Shifting Paradigm: Active and Towards More Efficient Patient Care

The paradigm is shifting on patient care… and in many directions. One of the many things that is exciting about this century’s palpable heartbeat is a noticeable and rightfully unabashed effort by providers of medical and health care (and many others concerned) to wear their sneakers once again, run around, jump up and down, and explore further how patient care is delivered. The resulting new and wiser approach includes the actual patient in the team—having a more active role in the process. This, as we try to reduce (or eliminate) the insurance companies’ role, a separate story that I will leave to the experts.

Before I put the pins on three of today’s determined fragments of this big endeavor, let me hover a little bit.

One of the greatest luxuries this time allows us to enjoy are all the collaborative tools, venues, and even challenges before us. Anybody can work on their opus and offer a piece to the collective as a possible answer to life’s questions. As we have said before, the floodgates have released a sustained flow of enhanced communications (and thus, potential collaboration).

An example of this are the more social and interactive media platforms that our computers now boast. The internet is our drawing board for virtually anything. It’s our direct line to our sought-after answers and fielded questions… and, hilariously, it’s even an open album of  our idiosyncrasies, receptacle for the prosaic details  of our existence.

Kidding aside, there is actual sanity involved in the push for the expanded use of electronic health records. Year after year, the efforts evolve and expand in the hope they will be a sound solution to the fragmentation of patients’ records.

This highlights the first aspect of this shift.

Not only will they be a container for defragmented patient data, they offer convenience in many aspects of care.

1. Enhanced telemedicine options:

Perhaps we can learn from Denmark.

Again, perhaps not to replace face time but to enhance better communication among all players of care, especially between the patient and her doctor.

…he can go to the doctor without leaving home, using some simple medical devices and a notebook computer with a Web camera. He takes his own weekly medical readings, which are sent to his doctor via a Bluetooth connection and automatically logged into an electronic record.

All of this is possible because Mr. Danstrup lives in Denmark, a country that began embracing electronic health records and other health care information technology a decade ago. Today, virtually all primary care physicians and nearly half of the hospitalsuse electronic records, and officials are trying to encourage more “telemedicine” projects like the one started at Frederiksberg by Dr. Klaus Phanareth, a physician there.

Danish information system is the most efficient in the world….
[via NY Times]

Read full article here or you may click on the screen capture above.

The next aspect of the shift requires looking at ourselves, learning from our behaviors and their consequences.

The constant regrouping of human populations is now occurring at a faster rate  than yesterday, speeding the exchange of ideas. Consequently breakthroughs in the sciences and medicine are accelerating, too.

The Human Genome Project — which is now elaborated by many practical offshoots: personalized medicine, bioengineering, gene mapping, synthetic biology, etc. — was just the beginning.

The emerging new theories on aging—gene silencing, mitochondrial theory, and multiple hormone deficiency , are of particular interest. For my own learning, this warrants a second, third, and fourth look, with questions on how we can tease out perfected applications or at least practical, helpful, and safe ones. It’s not so much about answering the unromantic  question of numbers and immortality, but realizing the promise of gaining additional days of quality (or healthy) life lived.

2. Proactive and personalized clinical preventive medical approaches:

Another model of interest is the preventive and integrative approach.

The day has finally come for practical applications, and we are fortunate to have these protocols available albeit with some remaining questions. It’s pushing the state of the art at this point (with differing expert opinions) but could it also pave the way for a new paradigm that is more effective, more efficient, more caring?  Nonetheless, the question of cost and affordability still remains. How can this be made more accessible, should it be proven as one effective model of clinical preventive and integrative care?

Advil, hot tubs and surgery keep most of the Old Timers going, but Bellizzi has ventured further. Two summers ago he became a patient of Dr. Florence Comite, a Manhattan endocrinologist affiliated with Cenegenics Medical Institute. Cenegenics, a privately held company based in Las Vegas, claims to have 10,000 patients and annual revenue of $50 million, making it the country’s foremost purveyor of so-called age-management medicine.

Dr. Comite’s relationship to Bellizzi is like that of an ace mechanic to a classic car. Her job is to keep him finely tuned despite worn parts. “I consider what I do aggressive prevention, the basis of which is metabolism modulation,” Comite says. “Twenty years from now, this will be the standard of care.”

[via NY Times]

Read full article here or you may click on the screen capture above.

Solutions often surface with continued collaboration. This is the third aspect of the shift.

3. True collaboration via patient sensitive health care design:

Innovative institutions like the Institute for Clinical Systems Improvement (ICSI), a non-profit organization, work with this motive. Through its collaborative effort to “provide more patient-centered and value-driven care,” they, along with their member medical groups and health plans, seek out patients for their advisory council.

A more active patient role mean more than encouraging patients to adopt the advice of physicians, nutritionists and physical fitness advisors (in ideal integrative care practices), ICSI opens doors to actual patients’ input in its mission of treatment and care. This also is a good example of shifting paradigms by its democratization of the delivery of care  by including patients’ perspectives in its policies. This venue, at least for those patients benefiting in Minnesota, empowers patients in this active role to make care better and more affordable.

Enhanced telemedicine options, proactive and personalized clinical preventive approaches, and patient-sensitive health care design are only some of the attractive practical components contributing to this shift in patient care. Yet big, open questions remain. How can all these transformative practices be made palpable for the broad population of patients? How can components of care be defragmented and electronic health records be safeguarded against compromised quality? Can there be a realistic balance between excellent patient care and cost-effectiveness?


~ by Karina Descartin on 28 January 2010.

2 Responses to “Shifting Paradigm: Active and Towards More Efficient Patient Care”

  1. ohh God ..the worlds is changing so fast article

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