2020 09 28 telemedicine blog 768x487 1

Telemedicine is House Call 2.0

Telemedicine is House Call 2.0 768 487 Exist Software Labs

It used to be that doctors were the ones doing the consult visits and by the patient bedside performing a medical consultation.  In modern times, these were replaced with the patient’s going to doctors’ offices and interaction was now happening across the desk. Factoring infection risks and patient comfort, telemedicine provides a necessary alternative — one which may soon become the norm.

The trip to the doctor, a rather uneasy experience for most people, suddenly turns to be a thing of the past.  The threat of COVID has put everyone on alert that even periodic out-patient visits have to be second-guessed in light of the risks. Unsustainability and population growth have put an end to doctors doing house calls in the same way that the threat of infection prevents people from showing up in clinics or hospitals.

Regardless of one’s attitude towards the use of technology, it is without a doubt that it has been part and parcel of the way that the practice of medicine continues to evolve.   Lab equipment and imaging machines aside, medicine and technology go hand in hand and would continue to do so. Right now, it teams up once again to bring the patient and the doctor together via a screen display.

While there are certain situations where a personal visit is warranted, the use of telemedicine presents a valuable tool in limiting the risks, especially in today’s pandemic.  Though talking to a screen would seem to replace the warmth of face-to-face interaction, the cold reality is that telemedicine provides each participant with a level of comfort by being in familiar surroundings.  Truth be told, it is probably not telemedicine that makes this interaction awkward because talking virtually with friends is certainly something most of us would look forward to.

Whether face to face or virtual, logic dictates that people heighten their guards when discussing serious topics, and talking about a health issue does fit into that category.  A smoker would certainly feel less comfortable being visited in his home by his pulmonologist because it exposes the reality that despite the advice, evidence at home would probably present more of an embarrassment.  For years, the privacy of a doctor’s office serves the patient more than the doctor.  Using telemedicine, a peek into the patient’s environment seems possible – which yields more valuable information (eg. senior citizens and home hazards like stairs, etc.) but only for those patients who have developed stronger relationships with their providers.

“In essence, COVID-19 has allowed us to lower our psychological barriers to the adoption of technology,” Professor Vishall Ahuja says. “All of a sudden, we realize we’re not as inflexible as we thought we were. We’re not as tech-adverse as we were. Necessity is the mother of invention.”


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2020 09 02 medcurial blog 768x487 1

Improving Healthcare Quality

Improving Healthcare Quality 768 487 Exist Software Labs

If there is a word often used (and abused) in marketing, it is the word ‘quality’.  Why not?  Positive quality connotes class, distinction, and a cut above the rest.  More often than not, it also subtly echoes what being upscale is as opposed to bargain type items as well as services.  From the abstract (one’s life) to the mundane (pencil, paper, computers), there is nothing quite as aspirational as shooting for superior quality.

In healthcare, patients, doctors, and care institutions pursue quality at every touchpoint.  Yet, knowing whether they’re (patient) getting or providing  (doctors, nurses, providers) quality care has always been a matter of debate.  Even medical professionals can’t always judge this. Quality management in health care works to measure the health benefits of doctors’ and hospitals’ work and improve patient outcomes.


Quality management in health care works to reduce errors and improve patient care. The safety and effectiveness of treatment are two of the most critical measures of quality.

Mr. Fraser Sherman writes an excellent piece about the challenge of measuring quality in healthcare.  

Put simply he writes that, “Quality management in health care works to reduce errors and improve patient care. The safety and effectiveness of treatment are two of the most critical measures of quality.”

He writes further that formulating healthcare metrics is complicated in healthcare compared to other businesses dealing with bottom-line sales and revenues. In health care, different patients may have widely different problems, even in the same specialization such as OB-GYN or oncology. Despite similarities, treatment, and services to patients’ conditions have to be individually tailored, not mass-produced.

Despite this, health care quality is measurable!

According to Tefen Management Consulting, it’s the degree to which programs, policies, services, and research produce good health care outcomes and lead to conditions in which people can stay healthy. 

The National Center for Biotechnology Information (NCBI) describes quality management in health care as a strategy or strategies that meet the needs of the industry’s customers, the patients.

You can read more on the informative piece here: https://smallbusiness.chron.com/quality-management-health-care-62136.html#socialshare

2020 09 02 medcurial infograpahic redesign

The effectiveness and safety of treatments are particularly important. Prioritizing quality management in these areas yields the best results.

Check out our healthcare product, MEDCURIAL, and see how it helped some of the biggest hospitals in the country provide better patient outcomes.

The Decision to Support Clinical 768x487 1

The Decision to Support Clinical

The Decision to Support Clinical 768 487 Exist Software Labs

There exists a  healthcare blueprint for achieving better patient outcomes and as it has been, it involves putting the right type of processed data in the hands of the helper.

Personal, Communal and Personalised

Like a broken record, I keep telling everyone that next to actively maintaining a healthy lifestyle, having a doctor as a close friend, is an investment that will reap dividends.  A personal medical referral affords the patient with personalised care which comes in the form of ‘special’ care and medical treatment generally reserved for those with plenty of cash to spare.  And even better, this favor usually extends to family and friends as well.

Why?  Because complementing the medical meritocracy, the healthcare journey still traditionally goes through familial and social networks for a patient seeking medical services and treatment.  

To put it simply, healthcare success has and will always be personal, at the start.

Take for example the story of Kathy Halamka who was diagnosed with cancer and how having a doctor for a husband enabled her journey towards the best care services possible.

Personal to Informational
But before you jump into a ‘familial’ conclusion, the story doesn’t focus on the benefits of having a medically-trained family member but on how the decisions that guided Kathy’s therapy — using evidence-based protocols from available clinical data, is creating a strong case for its adoption in a healthcare industry still undecided about making technology investments.

Hospitals focused on patient care cannot ignore the fact that “the complexity of medicine now exceeds the capacity of the human mind”, according to  Ziad Obermeyer, MD, and Thomas H. Lee, MD in the New England Journal of Medicine  and further adds, ‘because physicians and nurses, despite their years of education and clinical experience, have cognitive limitations”.

Their article further states that, “No single clinician can retain the petabytes of medical research and patient records now available in many clinical decision support systems. Nor can they be expected to see all the correlations and patterns required to make a fully informed diagnosis. No doubt these shortcomings are partially responsible for the disturbing number of misdiagnoses reported in the scientific literature.”

The standard of care for cases like Kathy’s is typically chemotherapy followed by mastectomy.  But having access to digital resources presented them with new options and an opportunity to test a personalised medicine approach.

Smarter Care Transformation
To achieve personalised medicine requires a more technology-enabled healthcare system. However, this is proving to be a hard sell to hospitals struggling to secure budgets and zeroed in on cash returns on investment.  

At the granular level, the transformation needs to start with the culture — on how medicine is being practiced. As the author Paul Cerrato states,  “[the] new resources can transform the practice of medicine, but only if clinicians are willing to recognize the need for such tools.”

As former Cleveland Clinic CIO, Martin Harris proclaims, “We must reimagine a healthcare system that will be built upon capabilities and connections that simply did not exist just a few years ago. To envision a new kind of HIT-enabled system of care, we will need people who see the role of technology in a more integrated way.”

What is required of technology as a start is the kind that will give healthcare providers access  to available clinical information that can lead to actionable insights and its management which should effect and transform the practice of medicine.  

Evidence-based & Clinical Decisions
Clinics and hospitals who use systems that are capable of collecting and storing clinical data provides patients with a huge advantage compared to facilities that are still stuck with technology that is focused on operational and billing efficiency.

As illustrated in Kathy’s case, availability of patient clinical data (with privacy and security features in place) is a treasure trove of insights waiting to be discovered and applied to a populace seeking not just personalized medicine but therapies and medical regimen that are evidence-based.

As defined by Dr.  David Sackett (1996), evidence-based medicine is the conscientious, explicit and judicious use of current best evidence in making decisions about the care of the individual patient.  It requires the integration of the best research evidence, clinical expertise and the patient’s unique values and circumstances.

Clinical expertise comes from knowing how vital ‘clinical’ data is and putting them to good use.  It comes with good history taking, physical examination and years of experience and the patient’s values include social and cultural factors besides the individual’s ideas concerns and expectations.

The need and demand for evidence-based health care is expanding rapidly driven by a combination of these factors: information overload, rising patient expectations, the introduction of new technologies and ageing populations.

The use of clinical decision support (CDS) systems to facilitate the practice of evidence-based medicine (EBM) promises to substantially improve health care quality by its potential to reduce medical errors thus lift care quality.  By matching patient characteristics with established knowledge base, updated evidence from medical research literature and practice sources, clinical decision support challenges clinicians to carefully consider and reconsider before jumping to conclusions (and biases) by presenting them with other diagnostic possibilities that don’t readily come to mind.

Currently, the numbers for different types of clinical decision support technology are steadily increasing.  These include knowledge-based tools like UpToDate, which gives users access online to a massive repository of medical textbooks and journals and guides users through interactive algorithms that recommend tailored recommendations.

We are in an era where medical advances continue to provide proof for healthcare providers to consider reasons to integrate technology innovation to their respective medical practices.  Amidst the promise, the goal to improve patient outcomes has never been under this type of pressure and scrutiny.  From the push to use electronic medical records to other core hospital clinical systems and decision support tools, the realisation that medicine needs to move past the limits and biases of human decisions is a provoking thought for it means that patient care is still currently subject to hits and misses.  If we need to raise the bar, healthcare providers and institutions will need help, too, in order to help guide their patients towards the best possible health care and outcomes.

Check out our healthcare product, MEDCURIAL, and see how it helped some of the biggest hospitals in the country provide better patient outcomes.