Clinical decision-making in complex healthcare delivery systems

Author(s):  
Kristen E. Miller ◽  
Hardeep Singh ◽  
Ryan Arnold ◽  
Gary Klein
Author(s):  
Faustina Acheampong ◽  
Vivian Vimarlund

Information technology has been suggested to improve patient health outcomes and reduce the burden of care. In this study, we explored the effects of collaborative innovation between caregivers and patients on healthcare delivery as a consequence of the use of an IT-based device by patients with atrial fibrillation. Two cardiologists and two nurses were interviewed while questionnaires were mailed to 75 patients querying them about the use of a home-based ECG for remote monitoring. Findings indicated that the caregivers considered the device to enhance the quality of clinical decision-making. Patients found the device to be useful and felt more involved in their own care. However, the introduction of the device presented work overload for the caregivers. Thus, the facilitation of timely diagnostics and decision-making were not realized. IT is an enabler through which innovation in healthcare delivery can be realized, but it must be integrated into work practices to realize potential benefits.


Author(s):  
Faustina Acheampong ◽  
Vivian Vimarlund

Information technology has been suggested to improve patient health outcomes and reduce healthcare cost. This study explored the business model and effects of collaborative innovation between caregivers and patients on healthcare delivery through remote patient monitoring by interviewing caregivers and surveying atrial fibrillation patients. Findings indicate that remote monitoring enhanced early detection of potential risks and quality of clinical decision-making with patients feeling more empowered and involved in their own care. The remote monitoring system which consisted of a home-based ECG and a web-based service and was offered free to patients, brought together caregivers, patients, service provider and the government as actors. The introduction of remote monitoring increased the workload of caregivers and facilitation of timely diagnostics and decision-making were not realized. IT is an enabler of innovation in healthcare, but it must be integrated into work processes with a viable business model to realize potential benefits and sustain it.


2011 ◽  
Vol 20 (4) ◽  
pp. 121-123
Author(s):  
Jeri A. Logemann

Evidence-based practice requires astute clinicians to blend our best clinical judgment with the best available external evidence and the patient's own values and expectations. Sometimes, we value one more than another during clinical decision-making, though it is never wise to do so, and sometimes other factors that we are unaware of produce unanticipated clinical outcomes. Sometimes, we feel very strongly about one clinical method or another, and hopefully that belief is founded in evidence. Some beliefs, however, are not founded in evidence. The sound use of evidence is the best way to navigate the debates within our field of practice.


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