BC Digital Health Demo Days | Keynote By Daniel Schwartz, QxMD
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Transcript of BC Digital Health Demo Days | Keynote By Daniel Schwartz, QxMD
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Enhancing Decision Making at the Point of CareDaniel Schwartz, MDQxMDMarch 29, 2012
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Becoming an MD…
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1 in 10 patients is actually harmed while receiving hospital care
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What is wrong with me?
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What will happen to me?
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What is the best treatment for me?
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Providing Better Answers
Diagnosis
Prognosis
Therapeutics
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Taking Breathing For Granted…
Drag picture to placeholder or click icon to add
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Taking Breathing For Granted…
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Savings Lives by Moving a Dial
High lung volumes | Mortality 40%
Low lung volumes | Mortality 31%
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EvidenceNecessary but not sufficient
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Knowledge Translation
Current Practice Improved Patient Outcomes
Evidence
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Prognosis | What will happen to me?
Kidney Failure Risk Equation
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Therapeutics | Best treatment?
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Membranous Nephropathy
Watchful waiting
Or
Intensive chemotherapy?
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Simple Tools Make Big Differences
“Testing for pulmonary embolism often differs from that recommended by evidence-based guidelines.”
Durieux et al. A computerized handheld decision-support system to improve pulmonary embolism diagnosis: a randomized trial. Ann Intern Med. 2009 Nov 17;151(10):677-86.
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Checklists
A simple safety checklist (the Surgical Safety Checklist) in the operating room can significantly reduce post-operative complications.
Specifically, death after surgery was reduced by more than 40%.
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Kids Are Not Small Adults
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Computer Aided Cancer Detection
Computerized assistance improves cancer detection
MDs failed to recognize missed cancer in 70% of cases where computer was right
Nishikawa et el. Clinically Missed Cancer: How Effectively Can Radiologists Use Computer-Aided Detection? AJR March 2012 vol. 198 no. 3 708-716 doi:10.2214/AJR.11.6423
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Impact of Clinical Decision Support
Decision support systems can improve clinical practice
But, up to 30% of systems don’t have any meaningful impact
Kawamoto et al. Improving clinical practice using clinical decision support systems: a systematic review of trials to identify features critical to success. BMJ 2005; 330 doi: 10.1136/bmj.38398.500764.8F
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Going to Medical School
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Airstrip
Tech
nolo
gie
s
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Better outcomes from better evidencePoint of Care Delivery