One of the big challenges that we currently face in Canada relates to the 'mapping' of healthcare information technology to the workflow process (clinical and business). What I mean by this is that we have not yet done a good enough job at describing the clinical and workflow needs of healthcare, understanding the current system and determining where and how EMRs/EHRs can be applied to enhance the process. We have tended to focus on the IT rather than focus on the underlying system, ensuring that the way that we currently work is the most efficient way to deliver care and then determining how we apply technology in the most effective manner.
If we have poor business processes relating to delivery of care (e.g. duplication of effort in schedule management, dual systems to manage the same data and complex referral systems) and we do not first fix the underlying problems, we simply enable inefficient processes with IT..... not an ideal solution.
The 'Choose and Book' system in the UK is gaining support and becoming more of the norm in terms of how patients are referred in the NHS. This short article in eHealth Insider, describes the progress that is being made.
"Choose and Book has been used for more than 25,000 bookings in a single day for the first time. The e-booking system recorded more than 25,000 referrals one day last week, according to Choose and Book medical director Dr Stephen Miller. Dr Miller told EHI Primary Care: “That is our highest ever bookings day in a single day.” Dr Miller said that despite the increase in bookings usage of Choose and Book remains around the 50% mark with around 85% of all GP practices using the system to make referrals in the last week. Dr Miller said the 50% figure was good news but there remained another 50% of bookings which were not made using the system. Link: E-Health Insider Primary Care :: Choose and Book breaks 25K a day.
Should we be developing similar systems in Canada? By adopting this type of approach, do you think we would force more attention on the detailed processes of care delivery?
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There has also be a fair amount of criticism directed towards Choose and Book in terms of its implementation and the basic philosophy behind it. We've done a study, just published in BMC Medical Informatics, that found patients were not experiencing the degree of choice intended: http://www.biomedcentral.com/1472-6947/8/36
Posted by: Dr Henry Potts | August 01, 2008 at 07:00 AM