IMS MAXIMS Wake upthe future is just leaving Innovation change and survival Trends and pressures Technology is advancing faster than we can implement it We cant afford national healthcare as we currently know it ID: 676086
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Prof Michael Thick
Chief Medical Officer and Chief Clinical Information Officer
IMS MAXIMS
Wake up……the future is just leaving!Slide2
Innovation, change and survival!
Trends and pressures
Technology is advancing faster than we can implement it.
We can't afford national healthcare as we currently know it.
Current models of Management are not fit for purpose.Changing things is hard!
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Technology
Always encounters a vested interest!
Frequently exceeds the imagination of those who have the power to implement it.
Service size and inertia is delaying the journey from Cure to Prevention.
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€1
€10
€100
€1,000
€10,000
0%
100%
Healthy,
Independent Living
Chronic
Disease Management
Doctor’s
Office
Community
Clinic
HOME CARE
Assisted Living
Skilled
Nursing Facility
RESIDENTIAL CARE
Community
Hospital
ICU
Specialist
Clinic
CLINICAL CARE
COST of CARE/DAY
QUALITY
of LIFE
Traditional
Health IT FocusSlide5
Development of the transformation
Number of tests available
Number of people tested
PCR and Chemistry based “dipstick” methods win
Protein arrays, microfluidics & POC drive uptake
Rapid DNA Sequencing, arrays, microfluidics drive costs down
PCR, DNA Seq & bead based methods drive simplicity
Gene Expression & <50 SNP tests
Protein expression & whole genome tests
<10 SNP tests
ICT solutions drive transformation
Today
2015
2008
2006Slide6
Characteristics of future information systems.
Empower the less skilled to do “bigger” roles
Decision Support will be the most important element
It will be “active”, and incoming data will be matched to it to make decisions
Patients
AND Carers will expect
Right data, Right information, Right place, Right time
Patient accessible (governance of content and consent)
Interoperability and mobile workingSlide7
Current models of management
Have to face situations, expectations and possibilities that are 21st Century
….is running with management models of the 20th Century
….in an organisational structure which is 19th Century
…and is highly politically sensitive and risk averse
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66% of hospitals offer inadequate care
Targets – 13% inadequate, 61% require improvement
7% of Health and Social Care Providers “Inadequate overall”
“Worryingly wide” variations in quality of care
CQC Annual Report 2015Slide11
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Command and control!Slide13
Chaos!
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Definition of Chaos
Chaos is the science of complex, dynamic, non linear systems.
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Instead of seeing our health services as passive machines, made up of cogs and wheels, we should see it as a living, thinking organism, composed of dynamic patterns of intelligence involving everyone who is part of it.
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From Newton to Quanta
See the system as a whole, with the power to change depending on constructing relationships rather than negotiating the authority of entities.
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“only those who will risk going too far can possibly find out how far it is possible to go.
T.S. Eliot.
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Changing things is hard!
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People are very open minded about new things…..as long as they are exactly like the old ones.
Charles Kettering
.
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“
Towards a million change agents”
Explores concept of “social movement” as means of bringing about change.
Literature review (Bate et al)
There is a place for “heroic” leadership. BUT
Evidence favours multiple, multilevel, dispersed and networked leadership. Slide30
Satisfaction
/Complacency
Denial
/Rejection
Anger/
Resistance
Acceptance/
Curiosity
Enthusiasm/
Hope
Commitment/
Excitement
OPPOSED ENGAGED
Communication
Priorities
Convey
urgency
Give facts
Provide
evidence
Convey big
picture
Listen
Show
concern
Restate
facts
Listen
Demonstrate
concern
Restate facts
Convey
commitment
Restate big
picture
Communicate
vision
Ask for help
Involve
Celebrate
wins
Inspire
Feedback
success
Inspire
Create
Champions
Communication & Resistance
Change - Resistance ModelSlide31
Test fast….fail fast…..adjust fast!
Tom Peters
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The iceman carried a series of tattoos to inform any “doctor” of his medical problems AND to identify relevant acupuncture treatment sites.
Patient sees doctor in 3200BC
The HRCT scan of the iceman missed the arrow head Slide34
The Future of Health
“…..The future is already here, it’s just not evenly distributed…..”
(William Gibson)
Professor Michael Thick
Chief Medical Officer/Chief Clinical Information Officer
IMS MAXIMS
Michael.Thick@imsmaxims.com