This wasn't on the front page of the Globe and Mail, but it should have been! Check out the examples of "using math and technology to re-engineer how the system works".
Monday, April 7, 2008
Front page news! Engineering techniques improve health care.
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3 comments:
Good link -- talked to him before I started all of this blog stuff. I was originally going to associate with U Waterloo but the focus is very much to research and research dollars. From my point of view we already have 90% of what is needed. The trick is putting the techniques into the hands of the primary care office administrators and workers so they know how and when to use it. hands down, thought, Mike is Canada's pre-eminant authority on lean process but he's on the research side not implementation.
Very good point Ian – we need to start at the Primary Care Level, not from the top down. It does not help to start when the patient is in ICU, the access level care and hold-ups have occurred way down the line.
The first step is information sharing, by the most appropriate provider at the point of care.
An example:
Patient X is seen after hours in a Walk-in Clinic
The First Physician (GP) has no immediate access to any previous information
The First Physician (GP) does all the relevant tests and examinations
The First Physician (GP) refers the patient to a Tertiary care Facility
The Second Physician (Specialist) has only the referral letter with no immediate access to previous information
The Second Physician (Specialist) does all the relevant test and examinations and refers the patient to the Third Physician (CCA)
The Third Physician (CCA) admits the patient to the ICU
The Third Physician (CCA) has only the referral with no immediate access to any of the previous information. The Third Physician request the standard “CCU workup”
The Third Physician (CCA) treats the patient successfully and discharge the patient to the ward
The Fourth Physician (Specialist, taking call for his/her colleague, the Second Physician) has no immediate access to any of the above information and repeat tests and investigations
The Fourth Physician discharges the patient to the Fifth Physician (Family Physician) who has not yet received the consult note from the Second Physician (Specialist), and has no means to access the First Physician’s (GP) notes to determine why the patient saw the Second Physician (Specialist). There is no way to access ICU records, and the Family Physician has no idea which tests were done by the Third Physician (CCU). The Fourth Physician (Specialist) did not dictate any notes yet, as he/she was just covering for the Second Physician (Specialist) – who is not back from leave yet.
The Family Physician, who is now responsible for this patient has only the discharge note stating which medications the patient is on……
By having one piece of technology –like a universal, accessible EMR, can you imagine how much money could have been saved? How many man-hours could have been devoted to access and patient care?
Dear Dr Kishore Visvanathan!
I'm a medical student and a medical blogger and I'm currently recruiting bloggers who would be interested in participating in a blogging panel at the Medicine 2.0 Congress taking place in Toronto (this September). Sam Solomon from Canadian Medicine directed me to you.
I would organize everything, we would only have to show our blogging skills in person and discuss some interesting points regarding the advantages and dangers of medical blogging.
If you're interested, please contact me (berci.mesko at gmail.com).
Thank you in advance!
Yours Sincerely,
Bertalan Meskó
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