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Andrew innes hull wsdan 30 june 2011a


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Andrew innes hull wsdan 30 june 2011a

  1. 1. Clinical Engagement and Telemedicine<br />Church View Surgery<br />Andrew Innes<br />
  2. 2. Why clinical engagement?<br />Makes sense<br />Viewed as self-evident in current UK health policy (1)<br />“ Improvement of the performance of healthcare depends first and foremost on making a difference to the experience of patients and service users, which in turn hinges on changing the day to day decisions of doctors, nurses and other staff”.(2)<br />High Quality Care for All: NHS Next Stage Review final report. London: Stationery Office, 2008.<br />(2) Ham C. Improving the performance of health services: the role of clinical leadership. The Lancet 2003;361:1978–80.<br />
  3. 3. General barriers to clinical engagement<br />Lack of time<br />Pressure of competing demands<br />Lack of understanding<br />Lack of expertise<br />Disinterest <br />Frank prejudice<br />
  4. 4. A question of culture<br />
  5. 5. Clinical culture and the role of clinical trials<br />
  6. 6. Cum ScientiaCaritas<br />First the science<br />Then the caring<br />Medical training<br />
  7. 7. Science<br />Epistemological schism<br />Mixed quality (better in heart failure than COPD)<br />Problems of considering cost effectiveness<br />
  8. 8. Caritas<br />Antithesis of personalized healthcare?<br />Remote<br />Cost-cutting?<br />Concerns about clinical governance and safety<br />
  9. 9. Overcoming barriers to telehealth – What excites clinicians?<br />Improved quality of care – an additional window on a patient’s problems<br />Improved clinical relationship with patients<br />Improved efficiency<br /> Improved cost effectiveness<br />A different way of working<br />Application of technology<br />
  10. 10. Overcoming barriers to telehealth – What excites patients?<br />Empowerment – the expert patient<br />Effective, timely and safer care<br />Improved access<br />
  11. 11. Why must clinicians change?<br />Tsunami of long term conditions<br />LTC affect 31% of the population and account for 52% of all GP appointments and 65% of all OPD<br />Around a 25% in the numbers of patients with LTCs over next 25 years<br />Changing practice with risk tools and community MDT<br />
  12. 12. Key components of resolving clinical engagement<br />Adopt a communication strategy that addresses the problems and the benefits in terms that clinicians understand<br />Good clinical evidence of benefit<br />Prioritise clinical domains rather than management targets<br />Local “Champions”<br />Funding – pump prime through enhanced service or QOF mechanisms. NB. Little evidence to support much of what QOF does and yet GP’s perform well in this framework<br />
  13. 13. Thank you<br />Any questions?<br /><br />