Disease Management. Business Re-engineering in Health Care: the Patient-Centric Management System

Roger Gower, CEO, Dr Global, opened by presenting data demonstrating recent phenomenal Internet growth. The Internet doubles in size two-yearly in terms of users. Numbers of Internet users worldwide have increased from 39 million in 1995 to 318 million in 2000 and predictions are for 717 million in 2005 (refer slide 3). Consumer Internet use is increasing with online users and e-health consumer numbers growing at approximately the same rate (refer slide 4). Numbers going online to research health information increased from 54 million in 1998 to 110 million as at March 2002.

Dr Global has developed a set of web-based tools that harness the existing capacity of web-based technology to enhance patient care and add to the tools available to physicians to assist the care process.

The emphasis is on a patient-centric record accessible by patients themselves and by all relevant groups involved in patient management (refer slide 8). Data may be kept in a myriad of databases but there is central access to it.

Providing patients with the ability to read their health record increases communication between patient and providers, and this may lead to early intervention. In addition, remote intervention becomes possible.

Improved patient outcomes are the result, largely because of enhanced accountability; involving patients in their own care encourages them to be more responsible.

One specific Doctor Global initiative is in the area of chronic obstructive pulmonary disease (COPD), which represents a major cost to health systems - 80% of winter hospital admissions are respiratory-related and there is always pressure to free beds. Doctor Global has developed a toolkit for improving the home-based delivery of COPD care. It allows home-based management of patients who have been discharged early, using homecare nurses who monitor patients and send data back to the patient records via the web ready for assessment by a hospital-based specialist. The approach lowers health provider costs and allows for better managed and auditable homecare. It improves the productivity of community nurses, hospital facilities and specialists.

Gower summarised the core strengths of Doctor Global as:
  â€¢ Using and developing web-based technologies and tools.
  â€¢ Building secure communications with patient databases.
  â€¢ Working with clinicians in solution design.
  â€¢ Central data repository management
  â€¢ Secure data management and management reporting.

Advantages of the Doctor Global solution include the availability of all information at the point of care, involvement of patients in their own health care status and the use of existing technology - the application’s functionality and infrastructure already exist and, thus, the latest version is always available; there is no computer hardware to purchase, no software programmers to hire and manage, no network engineers to hire and manage, no data centre leases required and no record security systems to develop, purchase or manage.

Gower closed by presenting a diagrammatic representation of data flows in the Doctor Global system, involving web and database servers with private interfaces between them (refer slide 16).
[View Roger Gower’s presentation Disease Management. Business Re-engineering in Health Care: the Patient-Centric Management System]