Anew voice is emerging to guide healthcare innovations, and it is that of the patients and families we serve. Instead of asking, "What is the matter with you?" we need to ask, "What matters to you?" The way we communicate with patients and engage them in their own care will allow us to achieve better outcomes-simply because they will be developed collaboratively.
It is clear that we need to change our healthcare system. Better care at a lower cost is an important dynamic inspiring innovation that will bend the cost curve of unsustainable healthcare spending. If we can simultaneously improve quality and cut costs, then weare creating new, sustainable healthcare systems.
In the coming years, we will see accountable care organizations, patient-centered medical homes, value-based purchasing, variations in pay for performance, and tremendous growth of telemedicine and health informatics. Such reforms will require us to think differently and embrace innovation, as well as test and implement new models of care.
Some innovations are quite simple; some are beyond our current imagination. We must look at existing problems with new vision and find ways to vision what we cannot imagine. One simple concept to improve patient outcomes is good hand hygiene. Recent innovations in hand hygiene at some facilities show promise that we can achieve 100% compliance. Sentara, Johns Hopkins, Vanderbilt, and Beth Israel Deaconess Medical Center all have fresh approaches that rely on new kinds of auditing tools to discern what really works: better surveillance, monitoring, and measuring; reengineering; constant education; and a laser-like focus on behavior and culture change.1 We have found that simple concepts such as hand hygiene comprise complex human behaviors and multifaceted systems issues.
Other concepts are less clearly defined, and we continue to search for correlations, predictions, and evidence to first identify problems. Only then can we apply the structure, process, and outcome method to develop our innovations. To do this, we need to question everything we do and consider the patient's perspective in every outcome. To accomplish this, we must collect and measure "big data" to look at patterns and trends that are beyond our vision.
Mayer-Schonberger and Cukier2 describe this concept in Big Data: A Revolution That Will Transform How We Live, Work, and Think. Using the electronic medical record and systems informatics, we are now able to analyze huge amounts of information about symptoms, treatments, interventions, and patient responses. Using large data sets, it is possible to discover patterns and relationships that have been invisible to us, allowing us to identify new problems and target new therapies or interventions.2
Digital technology has already transformed the way we live, and it will transform healthcare as patients and providers become armed with real-time data and information. A world of personalized healthcare is a reality as patients arrive with laboratory data and information to collaborate with providers who practice with powerful digital diagnostic devices and evidence-based practice guidelines.
Dr Eric Topol's recent publication, The Creative Destruction of Medicine: How the Digital Revolution Will Create Better Healthcare, describes how healthcare providers use technology as powerful tools that digitalize human behaviors. Integration of this data, within electronic healthcare infrastructures, creates unparallel opportunity to forever change the face of how healthcare is delivered.3
Innovations in clinical, educational, leadership, and research dimensions will be highlighted in future issues of DCCN. Send us your insights, ideas, research, and practice changes at mailto:[email protected]. It is an exciting time as we move forward together to transform healthcare!
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