Ken

Most practices use what's called a PMS - a practice management system. This software does basically everything, medical records yes, but also billing, appointment, scripts, referrals, etc.

My system is focusing on just one aspect - medical records, and the staff which use them.

Healthcare is regional issue - most patients at wellington hospital are from wellington. National sharing of information isn't always necessary. However, sharing of IT resources is.

Primary care is where the fight is. Most of your healthcare is at primary care, with small excursions out to specalists, or hospitals. Cost wise, primary care is cheap, compared to a hospital bed, or a specialist. Atul Gawande says fewer cowboys and more pit crews. The cost of healthcare is tricky - the cheapest care has best results.

Gawande has three skills a good system requires

  1. The ability to recognize success, and recognize failure
  2. Devise solutions
  3. Implement solution, get people to actually do these things

Managing complexity of science.

Clinics care mainly about looking after their patients, but they also care about looking after their business. The confusion of the two causes issues.

Vertical solutions can work - Kaiser Permanente by controlling the whole chain can create fantastic solutions


Thoughts

Support big data - first step in recognizing problems. Every module has a 'report' function.

First goal improve patient outcomes, a lofty goal

Second goal, improve software as GPs think is improveable

Don't divide regionally - divide by sector

Medication list designed by GP's and pharmacists

Newborn record designed by plunket

Specialist records desigend by specalists