Just-in-time Decision Support for Improving and Optimising Professional Practices

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Just-in-time Decision Support for Improving and Optimising Professional Practices. Geissbühler A. eHealth week 2010 (Barcelona: CCIB Convention Centre; 2010)

Just-in-time Decision Support for Improving and Optimising Professional Practices. Geissbühler A. eHealth week 2010 (Barcelona: CCIB Convention Centre; 2010)

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  • 1. Optimizing the Use of Hospital Resources through Real-world, Real-time Information Systems Prof. Antoine Geissbühler, MD Geneva University Hospitals
  • 2. Geneva University Hospitals • 2'200 beds • 3 campuses, 30 smaller sites • Primary, secondary and tertiary care • 50'000 admissions/year • 800'000 outpatient visits/year • 10'000 collaborators • 1‘500 physicians • 3'500 nurses
  • 3. Meaningful integration in the care processes
  • 4. Integrating information
  • 5. Considering today's serum creatinine level, I recommend that you adjust the dosage of intravenous gentamicin to 80mg every 24 hours (and check its blood level in three days)
  • 6. From documentation to coordination
  • 7. Collaborative care: clinical pathways
  • 8. Shorter feedback loops Resources Processes Results People Interventions Costs Equipment Medications LOS Space Tests Satisfaction Care Outcome Evaluation, feedback
  • 9. Shorter feedback loops Resources Processes Variance Results People Interventions % of goals Costs Equipment Medications achieved LOS Space Tests Satisfaction Care Often missed Outcome Goals goals Evaluation, feedback
  • 10. From orders to workforce adjustment Order entry Split orders into activities Schedule activities into acts Value the workload for each act Match with resources from HR system Adjust team workforce if needed
  • 11. From activity to flow modeling
  • 12. Connected to the real world of people and objects
  • 13. Real-world, real-time information Challenges: • Getting the information at its source, once • Connecting the various information domains with semantic consistency • Shorten feedback loops so that the link between actions and results is more likely • Errors are photodegradable → transparency