In my last HL7standards blog post, I brought up the term disruptive innovation. One reader did not think I (nor the health care system) was being bold and disruptive enough by suggesting retail clinics, EHR, and telemedicine had the potential to disrupt health care. Though different than mine, I appreciated his thoughts. In fact, they got me thinking about innovations and how health care innovations are shared.
I know I’ve often had brilliant ideas for what I thought would be great innovations (like that fruit and veggie cleaner in the spray bottle you see sold in the produce section) only to discover that someone already thought of it. If you want to watch a 120-minute example of what happens when people come up with the same innovation, check-out the film The Social Network.
Those with great ideas can often be protective of their concepts. They hold on to them, perhaps from fear of having their ideas stolen or in hopes of boosting revenue, rather than putting their innovations out there for others to use, tweak, or build upon. This may hinder progress essential to producing better products and delivery systems.
Fortunately, the Agency for Healthcare Research and Quality has a place for those in the health care sector to get and share ideas. The AHRQ Innovations Exchange is an online clearinghouse where professionals can exchange evidence-based innovations and tools. The exchange’s website consists of searchable innovations and quality tools and learning and networking opportunities.
Here’s a sampling of five innovations from the AHRQ Innovations Exchange. There are thousands more available on the site.
1. The National Naval Medical Center, Bethesda, Md., wanted to provide patients with personalized, coordinated, and preventive care. Integrated medical home teams in the internal medicine department provided patient care, made appointments with specialists and followed up with patients as needed. An online medical patient portal and electronic personal health record let patients add information to their medical records and communicate via e-mail with team members. The team members used the systems to identify patients needing follow-up care and to conduct virtual office visits. Diabetes, asthma, colon, and breast and cervical cancer screening rates increased and provider continuity, access to care, and patient-provider communication improved.
2. In 2008, Sunnybrooke Health Sciences Centre, Toronto, developed a program to see if patient outcomes improved and adverse events decreased when physicians received alerts of clinical decision support regarding abnormal lab values. The program had no affect on patient management or on the frequency of adverse events. Researchers felt if the program components were better integrated into the workflow and the system was simpler to use, both patient care and adverse effects would improve.
3. A collaboration between the Partners in Care Foundation, Vanderbilt University and the Visiting Nurse Service of New York assessed how home health nurses and care managers could use software-based protocols to manage geriatric patients’ regimens, and collaborate with pharmacists and physicians to decrease the risk of medication errors and adverse effects. The program identified and addressed many medication problems, leading to fewer cases of therapeutic duplication and more appropriate medication use overall and for cardiovascular medications.
4. To enhance pediatric emergency and critical care for patients in rural and underserved parts of Northern California, pediatric emergency and critical care physicians at the University of California at Davis Children’s Hospital provided 24-hour evaluation and consultation services via interactive videoconferencing. Patients and physicians in 15 emergency departments could access the physicians at UC-Davis’ Children’s Hospital. The program provided the remote emergency departments with a standardized triage protocol and monthly pediatric critical care training. The program improved the diagnostic and treatment process, as well as parent satisfaction rates.
5. The U.S. Air Force launched an interactive, Internet-based weight loss program for military personnel. Overweight, active-duty Air Force personnel at three bases participated in an Internet-based behavioral therapy program. The program was designed to help them lose weight and prevent future weight gain. It included regular reporting on food intake, physical activity, and weight; personalized written feedback on this information from a counselor; 24 weekly interactive lessons related to behavior-related weight-control strategies; and two 15-minute telephone calls with the counselor. The program moderately reduced weight, waist circumference and body mass index; reduced the risk of weight gain and improved eating habits.
Jennifer Thew, RN, MSJ
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