Medusa Blog: August 2008

Friday, August 8, 2008

E-Health Strategies

I’ve been reading through a number of different eHealth Strategies from around the world and have come to this conclusion: albeit unusual, politicians and governments of different countries seem to agree on how eHealth can benefit the patient and on how to move the health of the nations forward over the next ten years.

Although these strategies seem to align (and I’m sure intentions are honourable), I don’t see much that points to what works well now. It might be just me but, being from a Paramedic Training Manager background, I am hardwired to think that in order to progress we must first learn from what got us to where we are today. In order to treat, you must first understand what has happened. It’s easy to dismiss what’s in front of us as “this is how it is, let’s make it better” but, without tapping into the knowledge of the people who made it what it is, we can only re-design it and not develop it. Understanding what else is out there is also a significant factor in the success of any change. Has someone done it already? Does it work? How do they do it in other parts of the world? These are all fundamental questions to ask when considering a new approach; however, without the funding to support a round- the-world fact finding mission or spending a month wading through the internet searching for unbiased opinions on what works well, it’s almost impossible to get a realistic view.

We must also decide where we sit in the “Are we an Emergency service? Are we part of the healthcare infrastructure? or “Are we both?” debate. As EMS providers it’s easy for others to see us as isolated, away from the wider healthcare system and simply providing a fast route to the nearest doctor.

"During the UK ambulance strike in 1989 Kenneth Clarke, the then Secretary State for Health, described ambulance workers as ‘glorified taxi drivers’. This statement caused outrage within Parliament but that’s nothing compared to how we felt. In true British style every ambulance operating in the city of Manchester drove around for the next month with banner’s reading ‘Ken’s cabs’. One paramedic even had some business cards printed with Downing Street’s phone number on!"

Today’s EMS has moved on so much that it’s hardly recognisable from 20 years ago. Paramedics and the services they provide are an integral part of the healthcare services within developed nations. Not only do paramedics provide the lifesaving interventions that a patient needs, they take control of emotionally charged and dangerous situations, and provide the foundation upon which the whole patient care episode is built.

When eHealth strategies such as, ‘eHealth – Making Healthcare Better for European Citizens’, ‘Transforming Healthcare: The President’s Health Information Technology Plan’ and ‘Information for Health – the UK Department for Health’s Strategy’ are put out there citing scenarios such as those noted below, they don’t seem to take into account the huge role EMS can play in achieving this vision of the future. A senario portrayed on the White House website (http://www.whitehouse.gov/infocus/technology/economic_policy200404/chap3 :)

"Arriving at an emergency room, a senior with a chronic illness and memory difficulties authorizes her physicians to access her medical information from a recent hospitalization at another hospital - thus avoiding a potentially fatal drug interaction between the planned treatment and the patient’s current medications".

"Three patients with unusual sudden-onset fever and cough that would not individually be reported, show up at separate emergency rooms, and the trend is instantly reported to public health officials, who alert authorities of a possible disease outbreak or bioterror attack".

The first call a patient will usually make in an emergency situation will be to the EMS. The EMS starts the process. They are the first contact the patient has with the healthcare system and the information collected at that point is integral to the ongoing care of that patient. Why wait until the ER before the detail of past medical history is assessed? Why wait until the ER to identify disturbing trends in recent activity when all this information is available from the EMS when collected through their ‘state of the art’ ePCR system? The importance of accurate and early information when dealing with any patient is undisputed but, in order for this information to be used to its fullest potential, it must be shared between practitioners, organisations, regions and even countries and continents.

What is easy to forget is that the technology is already available. The systems are already built, tried, tested and live. The experience has already been gained.

We just need to share it.

Ian Wilkinson
Clinical Product Manager

posted by Medusa Medical Technologies # 3:54 PM 0 Comments

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