I'm a person who likes to do things the right way. My daughters joke that they would ask me for a plastic cartoon character lunchbox and I would buy a functional, long-lasting, man-sized metal lunchbox with a quart thermos. (I, of course, defend myself by insisting it's always better to pay for the high-quality option.)
That said, I am given pause by the healthcare community's insistence that:
- The expensive option is always the better option
- Multi-million dollar studies yield better information than common sense
- Decades-long technology implementations have any chance of working in our fast-changing world.
For instance, researchers from the University of Missouri recently did a $14.8 million study (funded by the Centers for Medicare & Medicaid Services) to look at the feasibility of implementing Health Information Exchanges (HIEs) at 16 long-term care facilities. Many of the facilities proved to have insufficient technology to implement the HIE plan.
The idea of implementing HIEs in long-term care facilties is excellent. The work is aimed at reducing avoidable re-hospitalizations among nursing home residents. When older adults transfer between nursing homes and hospitals, inefficient and unclear communication between the organizations can hinder patient care, reported the principal investigators in the grant, so they were looking for better ways for providers to communicate.
That said, $14.8 million dollars later, no collaboration had taken place, rehospitalizations hadn't changed, and the HIE plan is so burdensome that this kind of study (and heavy technology setup) is necessary.
Sometimes a notebook and pen are better for taking notes than a Macbook. And sometimes a simple telemedicine collaboration between individual providers is better than an integrated HIE implementation -- especially for long-term care facilities. I get frustrated when I hear that these facilities don't have the appropriate technology, since iClickCare operates on any smartphone or PC.
The goal itself is simple, according to Greg Alexander, associate professor in the MU Sinclair School of Nursing: “Ultimately, we want to facilitate a way for staff members to communicate safely and securely about patients’ health. We want to prepare nursing homes to communicate externally as well as internally so that care transitions smoothly and patients have better health outcomes.”
There are certainly complexities in acheiving that goal. However, we do wonder whether a simple approach might ultimately be better than a complex implementation. Could much of what they want to achieve happen by giving providers more time per patient? By creating more spaces (physical and virtual) for providers to talk to each other? How about through telemedicine consults using a healthcare collaboration platform (on existing PCs and smartphones) like iClickCare?
We don't have all the answers, but we do believe that a simpler answer now is usually better than a more complex answer later.
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