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Telemedicine Improves Healthcare Efficiency -- But is That The Goal?

Posted by Lawrence Kerr on Thu, Jan 21, 2016 @ 07:30 AM



“In the past, the man has been first; in the future, the system must be first,”
- Frederick Winslow Taylor


Many of us have read the beloved children's book Cheaper by the Dozen, but few of us were aware that Frank Gilbreth, the famous and flashy author, also made forays into the hospital and operating room.

Two articles in the Perspective section of the New England Journal of Medicine Vol 374 (2) January 14, 2016 look at Frederick Winslow Taylor and Cheaper's Frank Gilbreth. Two industrial efficiency experts that looked at the operating room (and the hospital in general) as fertile ground for their work.

Gilbreth emphasized motion studies -- and I can certainly relate to that. I spent untold hours in training: observing, imitating, and refining what I saw. That has been followed by years of further attentiveness to myself and others, including my brilliant partners and colleagues. The one-handed knot, without a turn of the hand, and seemingly a mere crisiscross of motion, became a source of pride to me. Economy of motion was about how to organize and conduct the operation. It was a question of efficiency that went to the core of good surgery. My experience echoes that of the surgeons Gilbreth was working with. During that time, surgeons were accepting of these efficiency studies because they saw the potential to reduce their patients' expsure to ether, by reducing the total operating time.

Gilbreth's predecessor and colleague, Frederick Taylor, also addressed efficiency. His work lead to the concept of Taylorism, which has influenced how factories are run as well as practices like Toyota's Lean Manufacturing. While some specifics of his approach never became adopted in medicine, their essence became part of the language of healthcare. Six Sigma is the certainly the continuation and evolution of his work.

Hartzband and Groopman explain that Taylor's core premise is: "there is one best way to do every task and it is the manager's responsibility to ensure no worker deviates from it." But is that true? What of communicating efficiently and well? What are our goals? I am aware of the ER logging response times. But, that is not communication -- merely notification and response. When we do healthcare collaboration effectively, we're actually shaping outcomes in different ways, not just relaying messages. What is the current state of the art? The value of efficiency and the effectiveness are both appealing and undeniable, but we have a long way to go.  

iClickCare absolutely helps with efficiency -- at least as measured by the cost of care. Yes, but do we (ALL of us who care for patients) want only that? Apparently not. What we really want to do is work effectively, safely, and with satisfaction and be able to go home, more or less on time, knowing that we did the right thing.

By doing the right thing, and collaborating, we become the leaders of real change in healthcare.


Hybrid Store and Forward Telemedicine can help bridge the gap between the efficiency demanded of you, and the medicine you want to be practicing. You can download our free ebook about it here:


ClickCare Quick Guide to Hybrid Store-and-Forward

Tags: telemedicine, good medicine, healthcare collaboration

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