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Category: Health System Redesign

The Myth of Evidence Based Medicine (in Primary Care in Australia)

The Myth of Evidence Based Medicine (in Primary Care in Australia)

Let me be clear from the outset: I’m grateful for modern medicine.  Without it, myself and many members of my family would be dead. I’m also grateful for doctors.  The majority are very well motivated.  Many are excellent at what they do. With all that said, the more I have worked in healthcare (in Australia), the more concerned I have become about the lack of standardised practice, particularly in primary care.  The idea that medicine is practiced based on consistent,…

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Can “Innovation” Make Healthcare Worse? 7 Common Innovation Anti-Patterns

Can “Innovation” Make Healthcare Worse? 7 Common Innovation Anti-Patterns

I work with a lot of healthcare organisations who, quite rightly, have a significant interest in “innovation”, and how new approaches, techniques and technologies can help them improve the quality, safety and efficiency of the healthcare services that they deliver. I’m genuinely excited by the potential of some of this innovation, which could transform our health systems in exciting and positive ways.  However, much of what passes for “innovation” falls short of being genuinely innovative. Having watched this space for…

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Care Plans, Goals, Actions and Outcomes: The Future Health Record

Care Plans, Goals, Actions and Outcomes: The Future Health Record

It has been a while since I last wrote, having been busy with consulting work, keynote speaking and a family holiday in Europe. As I have been reflecting on new topics to write about, I have realised that there are a number of exciting ideas that need some air time, as I have rarely seen them discussed in association with digital health.  I’ve decided to pull these together into a series of blog posts entitled “The Future of Healthcare”.  I…

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Why Paying Health Providers for Improved Data Quality Won’t Work

Why Paying Health Providers for Improved Data Quality Won’t Work

What if we began to educate health providers, and the public, that health providers that capture high quality data are actually delivering the best quality care?  What if we helped people to understand that clinical documentation and the capture of high quality data is a clinical task, not an administrative task?  What if doctors in hospitals stopped delegating completion of the medical record to the most junior clinician in the room, and began to take pride in recording clinical information…

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“And So It Begins…” – Why We Need To Talk About Medical Paternalism

“And So It Begins…” – Why We Need To Talk About Medical Paternalism

Without being a “difficult patient”, I believe that I would have had to go 50+ hours without food whilst waiting for surgery, rather than the 30 hours I did wait.  Was it really a reasonable expectation that a patient fit around the inability of the hospital to forecast and plan surgical demand in that way?  Did anybody notice or care about the way in which my enforced fasting might impact my outcomes as a patient?   Almost two years ago,…

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Why Digital Health Can’t Deliver Value Without an Understanding of Benefit Asymmetry

Why Digital Health Can’t Deliver Value Without an Understanding of Benefit Asymmetry

Delivering benefits through technology in healthcare has always been hard work.  Far too many projects have delivered a fraction of the benefits that they promised (I’m looking at you EMR systems) and then complained about a lack of health provider adoption.  We need to do better. These challenges are compounded by the fact that governance structures in healthcare are frequently complex, and the way in which benefits accrue within these structures has to be understood in order to appropriately manage…

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Why We Need a Partnership Model Between Patients and Doctors

Why We Need a Partnership Model Between Patients and Doctors

As our health systems slowly (and quite often reluctantly) become aware of the importance of listening to patients, and the growing evidence base to support the fact that engaged patients get better health outcomes, I want to make the case for developing a partnership model between patients and doctors. Before I discuss why I think this is critical to a sustainable health system, I wanted to start by defining what an engaged patient is… An Engaged (or sometimes we use the…

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Trust Network Rollout: A New Approach To Rolling Out Clinical Information Systems

Trust Network Rollout: A New Approach To Rolling Out Clinical Information Systems

As a former healthcare CIO and longtime health consultant, I’ve been through my share of clinical information system rollouts.  A couple have gone well.  Most have gone okay.  A few have left scars. I’ve been reflecting on the successes and failures of these efforts, and what could have been done better.  In doing so, I’ve hit upon an idea that I think is really cool.  I wonder if you’d indulge me… Our traditional approach to implementing clinical information systems is geographic…

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What Exactly Is Digital Health?

What Exactly Is Digital Health?

So what exactly is Digital Health? The majority of people that I speak to still don’t really understand what Digital Health is, nor its potential implications.  Many people, particularly Government health departments are still using the term synonymously with eHealth, which shows a great misunderstanding of the potential power of Digital Health.  As I’ve said previously…   Digital Health gives us an opportunity that we’ve never had before – the chance to reach into the lives of almost every health consumer…

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Is Poor Diagnosis a Leading Cause of Inefficiency in the Health System?

Is Poor Diagnosis a Leading Cause of Inefficiency in the Health System?

Much of the load on the health system is the consequence of the poor performance of current diagnosis processes.  Of GPs who think that their instinct is better than it actually is.  Of wild stabs in the dark based on prejudice, assumption and the couple of questions that GPs have time to ask in a six minute appointment.  Yes, I know that some things are hard to diagnose.  But for God’s sake, we have to get better at this if our…

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