Keep it to yourself!

I was at a conference over the weekend and patient confidentiality was not on the agenda.

Several speakers used CT scans or other materials in their presentations which clearly displayed the patient's name. In one case, the patient was not only identified, but also his medical condition was discussed in detail. This presenter was from the US, so it seems unlikely that anyone in the room would know that patient, but that's not the point, is it?

A Canadian speaker identified a patient by his initials only, but then went on to indicate that the patient was a retired physician. He went so far as to give his specialty. We know the locale in which the speaker practices, so there may have been other physicians in the room who could put this information together and recognize the patient. Once again, details of his medical history were revealed.

Both speakers are teachers at renowned medical schools. Time for a refresher course, professors!

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What's wrong with this picture? - II

Here's a close-up:




This is photo from the OR change room, but I've seen the same sign in many places around the hospital. I understand the problem: Laundry bag too full = heavy weight = back injury. But is this sign the best solution?

Rather than relying on people not to overfill the bags, we need to change the system so they can't overfill the bags. How about using smaller bags? Of course, the bags will need to be changed more often, or more bags need to be in place so laundry doesn't overflow onto the floor.

See the previous "What's wrong with this picture?". There's a pattern here. I'll keep an eye out for other examples and report back to you.

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Tech bonanza

Today I experienced a sweet technologic convergence that would make any propellor head weep.
Last month, we (finally) got wireless Internet access in the OR. A few of us had already been plugging in cables so we can remotely access our office server, but wireless is soooooo much more convenient.

When I do a clinic at the hospital, I may see up to 20 people. Traditionally, the evening before the clinic, I would make notes from my office computer records to jog my memory about each patient's situation. With wireless Internet, I can have access to my office records live from the hospital. I don't need to make my notes the night before. That saved me 15-20 minutes at the end of a long day.

We also decided to try out Skype's VOIP unlimited calls in North America for about $30. We make lots of long distance calls, so this could save us plenty of money. Today, I tried it out with a USB headset/microphone plugged into my laptop. Excellent sound quality. So far, Skype works great.

So today, I had my computer sitting on the counter outside our clinic room, live access to our electronic medical records, Skype to return any calls from my out-of-town patients, and my PDA running voice recording software to dictate letters which I would download to our remote transcription service.

Nice.

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What's wrong with this picture?

Here's a close-up:



This is a door at one of our local health facilities. By the presence of the fancy electronic lock, you might imagine that there's a reason to keep unauthorized personnel out. Alas, the door doesn't reliable close on its own, so we're relying on people to remember to pull the door closed manually.



Here's the other side of the door. No sign! So if you're on the way out, you won't be reminded.

Shouldn't the sign on this door read: Attention: Maintenance! Please fix this door. (?)

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New Blog - Wikiprostate

I've started Wikiprostate as a trial site for the Prostate Cancer Education Project.

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Wikiprostate - Website for Prostate Cancer Education Project

Check out Wikiprostate - this is where I'll try out ideas for the PCEP.

Type rest of the post here

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New Project! Prostate Cancer Education

The Saskatchewan Surgical Care Network (SSCN) is “an advisory committee to Saskatchewan Health dedicated to creating a more reasonable, fair surgical system for all Saskatchewan people.” I’m the urology representative on the Surgical Services Subcommittee. Our most recent initiative is to improve men’s experience when diagnosed with prostate cancer.

We’re looking at several aspects:

Initial diagnosis (from the initial primary care visit to prostate biopsy)
Access to treatment
Education about prostate cancer diagnosis and treatment

The first piece we’re going to work on is education. Our Prostate Cancer Education working group’s first meeting on October 2 included representation from:

Urology
Radiation Oncology
Patient support/advocacy
Provincial and regional health
Hospital foundation
Nursing education

The main chunks are content and delivery. We want to make the information widely accessible, taking into account varying levels of literacy and access to technology. Even though the final delivery may be using various methods (written, DVD, internet), I’m interested in developing the material using a collaborative, online model a la Wikipedia. I think this approach will help address several problems with producing patient education material.

Similar education projects I’ve been involved with laboured over the material for months, resulting in a monolithic product (usually a pamphlet or brochure) that can’t be easily modified. Even though we had reviewed the pamphlet many times, there would invariably be a forehead-slapping moment when we’d say “We forgot…”

Also, when the information is aimed at patients, it’s difficult for health-care professionals to know what content is appropriate. Is the information relevant? Have we assumed too much regarding prior medical knowledge? Are we presenting the information at a suitable literacy level?

Here’s my suggestion: Break the information into small segments (e.g. explaining the prostate biopsy, prostate anatomy and function, radiation treatment side-effects) and produce a brief, draft presentation on each topic. Post these presentations on the internet, using Youtube (for video) or Slideshare (for Powerpoint). Invite anyone and everyone to comment on them. (An email to a prostate cancer support group should get this rolling.) If the segments are brief, it’s easy to modify them with the requested changes. Once we’re confident that we’ve covered the necessary information, we can consolidate the segments into one presentation (for use on a DVD), or leave them separate on a website so users can more easily access the particular topic they’re interested in.

The most important part of this is Ready… Fire… Aim! Forget about the interminable planning and editing. Let’s get some product out there and rely on the real experts – our patients – to help us refine it.

Stay tuned…

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