fbpx

18

NOVEMBER, 2018

Overwhelmed Emergency Departments
Elderly patients with chronic conditions
Outdated treatments

Generally, people attending hospital Emergency Departments are doing so because they think they’ll receive immediate attention to their possibly critical health condition.

Possibly, they think that hospital emergency departments are staffed by medical specialists and nurses who have nothing better to do than sit around waiting for the next emergency case to arrive so they can collectively swoop on the unfortunate person with trolleys and emergency medical equipment to attend to them with utmost speed and efficiency.

This must be the case, because just about every TV show or movie where someone attends a hospital emergency department seems to get this kind of attention.

The reality is somewhat different.

People attending hospital emergency departments often find themselves in a situation where they are not experiencing any assistance whatsoever.

In some cases, there may be no medical staff available to attend to them at all – and even if there are the may find that doctors and nurses occasionally appear to maybe ask a few questions, (very often just repeating what was asked previously), then simply disappear never to be seen again.

The environment might be chaotic and noisy and people waiting for attention or treatment for the problem that took them there are moved from cubicle to cubicle.

They wait. And wait.

They can’t find a toilet. They can’t get a cup of tea or a sandwich.

Sometimes they are admitted by the hospital, often they are discharged with a recommendation to go see a GP.

The overall result is that they are ignored and the condition that took them to the hospital in the first place is mostly not resolved – maybe not being treated at all.

What have they done wrong? – why was it that their visit to a hospital to receive attention for something they obviously considered was serious was dismissed with little or no treatment?

The answer could be that they tried to force their modern health problem into an ancient model of care.

And like the step sisters foot in the Cinderella’s fairy tale, it just doesn’t fit the shoe.

Throughout recorded history, hospitals have been the destination of choice for people who consider they need urgent or complex medical assistance.

The earliest institutions providing medical care were documented in Ancient Egypt when the average life expectancy was only about to the age of 30.

People injured in battle received basic surgery and wound care and hospitals gave the dying some comfort.

As there was no knowledge about sanitation, obstetric care, antibiotics or immunisation most deaths were as the result of poor hygiene, infections and uncontrolled bleeding.

Since that time hospitals, which have been primarily charity based and administered by religious orders, tended to relatively young people who had contracted an serious injury a sudden illnesses.

Hospitals have been the destination of choice for people who consider they need urgent or complex medical assistance throughout recorded history

The earliest institutions providing medical care were documented in Ancient Egyptian the average life expectancy was only about to the age of 30 and at a time when hospitals operated under very different conditions.

People injured in battle received basic surgery and wound care and hospitals gave the dying some comfort.

There was no knowledge about sanitation, obstetric care, antibiotics or immunisation and most deaths were as the result of poor hygiene, infections and uncontrolled bleeding.

Since that time hospitals, which were primarily charity based and administered by religious orders, tended to relatively young people who had contracted an injury a sudden illnesses.

Ironically, improvements in health care has never originated from within hospitals themselves.

They have come from public awareness, scientific breakthroughs, changes to public hygiene and the need to provide better care for children’s health.

In the 19th century a range of public hygiene programs was introduced known collectively known as the Sanitation Movement.

Vast networks of underground sewers were constructed to take away human waster which up to then had just been dumped in crowed streets.

Hand washing was introduced prior to medical treatment and surgery.

Slums were replaced with housing regulations.

Epidemics gave way to child immunisation programs.

And in the 1960’s, Penicillin was introduced.

These changes impacted society as much as the two World Wars and started an increase in population growth as life expectancy increased along with an increased need for medical services to attend the ageing population.

“Patients 65 years and older represent nearly 40 percent of hospitalized adults”.
Hospital management of older adults

A vicious circle was forming.

By the year 1900 the average life expectancy in England was around 50 and by the 1950’s it had risen to 65.

Currently, life expectancy is around 80-85 and continuing to rise and by the year 2112, 39% of females are expected to reach the age of 100.

An issue is, while this trend is forming, hospitals are passive regarding the sytems they use for the treatment they provide.

They just don’t have the resources or foresight to cope with future medical services the ageing population will expect them to be able to provide.

But maybe modern technology has the capacity to revolutionise healthcare much like the sanitation movement did in the 19th Century.

What’s changing? Plenty …

… and the speed at which new innovation is arriving is increasing.

Using Artificial Intelligence to assess radiology scans in a far more accurate and easier to understand format.

Chemical ‘sniffing’ can detect early stage diseases.

3D printing can produce a myriad of bespoke objects from made to order patterns or computerised scans of individuals skeleton.

Voice recognition help to pick up early signs of neurological and mental health disease.

Treatments that use small devices, (connected by the ‘Internet of Things’), are beginning to appear at a staggering rate.

By using them, a range of data can be almost instantly be collected about an individual’s health and then ‘synced’ to information already stored about the individuals health history is accumulated and instantly analysed – not by overworked people but by computerised systems.

Easy to understand instructions are then returned to the individual, maybe by using as smart phone – almost instantly.

Collective genetic data is combined with big data sets to help understand of the trends and causes of current diseases and predict future risks.

It all sounds good, but very few innovative health technology products are being funded by Governments or private health insurers and even if they was the majority of medical staff in Emergency Departments are mostly unaware of these technologies or how to utilise them.

It turns out, if people attending Emergency Departments wants the accuracies, efficiencies and care that these new technologies can provide to actually suit their personal chronic conditions, they’ll need to change the way they manage their health – themselves.

They need to stop leaving tests, assessments, documentation and responsibility up to incessant visits to a Doctor and take care of their own health using these smart devices.

While making change is difficult the trade off will be ~

  • The ability to stay away from error prone hospital Emergency Departments
  • Stay at home longer, using smart devices to monitor individual health status
  • Stay in touch with their Doctor using teleconferencing
  • Understanding and managing age-related deterioration, using computer based cognitive tests and internet-based allied health programs
  • Overcoming loneliness and isolation using social media, smart TV’s, small robots and a host of innovative new connected devices
  • Avoiding traumatic and ill advised medical treatments by keeping end of life wishes up to date, with informative websites and online forms
  • Receiving acute medical treatments in the home, using innovative home nursing services

Let’s all do our best to bring modern technology to those people wasting so much time in hospital Emergency Departments.

There is a better way to access the care they need in a more accurate and timely manner.

Terry Cornick (a healthcare consultant) has started a infographic of Australian health tech startupsDr. Bertalan Mesko has published several eBooks about health and technology. The American Foundation for the Blind has created a series of links to health technology for vision impaired people. Dr. Koen Kas is collecting lists of health technology services.

Over the next three months the Wikihospitals spreadsheet will be transformed into a fully functioning web database, thanks to a supervisor and students from Swinburne’s Student Partnership Program. 

This will enable anyone from patients to Doctors and administrators to search for any health tech product, from around the world.

Over the next few week I will write about the history of the Melbourne Senior Entrepreneurs Group, it’s pivotal role in supervising the Student Partnership Program based at Swinburne and what this program has to offer startups and community groups.

Stay tuned!

© Wikihospitals November 2019

To Our Weekly Newsletter

To Our Weekly Newsletter

And never miss out on the latest in health technology

Welcome to Wikihospitals! Your newsletter will be sent every Monday morning.