• Health outcomes
• HIT
• Quality of care

Using revolutionary healthcare IT to achieve the Hippocratic Oath

Hippocrates will likely stand forever at the head of the medical profession, although very little of his original thought is genuinely extant. Even his greatest aphorism, do no wrong, is thought to be from the lips of Thomas Inman, a nineteenth-century English surgeon.

Although long in the tooth, the remark is exemplary, even if having been reappropriated by Google in its early days.

If Hippocrates lived today, I believe he would propound a basic set of ethical and behavioral guidelines — a code, if you will — by which healthcare ought to be practiced. The code is based on four simple tenets: quality and safety, access, outcomes, and the resulting cost of healthcare.

Every patient and every healthcare professional has these basic deliverables in mind for every patient transaction. Let us take a closer look at quality and safety, access, outcomes, and the resulting costs associated with twenty-first-century healthcare.

• First, the quality of healthcare services while ensuring patient safety in the process.
• Second, access to healthcare, and determining its outcomes.
• Third, outcomes that are satisfactory to both clinician and patient.
• Fourth, an investment-responsible process that benefits the patient, healthcare provider and society, and that can be managed to assure successful outcomes.

I replaced “cost” with the term “investment-responsible” because we need to shift our considering of patient care and outcomes from an expense to an investment, one benefiting both the patient and the provider. We need to recognize that a successful outcome truly accrues value to both.

When all four are performed at the highest levels of expertise, they collectively deliver superior outcomes. When this is the end result of the delivery system, it is inherently efficient, cost-effective and will satisfy the patient’s needs.

Quality and safety. Quality care is the result of the patient-clinician transaction – one, the quality of the clinical outcomes, and two, the quality of the experience. The quality of the outcome is determined by the problem and how it was diagnosed, cited and resolved, using the best possible practices known to the clinician on behalf of the patient.

That said, clinicians also benefit by knowing they have used best practices, established procedures, and appropriate functionality for diagnosis and treatment, whether for a sore throat or cancer. By expressing concern and care for the patient’s experience during the treatment phase, along with a level of professional service that was satisfying and corrective, the clinician has gained more and better experience and satisfying outcomes. Patient safety must always accompany quality care as an equally primary concern. Safety is tied to quality in many ways, clearly because it assures patients do not have bad outcomes.

Access. From a healthcare IT perspective, access is about capacity management (CM). CM design assures your organization can handle varying care demands of patients. The COVID-19 pandemic highlighted the importance of managing capacity well to best serve patients as their needs changed.

Outcomes. Ask any clinician and they will say that an outcome is, preferably, the successful treatment of a patient’s illness or completion of the applied medical intervention. It is far too common for the physician, and often the patient as well, to be somewhat uncertain about the outcome of a procedure. This is because the outcome is commonly the product of the clinician’s experience and intuition. While these perceptions are often spot on and should never be discounted or discarded, with today’s advanced technology, it is much to our advantage to use the vast amount of computer-based data to aid us in our quest for better and more predictable outcomes.

Investment responsible cost. We live in a rather ethereal world in which many enterprises operate at a loss year after year, ever waiting for the hoped-for turnaround. Healthcare cannot operate in this manner. Similarly, hospitals often do not know the true costs of their healthcare services, and as a result have no sense of what they should charge for them, which, of course, means they do not have a sound grasp on their P&L.

There is nothing hierarchical about these four mission-critical Hippocratic Code tenets of effective healthcare. Quality of care and safety, access, outcomes, and investment responsibility must be managed as an objective of healthcare service delivery, even when the P&L sheet reads like a Stephen King novel. And they cannot be managed for success without the grassroots involvement of healthcare information technology.

Barry Chaiken is the Physician Executive at Commure and has more than 25 years of experience in medical research, epidemiology, clinical information technology, and analytics. His recently published book on healthcare information technology is titled Navigating the Code: How Revolutionary Technology Can Transform the Patient-Physician Journey (https://navigatingthecode.com). Chaiken may be contacted at bchaiken@docsnetwork.com.