Sunday, November 6, 2011

Three S's of Clinical Innovation - Simpler, Smaller, Snarter

I will make government simpler, smaller, and smarter.

Mitt Romney

November 6, 2011 – Mitt Romney may be on to something – something that applies to clinical innovation as well as government.To make the point, here are three examples

The Instant Medical History - Simple

What takes the most time when a patient enters the exam room. That‘s simple. It’s eliciting the patient’s chief complaint and taking the medical history. When the symptoms are vague and multiple, this can be time-eater. Allan Wenner, MD, a primary care doctor in Columbia, South Carolina realized this more than 10 years ago. So he came up with the idea of having patients enter their own data from the their home computer or a laptop in the reception room. This software – consisting of clinical algorithms based on the chief complaint, gender, age, and symptoms – generates an easy-to-read narrative. Reading this narrative, the clinician can quickly focus on the problem, add his/her findings and comments, write a treatment plan, and generate a complete electronic record of the encounter – a record that used for referral letters, for coding purposes, and for the patient to take home. The Instant Medical Record is simpler because it saves data entry expense, gives the history from the patient’s point of view, allows the doctor to code for a comprehensive visit, and saves 4-8 minutes for each patient encounter.

The Shape-HP Device from Shape Medical Systems - Smaller
The treadmill and the equipment to record data for the traditional coronary stress test is bulky. It takes up the corner of a room and cannot be carried around. The Shape-HS cardiopulmonary device, on the other hand, is portable and its 3 components – an ECG, a mouthpiece, a small gas analyzer, and a laptop – fit nicely into a carrying case. The device is small, portable, easy-to-use and interpret, simple device requiring six minutes to test, and poses no risk to the patient Anybody can administer. Cardiologist presence is not required. The Shape-HS device distinguishesrbetween heart disease and pulmonary disease, can quantitate cardiopulmonary response to drugs or pacemakers, and yields prognostic information such as chances for hospitalization and death. The device has been approved by the Federal Drug Adminstration. It’s value has been verified by the Mayo Clinic, and it is used in multiple cardiology offices and centers around the Unite States.

The Copper Telecoil or Hearing Loop - Smarter

Then there is the copper coil or hearing loop that can be installed in any building or home or public place. Any person with a hearing aid can flip a switch, and the hearing aid will cut out all the clutter at musical event or an ordinary conversation. Words and music care transmitted to a wireless using a technology - a hearing loop. The technology, widely adopted in Northern Europe, has the potential to transform the lives of tens of millions of Americans. As loops are installed in stores, banks, museums, subway stations, and other public spaces, people who have felt excluded are suddenly back in the conversation. A hearing loop, typically installed on the floor around the periphery of a room, is a thin strand of copper wire radiating electromagnetic signals that can be picked up by a tiny receiver already built into most hearing aids and cochlear implants. When the receiver is turned on, the hearing aid receives only the sounds coming directly from a microphone, not the background cacophony. The basic technology, called an induction loop, has been around for decades as a means of relaying signals from a telephone to a tiny receiver called a telecoil, or t-coil, that can be attached to a hearing aid. As telecoils became standard parts of hearing aids in Britain and Scandinavia, they were also used to receive signals from loops connected to microphones in halls, stores, taxicabs and a host of other places.

Tweet: Sometimes the best clinical innovations are simpler, smaller, and smarter than more comprehensive, larger, and complicated health care solutions.

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