Bertalan Mesko recently "buzzed" this interesting report from "The Independent" on how drug companies are using a variety of technology to monitor patient outccomes. Quite an eye opener on the novel use of videogaming, and reminder systems. Back here in New Zealand, we are developing a proposal on how to use reminder devices to be used by elderly in their homes to remind them to take medications over telephone. Reminder systems work well, and we are testing the likelihood of reminder system installation reducing unnecessary hospitalisation.This set of new outcomes tracking are quite innovative.
Annals of Medicine: The Checklist : The New Yorker [feedly]
Just read this great article on the power of checklists written by Atul Gawande. The central thesis is that, checklists are simple to construct, implement in real world clinical settings and are associated with significantly improved outcomes. He starts with a scenario of complexity of saving lives in intensive care units; on an average that requires attending to about 180 stuff a day. Even with 1% mistakes, we are looking at two mistakes per day some of which could prove fatal for the patient down the line. That has driven the need for medicine being more specialist driven, which is true. At the same time, for small countries affording specialists may not be practical; ditto goes for smaller hospitals and care units. Pronovost’s studies show that checklists are good tools. Checklists are great stuff. I think what may extend the concept is go beyond checklists and work on the next actions based on the checklists more than ticking them off. Good reading. Wish this article could be a little shorter and to the point. You basically can skip the middle section where he talks about specialists. Worth a read. Learned a lot.
Annals of Medicine: The Checklist : The New Yorker
Automated Calls for Colorectal Cancer Screening Reminders Don’t Work – Physician’s First Watch [feedly]
An example, that the authors commented that application based on popular perceptions even before evidence emerges. Point to note.
Automated Calls for Colorectal Cancer Screening Reminders Don’t Work – Physician’s First Watch
Automated Calls for Colorectal Cancer Screening Reminders Don’t Work Automated telephone calls to patients do not improve screening rates for colorectal cancer, according to an Archives of Internal Medicine study. Roughly 20,000 people ages 50 to 64 were randomized either to usual care or to a single 3-minute automated telephone call using speech recognition that encouraged people to call their healthcare providers for screening. In the year after the call, the rate of any colorectal cancer screening — the primary outcome — did not differ between the two groups. These results, the authors suggest, show yet another instance in which “potentially ineffective policies and programs achieve widespread acceptance before evidence is available from controlled trials.”