Performance Enhancement

Performance management is defined as a means of obtaining better results from the organisation, teams and individuals by understanding and managing performance within an agreed framework of planned goals, objectives and standards of achievement and competence.
We defined performance enhancement in the healthcare context as a process or set of processes for establishing shared understanding about what is to be achieved in order to improve and deliver a patient centric care system. The modern ICU is a very complex and challenging environment and the key questions to be addressed are:
  • Where are you today?
  • Where do you need to be?
  • How do you get there>
A clinical information system (CIS) with emphasis on integration which key benefit is automation is much more a strategy than a product or architecture. A CIS can be defined as a combination of applications; one application can have physician order entry, results retrieval, documentation, decision support, flow charts and patient's care plans and notes. The second is ancillary services; radiology, laboratory and pharmacy and two new components such as PACS (Picture Archiving and Communications System) and Biomedical equipment. A CIS is basically an integrated suite of applications and the key differentiation is whether the system has enhanced functionalities that support the continuum of patient care. Today, the healthcare organisations that do it right are just not investing in a clinical information system. When the key driver is "we need that information to be able to deliver patient care, a CIS becomes an invaluable asset.

Most vendors are market-driven like any other industry. Traditionally, healthcare organisations have measured the value of IT in healthcare by saying "OK, where is the service-cost benefit? We believe that the most important benefit of a CIS is its effect on quality and safety, with cost taken into consideration. Measuring quality is a complex issue but we believe there are metrics than can measure quality, the kind of daily occurrences such as reduction in medical errors, reduce clinical utilisation, better charting capture etc. We believe that clinicians are the key piece in the quality issue as they are responsible for improving and maintaining the quality of care.

The current CIS market is dominated by the big players such as Siemens, GE and McKesson and although they do provide a complete Clinical Information System, what are sorely lacking are the key functionalities. Our approach is to work with clinicians to develop a SMART CIS. We will combine cutting edge Mathematical Science and Operational Research and our expertise to enable lightning fast, predictive and precision decision support. What good is a multi-million $ system if it cannot even alert a clinician that an adverse change in a patient homeostasis and physiological status has resulted in multiple organ failure, which may compromised his outcome?

MASH believes that for a CIS to succeed in the eyes of a clinician, it must have a set of "must dos" that a CIS can accomplish:
  • Enhance his or her recall (such as drug interactions)
  • Measurably improve his or her performance
  • Broaden his or her access to pertinent information
  • Alert him or her to risk when or before it happens
  • Be his or her own system. It cannot be IT's system. IT cannot design a system that meets the needs of all clinicians. It must be tailored and customisable for individual clinicians or a small team of clinicians working together, with shared goals. Only then ownership becomes a non-issue.
The barrier to a CIS is the high price demanded by the main vendors. Our vision is that each hospital has the opportunity to deploy such systems at an affordable price and without upfront huge capital expenditure but leased over an agreed period of years.
 
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