White Papers
Communicore publishes White Papers that offer well-referenced, objective, brief yet comprehensive overviews of important medical issues confronting the healthcare community. The majority of these White Papers are written for multiconstituency audiences, and include a review not only of the medical issues involved, but also of the administrative, economic and societal aspects of each issue. Click on any of the titles below to review an abstract of the corresponding White Paper.
Avoiding Electrosurgical Injury During Laparoscopy
Collection of Umbilical Cord Blood
Detecting the Silent Handicap in Children [Infant Hearing Screening]
Emerging Issues in Mechanical Ventilation Management
Enhancing Objectivity in the Diagnosis of Coronary Artery Disease
Evolution of Clinical Thermometry
The Evolution of Evidence-Based Clinical Performance
Measures
in Healthcare
Future of Low-Temperature Sterilization Technology
Hypoxemia on the General Care Floor
Hypoxemia on the General Care Floor: Economic and Risk Management
Issues
Information Management in Anesthesia
Microstream Technology: Expanding the Role of Clinical Capnography
Patient Awareness During Anesthesia
Radiation Exposure During Fluoroscopy
Supportive Therapies for Cancer Chemotherapy Patients
Transmyocardial Revascularization in the Management
of Angina
To obtain a copy of any of these white papers, please e-mail us and specify the white paper title.
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Avoiding Electrosurgical Injury During Laparoscopy
The dramatic increase in the number of minimally invasive surgeries performed in the U.S. each year has lead to a corresponding increase in iatrogenic complications, especially those associated with electrosurgical procedures. These complications generally result from unintentional and usually undetected burns to otherwise normal tissues, with consequent tissue trauma, necrosis, infection, and even death. Available technology, including active electrode monitoring, can effectively protect patients from this entirely avoidable negative outcome. Accompanies Issues Video of the same title. 1997, 26 pp.
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Breast Cancer Diagnosis
Advances in breast cancer diagnosis lag behind efforts to encourage widespread screening. Biopsy is effective, but costly, invasive, and can cause physical and emotional trauma. These aspects are explored as is the potential role of newer technologies--including high resolution digital ultrasound--as an adjunct to mammography to better distinguish between benign and malignant breast masses. 1995, 16 pp.
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Collection of Umbilical Cord Blood
The umbilical cord is an important source of blood sampling for use in numerous diagnostic, therapeutic, and screening applications, including transfusions, genetic testing, and providing cells for bone marrow transplants. New technologies can improve both the efficiency and safety--particularly to healthcare workers--of umbilical cord blood collection. 1992, 14 pp.
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Detecting the Silent Handicap in Children
[Infant Hearing
Screening]
Early identification of hearing impairment can help prevent problems in language and speech development that can have profound personal, societal and economic consequences. A new generation of technologies, including Auditory Brainstem Response (ABR) monitoring that measures the electrophysiologic response of the brainstem auditory pathways to an acoustic stimulus in infants, now allows testing to occur even in newborns, thereby removing what has hitherto been a significant barrier to the performance and reliability of early hearing screening. 1991, 20 pp.
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Emerging Issues in Mechanical Ventilation Management
Mechanical ventilation, while one of the most effective procedures in critical care medicine, has long been practiced more as an imperfect art than a science. Inadequate patient monitoring by the ventilator's built-in monitors has too often resulted in the patient fighting with, rather than being assisted by, the ventilator. New technology that monitors the patient's pulmonary function rather than the ventilating machine can effectively address this significant clinical challenge. Accompanies Issues Video Patient Monitoring in Mechanical Ventilation. 1992, 17 pp.
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Enhancing Objectivity in the Diagnosis of Coronary Artery Disease
Anatomic diagnosis of coronary artery disease, including angiography and thallium scintigraphy, indirectly and imprecisely identifies the functional significance of coronary artery lesions. An analysis of currently available diagnostic techniques includes a look at functional angiometry--direct, quantitative measurements of blood flow impairment--to more accurately determine the need to treat an observable coronary artery occlusion, thereby potentially avoiding unnecessary angioplasty or bypass grafting. Accompanies Issues Video of the same title. 1994, 13 pp.
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Evolution of Clinical Thermometry
The advent of the infrared (IR) aural thermometer with infrared optical sensors marks a significant change in both the method and location of temperature taking, resulting in accurate, rapid and convenient temperature monitoring in a variety of clinical settings. 1992, 17 pp.
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The Evolution of Evidence-Based Clinical Performance Measures in Healthcare
Evidence-based clinical performance measures are emerging as a powerful and credible information resource for enhancing a managed care organization's (MCOs) quality improvement efforts. Properly deployed and interpreted, these measures allow MCOs and providers to alter clinical practices to facilitate better outcomes and an improved standard of care. Using the measures to monitor quality over time requires knowledge of the purpose and intended use of the measures, the characteristics of the clinical conditions being measured, and the characteristics of the measures being considered for use.
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Future of Low-Temperature Sterilization Technology
Preventing patient exposure to microbial organisms on instruments utilized during diagnostic or therapeutic procedures is central to ensuring quality healthcare delivery. Environmental regulations, health and safety issues, the rapid rise of minimally invasive surgery, and cost constraints have all driven the need to develop new sterilization methods, including hydrogen peroxide gas plasma, to complement or replace older and less efficient or acceptable technologies. 1996, 28 pp.
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Hypoxemia on the General Care Floor
Hypoxemia--inadequate oxygenation of the blood--raises several significant clinical issues. Institution of safety standards and advances in monitoring for hypoxemia via telemetric pulse oximetry networks appear to be the most promising means of ensuring safety for patients on the general care floor at risk for the serious clinical effects of this preventable condition. Accompanies Issues Video Safety on the General Care Floor . 1992, 17 pp.
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Hypoxemia on the General Care Floor:
Economic and
Risk Management Issues
Hypoxemia--inadequate oxygenation of the blood--raises several economic and risk management issues in addition to the significant clinical issues. Expanded monitoring capabilities, including telemetric pulse oximetry, can improve risk management and result in significant cost savings, including those resulting from being able to transfer patients who only require continuous monitoring from acute care areas to less expensive general care areas. Accompanies Issues Video of the same title. 1997, 16 pp.
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Information Management in Anesthesia
Handwritten anesthesia records are no longer adequate to track a patient's clinical course during modern anesthesia. Computer monitoring not only enhances the quality of the anesthesia record--improving accuracy, reliability and credibility--but can also integrate management information that can significantly enhance resource and risk management strategies. Accompanies Issues Video of the same title. 1989, 13 pp.
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Infusion Therapy Safety
Issues of patient safety during infusion therapy arise from both the function and design of electronic infusion devices. Proactive development of safety protocols to ensure the safe delivery of intravenous fluids to an increasingly ill patient population, treated in increasingly diverse environments, is essential. 1992, 14 pp.
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Microstream Technology: Expanding the Role of Clinical Capnography
Deployment of microstream capnography in a variety of inpatient and outpatient settings now enables physicians to rapidly, accurately, and noninvasively detect changes in the status of patients suffering a variety of emergency, acute, and chronic cardiopulmonary conditions. Critical decisions to admit patients for treatment, to transfer patients from intensive care units, to switch from bi-level to mechanical ventilation, and to wean patients from ventilation can be made more objectively and cost effectively using microstream capnography. 1997, 20 pp.
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Patient Awareness During Anesthesia
Awareness during anesthesia may occur in up to 150,000 patients who undergo general anesthesia in the U.S. each year. Patients may suffer severe physical and psychological trauma from such an experience, which not surprisingly can also lead to significant malpractice claims. New EEG technology can greatly improve the accuracy of patient awareness monitoring during anesthesia. 1996, 23 pp.
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Radiation Exposure During Fluoroscopy
Fluoroscopy offers real-time x-ray imaging of the internal structure and functioning of the body. As more fluoroscopies are performed, however, radiation exposure to patients and medical staff is increasing. Alternative approaches to fluoroscopy design could result in reduced radiation exposure while preserving fluoroscopic image resolution. 1997, 28 pp.
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Sudden Cardiac Arrest
Sudden cardiac arrest (SCA) takes the lives of more than 350,000 Americans each year. Defibrillation administered within minutes of SCA is generally the only successful method of preventing a fatal outcome. A new generation of automatic external defibrillators (AEDs), with enhanced ease of use and maintenance, can now be deployed among a wider range of emergency first responders, such as police and fire department personnel, significantly improving the survivability of SCA, as can its availability in workplaces, sports facilities, airplanes and other public areas. Accompanies Issues Video of the same title. 1996, 19 pp.
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Supportive Therapies for Cancer Chemotherapy Patients
The inherent toxicity of cancer chemotherapy underscores the importance of quality of life as a treatment goal along with prolonging survival. As the potential benefit of chemotherapy increases, so does the responsibility to attend to the risks and side effects--physical, psychological, economic and societal--of that treatment. Accompanies Issues Video of the same title. 1995, 16 pp.
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Transmyocardial Revascularization in the Management of Angina
Not all angina patients respond successfully to traditional medical or surgical therapy, including angioplasty and coronary artery bypass grafting, raising important economic and quality of life issues. Transmyocardial revascularization (TMR) is a new therapeutic approach in which focused lasers perforate areas of ischemic myocardium creating new transmyocardial channels that bypass the coronary arteries altogether, offering treatment opportunities to patients otherwise considered unsuitable for further surgical intervention. 1996, 18 pp.
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