1 / 65

CPSE June 2011 Dr Brian Robson, Medical Director

When two worlds collide: Bringing Health IT & Quality Improvement together. CPSE June 2011 Dr Brian Robson, Medical Director. Bringing these worlds together. Improvement. Health IT. Improve quality of health and healthcare in the 21 st century. The two ronnies. Some cows. Computers

xanthe
Download Presentation

CPSE June 2011 Dr Brian Robson, Medical Director

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. When two worlds collide: Bringing Health IT & Quality Improvement together CPSE June 2011 Dr Brian Robson, Medical Director

  2. Bringing these worlds together Improvement Health IT Improve quality of health and healthcare in the 21st century

  3. The two ronnies Some cows Computers & Health USA

  4. Computers are useless. They can only give you answers Pablo Picasso

  5. Computers really can improve your health, or at least make your doctor less likely to kill you. The Guardian, Jan 2006

  6. Technology in our lives .....

  7. Advanced computer assisted healthcarecirca 1977 !

  8. http://www.amazon.co.uk/Connected-Health-Electronic-Transform-Delivery/dp/1118018354/ref=sr_1_1?ie=UTF8&qid=1305492814&sr=8-1http://www.amazon.co.uk/Connected-Health-Electronic-Transform-Delivery/dp/1118018354/ref=sr_1_1?ie=UTF8&qid=1305492814&sr=8-1

  9. We live in exponential times http://www.youtube.com/watch?v=cL9Wu2kWwSY

  10. What does this make you think ? • Scared ? • Excited ? • Bored ? • Someone else’s job ? • It’s for the geeks ? • Nothing to do with healthcare ?

  11. About those cows...

  12. Why do the cows in the Isle of Man have better computers than the NHS? Courtesy of Sean Brennan

  13. Data as a byproduct of care Helps to monitor udder condition – identifies possible mastitis – sends SMS to farmer !

  14. Every cow is individual – and has it’s own record .... Based on its ‘COW’ number !

  15. If we can do it for cows ...

  16. ‘Quality Healthcare’ ?

  17. Quality…… http://www.scotland.gov.uk/Resource/Doc/311667/0098354.pdf Scottish Government, May 2010

  18. 3 Quality Ambitions • No avoidable injury or harm from the healthcare they receive, and that they are cared for in an appropriate, clean and safe environment at all times. • The most appropriate treatments, interventions, support and services will be provided at the right time to everyone who will benefit, with no wasteful or harmful variation. • Mutually beneficial partnerships between patients, their families and those delivering healthcare services. Partnerships which respect individual needs and values and which demonstrate compassion, continuity, clear communication and shared decision-making.

  19. 98,000 Number of patients who die every year in US hospitals as a result of medical errors To Err Is Human, Institute of Medicine,2000

  20. To Err Is Human, Institute of Medicine,2000

  21. $38,000,000,000 The financial cost of medical error in the US every year. To Err Is Human, Institute of Medicine,2000

  22. 1200 Number of patients who die every year as a result of medication errors in hospital Audit Commission, E&W, 2001

  23. 2010 .... • 120,000+ adverse events /month • >40% avoidable • Contributing to ~90,000 deaths/year • $4,400,000,000 additional CMS costs http://www.nytimes.com/2010/11/16/business/16medicare.html?_r=2&ref=policy

  24. System failures - 2010 • 7 UK NHS organisations • Failures are common (13-19%) • Real risk to patients • 1 in 7 Rx records contained an error. 20% of which could have resulted in serious harm • 1 in 7 outpatient appointment proceeded with incomplete medical record. 1.5% with no record at all. • Wide variation in reliability • 1 in 5 operations involved wrong, faulty or missing equipment or staff didn’t know where it was or how to use it. http://www.health.org.uk/publications/research_reports/evidence_in_brief.htmlMay 2010

  25. knowledge ?

  26. Guidelines play a vital role ... Average 1.5 million hits / months

  27. Information overload … But every time I learn something new, it pushes something old out of my brain ....

  28. 17 years to apply 14% of research knowledge to patient care! Balas EA, Boren SA. Managing clinical knowledge for health care improvement. Yrbk of Med Informatics 2000; 65-70

  29. Information overload ..... Trainee in cardiac imaging • 40 papers a day • 5 days per week • 11 years to bring up to speed • Another 82,000 relevant papers • 8 years reading • And that’s only cardiac imaging ! …...... ‘It is impossible to be a specialist’ Strategies for coping with information overload. Smith.R. BMJ 2010; 341:c7126

  30. ‘SIGN Apps’ Available free from Apple App Store & Android Stores

  31. Healthcare and IT...

  32. London Times in 1834, describing the stethoscope Healthcare and technology “That it will ever come into general use, notwithstanding its value, is extremely doubtful because its beneficial application requires much time and gives a good bit of trouble, both to the patient and to the practitioner because its hue and character are foreign and opposed to all our habits and associations.”

  33. Almost 10 years ago ! The committee believes IT must play a central role in the redesign of the healthcare system if a substantial improvement in health care quality is to be achieved during the coming decade” Crossing the Quality Chasm 2001

  34. ‘ Widespread implementation of HIT has been limited by a lack of generalizable knowledge, about what types of HIT and implementation methods will improve care and manage costs for specific health organizations.’ Costs and Benefits of Health Information Technology RAND, 2006

  35. “….very limited rigorous evidence that these technologies actually improve either the quality or safety of healthcare”

  36. “….despite these substantial gaps in the evidence-base….. we are cautiously optimistic that a number of the eHealth applications ….will result in significant medium to long term benefits to organisational efficiency and patient care”

  37. Use of Electronic records in Primary care ( 2006 / 2009) Percent Source: 2006 and 2009 Commonwealth Fund International Health Policy Survey of Primary Care Physicians.

  38. State of the Nation - General Practice • 4% full ; 13% partial • ~ 83% not use EHR • High satisfaction • User reported increased quality of care

  39. State of the Nation - Hospital • 1.5% fully • 7.6% partial • ~ 90% not use EHR • 17% prescribing support

  40. $30bn(+) for Health IT

  41. Improve the care system then add IT “We know that if you try to apply IT to something that is fundamentally screwed up it doesn’t help very much!” Prof. Michael Porter Harvard Business School MIT Symposium on Healthcare IT July 2006

  42. Caution To Err is Human, …..but to really screw up you need a computer ! Carolyn Clancy, AHRQ

  43. *

More Related