Last Friday, we were helping one
of our neighbours write an important letter to his employer. J got a pen and
pad of paper out, whereas I wanted to use my laptop. When I suggested capturing
her thoughts on the computer she very sternly replied, ‘No, I like to think
when I write, and can do that better when I write my thoughts out on paper’. I
have learnt that in such situations, discretion and keeping silent is always
the best option to choose. But it made me think.
For me, the keyboard, computer
and Microsoft Word have been revolutionary. For writers, they have been a real
boon. I can capture my thoughts, write them out, review and change where
necessary, cut and paste a line or two, or even whole chapters, and no ‘Tipp-Ex’
is involved. For younger readers, Tipp-Ex (first produced in 1965) was a
wonderful thing for poor typists like me, and for poor students who wanted to
change a word or two in their papers. These days, I can’t imagine anyone using
the stuff. The computer has, like many things, made my life as an academic and
writer so much easier. In fact, it’s possibly the world’s greatest invention,
or is it?
The Nobel prize-winning Economist
Robert Mundell once famously declared that the most important invention in the 20th century was the chicken. Now regular readers of this blog and followers on
Twitter might think I am somewhat biased when I say I have to agree with him,
but bear with me. However, as a vegetarian and an avid collector of chickens of
all sorts, I’m not sure I agree with his reasoning. Mundell observed that
modern farming production methods had since the mid-20th century (between
the end of World War 2 and the 1970s) so dramatically reduced the price of
chicken that it was essentially, for all practical economic purposes, an entirely
‘new good’. In 1900, most people had to work two hours and 40 minutes to be
able to buy a 1.5kg chicken. By 2000, they only needed to work 14 minutes to
buy one and today it would be a mere three minutes! It’s perhaps not surprising
that what was once a luxury Sunday dinner is now an everyday source of protein.
Indeed, in the UK, 2.2 million chickens are eaten every single day!
As an economist, Mundell was
making the point that innovation is always as much about price, as it is about
creating ‘new goods’. The same is true in healthcare, as it is in food production.
Innovation has seen the development of cures for some cancers, successful organ
transplants, state-of-the-art diagnostics, hip replacements and so forth – there
is a long list of such innovations, and the good thing is that they continue to
be developed. But, our (that is Wigan Hospitals) Quality Champions initiative has shown
that there are also many smaller changes that can be made that make even the
most familiar of treatments much less expensive and more effective.
There are pitfalls, of course. Telemedicine
has oft been cited as an example of how new technology can move services
forward, but frequently has only resulted in people getting the same old services
but perhaps more rapidly and at a reduced cost. Its real benefit would come
from early detection of potentially serious health problems and avoiding expensive
‘upstream’ interventions. Electronic health records (EHR) are another way where
new technology, for example digital technology, has the potential to make both
the patient experience much better, and save a great deal of time and money by
reducing the number of times the same information has to be entered by different
professionals and administrators.
When I changed GP practices last year,
I had to fill in a nine page form that not only asked me for the same information
on many occasions, but was actually asking for information that my previous GP
already had. Ironically, I get text messages at least once a month to tell me I
can look at the information my GP has on my health file. So yes, new technology
is beginning to revolutionise the way we live, well at least it certainly has the
potential to do so, but have you ever considered what life might be like if
that technology was suddenly not there – if it were literally turned off?
Well, last week, that is
absolutely what happened to our hospital. Last weekend, starting with radiography,
various technological systems started to fail one by one. By Monday morning, things
were looking pretty catastrophic. Monday lunchtime came and we declared a Major
Incident and set up a Command and Control centre. All the hospital technological
systems had failed. Patient care was now reliant on the return of a purely paper-based
system for capturing diagnoses, treatment plans and so on. The Emergency
Department was shut to all but the most serious of cases, and these were stabilised
and then transferred out to other hospitals in the area. All elective and out-patient
work was cancelled.
The problems persisted until midday
on Thursday, when the systems started to be restored. As I write this there is
still no indication as to the root cause. The Trust was supported during this
dreadful time by so many people and organisations – Bolton Hospitals, North
West Ambulance service, Wigan Council and CCG to name a few - all provided fantastic
support and helped ensure compassionate and high quality care continued to be
provided. And of course, colleagues working in the hospital deserve the highest
praise for their determination to ensure they continued to provide the best
possible care for our patients.
And just like some people might
buy their value chicken breasts from Tesco, (yes there are other supermarkets) and
others will still go to Waitrose or directly to the actual farm to get their organic
corn-fed bird, new technological innovations will inevitably change how healthcare
is provided. Hopefully the more traditional hands-on, personal interaction between
healthcare practitioner and patient will still be there for everyone. Just as
when J had written her thoughts down on a piece of paper, I dutifully copied
them on to my computer enabling our neighbour to have his own printed copy to
take away.
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