SCIENCE, PRACTICE AND EDUCATION (pore size and capacities of extracting liquids under were differences between professionals who had or pressure) and the other is aspiration. Most users, had not previously participated in a telemedicine pro- mainly surgeons, were convinced of the approach ject (p < 0.05). Physicians believe in the usefulness of and used it in many clinical indications, applying the e-health. Professionals with previous experience with principle that ‘when it works in practice, the theory it are more open to its implementation and consider will follow’. However, the lack of high-level RCTs that the benefits of technology outweigh its possible demonstrating the added value of the foam had two difficulties and shortcomings. The relationship of us- long-term consequences, the difficulty of obtaining ers to technology differs according to their personal an adapted reimbursement and the introduction or professional experiences. by concurrent companies of devices focused solely on aspiration, which led to different clinical results In contrast to the above, some MDs that have ob- and controversies in the user community. Surgeons tained a certain level of evidence and whose efficacy claimed the foam’s spectacular efficacy and the sim- has been commented on in journals with high impact plification in wound care management, and the tool factors, like honey or maggots, still suffer from men- was adopted without being subject to a methodical tal projections in users’ minds. Honey is not generally decision process. Evidence-based assessments came regarded as innovative, and maggots are often linked later, but were considered by some statisticians to with images of post-mortem decomposition, an im- be biased, and consensus was hard to reach. While age stronger in Southern Europe. These examples still a topic of debate, accumulated pragmatic field highlight the other factors that may impact a device’s evidence suggests that the spread of NPWT was not a image of innovation and marketers’ and lobbyists’ mistake. 2 Nevertheless, this type of chaotic introduc- ability to renew the use of an old medical device. tion of new technologies in daily practice should be avoided, as the challenges in the ensuing years are so CONCLUSION dramatic in many aspects that there is no room for Implementing new technologies in daily practice is empiricism. never an easy task, despite it being necessary for the promotion of efficient healthcare management. The The compliance of physicians in adopting a new help of various professionals not always based in the technology medical field is also sometimes needed. Each indi- In a recent study by Ruiz Morilla et al. 7 to evaluate vidual must bring their own contribution, but a new the opinion of physicians regarding e-health, a ques- medical device has a greater chance of being success- tionnaire they had previously designed and validated ful if professionals are involved in its development was used to interview 930 physicians. The usefulness from the beginning. Technical achievement is also of telemedicine scored 7.4 (SD 1.8) on a scale from crucial for remaining in compliance with all regula- 1–10 (lowest to highest), and the importance of the tory requirements. One of the most difficult steps is Internet in the workplace was rated at 8.2 (SD 1.8). the building, developing and analysing of the results Therapeutic compliance (7.0, SD 1.8) and patient of a properly realised RCT. Another is ensuring a health (7.0, SD 1.7) showed the best scores, but there device’s adoption by a wide number of professionals. m REFERENCES 1. Kacetl J, Maresova P. Legislative and ethical aspects of introducing new technologies in medical care for senior citizens in developed countries. Clin Interv Ag- ing. 2016; 11: 977. 2. Téot L, Guillot-Masanovic M, Miquel P, Truchetet F, Meaume S, Dompmartin A, et al. Clinical impact of negative-pressure wound therapy: A 1126-patient observational. Wound Repair Regen. 2014; 22(3):341–50. doi: 10.1111/wrr.12179. 3. Greenhalgh T, et al., Beyond adoption: A new framework for theorizing and evaluating nonadop- tion, abandonment, and challenges to the scale-up, spread, and sustainability of health and care technologies. J Med Internet Res. 2017; 19(11):e367. 4. Mytton OT, Velazquez A, Banken R, Mathew JL. Ikonen TS, Taylor K, et al. Introducing new technology safely. Qual Saf Health Care. 2010; 19(Suppl 2):i9ei14. Doi:10.1136/qshc.2009.038554. 5. Misser NS, van Zaane B, Jaspers JEN, Gooszen H, Versendaal J. Implementing medical technological equipment in the OR: Factors for successful implementations. J Healthc Eng. 2018. doi. org/10.1155/2018/8502187. 6. Hunt LP, Whitehouse MR, Beswick A, Porter ML, Howard P, Blom, AW. Implications of introducing new technology: Comparative survivorship modeling of metal-on-metal hip replacements and contempo- rary alternatives in the National Joint Registry. J Bone Joint Surg (Am ed); 100(3):189–96. https://doi. org/10.2106/JBJS.17.00039. 7. Ruiz Morilla MD, Sans M, Casasa A, Giménez N. Implementing technology in healthcare: Insights from physicians. BMC Medical Inform Decis Mak. 2017; 17:92. doi 10.1186/s12911-017-0489-2. JOURNAL OF WOUND MANAGEMENT 13 OFFICIAL JOURNAL OF THE EUROPEAN WOUND MANAGEMENT ASSOCIATION
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