October 30, 2021

State of the art in cost-effectiveness

 How COVID Can Help Us Refocus On The How And Why Of Value Assessment

An excellent summary on cost-effectiveness, an update on conventional knowledge.

The COVID pandemic has challenged us to reevaluate the role of health care in our personal lives and our society, with important implications for how we approach value as a guide for allocating limited health care resources. We should not squander these insights as the initial shock of the pandemic fades.

Rather, examining our health care system through the economic lens we’ve described—seeing it as a fundamentally flawed market failing to deliver the societal welfare that it could—can guide ongoing efforts to innovate in value assessment and health care delivery writ large.

Banksy in Barcelona

October 29, 2021

AI everywhere (5)

Own the A.I. Revolution: Unlock Your Artificial Intelligence Strategy to Disrupt Your Competition

 In  SECTION II of the book, you'll find: Conversations with Today’s Thought Leaders on A.I., and inside there are interviews on health and medicine applications.

October 28, 2021

Vaccine makers

 Vaxxers: The Inside Story of the Oxford AstraZeneca Vaccine and the Race Against the Virus

The inside story of the Oxford AstraZeneca vaccine, from two of the leading scientists who created it.

Beyond the vaccines:

It seems to me that there are three broad areas that limited our response to Covid-19, and that we need to improve in order to be in a better place the next time: infrastructure (including research and manufacturing), systems (including surveillance, stockpiling and travel bans) and global cooperation and collaboration. The solutions are not necessarily cheap or easy: but nor is dealing with a pandemic. We invest heavily in armed forces and intelligence and diplomacy to defend against wars. In the same way, we need to invest in pandemic preparedness to defend against pandemics.


October 27, 2021

Digital health: the day after

 Digital Health: Unlocking Value in a Post-Pandemic World

This article presents 3 categories of digital health and their relationships to value metrics: (1) telehealth or direct care delivery, (2) digital access tools, and (3) digital monitoring. An evidence-based discussion reveals past successes, current promises, and future challenges in reducing defects in value through digital care. In the coming years, value transformation will become more crucial to the success of health care systems. By using the taxonomy in this article, health systems can better implement digital tools with a value-driven purpose. Defining the role of digital health in the post-pandemic world is needed to assist health systems and practices to build a bridge to value-based care.


October 26, 2021

Payment systems for long-term care

 Pricing long-term care for older persons

Flores M. Increasing beneficiaries and the decline in informal care in the Spanish long-term care system for older persons.
WKC Policy Series on Long-Term Care No. 7: Spain

Further information on this site.

October 22, 2021

Health systems performance

Mirror, Mirror 2021: Reflecting Poorly. Health Care in the U.S. Compared to Other High-Income Countries

Summary of the report : Norway has the best health care system among selected western countries, according to this research

October 21, 2021

Matching supply and demand for plasma

 From deficit to contribution: the case for voluntary compensated plasma collections in Spain

Summary of the report:

The Covid pandemic has exposed the threat to security of plasma supply that national blood operators have been warning about for years, resulting in a 25% decline in plasma donations in the United States. Since the US provides 75% of the world’s supply of plasma for the manufacture of plasma therapies, such a decline represents a threat to patients all over the world. Today only five countries allow the voluntary compensation of plasma donations: US, Austria, Czech Republic, Hungary, and Germany. These countries represent 5% of the world’s population but contribute to over 90% of plasma used for therapies. If the pharmaceutical industry can attend to current demand for plasma products like albumin and immunoglobulin, it is only thanks to the plasma collected in these countries.

Despite being home to Grífols, a world leader in plasma therapies, and despite the innovative approach that characterizes its organ donation and transplantation system, Spain and Catalonia employ an antiquated, inefficient, and ineffective model for plasma collection. The demand of immunoglobulin in Spain has increased 11.7% per year on average between 2015 and 2019. Relying entirely on non-compensated donors will lead to shortages and negatively impact R&D on new plasma-derived therapies.

The policy report published by The Ostrom Institute and coordinated by Peter Jaworski, Associate Teaching Professor at Georgetown University, provides empirical evidence on why Spain should allow the voluntary compensation of plasma donors and proposes a series of policy reforms. In short, Spain and Catalonia should mimic the Czech model of plasma collections and reform the Royal Decree 1088/2005 to allow voluntary compensation of plasma donors.

Food for thought.



October 20, 2021

AI everywhere (3)

 Algorithms Are Not Enough. Creating General Artificial Intelligence

In the last chapter:

An artificial general intelligence agent will need to:

• Address ill-defined problems as well as well-formed problems.

• Find or create solutions to insight problems.

• Create representations of situations and models. What do the inputs look like; how is the problem solution structured (modeled)? What is the appropriate output of the system?

• Exploit nonmonotonic logic, allowing contradictions and exceptions.

• Specify its own goals, perhaps in the context of some overarching long-range goal.

Transfer learning from one situation to another and recognize when the transfer is interfering with the performance of the second task.

• Utilize model-based similarity. Similarity is not just a feature-by- feature comparison but depends on the context in which the judgment is being conducted.

• Compare models. An intelligent agent has to be able to compare the model that it is optimizing with other potential models (representations) that might address the same problem.

• Manage analogies. It must manage analogies to select the ones that are appropriate and to identify the properties of the analogs that are relevant.

• Resolve ambiguity. Situations and even words can be extremely ambiguous.

• Make risky predictions.

• Reconceptualize, reparamaterize, and revise rules and models.

• Recognize patterns in data.

• Use heuristics even if their efficacy cannot be proven.

• Extract overarching principles.

• Employ cognitive biases. Although they can lead to incorrect conclusions, they are often helpful heuristics.

• Exploit serial learning with positive transfer and without catastrophic forgetting.

• Create new tasks.

• Create and exploit commonsense knowledge beyond what is specified explicitly in the problem description. Commonsense knowledge will require the use of new nonmonotonic representations.

I believe that with the right investments, we will be able to develop computer systems that are capable of the full panoply of human intelligence. We cannot limit ourselves to looking where the light is bright and the tasks are easy to evaluate.

At some point, these computational intelligences may be able to exceed the capability of human beings, but it won’t be any kind of event horizon or intelligence explosion. Intelligence depends on content as well as or perhaps more than processing capacity. The need for content and the need for feedback will limit the speed of further developments. If we fail to develop artificial general intelligence, our failure will not be, I think, a technological failure, but one of our own imagination.


October 18, 2021

AI everywhere

 A Citizen’s Guide to Artificial Intelligence

A book on how algorithmic tools are being used in areas ranging from health care, law and social services to social media and business, and it explains the basic technical components of AI in a jargon-free manner.

In chapter 10, on AI regulation:

We need new rules for AI, but they won’t always need to be AI-specific. As AI enters almost every area of our lives, it will come into contact with the more general rules that apply to commerce, transport, employment, healthcare, and everything else.

Nor will we always need new rules. Some existing laws and regulations will apply pretty straightforwardly to AI (though they might need a bit of tweaking here and there). Before we rush to scratch-build a new regulatory regime, we need to take stock of what we already have.

AI will, of course, necessitate new AI-specific rules. Some of the gaps in our existing laws will be easy to fill. Others will force us to revisit the values and assumptions behind those laws. A key challenge in fashioning any new regulatory response to technology is to ensure that it serves the needs of all members of society, not just those of tech entrepreneurs and their clients, or indeed those of any other influential cohort of society.


October 14, 2021

Algorithms: the underpinning of black box medicine?

 Algorithms as medical devices

The rapid growth of digital devices, software and technologies means that the medical device sector is changing. Many small and independent manufacturers are encountering medical device regulation for the first time. At the same time, responsive and effective regulation of digital devices requires sound understanding of the underlying new technologies and concepts.

Algorithms as medical devices describes how digital health is covered by existing medical device regulation and outlines three critical areas: 

The challenges that the digital health sector may pose for regulators and developers

How digital devices can be regulated as medical devices under UK/EU and US law

The specific problems that machine learning could pose to medical device regulation

 Meanwhile the market for black box medicine is growing, unless any regulator leaves their continous vacation.

October 10, 2021

Covid in Latin America

Pandemia y crisis: el covid-19 en América Latina

Free ebook:
La irrupción del coronavirus (Covid-19) ha provocado una multi-crisis sin precedentes. Sus consecuencias son globales y abarcadoras, aunque tengan particularidades en las diferentes regiones del mundo que la enfrenten en condiciones muy desiguales. Van más allá de un tema de salud debido a las repercusiones tan variadas y complejas. En este volumen se reúnen investigaciones desde las Ciencias Sociales y Humanidades que miden los impactos de la crisis sanitaria y de las medidas gubernamentales en América Latina y el Caribe durante la fase inicial de propagación de la enfermedad. Se analizan diferentes estrategias de políticas públicas y se mira cómo las desigualdades en torno al Covid-19 giran por diferentes lados; grupos específicamente vulnerables y efectos sobre subsistemas relevantes. Además, las investigaciones se enfocan en los discursos que circulan en el espacio público en relación con la crisis sanitaria que a su vez muestra las diferentes voces y posiciones en torno a la pandemia.

October 6, 2021

The role of hospitals

 Understanding Hospitals in Changing Health Systems

The health policy community has for decades opposed the roles of primary care and population health against those of hospitals, blinding us about how to govern and resource our health sectors properly

Gathering together expensive people and pieces of equipment in hospitals enables a delivery of care now and in the future which complements yet goes beyond what simpler settings can offer

October 3, 2021

Drug copayment

 Current drug copayment policy in NHS

Summary, 73% of population has income less than 18.000€. (!)

October 1, 2021

The business of pandemics



Chapter 1. Business and Management Lessons Learned from COVID-19

Jaime Ribera, IESE, Spain

Chapter 2. Developing Big Data, Computer Models, and Simulations for Predicting Its Spread

Scott Nestler, University of Notre Dame and Harrison Schramm, Center for Strategic and Budgetary Assessment, USA

Chapter 3. Conducting Global Business Virtually

Erin Makarius and Debmalya Mukharjee, University of Akron, USA

Chapter 4. Global Economic Impact Resulting from COVID-19

Thomas Hanson, Butler University, USA

Chapter 5. Communicating About COVID-19: Dealing with Fear and Emotion

Vincent Covella and Randall Hyer, Center for Risk Communication, USA

Chapter 6. Media and Communications About COVID-19: A WHO Perspective

John Butler and Gabriella Stern, WHO, Switzerland

Chapter 7. Growing Organizational Capacities for Increased Online Learning, Working, and Health

Sharif Nijim, University of Notre Dame and Paul Grist, Amazon Web Services (AWS)

Chapter 8. Social Impact Resulting from COVID-19

Wei Sun, Howard University, and Andrew Critchfield, Independent Scholar

Chapter 9. Online Learning and Educational Innovations Due to COVID-19

Darleen Opfer and Laura Hamilton, RAND Corporation, USA

Chapter 10. The New Work from Home Environment

David Cook, University College London (UCL), UK

Chapter 11. Re-Opening Markets and Businesses that Have Been Shut or Severely Curtailed

Rod McSherry and Matthew Jackson, University of Texas at San Antonio, USA

Chapter 12. Crisis Decision Making Using Analytics and Intuition

Gloria Wren, Loyola University-Maryland; Jean-Charles Pomerol, Université de la Sorbonne, Paris; Fred Adam and Karen Neville, UCC, Ireland