Thanks for Your comment.
Actually we tried. In ear-nose-throat outpatient care. The business case did not appear to be profitable. I think the scibes (PA/NP) should take over not only the note keeping, but also the rest of the administration and planning and thereby acts like a case manager for the patient in case of questions, request for information, sharing test results etc.
How to afford this expense or organize it in a profitable way?
Our experience is that in the care proces of a hospital admission medication history was taken several times by several professionals ( nurse, doctor on the ward, anaesthesist) because they checked again whether the list in the record was accurate. Still mistakes occurred.
By verifying medication on entry by a skilled farmacy-nurse we try to check medication upfront only once and thereby saving time and reducing errors.
The above comments share the idea that care-givers should turn away from administration to cope with future increase in adminisatration and data collection. I fully agree with that viewpoint and it sounds logic. But how did we get where we are?
One: Docters are from the middle ages a protected profession end responsible for healthcare. So the system is build with them on top. For a lot of decisions the system turns to doctors to join, to talk, to decide, to prescibe, to fill in the form, to decide, to govern etc. Is we want to be successful in lowering the burden of administration and make them available for the care, we should turn around the system a bit by making others end-responsible for the administration, operational task and governing. I would be nice if some doctors turn to this tasks as professionals, while the rest are dedicated to the care. SO TURN AWAY SOME RESPONSIBILITIES FROM DOCTORS.
Second: A lot of data are recorded at the point where the interaction between care-giver and patient is. For this to solve I think the proces should be split in a more administrative part like taking the history, notes, questionaires etc and a part with pure interaction with the caregiver for talk, investigation, ordering tests, shared decision making, followed again by a more administrative part like explanation, planning etc. SO SPLIT THE PROCES.
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