“Information Flows across Health”
Consider the following real-world example of one patient’s experience during early antenatal care in the USA. While this example has been taken from the American context, the events in this scenario could have easily and probably do take place in Australia.
When Ruth found out she was pregnant, she went to her primary care physician for a referral to a neighborhood birth centre. She had to schedule the appointment with her physician during work hours, quite inconvenient because she did not want to let her boss know she was pregnant. On the day of the appointment, she first registered with the receptionist and then saw her physician. The primary care physician confirmed the pregnancy with a urine test, similar to the one Ruth used to find out she was pregnant, and then wrote the referral letter.
Ruth called for an appointment with the birth centre and was able to secure a spot on a Saturday morning. She presented herself with the referral letter to the birth centre’s receptionist who placed the letter in a file folder she retrieved from the archive behind her. Ruth met with the midwife, answered a ten page long list of questions to assess any risk factors during pregnancy and underwent a physical exam. Ruth would have preferred to answer the survey at home because she would have been able to consult with her own mother about her family’s reproductive history. The midwife ordered that a blood sample be drawn and, according to the new hospital policy, suggested that she undergo a genetic test for cystic fibrosis.
The receptionist prepared the referral forms and sent Ruth to the blood laboratory in the nearby hospital. Ruth again registered in the main hospital and then waited for a phlebotomist to draw the blood. Because it was a Saturday, the phlebotomist was unable to draw the blood for the cystic fibrosis genetic test. Ruth would have to come back during the week. In this example, even though pregnancy check ups are routine events, all steps need to be planned and executed one at a time, resulting in an inefficient use of time of patients and health care providers and a chance for misunderstandings and sub-optimal care. Because it was too difficult to take time off work and after weighing the risks, for example, Ruth decided to forgo the cystic fibrosis genetic test.
(source: Berg 2004 pp85-86)
***Answer the following questions: –
• Identify the main issues as you seen them in the case study?
• As a Health Service Manager, what would you do to improve the patient care journey using ICT?
• What would be the benefits of your redesign?
• What are the risks with what you have proposed?
• Utilising your knowledge of legislation and policy, are there any major obstacles you envisage that may affect your success?
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