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  1. #1
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    Default Patients-Clinicians and Computers - Futuristic Call to Action

    It’s with gratitude I’m with you participating in what I sense is addressing what is about to be a turning point for the well-being of the patient-clinician-computer relationship.
    1. This relationship is broken.
    2. Healing relationships… the core of well-being… are at risk
    3. We are part of the solution, not the problem.
    I say this at a point in time when over half of clinicians are burned out and record numbers are exiting. Clinicians are, increasingly, either ending their careers or even their own lives. We are achieving a Reverse Triple Aim of increasing costs, lower quality-satisfaction, and a less healthy population. Health professionals have made great investments earning the right to have box seats in the drama of other’s lives. However, many of them now are burdened by the mandates of others seeking to exploit and control that relationship. Physicians, in particular, have become hamsters on wheels of data entry serving the needs of others, and not patients. They have been denigrated within systems generating profits for entities that consider their professionalism to be quaint and often in the way of greater profits. They’ve spent years making investment in obtaining the skills to be able to have positive impact in the lives of others. They earned the right to be trusted and respected. We just have to accept that those controlling health care assets often don’t value this investment. Instead of honoring the sacred patient-doctor relationship, they often view it as more of the problem rather than the solution. However… I sense most of us refuse to believe our health care system is unsalvageable. We refuse to believe that we can’t achieve the Quadruple Aim of lower costs, higher quality-satisfaction, healthier populations and improved clinician well-being. It’s time for each of us to demand… the trust and respect to be able to enhance the well-being of those within our realms of influence. I sense most of us have some sense of urgency that our health care systems needs reform. It is time to take action rather than procrastinate…
    • Now is the time to make real the promise of healing relationships that can be optimized by truly useful technology that will thus be embraced… voluntarily!
    • Now is the time to demand health information technology and workflows that enhances, rather than interferes with well-being.
    We will continue to fail until healing relationships are respected again. Each of us needs to just say “No” until respect re-emerges. In the process of reclaiming our rightful place we must not be contemptuous or act out of a sense of entitlement. Our challenge is not to allow our desire for trust and respect to lead to bitterness and scorn. We must strive to act with dignity and discipline. We must not allow our creativity to degenerate into apathy and passive aggressiveness. Repeatedly… we must rise to meet threats and put-downs from the Medical-Industrial Complex with gracious determination. Incredible intransigence and inertia must not lead us to distrust the system… for many in it are coming to realize that their destiny is tied up with our destiny.They have come to realize that their success is inextricably bound to our well-being. We cannot do this alone and we can’t continue to just endure.

    There are those advocating misguided use of heath informatics and mandates asking “When will you just accept and assimilate?” We can never be accepting as long as patients and health professionals are treated with such disrespect. We can never be satisfied as long as patients are denied the undivided attention of their health care professionals. We cannot be satisfied as long as long as the best we can hope for is that physicians go from giving away only 1 hour of their “free time” instead of 3 every work day. We certainly can never be satisfied as long as health professionals are being stripped of their professionalism by faux quality metrics that are poor proxies for measuring actual patient outcomes.
    Clinical Quality Measures - Are great when used as key performance indicators for internal quality improvement. In contrast, when used as financial incentives, the result is gaming, demoralization, and net-worse patient outcomes. This approach does more harm than good. For examples of why using performance metrics within complex social systems always fails, review the history of No Child Left Behind in the U.S. or the Quality Outcome Foundation (QOF) in the U.K.

    We cannot be satisfied as long as patients and clinicians continue to be dealt such barriers, burdens, hassles and hazards… often by design. Health professional’s quest for healthy relationships has been battered… such as by attempts to force them to enter often meaningless data into inflexible algorithms. They have become veterans of creative suffering just to endure.
    Rather than just wallow, let’s take action!
    We can insist that information technology steps up to connect and communicate meaningfully between patients and their care teams. An example would be to initially focus on more exchange of the narrative information of immediate value to patients and doctors before concentrating on the needed structured data. Otherwise, we end up with so much computer vomit.

    The mainstream approach is broken. However there are a couple of brooks bubbling up:
    1. Team care-documentation to manage and delegate the 3rd party data demands
    2. Membership practices having the luxury to mostly ignore them.
    Sometimes, starting simpler can actually make health care more… about caring.
    Survival is going to require that administrators and informaticists sit down with clinicians-patients in order to determine where to start… rather than standing up before them to announce what will manifest and then asking for tweaks.
    In the future, my 2 granddaughters will have health care in a system that respects their individual uniqueness… rather than being a system having an informational infrastructure that… at its core is designed for them to be more as vessels for codes that shift dollars around. For example, In the future, the point of care will be wherever they are. They will be able to conveniently, consistently, and comprehensively access trustworthy healthcare guidance.
    Our professional organizations must be first focused on the well-being of their membership. Secondly they can oportunize their membership within the Medial Industrial Complex. The Faux Quality Industry has become a monster in and of itself, and is well entrenched within multiple lobby groups.
    As a lover of health information technology and a believer that it is necessary for optimal care, it troubles me greatly that the net-scientific evidence clearly confirms current approaches to pay-for-performance (P4P) and “value-based” care are doing more harm than good. Current justification for their present implementation is only possible by cherry-picking supporting data and lemon-dropping evidence that doesn’t. Considering the overall TOTAL evidence, advocacy for current P4P and value-based care simply is… unscientific. However, health information technology is going to be better:
    • More of a welcome-useful tool than a burden.
    • It will free us up to be more face-to-face and less face-to-screen.
    • Clinicians will no longer be forced to text while driving though patient encounters. Their skills to grace others with enhanced well-being will be facilitated.

    Only by believing it will be better will we be able to unite to truly serve patients. By believing in this, together, we will be able to suffer through a period of misguided and misapplied requirements such as annualized performance metrics as the targets which determines the financial survival of health professionals.
    This belief will allow us to innovate together… to stand up for professionalism and true excellence.
    Let’s not forget… with the freedom to enhance the well-being of each and every, unique individual we will we be on the path to a healthier population.

    1. The patient-clinician-computer relationship is broken
    2. Healing relationships… the core of well-being… are at risk
    3. We are part of the solution, not the problem.
    Last edited by roates; 03-20-2017 at 12:52.

  2. #2
    SOAPware Forum Junkie!
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    Agree 100%. Next, How do we effect change in this?


    Quote Originally Posted by roates View Post
    It’s with gratitude I’m with you participating in what I sense is addressing what is about to be a turning point for the well-being of the patient-clinician-computer relationship.
    1. This relationship is broken.
    2. Healing relationships… the core of well-being… are at risk
    3. We are part of the solution, not the problem.
    I say this at a point in time when over half of clinicians are burned out and record numbers are exiting. Clinicians are, increasingly, either ending their careers or even their own lives. We are achieving a Reverse Triple Aim of increasing costs, lower quality-satisfaction, and a less healthy population. Health professionals have made great investments earning the right to have box seats in the drama of other’s lives. However, many of them now are burdened by the mandates of others seeking to exploit and control that relationship. Physicians, in particular, have become hamsters on wheels of data entry serving the needs of others, and not patients. They have been denigrated within systems generating profits for entities that consider their professionalism to be quaint and often in the way of greater profits. They’ve spent years making investment in obtaining the skills to be able to have positive impact in the lives of others. They earned the right to be trusted and respected. We just have to accept that those controlling health care assets often don’t value this investment. Instead of honoring the sacred patient-doctor relationship, they often view it as more of the problem rather than the solution. However… I sense most of us refuse to believe our health care system is unsalvageable. We refuse to believe that we can’t achieve the Quadruple Aim of lower costs, higher quality-satisfaction, healthier populations and improved clinician well-being. It’s time for each of us to demand… the trust and respect to be able to enhance the well-being of those within our realms of influence. I sense most of us have some sense of urgency that our health care systems needs reform. It is time to take action rather than procrastinate…
    • Now is the time to make real the promise of healing relationships that can be optimized by truly useful technology that will thus be embraced… voluntarily!
    • Now is the time to demand health information technology and workflows that enhances, rather than interferes with well-being.
    We will continue to fail until healing relationships are respected again. Each of us needs to just say “No” until respect re-emerges. In the process of reclaiming our rightful place we must not be contemptuous or act out of a sense of entitlement. Our challenge is not to allow our desire for trust and respect to lead to bitterness and scorn. We must strive to act with dignity and discipline. We must not allow our creativity to degenerate into apathy and passive aggressiveness. Repeatedly… we must rise to meet threats and put-downs from the Medical-Industrial Complex with gracious determination. Incredible intransigence and inertia must not lead us to distrust the system… for many in it are coming to realize that their destiny is tied up with our destiny.They have come to realize that their success is inextricably bound to our well-being. We cannot do this alone and we can’t continue to just endure.

    There are those advocating misguided use of heath informatics and mandates asking “When will you just accept and assimilate?” We can never be accepting as long as patients and health professionals are treated with such disrespect. We can never be satisfied as long as patients are denied the undivided attention of their health care professionals. We cannot be satisfied as long as long as the best we can hope for is that physicians go from giving away only 1 hour of their “free time” instead of 3 every work day. We certainly can never be satisfied as long as health professionals are being stripped of their professionalism by faux quality metrics that are poor proxies for measuring actual patient outcomes.
    Clinical Quality Measures - Are great when used as key performance indicators for internal quality improvement. In contrast, when used as financial incentives, the result is gaming, demoralization, and net-worse patient outcomes. This approach does more harm than good. For examples of why using performance metrics within complex social systems always fails, review the history of No Child Left Behind in the U.S. or the Quality Outcome Foundation (QOF) in the U.K.

    We cannot be satisfied as long as patients and clinicians continue to be dealt such barriers, burdens, hassles and hazards… often by design. Health professional’s quest for healthy relationships has been battered… such as by attempts to force them to enter often meaningless data into inflexible algorithms. They have become veterans of creative suffering just to endure.
    Rather than just wallow, let’s take action!
    We can insist that information technology steps up to connect and communicate meaningfully between patients and their care teams. An example would be to initially focus on more exchange of the narrative information of immediate value to patients and doctors before concentrating on the needed structured data. Otherwise, we end up with so much computer vomit.

    The mainstream approach is broken. However there are a couple of brooks bubbling up:
    1. Team care-documentation to manage and delegate the 3rd party data demands
    2. Membership practices having the luxury to mostly ignore them.
    Sometimes, starting simpler can actually make health care more… about caring.
    Survival is going to require that administrators and informaticists sit down with clinicians-patients in order to determine where to start… rather than standing up before them to announce what will manifest and then asking for tweaks.
    In the future, my 2 granddaughters will have health care in a system that respects their individual uniqueness… rather than being a system having an informational infrastructure that… at its core is designed for them to be more as vessels for codes that shift dollars around. For example, In the future, the point of care will be wherever they are. They will be able to conveniently, consistently, and comprehensively access trustworthy healthcare guidance.
    Our professional organizations must be first focused on the well-being of their membership. Secondly they can oportunize their membership within the Medial Industrial Complex. The Faux Quality Industry has become a monster in and of itself, and is well entrenched within multiple lobby groups.
    As a lover of health information technology and a believer that it is necessary for optimal care, it troubles me greatly that the net-scientific evidence clearly confirms current approaches to pay-for-performance (P4P) and “value-based” care are doing more harm than good. Current justification for their present implementation is only possible by cherry-picking supporting data and lemon-dropping evidence that doesn’t. Considering the overall TOTAL evidence, advocacy for current P4P and value-based care simply is… unscientific. However, health information technology is going to be better:
    • More of a welcome-useful tool than a burden.
    • It will free us up to be more face-to-face and less face-to-screen.
    • Clinicians will no longer be forced to text while driving though patient encounters. Their skills to grace others with enhanced well-being will be facilitated.

    Only by believing it will be better will we be able to unite to truly serve patients. By believing in this, together, we will be able to suffer through a period of misguided and misapplied requirements such as annualized performance metrics as the targets which determines the financial survival of health professionals.
    This belief will allow us to innovate together… to stand up for professionalism and true excellence.
    Let’s not forget… with the freedom to enhance the well-being of each and every, unique individual we will we be on the path to a healthier population.

    1. The patient-clinician-computer relationship is broken
    2. Healing relationships… the core of well-being… are at risk
    3. We are part of the solution, not the problem.

  3. #3
    Administrator
    Points: 18,303, Level: 93
    Level completed: 51%, Points required for next Level: 197
    Overall activity: 0%
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    VeteranOverdrive10000 Experience Points

    Join Date
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    Posts
    596
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    Default

    Quote Originally Posted by mlittle10 View Post
    Agree 100%. Next, How do we effect change in this?
    When asked to go to the back of the bus... resist.

 

 

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