May 2017

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« PROOF Open House - Physician Resource Office of the Future | Main | What is Physician Engagement? »

Comments

Dave Sellers

We are have a pilot trial working were the Dietitian can distribute a CD to her patients which has an application that the patient can install on their PC. This application captures all the food they eat in the specified time period. This data is emailed to the Dietitian who then can import it into her local application, running detailed analysis reports which she will discuss with the patient at a future meeting. This will save her 2 hours per patient.

We also let our patients input via our web site their weight and waist measurements. This data is appended to their EMR nightly. The Medical staff (Dietitian, Physician, Nurse Practitioner) can then review this data at any time, run graphs, etc.

We have other "risk" surveys that we are developing that will also be uploaded into the patients EMR.

The patients can not view any medical data via the Internet.

John Fernandes MD

Nice idea, but I would be concerned regarding the cost of implementing the technology in terms of software/hardware/monitoring cost.
It would perhaps be worthwhile to see if implementing the technology under certain reproducible circumstances, would represent an overall cost savings to the government....under that condition, I would imagine that it could be implemented with government support.

I am also concerned about the gradual progression of relegating human interaction to "remote monitoring". This technology should be a COMPLEMENT to human interaction and monitoring, not a replacement for it. The temptation for the latter should be avoided in strict policy implementation guidelines....

I can barely get my grandmother-in-law to turn on the TV, never mind set up a "video chat conference" with somebody for a quick chat about their health. It would be nice to see that the technology could be implemented with reliable ease of use that requires no maintainence by the home user.

I can also imagine the video chat hardware flying out the window after my grandmother-in-law viewed her third "fatal error encountered" message on her video chat screen that has been set up on a system running something from Microsoft...

Craig

This is the future of monitoring. Hospitals do not have the budget to monitor people in the bed, but as people survive more and more surgeries, you will see more and more remote monitoring coming into the market. It's an exciting and growing market. Not perfect, but there is huge potential here.

Alan Brookstone for Ken Hurley

I received the following insightful comments from Ken Hurley and have posted these on his behalf:

I looked at this from three perspectives, as an Healthcare informatics implementer of EMR software, as a Sr. healthcare informatics systems consultant, and as a family care giver for senior family members.

From the first perspective it goes without saying that the change process for the health care team (physician, community nursing and family members) to adopt this kind of technology will have to be carefully planned and coordinated if it is to be of value. That being said it is quite apparent that there are many significant benefits that can be derived for both the patient and health care team as a whole; savings in care time resulting in both cost savings and efficiency gains, a greater security of delivery along the care path, the patient's emotional stability and confidence in their care team could be much improved, resource savings overall for both healthcare and the family, all that is needed is the will to do it and the required supporting infrastructure resources to make it happen.

From my second perspective, I have been actively involved with the extended care of several Senior members of our family for the past 15 years. Both my wife and I found this to be an exciting and enlightning development, once we have explored it in more detail and discussed it amongst our family group I am quite confident that we will engage and challenge our healthcare team to implement some of the components of this technology wherever practical and supportable.

Finally from a Sr. systems worker (25+ years) point of view; the technolgies represented here are not new persay, over automation is always a concern. While working in the Aviation industry for several years we conducted studies into the safety of cockpit automation and found that when actual human interventions were omitted from processes the result could be disastorous. However it can be overcome by careful analysis. In this case, it is critical to both document and understand the processees that are at play in respect of remote health care of Senior or Chronic patients.

Telehealth has been around for a long time, in the UK/Scotland they have a hybrid callout system that would be very supportive of this kind of care technology. At it's core however is an established on the ground local healthcare team (the human component) very much involved, coordinated, and accessible locally to facillitate and manage the care. In Canada/BC we are just now starting to build this kind of care model, but have a long way to go, the human resource area is our weakest link or lack therof.

Our challenge is 'The future is here, we need to have the will and resources to organize ourselves collectively.'

jonathan Marcus MD

I am certain that this type of monitoring, collection and collation of data into an EMR/ EHR will happen in the future.

But I think that the infrastructure for such evolution needs to start now with much lower tech ways of expanding EMR's to be much more user friendly. This user friendliness should extend beyond the doctor's office and onto secure internet access for not only the doctor but also for the patient. Patients should be able to view their own health records. Additionally they should be able to add to these records when and where relevant. This should start with them being able to update their demographic info and extend into managing appointments. Furthermore they should be able to upload blood pressure reading and blood sugar measurements as well as any other relevant information. EHR should be customizable so that at definable points, the doctor and patient could be prompted to contact their healthcare professional.

I've been looking at EMRs in the past few months and sadly they all seem about the same...not particularly user friendly, not customizable to any great degree. I'd really like to know when the vendors will start trying to design products which suit health care professionals and patient rather than trying to shoehorn us into their products.

I have many other ideas on this topic but will leave it with these brief comments.

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