient satisfaction with care, and patient perceived health status? To answer these questions, structured surveys were administered to SHOW clinic patients at the end of their visits. Results were analyzed using Pearson’s correlations and odds ratios. 21 patients completed the survey over four weeks in February-March 2017. We did not identify any statistically significant correlations between predisposing factors such as severity/duration of homelessness, mental health history, ethnicity, or LGBTQ status and quality of care outcomes. Twenty nine percent of surveyed patients reported having one or more unmet needs following their SHOW clinic visit suggesting an important area for future research. The results from this study indicate that measuring unmet needs is a feasible alternative to patient satisfaction surveys for assessing quality of care in student-run free clinics for homeless populations.
This study examines patient care in the SHOW free clinic in Phoenix, Arizona, which serves adults experiencing homelessness. This study asks two questions: First, do clinicians in Phoenix’s SHOW free clinic discuss with patients how to pay for and where to access follow-up services and medications? Second, how do the backgrounds of patients, measured by scales based on the Gelberg-Anderson behavioral model for vulnerable populations, correlate with patient outcomes, including number of unmet needs in clinic, patient satisfaction with care, and patient perceived health status? To answer these questions, structured surveys were administered to SHOW clinic patients at the end of their visits. Results were analyzed using Pearson’s correlations and odds ratios. 21 patients completed the survey over four weeks in February-March 2017. We did not identify any statistically significant correlations between predisposing factors such as severity/duration of homelessness, mental health history, ethnicity, or LGBTQ status and quality of care outcomes. Twenty nine percent of surveyed patients reported having one or more unmet needs following their SHOW clinic visit suggesting an important area for future research. The results from this study indicate that measuring unmet needs is a feasible alternative to patient satisfaction surveys for assessing quality of care in student-run free clinics for homeless populations.
ContributorsWilson, Ethan Sinead (Author) / Jehn, Megan (Thesis director) / Harrell, Susan (Committee member) / School of Human Evolution and Social Change (Contributor) / School of Life Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2017-05
Description
Introduction. Evidence shows that the United States' healthcare system is inefficient and lacks the quality and cost-effectiveness of other systems. The Institute for Healthcare Improvement outlined the Triple Aim to improve the healthcare system through 1) improvement of population health for a defined population, 2) enhance the patient care experience, and 3) reduce per capita cost of care. The World Health Organization has identified interprofessional practice (IPP) and interprofessional education (IPE) as a possible approach to achieve the Triple Aim. The Student Health Outreach for Wellness (SHOW) initiative is an interprofessional free clinic and outreach initiative for individuals experiencing homelessness. The goal of the current study was to evaluate whether interprofessional care delivery through SHOW moved SHOW's practice towards the Triple Aim for SHOW's defined population. Methods and Results. Data assessing adherence to Triple Aim goals of population health and costs of care were collected from voluntary post-visit patient satisfaction surveys, while data assessing patient experience were collected from shift rosters of SHOW versus a similar non-interprofessional clinic. SHOW, on average, provided access to more disciplines than a similar non-interprofessional clinic. Access to care cost savings was assessed by surveying patients on where they would have sought care elsewhere SHOW had not been available ; of the 53 patients surveyed, 14 indicated they would have gone to the emergency department (ED); in all, SHOW diverted a little over $30,000 in patient ED visits. Improved health outcomes were measured by each patient's self-perception of his/her health. 91% of patients agreed or strongly agreed that their health had been improved by coming to the clinic. Conclusion. Preliminary data suggest that SHOW's IPP care delivery results in high patient satisfaction rates and positive self-perception of health outcomes, thus may improve the patient experience and minimize costs of care by deterring ED visits within the population. Further studies are needed to determine how specific aspects of interprofessional care can further move towards Triple Aim objectives.
ContributorsSingh, Sukhdeep (Co-author) / Paode, Pooja (Co-author) / Harrell, Liz (Thesis director) / Wermers, Rita (Committee member) / Department of Finance (Contributor) / Barrett, The Honors College (Contributor)
Created2016-05
Description
Biosimilar pharmaceuticals are new lower-cost drugs awaiting large-scale approval within the United States (U.S). Biosimilar pharmaceuticals or simply biosimilars, are complex, large-molecule, and biologically-derived drugs that are deemed molecularly similar to currently approved reference biologics. Biologics and biosimilars both treat a wide range of conditions with no clinically meaningful difference between them. However, numerous states, with help from large pharmaceutical companies lobbying, are passing legislation complicating the prescribing and dispensing process for biosimilars by mandating a "notification" or "communication" requirement. The notification requirement requires pharmacists to contact prescribers when dispensing an interchangeable biosimilar in place of its reference biologic. This type of mandate is not only unprecedented in current U.S. pharmaceutical law, but it also incentivizes pharmacists to dispense more expensive biologics in place of biosimilars. The notification or communication requirement also falsely gives consumers the appearance that biosimilars are more dangerous in comparison to other types of biological medicines. These two factors, pharmacist hesitation and consumer distrust, serve as barriers to successful biosimilar market entry. High research and development costs and forecasted poor sales inhibit biosimilar companies from making the investment in innovating new drugs. The lack of investment in research and development prevents new biosimilars from entering the market to compete with currently approved biologics. In turn, current biosimilar legislation is reducing pharmaceutical competition and increasing drug prices. Information Measurement Theory supports the notion that in climates without competition (caused by a lack of transparency) sparks low quality and high costs. Transparency and improved biosimilar market conditions can be achieved through repealing the large pharmaceutical company backed notification requirement.
ContributorsFelthouse, Karis Renee (Author) / Kashiwagi, Dean (Thesis director) / Kashiwagi, Jacob (Committee member) / School of Politics and Global Studies (Contributor) / School of Film, Dance and Theatre (Contributor) / School of Sustainability (Contributor) / Barrett, The Honors College (Contributor)
Created2016-05
Description
The Performance Based Studies Research Studies Group (PBSRG) at Arizona State University aims to evaluate and provide solutions to problems by using concepts derived from deductive logic. The research group identified that problems in most industries are due to the traditional approach of management, direction and control, and offers a practical contrasting model. The author is a biological sciences major interested in the health care industry. As a volunteer at a local non-profit pregnancy clinic in Tempe, AZ, the author noticed characteristics of the clinic structure that resembled both the traditional approach of management, direction and control and the best value (BV) approach. Although the pregnancy clinic has existed for 30 years and has high patient satisfaction, it faces problems that jeopardize its long term sustainability. This study analyzes the stereotypical structure of non-profit health clinics through literature review and through a case study of a local non-profit pregnancy clinic in Tempe, Arizona. The study identified and analyzed the factors that contribute to inefficiency within non-profit health clinics. The conclusions of the research demonstrate that characteristics of non-profit health clinics that resemble the traditional model perform in a manner that is unsustainable. Recommendations were based on concepts derived from Information Measurement Theory (IMT) and aimed to improve efficiency and effectiveness. The study identifies sources of risks and examines the performance of such organizations; the study concludes that rejection of traditional models and adaptation of the new approach is preferable in improving performance and increasing patient, employee, and volunteer satisfaction.
ContributorsTran, Yvonne Ho (Author) / Kashiwagi, Dean (Thesis director) / Kashiwagi, Jacob (Committee member) / School of Life Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2016-05
Description
Exploration of the history of the managed care industry and the key drivers of profitability using Cigna as a case study. Four key current issues facing the industry are explained and contemplated in different DCF scenario analyses using both fundamental projections as well as modifications to the CAPM formula. Lastly, the recent price action of Cigna is compared to forecasted predictions and explained using the discounted cash flow model.
ContributorsFallin, John Michael (Author) / Simonson, Mark (Thesis director) / Sacks, Jana (Committee member) / Department of Finance (Contributor) / Economics Program in CLAS (Contributor) / Barrett, The Honors College (Contributor)
Created2020-12