I try, whenever possible, to listen to the TED talks as I find them a fascinating and eclectic mix of ideas and concepts with broad application. Paddy Ashdown is a British politician and diplomat who served with the United Nations and as a negotiator on behalf of the UN in Afghanistan. He states, “Everything is connected to everything” (12:58 of the presentation). “The paradigm structure of our time is the Network... the most important thing about what you can do, is what you can do with others... resulting in a shared destiny.” These are lessons that can be applied to the healthcare system.
So, what does this have to do with healthcare and, more specifically, health IT? In a traditional model, acute, community, and primary care function independently with loose connections between the sectors. Each has its own oversight, budget, and governance. Sometimes the sectors communicate with one another, but frequently they do not, resulting in duplication of services (e.g. lab results and diagnostics), ineffective hand-offs (hospital or ER discharges), and poor coordination of care (particularly in primary care).
The reality is that in a healthcare system struggling to sustain itself with unlimited demand for services, we can no longer afford silos. In the words of Paddy Ashdown, as patients we “share a common destiny”. The barriers are artificial — created by historical structures, processes, and policies.
In order to “fix” the healthcare system, we have to turn many of these accepted norms upside down and place the patient at the centre of the re-engineering process.
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