Category Archives: healthcare

Free GP (primary care) visits for children 6 and under

The debate/ argument/ disagreement about introduction of free GP care for children of 6 and under is now really heating up.  There seem to be a few elements at play, including:

  • GP view that this change is being forced upon them
  • GP view that the government is taking a very specific interpretation of competition law to prevent GPs coming together to argue their case
  • GP view that their’s is the one part of the health care sector which is working effectively and why (on earth) would anyone want to break this first up#
  • Government determination to push forward with this as one of the first steps in introduction of UHI (to include Primary Care).

I tend to look at GPs much as I look at myself – running their own consulting businesses – with a combination of smaller customers (individual patients) and larger customers (GMS patients through government).  And we share many challenges – be it cash management, winning new business, changing economic circumstances, funding a pension, whatever.

But I just read back through the ‘Future Health’ document published by the Department of Health in November 2012.  And it’s there in black and white on page 32: ‘…the removal for fees for GP care…..this reform is required because the body of evidence that user fees are a barrier to accessing care at the primary care level and thereby cause late detection of illness, poorer health outcomes and greater pressures on the acute hospital and long-term care systems.’  And they make it clear that the y intend introducing this on a phased basis.

So, in spite of the fact that many may believe the GP system is serving us well, it is clear from the Department’s point of view that the GP system is part of the problem.

And as I reread the Department’s strategy for health and its intentions re primary care and a much broader and more integrated primary care environment I struggle how to see this can be married with the traditional role of the self employed GP.  Yes – many go ahead GPs have come together to form practices which enable them to provide a wider range of solutions and to share/ develop specialties.  But the language of the document seems to be very focused on integration of GPs and lots of HSE employed professionals (or perhaps the plan is that more of these professionals would operate outside the HSE?) – this does not seem to be clear in the document).

Universal Health Insurance has a long way to run – seems that the GPs are being thrown into the mixer upfront.

Varying standards across hospital websites

As with all websites – the question to be asked: who are you serving?

American Medical News references a recent report from the Journal of Healthcare suggesting that medical practitioners and hospitals need to addess accessibility of their web sites – content should be written for the reader, not for the writer.

This is a challenge for all websites – not to bombard the reader with technical jargon.

Excellent example quoted is: ‘For example, some websites have data related to ventilator-acquired pneumonia, but they used only the acronym. Or they used “nosocomial infections” instead of the more understandable term “hospital-acquired infections.”‘.

The report also references limited use of social networks.  This is also consistent with findings of recent Deloitte report – suggesting only 6% of physicians using social media to communicate with patients.



Why such variation in adoption of IT by medical practitioners?

As someone who depends on doctors for medical advice, someone who works with doctors and someone who promotes innovation through technology I am frustrated at the inconsistencies across healtcare in the adoption of IT.

Core questions for me seem to be:

  • Does adoption of IT solutions have the potential to improve patient healthcare?
  • Can IT reduce risk to the patient?
  • Can IT assist medical professionals in getting more of their decisions right?
  • Can IT be implemented without significant impact on the business of the medical professional?
  • Does IT offer the medical profesional and the patient improved communication/ cooperation/ collaboration?
  • What are the downsides for the patient and for the doctor?
  • Are there quality applications and secure frameworks available to the doctor and the patient?

This new report from Deloitte, based in the US, would suggest that adoption is slow and inconsistent.

It would seem to me that market forces will ultimately drive this – and by market force I mean choice for the patient, requirement to communicate/ collaborate and regulation or the increasing requirement to demonstrate the quality of proceses followed.




Seeking changes in Health & Education in Ireland

Interesting to read Paul Rellis (CEO Microsoft Ireland) pushing significant amounts of technology in Education and Health as ways to address much of the problems we have.

Would agree 100% with Paul Rellis’s ideas around uses of digital technology.  However seems to me risk putting cart before the horse.  First we need a clear vision of what we are looking to achieve, then commitment from those in Health & Education to achieve the vision, commitment from the investor (govt.) in terms of any required investment.  The technology bit is not actually that hard – using Microsoft technology, other proprietary technology and open source technology – in any, to be agreed, configuration.

But first let’s set vision, get some commitment and manage the change.

Patient doctor collaboration

Interesting post on project healthdesign: The Doctor’s Role in a Health 2.0 World.

Describing the patient as the ceo for his own body ie he takes responsibility, while the doctro is described as the consultant – advising the patient, seems like a good model, which reinforces the idea that the patient needs to manage his own lifesytyle, etc.

The other interesting obeservation relates to the general ‘information overload’ being experienced by all of us in all walks of life.  It is quite possible that a patient may know a great deal more about his specific condition than the doctor providing the advice.  However the doctor hopefully brings a broader picture and understanding.  Seems no reason why the patient and doctro should not collaborate in advaincing the situation.  Of course this does tend to turn the more traditional doctor/ patient model on its head.