Component 2: The Culture of Health Care Unit 4: Health care processes and decision making Lecture 5 This material was developed by Oregon Health & Science.

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Presentation transcript:

Component 2: The Culture of Health Care Unit 4: Health care processes and decision making Lecture 5 This material was developed by Oregon Health & Science University, funded by the Department of Health and Human Services, Office of the National Coordinator for Health Information Technology under Award Number IU24OC

Sir William Osler ( ) Keeping Track of Care “never ask a new patient a question without note-book and pencil in hand... Component 2/Unit 4-5 Health IT Workforce Curriculum Version 2.0/Spring

Problem List Building relationship, negotiating plans Diabetes –poly U/D/phagia –hyperglycemia HTN –high BP x 3 –LVH ECG Hyperlipidemia –LDL 162 –Triglyc 250 BMI 34 Component 2/Unit 4-5 Health IT Workforce Curriculum Version 2.0/Spring

Who is the Audience? What is the message for each? Patient Family, Friends, the Public Clinical staff – nurses, lab, x-ray, therapists, pharmacists, dietician Yourself – now and later Colleagues Consultants Insurance companies Lawyers (plaintiff and defendant Compliance officers, regulators Researchers, data miners Performance measures Component 2/Unit 4-5 Health IT Workforce Curriculum Version 2.0/Spring

Communicating with Patient Patient Education – what’s wrong Instructions – what to do Reassurance – what will happen Motivation, hope Acknowledgement, acceptance “I’ll be there for you” Component 2/Unit 4-5 Health IT Workforce Curriculum Version 2.0/Spring

Family, Friends, the Public What do they need to know? What will be best for the patient? What will be best for the family member? What can I legally tell? What can I ethically tell? Component 2/Unit 4-5 Health IT Workforce Curriculum Version 2.0/Spring

Clinical Staff Nurses Pharmacist Dietician Therapists: physical, occupational, respiratory, massage, acupuncture Lab X-ray Component 2/Unit 4-5 Health IT Workforce Curriculum Version 2.0/Spring

Oneself “Nothing clears up a case so much as stating it to another person” (Sherlock Holmes) Processing effect of recording case Effect of structure and order Impact of recording technology Prospective memory – notes to myself, a la “Memento” Component 2/Unit 4-5 Health IT Workforce Curriculum Version 2.0/Spring

Other Clinicians Colleagues Future responsibility for patient Format Content Detail “Experts share knowledge not only of their domain, but of the structure and goals of their discourse” (Evans) Consultants Ask a clear question – get a much better answer What to share – what to leave out –Neurologist –Psychiatrist –Cardiologist –Radiologist Component 2/Unit 4-5 Health IT Workforce Curriculum Version 2.0/Spring

Insurance companies Documentation of the illness –ICD9 Documentation of the procedure –CPT4 Documentation of the process –Details to support the Dx and Tx Component 2/Unit 4-5 Health IT Workforce Curriculum Version 2.0/Spring

How much detail In what form? Lawyers Regulatory agencies Data mining Clinical and Outcomes research Quality and Performance improvement Patient Safety Component 2/Unit 4-5 Health IT Workforce Curriculum Version 2.0/Spring