On Wed, Mar 14, 2018 at 11:28:28AM +0100, Philippe Ameline wrote: > because MD > keep seeing information systems as "back office" components, also > because they are often individualists very at ease in silos (practice > and specialty))
Practitioners need to be able to control their space for, at a minimum, liability concerns, which are brought about by the amount of implicit trust that is put forword towards them (and then happily withdrawn at the slightest chance of litigation). It is only natural that most MDs will resist "change for no good reason" and be *very* conservative. > and they are still fully organized for acute care (to > put it simply, the medical system is fully upside down and the GP should > become an orchestra conductor (what she often dreams she already is) but > is stuck in the one-man band role). ~70% of _all_ reasons for encounter are fully solvable inside the GP "domain". But that goes counter to what most patients want and believe they need. Which is the biggest obstacle for primary care based healthcare. At least in Germany. "Chronic care" is nothing new, it has been the mainstay of General Practice for, what, centuries ? (not that any noticeable number of IT solutions had fostered that approach so far) > the dynamic team of the > contributors around a given individual). That, of course, is a vision in need of better application. > The most important point to consider here is that, when considering the > person's bubble, it is really mandatory to be plainly holistic, that's > to say to consider health as a project among many other projects > (education, employment, social issues, ordinary life projects, etc). It > is a place where the term "patient" is prohibited. If we remove the term "patient" we will remove the very last trace of what it means to fall ill - to endure, with the necessary patience. Only "clients" remain, believing that healthcare can work like a business process, getting themselves repaired as needed. While I fully support the process of informed shared decision making, and embrace it to the extent possible, 15 years of daily face-to-face encounters with literally many thousands of patients painfully teaches that the majority is not currently able to take matters into their own hands AND live with the consequences. So, yes, let's build systems to be open and to enable caretakers and caregivers, but let's not expect those systems to be used that way by the great majority. Karsten (speaking from a German healthcare perspective only) -- GPG key ID E4071346 @ eu.pool.sks-keyservers.net E167 67FD A291 2BEA 73BD 4537 78B9 A9F9 E407 1346 _______________________________________________ openEHR-technical mailing list [email protected] http://lists.openehr.org/mailman/listinfo/openehr-technical_lists.openehr.org
