I really dislike wasting time . Time is finite and we never know when we will run out of it.
I love trying to make things easier, processes simpler and more efficient. I’m a huge believer in the power of technology to help us accomplish this, to facilitate our lives.
Sometimes, despite all the Innovation and the amazing potential available today, our daily medical practice can be so frustrating,
Take for instance, in the words of a surgeon, the morning “rounds” of a physician in the hospital. Every day, all the “inpatients” under our care, have to be checked and visited; we have to gather data in each one of them, examine them, analyze each case and then produce and enact a plan to hopefully help them heal and get better.
In the “old days”, we would talk to and examine the patients, check their vitals, review with the nurse and their assessments and then come up with a final plan.
In the modern days of Digital Health and Electronic Medical records (EMR), the routine goes something like this: We get a -usually printed- list of “our patients” at the beginning of our day, walk to the ward where the patient is located, sit (or stand) in front of a computer device, sign-in (wait for a few seconds, or more), type our password (which frequently has to be updated, for security reasons/ wait for several seconds), select the right name (wait for a few seconds), “open” their “electronic” chart (again wait for a few seconds, or more), and then spend minutes browsing and scrolling the different screens, clicking and scrolling the mouse (or tapping the screen), searching for the different data points, lab results, images, notes, comments, consultations, etc.
Afterwards, we quickly go to the patient’s room and at last, interview and examine them.
Then, we analyze and process all these variables and come up with a treatment plan.
Now we, still in front of the computer, input all the electronic orders (CPOE, Computerized, Physician Order Entry), review and then press ENTER.
Voilá. Done. Now up to the next patient!
All of these steps usually take several minutes, a costly chunk of an already, very limited daily allowance of time. I would argue, that when trying to free up more “Chronos”, unfortunately, most providers will start by trimming the minutes physically spent with the patient or the time taken to review the case with the nurses or the consultants. In my view, this represents BAD MEDICINE.
“Time is Money“, they say, but in Medicine, Time usually means Better Care. I would argue though, that it is not the Amount of Time but the quality and efficient use of that time what counts.
Since TIME is finite, How can we make better use of it? How do we make every step more efficient?
Again, I believe that technology can be a big help.
Having a wearable, smart-glass computer, connected to the EMR and the internet; it is activated by touch, voice or by touchless commands, by “hand- gestures” (think “Minority Report“-the movie). It has a proximity sensor, a GPS, so it knows where-about in the hospital you are. It recognizes your location, so when in front of Mr.patient X’s room, it will display his EMR data; it has notifications, so any important or abnormal results from the digital history, will be instantaneously streamed to you. The device has a “Face-Recognition” feature, or the ability to “scan” a patient-dedicated QR code or an equivalent, to access their record.
My classmate and friend from Exponential Medicine/ Singularity University, Lucien Engelen (and his team) produced a video in 2013, based on Google Glass (and I know Google Glass well), which is a fantastic proof-of-concept of this idea.
When you are in front of the patient, you have access to all her/his data, you can review it without turning away or leaving the room; you can look-up information and update the patient or the family on-the-go, or remotely give the them comfort or palliation in end-of-life situations.
One can use it to stream an anatomical photo of the patient or even do live video streaming, in order to “present’ the patient to a remotely located colleague, for a consultation. You can search for an answer to a medical question or query; you could even “tap” IBM-Watson’s Medical brain.
The ability to look up your patient’s “quantified-self” data streams, as you round on them. To interact with it, reinforce the positives and discuss and educate them about the negatives.
The funny thing is that these devices are already available (see below). I and a few others, have been traveling around he world to many venues, speaking about these technologies and demonstrating them on stage, along with their capabilities to improve healthcare delivery, making it safer, more widely accessible and less expensive.
We just need to design or improve on the hardware and software platforms to enable them to deliver the right results.
There’s No Excuse for the current medical establishment (at least in the so-called “developed” countries & healthcare systems) not to embrace the clinical use of these devices!
The possibilities are increasing exponentially. We can explore them for both productivity and especially, the well-being of our dear patients.
Privacy of medical information is really not an issue (or an excuse) any longer; there have been several recent software developments, which ensure that the data is kept as secure as possible, complying with HIPAA regulations.
I passionately believe that engaging the medical community in the use of these amazing tools, will help reduce the unsustainable and shameful, high cost and prevalence of preventable, sometimes deadly, mistakes that stain our profession.
But More Than Anything, we need to re-educate the politicians, the public and especially the medical providers and administrators, to change their culture of healthcare delivery.
Once these technology evolves and is optimized, we won’t need to prove that these devices are better to connect or communicate, among ourselves or with our patients, just as we don’t need to prove that a smartphone is better than a land-line telephone.
It won’t be called Tele-medicine, just Medicine.
Good, Not Bad Medicine!
It will be intuitive.