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Lawrence Kerr

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No Doubt About It: If You’re a Healthcare Provider, You’re a Hero

Posted by Lawrence Kerr on Thu, Aug 15, 2019 @ 06:00 AM

steven-libralon-Do1GQljlNk8-unsplashThere is a lot that’s broken in healthcare. Costs are soaring, insurance is a fiasco, and many people don’t get the care they need.

Though healthcare is a rewarding career, it can be relentless. The hours can be challenging, but more than that, the responsibility and stress tend to weigh on on every single person involved in a patient's care. (So much so that more than 50% are experiencing healthcare provider burnout.)

So it’s understandable if you’re a healthcare provider that you might feel a sense of frustration and hopelessness about the work.

The reality is that despite all of that, you are a hero. No superhero in any movie does as much good as any aide or doctor or nurse in their career. Healthcare providers save lives and change lives hourly.

Yes, it’s something I already know — but two things happened in the last week that brought this reality into vivid relief for me.

On a personal level, last Friday my 8-month-old grandson was swept away by ambulance and admitted to the PICU after airway issues began to severely restrict his breathing. Perhaps healthcare is broken, but it wasn't for him. Dozens of people cared for him over 4 days — and each and every person did so flawlessly, compassionately, attentively, and brilliantly. The people who cared for him saved his life — and the way they cared for him got him and his family quickly on the road to health and calm. 

On a national level, that same weekend, a shooter killed 22 people and horrifically wounded 20 others. A New York Times story shows the incredible heroism, selflessness, ingenuity, and courage of the medical providers (from surgeons to housekeeping staff) who saved the lives of the wounded and kept the death toll from rising still higher. Of course, this was integrally linked with the professionalism, efficacy, and bravery of the first responders that day. 

People who provide medical care take on the stress, trauma, and everyday struggles of their patients. And they do so in service of their patients' lives — placing the patients' well-being above their own, in many cases. That's the definition of selfless courage in my book. 

Whether you do medical collaboration or not... whether you do telemedicine or not... whether you feel it on any given day... you are a hero. And while that can't make the job easier — it should let you feel pride for what you do. 

 

Find more inspiring stories about healthcare providers working together here:

ClickCare Quick Guide to Medical Collaboration

 

 

Tags: good medicine, emergency first responders, emergency medicine

Bold Military Initiative Shows Medical Collaboration is Key to Value-Based Care

Posted by Lawrence Kerr on Thu, Aug 08, 2019 @ 06:00 AM

jeffrey-f-lin-tT3LjNT-Oq8-unsplashThe military has always been on the front lines of technology, innovation, and medicine.

On the one hand, the demands are significant and the conditions are challenging. On the other hand, rewards for getting these things right can save lives and protect the country.

So when the military tests a brand new way of doing value-based care — I definitely pay attention.

Recently, the naval hospital in Jacksonville Florida launched an ambitious pilot project.

The goal, as Fierce Healthcare reports, was "to explore whether multidisciplinary care teams could improve the cost of care for active-duty personnel and their dependents."

The magnitude of the results of the pilot could be huge. As of 2019, the Navy spent $9.5 billion to deliver medical care to 2.8 million people (active duty personnel, retirees, and their dependents.)  And the initiative was ambitious -- pioneering a multidisciplinary way to take ultimate accountability for the results and the costs for complex conditions. 

The structure of the pilot was as follows: 

  • Two project managers met weekly to guide the program.
  • Medical conditions with high incidence and spending were chosen: back pain, osteoarthritis, diabetes, and high-risk pregnancy.
  • Each condition had a physician and nurse co-champion with an interdisciplinary team working closely together to plan and execute care.

The results were very promising. Results showed that care was better, costs were lower, and active-duty personnel got back to work faster. 

Robert Kaplan, Harvard Business School co-author of the paper said that the results “demonstrated that no new medical advances or techniques are required to improve the health of these populations; just the need to better organize care around the patients’ conditions and treat them pro-actively with focused multi-disciplinary teams.”

What's fascinating to me about this project is that the military has an incentive to not only improve care and decrease costs -- but also to get personnel back to work as quickly as they can. In other words, it's a great demonstration truly considering all of the impacts of treatment -- care, costs, and the ultimate impact on the patient's life.

There were certainly challenges -- but the pilot showed the incredible value of working together, under an organized vision, and collaborating in multidisciplinary teams. These dramatic results could be transformative, certainly, for the military -- but it's possible they could be applied in many contexts with great results. “At a broader level, given the positive experience with this value-based health care pilot, the Navy’s implementation model could serve as a model for other organizations, including the Veterans Health Administration and those in the private sector, that are interested in new ways of organizing, measuring, and improving the care they deliver to patients,” the paper concluded.

 

To read more about the impact of medical collaboration, download our Quick Guide: 

ClickCare Quick Guide to Medical Collaboration

Tags: medical collaboration, hybrid store and forward medical collaboration

5 Fascinating Trends in Telehealth That Will Affect You Sooner or Later

Posted by Lawrence Kerr on Fri, Aug 02, 2019 @ 06:00 AM

william-iven-SpVHcbuKi6E-unsplashEven 20 years ago, it felt like the core practice of medicine was fairly untouched by technology. The biggest technological shift was the advent of the Electronic Health Records. And of course, we used technologies like imaging and tools every day -- but that is as far as technology extended into our practice of medicine (at least in terms of how we tended to think about it).

These days, technology is developing quickly... and its penetration into our medical practice seems to get faster every day. 

I spotted several fascinating trends that are part of this quick evolution -- and are likely on their way to a doctor's office near you.

As you contemplate the trajectory of technology in medicine, there are some trends you can ignore... others that are obvious... and then there are those that are definitely coming your way -- but you may not be as aware of. 

 

5 Fascinating Trends in Telehealth That Will Affect You Sooner or Later

  • Many patients will choose not to use telehealth.
    In an effort to start making money off the telehealth market, JD Power (yep, the car people) are beginning to rate telehealth programs. Interestingly, their first survey shows that many patients are deeply skeptical of using telemedicine as a replacement for their doctor's visit. According to Fierce Healthcare, about half of respondents believe telehealth quality is worse than a regular visit, and that it's less personal than a regular visit. And -- 0% of patients who rate their health as "poor" use telehealth. This resistance and mistrust (founded or not) is going to be a crucial dynamic to understand as we find the best ways to move forward with telehealth. 

  • Patients will lose all sense of boundaries (until we create them.)
    The connectedness between doctors and their patients has evolved over time. There were the days of family doctors making house calls... there were the days of beepers and answering services... and now there are the days of messaging via patient portals. Unlike past eras, there are no natural norms, boundaries, or protocols for this messaging. As Fierce Healthcare illuminates, "There’s nothing to get in the way of a [patient's] concern and the perception and expectation the physician should be available... what’s a reasonable time for a physician to reply to a message? What’s the liability if a patient sends a clinically urgent message during the night or on the weekend? And will pediatricians soon be dealing with messages from their adolescent patients, as well as their parents?"  Of course, this isn't a situation that can last forever -- eventually, we need to create boundaries and systems, even if technology doesn't. Our norms and practices will struggle to catch up to technology. But it's up to us to make them work for doctors and for patients.

  • Alexa will be watching your every move.
    Alexa, the "always listening" speaker powered by Amazon has some incredible skills. "She" knows if you want milk added to the shopping list... and she may be able to hear if your breathing suggests you may be having a heart attack. Kaiser Health News looked at a "gold rush" of health companies looking to innovate around using Alexa for health goals. It seems likely that Alexa -- plus similar technologies -- will play an increasing part in our telehealth monitoring landscape. So it's up to us to find ways of making this work wisely and intelligently. 

 

Kevin Kelly, the futurist and technologist, says that there are certain inevitable trajectories or trends that technology will take. But it is up to us how we then guide and govern and use those technologies. I believe that the more quickly medicine adapts to the realities of technological change, the more we can guide that change in the best possible ways for us and for our patients. 

 

Curious about the future of telemedicine? Get our quick guide on hybrid store-and-forward here:

ClickCare Quick Guide to Hybrid Store-and-Forward 

Tags: telehealth, telemedicine technology

The Doctor’s Office of The Future Exists, and It’s In Washington DC

Posted by Lawrence Kerr on Thu, Jul 25, 2019 @ 06:00 AM

samantha-gades-BlIhVfXbi9s-unsplashMany doctors avoid going to the doctor.

There are probably many reasons for that — among them, the reality that we can answer many of our own health questions. But I think there is also an unfortunate reality to the fact that doctors know how flawed the current medical system is… and they don’t have the patience to deal with it.

So I have to admit that I was interested to read a description of what sounds like the doctor’s office of the future. Although I was skeptical, I have to say — it sounds pretty good! But there are some important caveats to keep in mind.

A startup called Forward is trying to reinvent how primary care happens. It's part of an overall shift and exploration of tech-enabled concierge medicine... using different forms of telehealth to support an all-in-one paid medical model. 

First, you subscribe to Forward, as you would a gym. Called “tech-enabled direct primary care,” you pay a monthly fee that covers labs and care. The experience is meant to merge the best of hospitality, tech, and healthcare. "We're trying to make healthcare like all the other services we're accustomed to using in our lives,” Forward's Chief Medical Officer Nate Favini, M.D. told Fierce Healthcare

Admittedly, that’s a description that puts my hackles up. To me, healthcare should be much more than hospitality. Truly good healthcare isn’t about making sure patients are comfortable all of the time. It’s about collaborating with patients to go on a journey of their own healing.

But the reality is that Forward’s model has a lot of compelling elements. Patients don’t wait; every appointment begins on time. Costs are saved by reducing the number of support staff involved in patient check-ins and even taking basic stats (that’s done with a body scanner.) The care room has been reinvented to allow doctor and patient to face each other in a serene and comfortable setting. Every appointment is a luxurious 60 minutes and covers a variety of holistic elements, including things like nutrition and even genetics.

So much of what Forward is doing is simply better than how we do it today.

But I worry about a model like this for a few reasons:

  • Patients should be treated as people, not consumers.
    The “shadow side” of a model based on hospitality is that we begin to view our patients as “customers” not as people whom we have a sacred duty to care for. In the new model, doctors become more interested in profit margins and satisfaction scores than they do about the Hippocratic oath… and perhaps giving patients the care they need, even if it’s not always the care they want in that moment.
  • Everyone deserves excellent care, not just those who can pay for a membership.
    Although this membership seems affordable, I worry that having too many of the country’s healthiest people buying their own memberships could create a situation where we’re not considering healthcare as a community. Rather, that we’re considering healthcare as something that we must get for ourselves, above all.
  • People forget that healthcare is both for primary care, and for situations when we are truly sick.
    Not all healthcare should be fun or comfortable. Sometimes healthcare is a battle for your life. In many cases, healthcare demands the highest level and intensity of care and collaboration. And that’s a reality that even a beautiful lobby can’t gloss over.

 

Long story short: I think what Forward is doing is great. Also: we need more than just prettier healthcare or easier healthcare or healthcare the way patients want it. We need to make better healthcare — and that involves patient experience as well as making sure healthcare providers can work in profoundly better ways.

 

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Tags: telehealth, good medicine, concierge medicine

VA Telehealth Program Explodes -- But Is Care Better?

Posted by Lawrence Kerr on Thu, Jul 18, 2019 @ 06:00 AM

john-schnobrich-FlPc9_VocJ4-unsplashHealthcare in the United States is struggling.

We need better care, more innovation, and to drastically cut the cost of care. We need everyone in the US to be insured, and we need to make sure that regardless of income, you have access to fantastic healthcare.

It is possible that small, incremental changes aren’t going to get us where we’re trying to go — it’s important for us to act boldly and to dare to rethink how we do medicine. But the reality is that our mindset tends to trap us into using even groundbreaking technologies in old fashioned ways. And a new VA program is no exception.

As Fierce Healthcare reports, the VA has gone in big with a new telehealth program. 

In a span of just 11 months from 2017 to 2018, veterans received care in 2.3 million episodes of telehealth. About half of these were video "visits" from veterans to providers; the other half was VA staff accessing or reviewing data sent via similar means.

It's inspiring to notice how much traction telemedicine has gained in the last several years. It has truly gone from something that very people understood or knew about — to something that many people will have contact with as a patient at some point soon. And I also applaud the willingness of the VA to adopt a new technology and implement it in an expedient manner. 

That said, I worry that the VA has found a more affordable way to provide care — having veterans have virtual visits with providers rather than in-person visits — but not a better way to provide care? In one way it is better: veterans don't have to leave home to be "seen" by a provider. But I worry that the quick telehealth virtual consult might lose the richness that an in-person visit can offer. For instance, perhaps the "doorknob" questions won't happen — those offhanded questions a patient asks once the doctor's hand is on the doorknob, on their way to another appointment... which often turn out to be the most important part of the visit. 

Beyond that, the expansion of these telehealth visits makes me think of another time in our history when we used a new technology in old fashioned ways. When the telephone was invented, no one could fathom wanting to have a conversation by phone — so the first phones were actually a tool to read telegrams aloud. We used our old fashioned telegram concept to shape how we used the new technology of the telephone. 

Similarly, we often use telemedicine as a "better version of the telephone" — and that's precisely what these VA telehealth visits are. Just as with the telephone, weak points of the system abound: no medical collaboration occurs because it is simply a 1:1 call; the case and information isn't archived or accessible to other team members or accessible for learning; schedules have to be coordinated for each visit to occur. It's using telemedicine as a fancier telephone — just as we initially used the telephone as a fancier telegraph.

I think it's important that we try to envision the highest and best use of the telemedicine technology we now have. To me, that means using it to facilitate asynchronous medical collaboration among medical teams. Because ultimately, that is the way to provide better care, not just cheaper care. 

ClickCare Quick Guide to Medical Collaboration

 

Tags: telehealth, hybrid store and forward medical collaboration, medical collaboration software

Doing Embarrassing Manual Workarounds Instead of Using Tech? You’re Not Alone

Posted by Lawrence Kerr on Thu, Jul 11, 2019 @ 06:00 AM

clark-young-fQxMGkYXqFU-unsplashI run a technology company. So people are sometimes surprised when I choose decidedly low-tech solutions in my life or work. For instance, in my hobby of woodworking, I don’t use any electric tools — just hand saws, chisels, and the like.

I know that many people approach technology in their work and medical practice similarly. There may be a higher tech way of doing things, but many of us have either habits or very good reasons for doing things manually.

So when is technology the wise route? And when can that have hidden downsides that we’ll only realize once it’s too late?

A new report looks at the choices that Operations Executives make when it comes to technology and digitization. 

There are many automated tools for data visualizations and analysis that many COOs need. It would make sense for these executives to adopt the technologies — they limit mistakes and save time. The reality?  62% of operations executives say that their core systems make it hard to digitize processes. Often, the choose manual processes and manual workarounds instead — but the results are outstandingly negative: 

When processes are manual, operations execs report major risks to businesses: 

  • 62% say it slows down performance
  • 48% say it increases costs
  • 38% say it increases compliance risks

Usually, these manual workarounds are desperate attempts after having tried other tech solutions and being backed into a corner. Many executives try "off the shelf" solutions but report other big business issues: 

  • 36% said it couldn’t meet their mobile requirements
  • 21% said it required additional professional services
  • 31% said it couldn’t deliver the customization they needed

We've run into this over and over again with hospitals and medical practices. They think they "should" use technology for medical collaboration or telemedicine. They try some comprehensive, expensive, hardware-heavy solution. And the results are very similar to the above: the systems don't fit into their providers' workflows, they don't work across different hardware (e.g., mobile), and they're not adaptable in different situations and over time. 

As this author shares, "Operations executives need a software solution that enables them to easily build and modify applications that address their unique processes and systems. Furthermore, they need to be able to do so quickly, cost effectively, and without compromise." 

Honestly, that's precisely why we made iClickCare so low-cost, adaptable on any hardware, and endlessly flexible for different workflows. Ironically, some hospitals and executives have balked at iClickCare being so affordable and adaptable — perhaps looking for a "big splash" implementation. 

I believe that you should use the technology that's most appropriate for your situation and your goals. For my woodworking hobby, that means no electric tools — less injury, more craft, and a better experience. For many providers looking for telemedicine or medical collaboration technology, that means a flexible, low-overhead tool like iClickCare. Don't fall into the trap of reverting to old manual processes or tools that aren't really working — and don't fall into the trap of the "big splash" implementation. Be courageous enough to insist on technology that's appropriate for you, and for your patients. 

 

You can try iClickCare today, with a free download: 

Get Started

 

Tags: telemedicine solutions, telemedicine technology, medical collaboration tool

Doctors Face Life or Death Decisions — But We Undermine Them In Deciding

Posted by Lawrence Kerr on Fri, Jul 05, 2019 @ 06:00 AM

matheus-ferrero-yfmjALh1S6s-unsplashIn recent years, some of healthcare has become more of an industrial, technician-oriented, conveyor belt model. The “glory days” (many of which weren’t so glorious) of gentleman doctors and their code of honor are definitely a thing of the past.

In some ways, the new world order — more democratic, more distributed across a team — in medicine works well. It helps contain costs. More providers across the continuum of care are able to make decisions and care for patients. People are able to be great doctors and have a sane personal life.

But sometimes we are reminded that there is something timeless and sacred about the relationship between a doctor and a patient. And that may just be something we need to honor more in today’s healthcare environment.

There is something timeless and sacred about the relationship between a doctor and a patient. There is also a sacred and unique relationship between a nurse and his patient; and between a caregiver or aide and her patient. They are all equally valuable, but the nature of each relationship is different. And there is something unique about the quiet, hallowed space between a doctor and the patients they have the ultimate responsibility to care for.

But in the ever-growing pursuit of a more democratic but also more “factory-style” medical system, healthcare has tried to gloss over the importance and primacy of that relationship. It’s tempting to argue that you can spread care out between an aide, a nurse, a Nurse Practitioner, with little “star appearances” by a doctor — and that nothing is lost. Or, similarly, that you can have a doctor provide telehealth in 4-minute video calls with people across the country… and that nothing is lost.

I think that the real risks and downsides of this approach becomes brutally clear in the most extreme care situations. For instance, dramatic news stories have come up recently that, in one way or another, touch on the role of the doctor as ally, guide, leader, and healer — not just as a technician. For instance:

These are all hot-button issues. And politically or ethically, you may have strong opinions about them. My point isn't which side you fall on each of these. My point is that in each situation, there is an extreme responsibility that the doctor has to collaborate with his/her patient and make a decision that is truly life or death. They're not situations where you can simply follow protocol. They're not situations where there's a single right answer. And they're not situations where a doctor can make a unilateral decision without truly understanding the patient and the patient's family. 

The truth is that, just as was true 200 years ago, doctors today have a grave responsibility to understand their patient — and act (as well as lead the patient to act) in a way that is truly in the patient's service. I believe that even as we keep an eye on costs, efficiencies, and teams — it's also fundamentally important that we honor the seriousness of the decisions that providers make with their patients. And that we support them — practically and emotionally -- in making them. That's where the role of medical collaboration comes in. It's not about 5-minute telemedicine videoconferencing. It's about helping doctors (and others across the continuum of care) in getting the collaboration and support they need to make the life-or-death decisions that they must make.

 

ClickCare Quick Guide to Medical Collaboration 

Tags: telemedicine, medical collaboration, good medicine

That Rude Doctor? He May Be Hurting His Patients, Too

Posted by Lawrence Kerr on Thu, Jun 27, 2019 @ 06:00 AM

ethan-sykes-TdM_fhzmWog-unsplashIn medicine, we tend to separate the “hard” skills of medicine from the “soft” things that simply don’t matter so much. For instance: surgical skill matters; the comfort of your waiting room chairs doesn’t.

Many providers have an ethos that is almost sports-like in its single-minded focus on executing the hard calls, crucial maneuvers, and life-saving techniques on behalf of the people we serve. Things like the tone we use with our colleagues, whether we sit down and listen to an aide with an idea, or even seeing a patient post surgery — these can all be dismissed as relatively inconsequential.

Well, it turns out this approach is wrong — and there’s data to back me up.

I’m not sure whether professionalism and teamwork are getting better or worse in healthcare, but there is certainly a lot of room for improvement. It used to be that there was a bit of a “gentleman’s club”  attitude, that, while exclusive to a very specific group of people and often excessively hierarchical, at least it had high standards for the work. Flash forward to current times, and (thankfully) medicine is less exclusive and more democratic… but many providers also treat it more like a job than a calling.

All of which is to say: not every provider has high standards for their personal conduct, professionalism, and team leadership. For so long, at ClickCare, we’ve been advocates of all of these things. Our own medical experience is that politeness, professionalism, respect, listening, collegiality, and leadership all are the foundation of good medicine. In fact, we've always believed that good patient care simply can't exist unless these "softer" elements are in place. 

This has not always been a popular viewpoint. Many doctors and healthcare providers have challenged us on the importance of these approaches, saying that they don't have time to concern themselves with that kind of thing. Certainly, we have the ROI of iClickCare to prove the validity of these approaches. But we've never had a more general confirmation of the importance of professionalism — until now. 

A recent study in JAMA found that “Patients whose surgeons had higher numbers of coworker reports about unprofessional behavior in the 36 months before the patient’s operation appeared to be at increased risk of surgical and medical complications."  Other studies also found links between the way healthcare providers treated their teams and the effect on their patients.  Why?  Well, as JAMA reminds us, “For surgical teams, high reliability and optimal performance depend on effective communication, mutual respect, and continuous situational awareness.”  Part of the core job of a surgeon is to be a team leader — and that means creating a team that displays and expects respect and professionalism. If that's not the case, the team doesn't function as well, and outcomes simply aren't as good.

I'll be blunt. Just as it is your responsibility to scrub before surgery, it is your responsibility to collaborate effectively with your team. Good patient outcomes depend on both; and both are within your control. Demand the tools to collaborate, certainly. But don't let yourself off the hook. 

 

Learn how other providers do medical collaboration quickly and easily here: 

ClickCare Quick Guide to Hybrid Store-and-Forward

 

 

Tags: good medicine, medical collaboration tool

5 Big Insights from a (Yes, Really) Tele-ICU Program

Posted by Lawrence Kerr on Thu, Jun 20, 2019 @ 06:00 AM

luis-melendez-530478-unsplash (1)Telemedicine has its limits. There will never be a completely virtual replacement for in-person visits and care. 

Where that limit really is, though, I don't know. I find I hear about more and more unbelievable telemedicine programs every day. The most recent? A tele-ICU program that actually seems to be working. 

Honestly, I'm not positive whether this program is ultimately "good medicine" or whether it's a shortcut that shouldn't be taken. But I do think that the very extremeness of the the program gives us some insights about telemedicine and medical collaboration more broadly (not all of which are positive.)

Recently, Lou Silverman of the telemedicine company Advanced ICU Care sat down with Fierce Healthcare to share thoughts about his program and about telemedicine more generally. 

And these are 5 insights about telemedicine and telehealth that that came out of that conversation:

  • Good care is what matters -- not whether it has "tele" in front of it.
    We've always said that if you put the individual patient first, the means for caring for them will follow. For instance, you get a telemedicine consult via iClickCare because the patient's case demands it -- not because it's routine. As Mr. Silverman says, "The industry has done itself a disservice by continuing to imply that 'health' is distinct from 'telehealth' or that 'medicine' is distinguishable from 'telemedicine.'  My view is that we are all part of a singular ecosystem with uniform goals and a unified vision around improving care for patients and delivering the care where and when it is needed in a manner that is both clinically and cost effective."
  • Medical collaboration gives us the best answer, regardless of who contributed it. 
    Most people in medicine are altruistic; but egos can also creep in. That's why Mr. Silverman's reminder about team collaboration is crucial: "Success is achieved by the team, that performance counts and politics do not. Our attitude is that the best answer always wins. Period. It doesn’t matter who had the idea or how we got there."
  • Expensive technology does not make a program "important."
    We've had hospitals turn down iClickCare because it doesn't require any expensive hardware -- it's shocking how much people connect expense, novelty, and quality. But Mr. Silverman is right: "Great healthcare delivery is a fusion of data, expertise, experience and empathy. Viewing technology as a facilitator—and not a shiny new toy unto itself—is also an important part of the mindset. Healthcare is about people helping people. Twenty-first century healthcare is about helping the most people possible achieve outcomes that they did not think were possible."
  • Broad telemedicine adoption is on its way. 
    It's so heartening to know that telemedicine is finally finding broad support. "Today, there are very favorable tailwinds regarding government policy in telemedicine. Individual states and the federal government are making tangible progress in advancing telemedicine initiatives," Lou Silverman confirms. 
  • Just because something is possible, doesn't mean it's desirable. 
    The fact that a tele-ICU program is even possible is reflective of just what an amazing time we live in. That said, the fact that it's possible doesn't necessarily mean it's the best way to provide care. The truth is that I am not completely familiar with the realities of this program. But I do think it's crucial to always look beyond ROI to what makes an impact on the patient. 

 

Telemedicine is an exciting and important tool. But as the insights above illustrate -- it's not an end unto itself. It's about finding the best tool for the best care. And that's for each provider and hospital to decide. 

Curious about using telemedicine for medical collaboration in your setting? You can get started here. 

Get Started

 

Tags: good medicine, telemedicine technology

When It Comes to Gun Violence, Doctors Need Collaboration to Save Lives

Posted by Lawrence Kerr on Thu, Jun 13, 2019 @ 06:00 AM

alejo-reinoso-1330078-unsplashWhen a gun shot victim comes into the Emergency Room, so much has gone wrong.

An interaction between people has gone awry. Our social fabric that keeps violence at bay, has torn. And of course, our patient’s body is experiencing a cascade of things going seriously wrong.

So as doctors, it’s natural to do everything we can to fix the patient in front of us… but shrug our shoulders at all of the other things that have gone wrong to put that person in that position. Our job, it’s common to believe, starts when the stretcher enters the door. But a new program has me rethinking that — in ways that could save millions of lives.

Massachusetts General Hospital announced the launch of the Mass General Center for Gun Violence Prevention last week. The center was a collaboration of everyone from the Boston Police Department to doctors themselves. And it's envisioned to include programs ranging from providing education for providers on treating gun violence to sponsoring gun buyback programs. The center was founded by the pediatric surgeon Peter Masiakos, who says: 

"For as long as our profession has existed, our patients have depended on doctors to be sentinels against hidden societal dangers and advocates for policies that protect us against such dangers. On the front lines of patient care, we are routinely exposed to the faces affected by modern ills such as unemployment, food insecurity, substance use, racism and gun violence. We must stand front and center to better understand the determinants of gun violence and to develop the tools to impact this epidemic that is indiscriminate of race, age, creed, gender and sexual identity.”

The center itself challenges some of our implicit understandings of where healthcare providers start and end. It reminds me of the NRA's plea from last year for providers to "stay in their lane" and the heartfelt rejoinder by an ER doc that guns and violence prevention are very much a doctor's "lane."  This initiative goes even farther than advocacy and treatment — it positions doctors and the hospital as responsible for actually "treating" gun violence before it starts, in all of the social, economic, cultural, and educational ways that can happen.

The truth is that when I first read about Mass General's project, it seemed a surprising use of hospital time and resources. But the more I thought about it, the more the initiative made sense to me. This is a collaboration among multiple stakeholders. Just as we need collaboration across the continuum of care within medicine and for any given patient case, we need collaboration across diverse stakeholders outside of medicine to really change results for our patients.

It's one more reminder that, as doctors, we need to keep asking: 

  • How can we be more collaborative to get better results for our patients?
  • Who are the people we need to collaborate with for the best possible care?

Mass General's answers to these questions led them to a comprehensive new program. Your answers might just lead you to chatting with a colleague in the hallway. But all of us can ask the questions. 

 

For more stories of medical collaboration, download our free Quick Guide: 

ClickCare Quick Guide to Medical Collaboration

 

Tags: medical collaboration, medical responsibilities

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