What if we changed the way we delivered healthcare?
A system of home-based care, facilitated by modern telecommunications and information technology, will extend the reach of our primary care health workers enabling them to monitor a patient from a distance, and, more importantly, it will allows us to scale the limited clinical specialist resources we currently have.
One can't miss the recent press around our healthcare system. The hospital based system which we have relied on for decades is creaking at the seams with high occupancy rates, a plethora of quality and safety issues, nosocomial infections getting front page press, and much more.
Yet when we look at ways of fixing the system, all we come up with is build more hospitals, and hire more staff to man these new hospitals. We have opened new medical schools to provide staff for the new hospitals we are building, but no one has stopped and looked at the problem from a different perspective.
Hospitals were designed to take our most acutely unwell people, fix them up, and send them back to the community where their care would continue. However, in the last few decades we have turned them into their own worst enemy. They have become hotels where sick people stay for protracted periods of time.
This is especially true for our elderly. Rather than only admit them when they a need it, we use hospitals as half way homes for elderly people with chronic diseases that can't be treated in a large hospital. Even worse, we increase their risk of infection, physical deconditioning, social isolation, falls and other mishaps.
So if hospitals aren't the solution, how do we cope with an increasingly ageing population, the explosion in chronic diseases being diagnosed, and the significant workforce issues we face in healthcare?
One way would be to invest more in preventative health, which is important, but won't make a dent in the demand for many years.
Another way is to find new models of care for the conditions we know we will have to handle in the short to medium term. These models of care must provide high quality care to their recipients, yet not require us to build new facilities we cannot afford, or hire staff we cannot find. To do this we have to leverage what we have available now, our homes, or family and other caregivers, our primary care health workers, and technologies that didn't exist when we first started building hospitals.
I would suggest that a system of home based care, facilitated by modern telecommunications and information technology allows us to leverage what we currently have available to us and still provide high quality care. Extending the reach of our primary care health workers via the ubiquitous telecommunication networks that exist today, and the advanced technology that allows us to not only monitor a person from a distance, but also interact with them as if we were there. More importantly, it allows us to scale the limited clinical specialist resources we have.
Can a family member in the home facilitate a consultation between an elderly relative and a consultant specialist without having to bundle the elderly relative into a car and travel across the city to wait in a crowded waiting room? Well, just watch your kids communicating with their friends across the world using Skype or MSN and you can see that it isn't "rocket science" so to speak.
To make this available to all who need it requires a scalable solution, and for it to be scalable it has to be able to be provided by a number of vendors. Building solutions around industry standards ensures that the solution is not only scalable, but repeatable and adaptable to change. Industry groups like the Continua Alliance are working to ensure these standards are not only defined, but can be used by the industry to provide solutions.
The opportunities in this area are great, and the benefits even greater. We just need to ensure we are willing to make the leap from old models of care to new ones.
Dr George Margelis (MBBS M.Optom GCEBus) took on the role of Industry Development Manager for Intel's new Digital Health Group in November 2005. For him it was an opportunity to take an active role in changing the way healthcare was delivered in Australia. Prior to joining Intel Australia, George has been very active in the healthcare informatics arena as the CIO of a private hospital group in Sydney, manager of an innovative software development group developing solutions for healthcare providers and consumers, and board member at the state and national level of the Health Informatics Society of Australia. He is a registered medical practitioner having graduated from the University of Sydney. He is also a registered optometrist and holds a graduate degree in E-Business from the University of Southern Queensland. George ran a successful software company during the heady days of the late 1980s and early 1990s and has been an active computer enthusiast from the late 1970s when he acquired his first PC, a Sinclair Z80.
foggy
July 6, 2009 at 5:14 pm
changing ways
I agree investing in preventive medicine is doubly beneficial.also extending the reach of primary health workers via ubiquitous telecommunication networks has multifold benefits.once online appointments are obtained i wish to define the role of a healthcare worker a tiny bit more.
Gone are the days when health volunteers,used to just read(books, news dailies and poems)to the aged.now i feel it is a must for healthcare givers to also get hands- on- training, to describe in simple terms, the many medical equipment which may be used for screening the functions of various systems of the body.especially the ‘tombstone’ like MRI machines.such health care volunteers should stay by the side or near enough to the ageing person being screened or undergoing some necessary tests especially when they tend to be left somewhat alone like in ekg, MRI, LAB specimen collecting, radiological-like when you swallow a bolus or dring several glasses of water for several sequences of tests. healthcare volunteers who understand how to take care of the active and healthy though ageing persons boost confidence in them and create awareness of getting regularly screened for malignancies of their particular age group or check the changing pattern of their hitherto regular blood pressure.and this is definitely a good habit.online reports consultations and follow up naturally follow.