My Dad died because the Cardiologist didn't think to refer to a Neurologist
My Dad died because the Cardiologist who was treating him didn't know that he was going to have a stroke even though he complained of all the typical pre-stroke symptoms, i.e. severe headache, high blood pressure, high cholesterol, dizziness. The doctor controlled his blood pressure but, saw nothing alarming in EKG, ECG etc.
Could this have been avoided if the Cardiologist and a Neurologist consulted each other. Hell yeah. Can we solve this with software tech? I think so, I am working on a platform (Web + Mobile) for simpler, better communication between different specialists in medicine (unfortunate, sometimes doctors in the same hospital don't talk to each other, let alone outsiders)
I know HN is a great place with forward thinkers, your thoughts are much appreciated.
(
13 comments
| 13 points
| on HN
)
Eventually we will have a better system. Unfortunately this is likely to be a very slow, gradual process, which I hope to witness over the course of the next few decades. In this particular case, software tech could have served as a communication platform to reduce the chances of doctor miscommunication and/or overlooking a patient's varying conditions. Generally speaking (and by my personal experience), doctors seem to be notoriously bad about communicating the overall picture to responsible parties, at least here in the U.S. Each doctor takes care of his/her own "backyard" before dashing off to the next patient. I recognize that this is by no means solely the fault of the doctor. It's the system!
Again, good on you for wanting to be part of the solution.
That's not easily solved with tech. It's solved with hospital policies that foster communication.
I'm sorry for your loss. Unfortunately, the doctor would still have to recognize that a neurologist needs to be brought in, even if communication was facilitated.
What if the patient himself foster the communication? If the patient can input all the symptoms and the results of all the exams ordered by one doctor, the system can detect all the "red flags" that a particular result raises and tell you which kind of specialist should take a look at it. Example: your cardiologist register dizziness and high blood pressure. The system knows that a cardiologist already saw it, but it also alert you that these results and symptoms should be studied by a neurologist and a endocrinologists.
I'm not saying it isn't worthwhile. It is. But let's say you raise all these symptoms and red flags and decide you need specialized testing from 3 different specialists. Then it turns out you didn't need that testing at all.
Who pays for it? Your insurance company won't.
One of the things I'm working on right now is software to facilitate the coding process for payment and insurance purposes, and let me tell you, it is complex for a reason. The insurance companies do NOT want to pay.
This is changing. One of the most likely potential models is a condition based pay model. An example case would be a 50 year old smoker with high blood pressure; the insurance company says, ok, on average it costs $1000 to cover this person for one year. They pay the hospital $1000. If the patient needs a procedure, the hospital eats the excess cost. If the patient needs no procedure, the insurance company does.
Now, couple this with a change in how MD's are reimbursed, so it's a performance based plan rather than a procedure based plan, and you have a more efficient and better managed system.
We're not quite there yet. When we are, your planned software might work. Give it 1.5-2 years at a minimum. The new coding processes come out in 2014 and we're shifting away from private practice, but it takes time.
one big difference between what i am developing versus what healthtap is doing is that i want to develop some sort of scoring for doctors' responses so that we can help the patient make a better decision instead of being confused with 10 or 20 different responses. actually even worse, many doctor responses on healthtap and other such sites is something along the lines of "you should see your doctor", duh!
I doubt it has a public API available (although that's certainly something I'd advocate the NHS building), but it might give you an idea of the sheer complexity involved in something like this.
This way your dad would get an immediate feedback on his screen: "POSSIBLE STROKE! URGENTLY CONTACT YOUR DOCTOR", allowing him or his loved one to apply extra pressure to medical professionals.
All those doctors can use IM, phone, email to communicate.
they should be able to work on a higher level, just as we moved up the chain from punch cards and assembly code on 8080s doctors need to move up the chain as well, otherwise we will have many near and dear ones dying due to single point failure (PCP)!
to answer your question, i am working on an app (will post a link to it in the next 2-3 weeks) that brings the patient closer to more physicians, hopefully someone relevant, in my dad's case, a neurologist (at least it takes the risk of seeing one doctor out of the equation).