Tag: Co-production

Who was Warner Slack?

Subtitle: Why communication technology matters.

I read last week’s BMJ obituaries, as I often do. (read the article HERE) The main tribute reflected on the work of Dr Warner Slack, who believed that ‘the patient is the largest and least utilised resource in healthcare’.

As I read further, I was astonished at the foresight of his vision. In the 1970s, with others, he set up the Center for Clinical Computing at Harvard, and created one of the earliest hospital information systems. He wrote much about clinicians and information technology, but the area I wish to focus on today is his vision of patient-clinician partnership, enabled by Information Technology.

Dr Slack trusted the agency of patients to use automation for their benefit decades ahead of his time. His underlying inspiration was that computing and information technology would empower clinicians and patients. He wrote about online patient communities, now a reality, with websites such as Patients like me and Smart Patients empowering patients to find out from others about the experience of their conditions, and the reality of treatment choices.

He also believed that patients should have access to their digital records, and now we have the OPEN NOTES movement.

I believe that patients need time to understand what we have told them, have the right to consider what we have recorded in their notes, and to consider the implications of their condition and the treatments that they are choosing between. This access, alongside health literacy, means that patients are on the therapeutic team for their own care.

I’ve had a look at the Primary Care Digital Services analysis of what we are working towards, and patient access to their clinical notes has been classified as High Input, Low Impact, meaning that it will be low down on the list of projects being progressed. I know that this is already part of the English GP contract, so it can be done.  This week’s mission: to find out whether this access is coming across Scotland, across the Western Isles, and on Benbecula.

Also, to link the blog to the practice website and the practice patient participation facebook page. (Done)

I’m inspired by Dr Slack, whose ideas are so relevant to Realising Realistic Medicine.

A mini-inventory

I’m still pondering on who should be involved in this adventure, what exactly we are trying to achieve, and how. In the meantime, every day, something happens that reveals a new dimension, new ideas to try and new resources to explore.

Before I start changing everything, I thought I should do an inventory of what we do in our practice to support patients to be ready for a dialogue about their choices. Here is my photo-inventory.

  1. Signposting cards. I have used these for a while, and then recruited them into a project to reduce the time patients wait in the surgery for their appointment. I give them to patients to look things up after the consultation. On the back, there is space for recording the next appointment. I could add the ‘five questions’. 2018-09-18 08.56.28
  2. Pre-consultation leaflets: part of the same project was to see if patients could be supported to make the most of their appointment. This seemed a brilliant idea, but patients are only be persuaded to use the forms if they were pressed upon them by the admin staff. The posters in the waiting room are still there, and the forms are at reception.2018-09-18 08.54.59
  3. We have also tried to direct people to contact the right person for queries about referrals, appointments and investigations, and to get the best from their hospital appointments. We should really do a proper interface project, but most of the consultants visit from out-of-the area, so that hasn’t taken off yet. However, the poster already has the ‘five questions’.2018-09-18-08-54-52.jpg
  4. We have also supported our practice population to attend workshops run by the Scottish Health Council to empower them to speak up about what matters. 2018-09-18 08.55.27

So, for the quick look round the surgery, we have some solid foundations. We also have a patient participation group facebook page and a practice website.

I strongly believe that people,our patients,  are a under-used resource for revolutionising health care. Enpowering them to spread the concepts of Realistic Medicine, they will spread through our health and care systems, asking for change, reaching the cynics as well as the enthusiasts.