BC Digital Health Demo Days | Keynote By Daniel Schwartz, QxMD

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QxMD was pleased to be invited to present at Sanotron's BC Digital Health Demo Day. Dr. Daniel Schwartz presented his thoughts on the potential for enhanced clinical decision support at the point of care.

Technology Health & Medicine

Enhancing Decision Making at the
Point of Care
Daniel Schwartz, MD
QxMD
March 29, 2012

1 in 10 patients is actually
harmed while receiving hospital
care

Providing Better Answers

Diagnosis
Prognosis
Therapeutics

Savings Lives by Moving a Dial

 High lung volumes | Mortality 40%

 Low lung volumes | Mortality 31%

Knowledge Translation

Evidence Improved Patient
Current Practice
Outcomes

Prognosis | What will happen to me?
Kidney Failure Risk Equation

Membranous
Nephropathy

Watchful waiting

Or

Intensive
chemotherapy?

Simple Tools Make Big Differences

“Testing for pulmonary embolism
often differs from that recommended
by evidence-based guidelines.”

Durieux et al. A computerized handheld decision-support system
to improve pulmonary embolism diagnosis: a randomized trial. Ann
Intern Med. 2009 Nov 17;151(10):677-86.

Checklists

 A simple safety checklist (the Surgical Safety Checklist) in
the operating room can significantly reduce post-
operative complications.

 Specifically, death after surgery was reduced by more
than 40%.

Computer Aided Cancer Detection

 Computerized assistance improves cancer detection

 MDs failed to recognize missed cancer in 70% of cases
where computer was right

Nishikawa et el. Clinically Missed Cancer: How Effectively Can Radiologists Use
Computer-Aided Detection? AJR March 2012 vol. 198 no. 3 708-
716 doi:10.2214/AJR.11.6423

Impact of Clinical Decision Support

 Decision support systems can improve clinical practice

 But, up to 30% of systems don’t have any meaningful
impact

Kawamoto et al. Improving clinical practice using clinical decision support
systems: a systematic review of trials to identify features critical to success.
BMJ 2005; 330 doi: 10.1136/bmj.38398.500764.8F

Better outcomes from better
evidence
Point of Care Delivery

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BC Digital Health Demo Days | Keynote By Daniel Schwartz, QxMD

1. Enhancing Decision Making at the Point of Care Daniel Schwartz, MD QxMD March 29, 2012

2. Becoming an MD…

3. 1 in 10 patients is actually harmed while receiving hospital care

4. What is wrong with me?

5. What will happen to me?

6. What is the best treatment for me?

7. Providing Better Answers Diagnosis Prognosis Therapeutics

8. Taking Breathing For Granted…

9. Taking Breathing For Granted…

10.

11. Savings Lives by Moving a Dial  High lung volumes | Mortality 40%  Low lung volumes | Mortality 31%

12.

13. Evidence Necessary but not sufficient

14. Knowledge Translation Evidence Improved Patient Current Practice Outcomes

15.

16. Prognosis | What will happen to me? Kidney Failure Risk Equation

17. Therapeutics | Best treatment?

18. Membranous Nephropathy Watchful waiting Or Intensive chemotherapy?

19. Simple Tools Make Big Differences “Testing for pulmonary embolism often differs from that recommended by evidence-based guidelines.” Durieux et al. A computerized handheld decision-support system to improve pulmonary embolism diagnosis: a randomized trial. Ann Intern Med. 2009 Nov 17;151(10):677-86.

20. Checklists  A simple safety checklist (the Surgical Safety Checklist) in the operating room can significantly reduce post- operative complications.  Specifically, death after surgery was reduced by more than 40%.

21.

22.

23. Kids Are Not Small Adults

24. Computer Aided Cancer Detection  Computerized assistance improves cancer detection  MDs failed to recognize missed cancer in 70% of cases where computer was right Nishikawa et el. Clinically Missed Cancer: How Effectively Can Radiologists Use Computer-Aided Detection? AJR March 2012 vol. 198 no. 3 708- 716 doi:10.2214/AJR.11.6423

25. Impact of Clinical Decision Support  Decision support systems can improve clinical practice  But, up to 30% of systems don’t have any meaningful impact Kawamoto et al. Improving clinical practice using clinical decision support systems: a systematic review of trials to identify features critical to success. BMJ 2005; 330 doi: 10.1136/bmj.38398.500764.8F

26.

27. Going to Medical School

28.

29. Airstrip Technologies

30.

31. Better outcomes from better evidence Point of Care Delivery

Editor's Notes

Terrifying
To Err is Human Report 98,000 deaths/year
Membranous Nephropathy Prognosis

BC Digital Health Demo Days | Keynote By Daniel Schwartz, QxMD

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