Transcript Recommendation of a Strategy

Healthcare Drivers
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Quality of care – consistency, appropriateness
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Patient safety – diagnostic & therapeutic error rates
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Cost of care delivery
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Shortages of skilled healthcare workers
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Public health – biosurveillance, health policy
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Biomedical Research
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Environment
Philosophical Trends
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Maximizing efficiency
- maximizing output per unit of input
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Moving towards “perfect information”
- both evidence and clinical data
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Computers will become smarter than us
The Doctor may not be the best person
for the task
- new models of chronic disease management
- driving behavioural/social change, prevention
GP Practice Trends
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Movement away from reactive, biological
model of health – holistic bio-psycho-social approach
Displacement of doctor by computer
– but emotional and technical roles remain important
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Neither GP nor Specialist in charge
- decentralized, multi-disciplinary collaboration
- patient as active participant
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Focus on prevention
- behavioural/social change
- intensive use of social media / internet technologies as
enabler
GP Technology Trends
1. Interconnectivity
- social media, smartphones, portals; behavioural change
- telemedicine, distributed teams, care co-ordination
- distributed processing, storage
2. Mass aggregation of data
- biosurveillance, research, audit, case finding, policy
3. Rapid innovation
- Global/national/regional SDO-like approach to
guideline development; filtering evidence; data mining;
rapid deployment of guidelines/pathways/workflow
GP Technology Trends (2)
4. Machine reasoning
- automated systems for applying information:
- information → pathways → advice → autonomous agents
- personal intelligent agents co-ordinating everything
- machine diagnosis
- smarter systems → personalized care; genomics
5. Machine assessment
- automated systems collecting information:
- computer-guided history, examination
- computerized sensors, internet-enabled
- machine interpretation of images, x-rays
- looking for patterns in data
Predictions for General Practice
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The role of the GP will go back to what it
was at the start – caring and comforting
- computers will take over all other functions
- the GP's EQ will be their key characteristic
- the computer will still need the GP's intuition – the ability
to pick up on what is really going on with the patient
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Knowledge-based specialties will decline,
technical specialties will survive
Increasing roles for nurses, assistants
- physical examination, technical tasks will still need humans
- practising under computer direction