Cast & Curious

Tag: health care administration

  • Do you want your healthcare professionals or healthcare institutions to have a social media policy?

    Yesterday I started a survey  asking healthcare professionals (physicians, nurses and allied medical professionals) if their healthcare institutions have a social media usage policy. (If you’re a healthcare professional you can still vote and comment in that post. ) Now its time to ask our clients, the Filipino patients:

    Do you want your healthcare professionals (physicians, nurses allied medical personnel) and /or healthcare institutions (hospitals, clinics) to have a social media policy?

    Philippines, the social media capital of the world!

    This question is important and highly relevant. Why? Philippines is the social media capital of the world and there’s a surge of content sharing in these social networks. That is according to this report by the Global Web Index. Sharing health related patient information on these social networks threads dangerously on an already greyed (if there is/was) privacy and health information laws here in the Philippines. Without enforced laws or governing policies, a breach of patient’s privacy and confidential information have consequences that pose a threat to the mutual trust between patients and his/her physician or that of his/her healthcare institution.

    The other reason is about enhancing patient communication. Social media is  an alternative, revolutionary way in which healthcare professionals or institutions communicate or interact with their patients.  Social media (though research data is lacking on this) could be  a venue for positive reinforcement of actual clinical consults and follow ups. A recent survey also shows that social media is now gaining ground as source of health information in first world countries. The absence of policies regarding its use defaults the interaction to a “free for all” and often negatively affect the overall outcome of these patient-physician  or patient-healthcare institution interactions.

    So again, I’m asking you, Filipino patients, or anyone since obviously you are the ones will be ultimately affected by this policy.

    Do you want your healthcare professional or healthcare institution to have a social media policy use?

    Please vote below and comment (in the comments section) if you wanted to explain your answer. Should you want to maintain anonymous, just email me privately thru this contact page and I will assure you of your confidentiality)

    [poll id=”3″]

  • Do you have a social media policy in your healthcare institution?

    Philippines ranks first in the global social media penetration according to a February 2011 market survey by Global Web Index. In this survey, it was also pointed out that asian countries do more ‘content sharing‘ than sharing messages as in other countries (UK, Canada). What is the implication of this survey results to Philippines’ healthcare system?

    Philippines tops social media usage globally! (Infograph from Mashable by Global Web Index)

    Possibly huge. Possibly positive. Sometimes, menacingly negative.

    For Filipino patients, the surge of content sharing and social media usage puts a huge stress on prevailing (or lack of) Philippine laws that govern patient information confidentiality. The lackluster enforcement of such laws, if there is/was, is/are sporadic. One does not need to look further. The gruesome photos (trauma, surgical, etc) that somehow lands on your Facebook wall is a testament to this breach. It’s also not uncommon to read patient blogs, tweets and comments on Facebook that cast doubts on healthcare professionals or or institution’s credibility. Some even lead to sensational malpractice suits.

    To healthcare professionals (physicians, nurses, allied medical professionals) the responsibility is even greater. In first world countries, there are stringent rules of engagement for healthcare professionals on how they relate to their patients and to healthcare institutions on social media. Such policy govern healthcare professionals employed in healthcare institutions and who’s social media usage directly or indirectly affects that of his or her employer. In the Philippines , while majority of healthcare professional and institutions  does not seem bothered  yet,  catastrophic consequences still hangs in the future . How many times have you encountered photos on Facebook that are in one way or another health patient or institution related? Too often?

    For healthcare institutions, this surge is promisingly positive should they take advantage of social media usage. This study by the Global Web Index for example is a market survey for business entrepreneurs. This could be an area for healthcare institution to reach out, communicate to their clients and improve the institutions online visibility. This is what the Mayo Clinic, Mount Sinai hospital for example is doing crafting their own social media policy to enhance patient – institution communication.

    Filipinos spend one fourth of a day on social media network.(Thanks to Dr. Iris Isip Tan for posting this infograph)

    But without a policy to govern such social media practices by their employees (internal) or their patients (external), the healthcare institution risks running into so many potential negative social media issues aside from economic ones (employees using social media at the workplace).

    As an afterthought, let me share another info graphic about use of health related IT technologies in US (source). Take a look at the social media usage. To think, Philippines is ‘ahead” of US in terms of per population social media usage. I don’t know if Philippines has have similar figures in terms of health related social IT. This should be an interesting research for healthcare markets.

    Health related IT technologies usage in US (source)

    So to answer this post title-question, I’m making an informal, non scientific survey here. This is open to all medical and allied medical professionals. Please answer the poll and please comment below if you need to explain your answer.

    [poll id=”2″]

    Thank you for voting!

  • Do we need a law that protect healthcare providers if they disclose or confess medical errors?

    Central to correcting medical errors is accepting one first, if it did happen. Improvement in healthcare delivery will only happen if we learn from our mistakes and make concrete, active steps to rectify it. This is what we actually do during mortality and morbidity conference- analyze medical events and cases to help improve delivery of healthcare services.

    The health care industry accepted the occurrence of medical errors decades ago. But disclosing medical errors publicly is unpopular even in countries where litigation is relatively not so common. Why? No one really knows. In our society however, publicly apologizing for one’s true medical mistakes is akin to killing your medical career. I guess it’s a bit easier to admit moral turpitude publicly than let’s say admitting you misdiagnosed a patient. The acceptance is just too low.

    But what can we do? First, we should create an environment of open-mindedness among medical peers and enact laws that will protect disclosures of medical errors publicly. That way, we can freely examine medical errors to institute appropriate corrective actions based on acceptable and evidenced based medical practice.

    This is what John Hopkins University Hospital is doing since 2001. Their  Disclosure Policy  protects and actually encourages employees to confess or report medical errors. This is partly the reason why JHUH  litigations have continually decreased ever since the policy has been implemented.  John Hopkins is the top ranked hospital in the US for 20 years already.

    Medical errors simply don’t surface over time. For us, providing a “medical whistle blower” law might just be the first step in improving delivery of healthcare services. Don’t you think so?

     

  • Do you charge professional fees for additional procedures done to address complications or morbidity?

    This question was thrown on me recently by a newbie colleague who was agonizing on whether or not to charge patients for an additional procedure he did to address a complication. I instantly went blank thinking what to say.

    when surgery goes wrong…will you charge mr. bean?

    In the field of medicine or at least here in the Philippines, there’s really no hard and fast rules on charging professional fees for services rendered to patients. This service for fee setup of our healthcare system is somewhat messy and often embarrassing to patients and doctors alike. The price haggling is totally unnerving. Sadly, this is what plague the professional practice of most physicians here in the Philippines.

    Such charging “grey” is even more embarrassing in cases where patients entailed additional services outside of their routine or planned operative procedure. While explaining and appraising procedure risks and complications to patients is a requisite of any informed consent, most patients still think that additional procedures,  should be an additional work for the physician and the healthcare providers alone. Patients or their financiers are not obliged to pay the healthcare providers for the services rendered for these additional procedures. Wherever, that notion came from, the stress on the attending physician(aside from that of managing the complication) is enormous, working on a very limited logistics to address complications. Besides, Docs have mouths to feed too.

    This situation is akin to the “heroic” services rendered by physicians to dying patients. Just because the patient dies (despite the doctors valiant efforts to revive the patient), the fees for the physician’s services (resuscitation)  does not “die” with the patient too. Services rendered have to be paid even if the service given did not achieve its original goal (that of reviving the patient). Can this situation be applied to procedures done to address morbidities?

    What do you think??

  • Chief’s Notes:Life and death tasks and physician’s perception to change

    Amongst professionals around, physicians are slow in adopting to change. By change I mean adapting  innovative ideas to handle cases, concerns and issues. In our aim to effect innovative administrative policies and changes, I’m trying to understand the behavioral reason behind this “reluctance” to adapt among physicians.

    Many physicians are not inclined on taking risks, especially when the issue on hand concerns them, their patients or their practice. An admirable trait perhaps that evolved primarily to safeguard patient’s safety and is ingrained in the professions’ dictum- “Primum non nocere“. First do no harm.

    When taking to the extreme, and coupled with an obsession towards handling ALL (medical or otherwise)  tasks as a matter of life and death, breakthroughs for innovations rarely push beyond the research stage. A physician will stick to whatever will sustain life from his or her experience. Thus, whenever an innovative solution for improvement quality of care is implemented, changing perceptions and attitudes will be a bloody issue to tackle.

    One other reason is the lack of  (new) knowledge and skills needed to adapt to change. For whatever reason we have, without the necessary new knowledge and skills, no physician will dare venture into any “unfamiliar” tasks. A seemingly slow adaptation is seen among physicians.

    It’s quite obvious then that to effect a change in perception or hasten adaptation of any new policies, innovations, or new ways of treating a particular disease, knowledge, attitude, values and skills (KAVS) should be initiated first. That way adaptation to  innovations and policy changes will be a bit faster than what we usually observe today.