MbChB (Otago), FRACP, FCICM, MD (Monash), Grad Cert Health Economics

Michael Buist is a fulltime academic physician and intensive care specialist. He is a graduate of Otago Medical School in New Zealand (MB ChB 1983) and completed specialist training with the Royal Australasian College of Physicians in intensive care medicine (FRACP 1991, FCICM 2010). In 2007 he graduated Doctor of Medicine with the submission of his thesis to Monash University; “The epidemiology and prevention of in hospital cardiac arrests.” He also has a graduate certificate in health economics from Monash University (2001). He is currently the Director of Intensive Care at the North West Regional Hospital in Burnie, Tasmania and Honorary Clinical Professor, Faculty of Health, University of Tasmania. In addition he undertakes private physician clinics in a community general practice in Wynyard, Tasmania and is a clinical co-ordinator for Ambulance Tasmania.

Michael is supported by the RACS Visitor Grant Program.

ABSTRACT

Bleeding Out Post Operatively; Could ICT (Information Communication Technology) Get The Surgeon To Reoperate Faster Than The Traditional Referral Model Of Care?

In 2003, David Bates and Atul Gawande from Harvard Medical School, wrote of the potential for Information Technology to improve patient safety, stating (1),

“The fundamental difficulty in modern medical care is execution. Providing reliable, efficient, individualized care requires a degree of mastery of data and coordination that will be achievable only with the increased use of information technology. Information technology can substantially improve the safety of medical care by structuring actions, catching errors, and bringing evidence-based, patient-centered decision support to the point of care to allow necessary customization. New approaches that improve customization and gather and sift through reams of data to identify key changes in status and then notify key persons should prove to be especially important.”

Fifteen years on by and large this vision has not been achieved. Instead as discussed, by Atul Gawande (a surgeon) in the New Yorker (2), we have large massively expensive Electronic Medical Record (EMR) systems that rather than improve patient safety, make the users (mostly doctors) “slaves” to a user interface (UI) that detracts from their clinical work, and most importantly time with their patients.

Over this identical period (2003-2018) based on principles of patient centred care and the actual day to day requirements of the clinicians who actually manage patients an ICT system called Patientrack was developed, tested and commercialised. The original concept originated from the preventable death of a post-operative patient on Melbourne Cup day 2001, and the subsequent coronial inquest. Initially Patientrack was a simple digital real time electronic system that connected patient status to the most appropriate responsible clinicians, by a configurable set of escalating alerts. In response to a corporate strategy of client/customer service the original product has evolved into a system that incorporates multiple configurable patient assessments into a UI that has been designed by our users for maximal clinical efficiency. With the acquisition of Patientrack by Alcidion (ALC), the full potential of the system can be released by the use of an Artificial Intelligence platform, to allow for real time data analytics of what is really going on at the bedsides in our hospitals.

References

  1. Bates DW, Gawande AA. Improving safety with information technology. N Engl J Med 2003; 348: 2526-34.
  2. https://www.newyorker.com/magazine/2018/11/12/why-doctors-hate-their-computers.

Disclosure

Prof Michael Buist was the founder of Patientrack in 2003. He was a Company Director until 2011, and Chief Medical Officer until 2018. In both these roles he received either share options or an honorarium. His only current role is that of a major share holder in Alcidion the details of which can be found from their 2018 Annual report. https://hotcopper.com.au/threads/ann-appendix-4e-and-fy18-annual-report-to-shareholders.4400459/

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