BC Digital Health Demo Days | Keynote By Daniel Schwartz, QxMD
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Enhancing Decision Making at the Point of Care Daniel Schwartz, MD QxMD March 29, 2012
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Transcript of BC Digital Health Demo Days | Keynote By Daniel Schwartz, QxMD
Enhancing Decision Making at the Point of CareDaniel Schwartz, MDQxMDMarch 29, 2012
Becoming an MD…
1 in 10 patients is actually harmed while receiving hospital care
What is wrong with me?
What will happen to me?
What is the best treatment for me?
Providing Better Answers
Diagnosis
Prognosis
Therapeutics
Taking Breathing For Granted…
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Taking Breathing For Granted…
Savings Lives by Moving a Dial
High lung volumes | Mortality 40%
Low lung volumes | Mortality 31%
EvidenceNecessary but not sufficient
Knowledge Translation
Current Practice Improved Patient Outcomes
Evidence
Prognosis | What will happen to me?
Kidney Failure Risk Equation
Therapeutics | Best treatment?
Membranous Nephropathy
Watchful waiting
Or
Intensive chemotherapy?
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.
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%.
Kids Are Not Small Adults
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
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
Going to Medical School
Airstrip
Tech
nolo
gie
s
Better outcomes from better evidencePoint of Care Delivery
