In the space of just two weeks, a paper has appeared and a new UK government task force has been launched which both point to the important role that will be played by the symptom checker in the brave new healthcare world where the patient starts to take greater control.Read More
Isabel Healthcare Blog
I wrote about Ebola and the importance of mobile diagnosis decision support in 2012 when the last outbreak occurred. Now in 2014, West Africa is experiencing the worst outbreak of Ebola in history with as many as 7000 people diagnosed and 3,338 people who have died from the disease. However, these figures may be underestimated due to under reporting and the fact that many cases are not counted as people aren’t attending health care facilities due to lack of transport or as they are full and closed to new admissions.
In the USA, media articles are reporting the Dallas Ebola case of Eric Duncan who had helped carry a pregnant woman in Liberia who was desperately ill with Ebola. Mr Duncan then returned to the USA and presented twice at a hospital with Ebola symptoms, unfortunately he was not diagnosed until his second visit when he presented with severe symptoms. During his first visit to the ED, his travel history of having recently visited West Africa was recorded by a Nurse in the Electronic Health Record (EHR) but due to a system / process / workflow breakdown key members of the care team did not see this vital information. We could go round in circles allaying blame on the EHR, the Nurse or the Physician but this is pointless. Overall it's a system failure and the lesson to learn is how could this have been prevented from the onset and rectified so it doesn't occur again.Read More
NHS England today 23rd October 2014 has published its 5 Year Forward Report which shows the NHS is at a cross road and needs to change and improve as it moves forward. The report is a collaboration between the six leading NHS groups including:Read More
There is increasing coverage and discussion in the press about the empowered consumer and all the tools that are now available for people to use to help be empowered. The symptom checker is one of the key tools that consumers should use as it helps make sense of all the data such as symptoms, abnormal test results or abnormal readings from the various monitors that are now available.
The Wall Street Journal ran a special report on healthcare this week and included two great articles that both referred to the Isabel diagnosis decision support tool:
A study entitled ‘The Ecology of Medical Care Revisited’ from the NEJM of June 2001 graphically shows how important it is to try and guide and influence the patient from a very early stage in order to ensure appropriate flows into primary and secondary care. Encouraging patients to use a symptom checker could be one way to help them at that crucial stage when they are considering seeking care.
Perhaps a controversial headline but a study recently appeared in JAMA (Journal of the American Medical Association) ‘Physicians' diagnostic accuracy, confidence and resource requests which revealed some rather shocking figures about the levels of physicians’ diagnostic accuracy, confidence and the contribution to diagnostic accuracy made by lab tests and imaging.
It is with great pleasure that we introduce our guest post from Robert Hitchcock, M.D., FACEP, Chief Medical Informatics Officer, Vice President, T-System, Inc. describing 'How to avoid Diagnostic Errors in the Emergency Department'.
With the Duchess of Cambridge being admitted to the Lindo Wing at St Mary’s Hospital, Paddington, London there is worldwide interest as to when the royal baby will arrive, especially as her husband the Duke of Cambridge was also born there. Isabel Healthcare which produced the Isabel clinical decision support system for Health Professionals and the Isabel Symptom Checker has strong links with St Mary’s Hospital in Paddington as it is where Isabel Maude was treated, at age 3, with Necrotizing Fasciitis on the Pediatric Intensive Care Unit (PICU) after being misdiagnosed at her local hospital. It is where Jason Maude and Clinicians from St Mary’s conceived the structure of what became the Isabel clinical decision support system. Further reading on how Isabel was developed can be found here.
We are often asked by clinicians whether they would be better or worse off in a malpractice case if there was a record in the medical notes of their full differential diagnosis and the diagnosis missed was in that list. Our view is that it’s always better to have documented what you have done and thought. If you were wrong and had a reasonable explanation for why you did not think the diagnosis missed and on the list was the most likely and the one that you treated for, then it is better to be able to show that you thought about other possibilities. At the very least you show yourself to be a concerned and caring clinician rather than one that couldn’t be bothered.