Love without a budget is not true love

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First found May 22, 2018

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English
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Donald Berwick
Donald Berwick

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Transcript

There’s light at the end of the tunnel
(Special conditions apply: above statement does not include Minister of Health).
Old system
New system
Centralised
Specialist-led
Professional care
Siloed professional groups
Supplier driven
Quality of care
Care and disease
Institutional care
Decentralised
Generalist-led
Self-management
Multi-disciplinary team
Patient focused
Quality of life
Health and behaviour
Community care
“I can plan my care with people who work together to
understand me and my carer(s), allow me control, and
bring together services to achieve the outcomes
important to me”.
“We are sick of falling through gaps. We are tired of
organisational barriers and boundaries that delay or
prevent our access to care. We do not accept being
discharged from a service into a void. We want services
to be seamless and care to be continuous”.
National Voices
“The patient is always a
person,
The person is sometimes a
patient.
The person is more than an
individual.
The person is part of a
context.
The person exists because of
their context”
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Providers involved for 5 hours per year,
patients for the other 8755 hours
Patients, families and communities have
assets that should be used
Partnership of Equals- with patients not to
patients
Informed and empowered patients are more
likely to make healthy lifestyle choices.
On-line self help tools reduced consultation
rates by ~20%.
“ All changes and new concepts that we initiate
in order to make the healthcare sector more
person- centred must include all stakeholders.
We must make sure that everybody is on board
or we are not likely to succeed”
Jacqueline Bowman-Busato European
Platform for Patients’ Organisations
“ There needs to be a radical redesign to move the
focus of health from a quality improvement health
focus to a courageous pursuit of wellbeing”
Donald Berwick
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We spend too much time hearing about the
“what” and not enough about the “why”- data is a
poor motivator
Be a “Dot-Joiner”- orchestrate, encourage,
payment formats, it’s more sociology than
technology
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Listen to the Nay-Sayers- they’re vocalising what
the silent majority think
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“Fly under the radar”- make changes then work
out the governance.
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Quality is never an accident. It’s always the
result of high intention, sincere effort,
intelligent direction and skilful execution. It
represents the wise choice of many
alternatives
Embed health in all government policy
Reduce Variability
Allow staff specialisation and create
community specialists
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Quality of Care Quality of Life. We need to
work on Advanced Care Planning, Advanced
Directive and NFR orders.
Health/Disease
Health/Behaviour
Institutional Care
Care in and by
communities
Years of Healthy Life not just Years of Life.
Care co-ordinators/Navigators
Health Care Home/Neighbourhood Networks
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Changes will be evolutionary not
revolutionary
Pace of change will be dictated by what
providers can cope with and wish to do
Underlying philosophy is to make care more
patient centred and coordinated
However changes should also make our work
more enjoyable and allow us to work to the
top of our scopes
 Care
Select
 Care Insight
 Secure Messaging
 Patient Portals
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Health Link Tool- used to make e-referrals to
private specialists and NGOs.
Doesn’t require the recipient provider to have
a PMS
Will allow provider to send back an inbox
message to our PMS
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Sport Northland
Hospice
Arthritis Foundation
Alzheimer’s society
Cancer Society
Northable
Epilepsy Northland
Stroke Foundation
Parkinson’s society
Plunket
Maori Providers
Manaia PHO
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Health Link Tool- used to make e-referrals to
private specialists and NGOs.
Doesn’t require the recipient provider to have
a PMS
Will allow provider to send back an inbox
message to our PMS
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Gives a view of classifications, medications,
allergies, immunisations to external providers
Currently being accessed by ED, WhiteCross,
Mid/Far North afterhours GPs and the
hospital pharmacists
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Most used by hospital pharmacists
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May be replaced by CCMS Secure Messaging
tool.
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A component of the Care Connect Tool
Trial starting in the Hokianga and Bush Road
Medical Centre to allow 2 way messaging
between general practice and hospital
specialists
A more elegant solution than e-referral
simple advice
Message can be initiated by secondary
services
May lead to more comprehensive shared EHR
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MedTech Manage My Health and My Practice
Health 365.
Access if via a secure website- same level of
security as internet banking
Patients can be enrolled at whatever rate
practices feel comfortable with
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save time for practice staff
improve workflow management
reduce phone tag
reduce paperwork
automate patient recalls and appointment
reminders
• improve safety by giving patients a written
record of clinical instructions
• provide 24/7 convenience for patients without
extending practice hours
• increase patient’s awareness and ability to
manage their own health.
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Patient Portal have an option to allow patients
to read their notes from the time they enrol
onto the portal
Evidence strongly suggests that having Open
Notes
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Improves health literacy
Improves compliance
Strengthen doctor/patient relationships
Is well liked and accepted by doctors and patients
Does not increase patient complaints or doctors workload
“Good will is easy. It gets complicated when
it’s about money and income.”
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