Care coordination and telemedicine are coming to the fore. The last two weeks have made 5 P's worth discussing.
- Pigeon Holes
Briefly, Publicity and Pinterest have introduced many new people to ClickCare. This is exciting and we will talk about both first. Secondly, with the introduction of something new, the natural inclination is to try to fit the new into something old -- in other words a Pigeon Hole. Since innovation and disruption cannot be pigeon-holed, we look to the Principles, based on classic oaths, to codify good Patient care.
Publicity. The New York Times article by Eilene Zimmerman created a lot of conversation. Clear and concise, it was described by a respected colleague who lives in the independent country of Georgia as "informative, analytical and useful." This article also lead to a lot of conversation and interpretation of just what ClickCare is, and what iClickCare can do, and for whom.
Some commonly heard pigeon holes: it's only for nurses or doctors, rural or urban, inpatient or outpatient, skilled nursing facility or ICU, aide or family, or so on -- wounds, rashes, clefts, heart disease, home care. But we ask: “Why?”
Another pigeon hole: It is just an App. Look for our banner at ATA 2012 that declares: "More than an App!" While iClickCare uses the iPhone, it also uses the Cloud, desktops, laptops, iPads and digital cameras. It is an integrated system that meets the many needs of many medical workflows by many medical providers. It even includes families when appropriate.
Principles. Good care has never changed. Even from ancient days, long before electrons were known, the purpose of telemedicine is presaged.
We greatly respect the contributions of each person who cares for patients and we strive to bring them all together as a team. The following oaths are Physicians Oaths -- there are others for other members of the team -- and remind us that the “new and challenging” is really nothing new at all but built on the foundations established even before Hippocrates.
So, the point of all of this is that good care, ethical care, giving care is universal and timeless. The technology doesn’t change anything, instead, it makes sure that the right thing can happen. So to pigeon-hole iClickCare as wound care, as an app, or for nurses, or doctors, or nursing homes, or hospitals, negates the principles of good care which are offered as three different Oaths below.
Patient. The patient is first. HiPAA is described. Specialization and coordination of care anticipated. It is all there. Nothing is said about market share, referral enhancement, or spin off technology. All of us forget why we do what we do sometimes. When we remember, we understand ourselves and how we can improve our world. We see technology as a way to care for those we are sworn to protect. We don't need pigeon holes to understand it all. We can embrace change and move forward.
For your reference, here are the Oaths:
The Physician's Oath (modern).
At the time of being admitted as a member of the medical profession:
- I solemnly pledge myself to consecrate my life to the service of humanity;
- I will give to my teachers the respect and gratitude which is their due;
- I will practice my profession with conscience and dignity;
- The health of my patient will be my first consideration;
- I will respect the secrets which are confided in me;
- I will maintain by all the means in my power, the honour and the noble traditions of the medical profession;
- My colleagues will be my brothers and sisters;
- I will not permit considerations of religion, nationality, race, gender, politics, socioeconomic standing, or sexual orientation to intervene between my duty and my patient;
- I will maintain the utmost respect for human life; even under threat, I will not use my medical knowledge contrary to the laws of humanity;
- I make these promises solemnly, freely and upon my honour.
Oath of Maimonides.
"The eternal providence has appointed me to watch over the life and health of Thy creatures. May the love for my art actuate me at all time; may neither avarice nor miserliness, nor thirst for glory or for a great reputation engage my mind; for the enemies of truth and philantropy could easily deceive me and make me forgetful of my lofty aim of doing good to Thy children.
May I never see in the patient anything but a fellow creature in pain.
Grant me the strength, time and opportunity always to correct what I have acquired, always to extend its domain; for knowledge is immense and the spirit of man can extend indefinitely to enrich itself daily with new requirements.
Today he can discover his errors of yesterday and tomorrow he can obtain a new light on what he thinks himself sure of today. Oh, God, Thou has appointed me to watch over the life and death of Thy creatures; here am I ready for my vocation and now I turn unto my calling."
Original Hippocratic Oath, translated into English.
I swear by Apollo, the healer, Asclepius, Hygieia and Panacea, and I take to witness all the gods, all the goddesses, to keep according to my ability and my judgment, the following Oath and agreement:
To consider dear to me, as my parents, him who taught me this art; to live in common with him and, if necessary, to share my goods with him; To look upon his children as my own brothers, to teach them this art; and that by my teaching, I will impart a knowledge of this art to my own sons, and to my teacher's sons, and to disciples bound by an indenture and oath according to the medical laws, and no others.
I will prescribe regimens for the good of my patients according to my ability and my judgment and never do harm to anyone.
I will give no deadly medicine to any one if asked, nor suggest any such counsel; and similarly I will not give a woman a psessary to cause an abortion.
But I will preserve the purity of my life and my arts.
I will not cut for stone, even for patients in whom the disease is manifest; I will leave this operation to be performed by practitioners, specialists in this art.
In every house where I come I will enter only for the good of my patients, keeping myself far from all intentional ill-doing and all seduction and especially from the pleasures of love with women or with men, be they free or slaves.
All that may come to my knowledge in the exercise of my profession or in daily commerce with men, which ought not to be spread abroad, I will keep secret and will never reveal.
If I keep this oath faithfully, may I enjoy my life and practice my art, respected by all humanity and in all times; but if I swerve from it or violate it, may the reverse be my life.