Essay on Informatics Solution Proposal

Reducing Wait for Time in Windsor-Essex Regional Hospitals

Executive Summary

This report outlines the profound study of major key factors causing increasing wait time in Windsor Essex region hospitals. Moreover, it provides a unique solution to address problem statements and other related problems. It also explains in what way solutions can improve the current management system of hospitals. At the outset, every individual in Canada is fed up with long wait times for basic healthcare services. An analysis from the Canadian Institute for Health Information (CIHI) proclaims wait times for cancer, cataract operations, and knee replacements have increased across the Canadian population since 2015 [1]. The critical instigating factors that affect the wait time of patients differ from hospital to hospital. Furthermore, Deficient employee and available resources management. i.e. few number of specialists available in the hospital compared to the intake of patients on a daily basis. The patient administration system used in individual hospitals also plays a vital role i.e. without having a thorough knowledge of the patient medical conditions it becomes difficult and time-consuming for the doctor to identify diseases and sometimes this can have catastrophic effects on patients’ health. In addition to this, modern health care is expensive and it charges more than many people are happy to pay for, whether through taxation, insurance premiums, or out-of-pocket payments [2]. Moreover, the budget of the individual hospital is also vital to the wait time of patients. Based on the above diagnosis, some solutions and recommendations are suggested to reduce the overall wait time of patients.

The demand for some specific surgery is also variable. Eliminating people who are not in dreadful need of surgery from waiting lists improves access for other individuals. It also avoids the overtreatment of healthy individuals which is widespread in many areas of medical streams. For example, 32 percent of patients waiting for cataract surgery in British Colombia had nearly perfect vision [2]. The low budget of individual hospitals can be resolved by “activity-based funding” i.e. an individual hospital has a considerable number of patients for some particular surgery thus institute funding should emphasize centrally that particular treatment. The budget and timeline for implementing all recommendations in a new solution to improve wait time for patients are also discussed with logical reasoning. Moreover, we have discussed the advantages and disadvantages of this new solution. Introduction North America is suffering from numerous social and environmental problems, such as starvation, healthcare services, protection of human rights, carbon emission, insanitation and illiteracy, enormous resources running to waste, etc. Professor Charles Weiss of Foreign Service at Georgetown University, Washington, said before the meeting of the AAAS (American Association of the Advancement of Science) Consortium for International Programs that science is the solution to all issues mentioned above, and indeed, nobody can now afford to ignore it [3].

Health informatics (HI) is the discipline/tool/method/procedure, which emphasizes on collecting information from multiple sources and analyzing it to generate reliable predictions/patterns/knowledge to support clinical care, medical research, health services administration, and medical institutions [4]. In addition to this, adequate medical records are always needed, when there is an immediate therapeutic action needs to be taken. Considering a scenario, when an ambulance arrives at a scene of an accident after the critical minutes have passed and doctors do not have any medical history about the person. They will only have the option to follow their necessary procedure regardless of the person’s pre-existing medical conditions. This can lead to a dangerous or sometimes life-threatening situation. That is when Health Informatics plays a vital role. Health informatics places between two of the sub-branches The fact that the bionic world is growing rapidly and transforming health care to whole new standards should come as no surprise to anyone. From robotic arms that perform surgery to Nanorobots that deliver drugs through the bloodstream, the days of being tended to by the human country doctor seem to have entirely given way to machines and software more in keeping with the tools [6]. Public health surveillance is one of the sub-branches of health informatics which is the systematic, ongoing collection, management, analysis, and interpretation of data [7]. In the future, for the betterment of public health care, different experts from different disciplines should come together to create an inclusive database of patient illness which includes: The physician, the engineer, the nurse, and probably the essential member the statistician [8]. Which in terms of attempts to offer thoughtful knowledge about a patient’s medical condition and can be used to analyze for the future prediction of a patient’s medical conditions.

Background and Literature Review

At the outset, Every individual from Canada faces a waitlist in all the possible areas of medical healthcare. Physiotherapy specialists measured a median waiting time of 21.2 weeks between an appointment with a general physician and the first time of treatment from the doctor. which is more extensive than the wait of 20.0 weeks stated in 2016. Moreover, in the year of 2017, Researchers’ study for wait time in hospitals reported the longest of all time in medical history; 128 Percent longer compared to the year of 1993 when it was just 9.3 weeks. In addition, the total number of populations waiting for treatment in the year of 2017 was 1,040,791 which is 2.9 percent of the Canadian population on the waitlist of health care [9]. Between General Practitioner and Specialist Consultation to the point of fist time treatment Wait time 6.7 Weeks 8.6 Weeks Nation’s average 10.2 Weeks 10.9 Weeks Specific situation, anticipating serious medical treatment can have a catastrophic effect on patients such as those suffering from serious pain and mental trauma. In certain examples, this can turn physically and mentally well patients into inferior mental conditions for instance transforming potentially reversible illnesses or injuries into chronic, irreversible conditions, or even permanent disabilities. One clear example is patients may also have to forgo their wages while they wait for treatment, resulting in an economic cost to the individuals themselves and the economy in general. The average amount of time expended in the emergency department escalated by 10.9% over the previous years for patients admitted to the hospital. a considerable amount of cancer operations were not completed within the determined recommended wait time. Furthermore, the average time patients waited in an emergency to see a doctor rose slightly over the past year, to 1.5 hours from 1.4 hours.[10]

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Canadians reported some of the longest wait times for doctors, specialists, and emergency department visits in compared to citizens in neighboring countries. The majority of Canadian patients experienced difficulty to get primary care doctors for getting their specialized diagnostic tests. Canada continues to accomplish below the international average on 7 out of 8 procedures of appropriate access to health care. Access to emergency hours is also difficult in Canadian hospitals compared with most of the other countries, such as only 1 out of 3 patients being able to receive medical care on weekends or on holidays. More than half of the patients who visit hospitals wait longer than 4 weeks to see a specialist, compared with the international average of 36 percent.[11] Waiting Time Ratio with respect to years Figure 2- Wait Time Ratio with respect to years [12] A sum of $41.3 billion spent by the Canadian federal government over 10 years, which includes $5.5 billion to specifically address wait times in five key areas: Cancer, cardiac, sight restoration, medical imaging (CT and MRIs) and joint replacement [13]. The researchers suggest to implement a National Seniors Strategy which implies seniors need separate support and solutions. This allows hospitals to perform the required actions they needed to look after acutely ill people and perform procedures and surgeries [14].

Statement of Problem

In this era of globalization and modernization, collecting information from various sources and analyzing it to generate reliable predictions is playing an important role these days. however, there is an unfolding healthcare crisis in Ontario that requires serious attention. Specifically, in Windsor-Essex regional hospitals, where even a regular check-up, which is done 3-4 times a month takes a similar amount of waiting time. Moreover, the statistical data of the survey showed that it took almost 60-120 minutes for an appointment. In addition to that, even after waiting for this much time, almost 64% of patients were unsatisfied [15]. Furthermore, without having the patient's medical background, almost all the time doctors proceed with their training, which could sometimes lead to devastating results [16]. Other problems which can be addressed by the solution, are

• Deficient management of the Workforce
• Inadequate history of medical data
• Lack of knowledge of the medical background of the patients
• Maltreatment of patients
• Better exposure for local specialists
• Improved relations between doctors, patients, and government
• Centralized and transparent system
• Overcome paper-based outdated health care system (i.e. fax)
• Avoiding backlogging of patients
• Digital data available to access 24/7

Requirements and Criteria Requirements

1. Digitalize existing systems of hospitals with highly advanced computers and high-speed broadband internet
2. All clinics, hospitals, and local specialists must be convinced to register in the system and provide the necessary data.
3. powerful Software environment which can handle an abundance amount of data from multiple sources.
4. All new doctors and each individual from the nation have to register their self with the new system
5. The manufacturing cost of the health card should be minimal.
6. the artificially intelligent adaptive algorithm which gets trained by itself with the trends in medical science.
7. Referrals to other clinics or specialists must be feasible enough in accordance with the disease, the patient is carrying.
8. organize seminars and other ways to reach with people of the nation to educate them to understand the new system
9. project needs approval from the ruling government of the nation
10. project requires a large amount of money and a powerful backend workforce

Criteria for success

The offered solution ought to be assessed by the criteria expressed underneath.

1. The downtime of the system must be as minimum as possible.
2. No one should be able to hack or the system should not be vulnerable to inferior individual
3. Each individual should have a thorough understanding of the system
4. Information provided by the customer should be as much as accurate possible
5. The healthcare and healthcare hospital computer software proposed in the solution must be easily acquirable as well as accessible.
6. Both the healthcare card and Software should have to be user friendly

Proposed Solution

Developing a self-assisting powerful backend system with medical health card which has the following key points:

• Efficient backend smart system with the ability to process large numbers of patient’s medical data to assist patients in their bright medical future. In general, the healthcare system will analyze a patient’s medical history to assist patients with the future diseases he/she might face.
• The system will also store data of all the clinics, hospitals, and local specialists, containing available beds, available services, and the number of people waiting for the service. It will allocate the best place that reduces the wait time for the patient.
• The system will conduct a general survey of the individual while he/she is facing some medical difficulties (i.e. Cold fever) to assist patients and help doctors and others by avoiding being on the waitlist.
• The system will prioritize individual patients with their medical difficulties and available specialist to decrease wait time and increase the efficiency of the system.
• The system would be transparent to everyone and each individual such doctor, patient, and government official will be able to access the system at any point in time.
• Patients will be able to book their appointment with the doctor and they can monitor it from anywhere and at any time.
• Patients will get a profound analysis of their medical conditions every month.
• For the front end, a smart medical card, which will store all the data; will have an electronic microprocessor that can be read by a machine to access the backend data.
• The system will conduct feedback from the patient after a certain number of days from the visit date.

Cost and Timeline Cost

This section discusses the cost and timeline of making a new website for reducing waiting time. Although there might be some systems for handling all the medical data and for handling appointments, this chapter focuses on making a new flawless website with the latest platform. The expense of making a new website can be as little as $4000 USD or as large as $2 million USD that depend on requirements as well as platform. It is quite hard to precisely decide the estimation of a new website, particularly just with an ambiguous gauge on what number of clients will be available. Firstly, a set of features should be categorized to reduce the start-up cost. Next, a reasonable business should be established by using this minimalistic set. Lately, additional features should be added while maintaining business growth. An estimate to maintain the moderate website is $25,000 USD in setup and $30,000 USD in annual maintenance. The most expensive feature will be the electronic microprocessor. The cost to implement a chronological sorting feature is around $30 USD [17]. Factors Cost (US$) Setup 160 Design and building 4000 Content creation 500 Website operation training 400 Maintenance 500 Advertisements 50 Personal domain 70 Unlimited bandwidth 80 Thus, the rough estimation cost of creating the new website is $25000 USD to $30000 USD. Moreover, the cost can vary with the change in platform for building the website. Once, the website is properly maintained more features can be added to it which may be expensive.

References

1. http://theconversation.com/how-to-solve-canadas-wait-time-problem-96170
2. https://www.thestar.com/opinion/contributors/2018/05/22/how-to-shorten-hospital-wait-times-in canada.html
3. “Linking Science to Economic Development” American Association for the Advancement of Science. [Online]. Available: https://www.aaas.org/archives/linking-science-economic-development. [Accessed: 11-Nov-2018].
4. C. J. Gibson, K. J. Abrams, and T. Pletcher, “Chapter 2 - Health Information Exchange as a Profession,” in Health Information Exchange, B. E. Dixon, Ed. Academic Press, 2016, pp. 21–38.
5. E. H. Shortliffe, “Biomedical Informatics: The Science and the Pragmatics,” in Biomedical Informatics: Computer Applications in Health Care and Biomedicine, E. H. Shortliffe and J. J. Cimino, Eds. London: Springer London, 2014, pp. 3–37.
6. “6 Ways Health Informatics Is Transforming Health Care - HIT Consultant,” 02-Mar-2016.
7. “Public Health Surveillance Workforce of the Future.” [Online]. Available: https://www.cdc.gov/mmwr/preview/mmwrhtml/su6103a6.htm. [Accessed: 04-Feb-2019].
8. “The Untilled Fields of Public Health on JSTOR.”
9. https://www.fraserinstitute.org/studies/waiting-your-turn-wait-times-for-health-care-in-canada-2017”
10. https://www.hqontario.ca/System-Performance/Yearly-Reports/Past-Yearly-Reports Under Measuring Up 2017 - Full Report (PDF) (https://www.hqontario.ca/portals/0/Documents/pr/measuring-up-2017-en.pdf) page 53”
11. https://www.cihi.ca/en/land/in-focus/perspectives-on-wait-times-in-canada”
12. https://www.theglobeandmail.com/opinion/editorials/a-retrospective-on-the-fix-for-a-generation/article4096807/
13. http://theconversation.com/how-to-solve-canadas-wait-time-problem-96170
14. “Outpatient clinic waiting times and non-attendance as indicators of quality: Psychology, Health & Medicine: Vol 5, No 3.” [Online]. Available: https://www.tandfonline.com/doi/abs/10.1080/713690194?casa_token=LDssW5fghtEAAAAA:5w_KRjzLM_6vo5a7Z70W2CJ9DKb5X5iqFsoGkL1YkrzdPhxexdJXoXFSlfTYBcM2y8F9mI1Vyniz. [Accessed: 05-Feb-2019].
15. “Advance Health Informatics - YouTube.” [Online]. Available: https://www.youtube.com/watch?v=HQeJBHpjNqw&list=LLN_K5jMumKZqtpoX3GNwk9A&t=159s&index=2. [Accessed: 05-Feb-2019].
16. WebFX, “How Much Should a Website Cost in 2018?” WebFX. [Online]. Available:https://www.webpagefx.com/How-much-should-web-site-cost.html. [Accessed: 02-Dec-2018].