How can the power of collaboration improve health care?

By its nature, good health is a collaborative effort - between doctors, patients, nurses, therapists, workplaces, schools, governments and community organizations. Despite this - the health care industry is just now contemplating the use of collaborative technologies in the treatment and prevention of disease. In most countries of the world, today's healthcare information systems are disjointed: they deploy multiple human and computer systems operated by multiple organizations, following multiple separately evolved agendas. While this gap is not the fault of anyone, the evolution of disparate systems is hugely expensive, inefficient and confusing. Given that in many nations health care costs are exploding as their systems struggle to serve an aging population - isn't it time to consider a new approach?

Martin Cleaver says Imagine a planet where where health providers and agencies collaborate to keep people healthy rather than treating disease, where resources are shared efficiently between organizations, and where processes span and effortlessly mesh over multiple health care provider types (Hospitals, Community Agencies, Doctors). With sufficient transparency and mass collaboration health providers and vendors can self-organize to optimize the overall population health and while lowering their costs and improving their results.

Creating hope
Could e-versions of Alcoholics Anonymous, suicide prevention, bereavement support, and communities better help people help each other? Can web based systems improve service for people in crisis, where timeliness and availability are so important? Mental health has a core component that seems to revolve around getting patients to emerge from isolation and re-engage with society. Participation, cooperation, social contact, interacting with others is key to many therapies. A wiki could be an ideal venue for mental health clients to rally around for group projects. Those who like to read and research, or who have natural talents or expertise, could work with others in creating treasuries of wisdom on various topics, like art, gardening, music, etc.

Building knowledge
Wikis could also be used to pool talent of mental health care professionals, to collaborate on cost saving ideas and innovative programs, like pet therapy. Wikis could assemble a treasury of herbology, natural remedies, like Jethro Kloss Back to Eden book.

A more generic healthcare application would be using a wiki for professionals to create, update, and disseminate clinical practice guidelines. These are peer-reviewed documents intended to reduce provider-to-provider variability in the management of common problems, both chronic and acute. Examples include diabetes management, otitis media, allergic rhinitis, asthma, ADHD, to name just a few. The U.S. Agency for Healthcare Research and Quality (AHRQ) maintains the National Guidelines Clearinghous (www.guideline.gov), which might provide a good foundation from which to build.

Low cost high potential
Success in using collaboration tools can enable faster creation and distribution of knowledge - but realizing the full benefits would require an adoption strategy which includes adapting the current professional culture of guideline development while core elements of current system - the peer review process - are and always will remain critical - the possibility of using the flexibility and transparency of collaborative to both speed up and intensify peer review is intriguing.

Local health care intranets
There is a revolution underway in how health care dollars are allocated and managed. Up until now, providers have operated primarily in silos when co-delivering services to "clients"/"patients". Canada's Healthcare System is being re-organized, in a manner that bears a close resemblance to the Wikinomics paradigm it incluse

• an upheaval in the funding structure, governments, instead of funding distinct organizations, now channel health care dollars to Local Healthcare Integration Networks (LHINs)
• the LHINs allow community-based care that is planned, coordinated and funded in an integrated manner within the local community.

In the United States, a considerable amount of work has been done (and is ongoing) to create an open source platform for electronic medical (health) records; see www.openehr.org for a great introduction. Similarly, many regional health information organizations (RHIOs) in the US and Local health integration networks (LHIN's) in Canada are making grassroots efforts to improve communication and data access among different health care organizations; ultimately, this will improve quality and reduce waste due to duplication of services. There are numerous problems to be resolved such as security across multiple information platforms, and the privacy issues related to managing patient information in a collaborative environment.

There is good space for co-operative action in providing the best health information to the general public when they need to know in jargon free language what is wrong with them and what their diagnosis means. Also co-operative assembly of information on the best food supplements and additives for particular conditions such as Parkinsons would be useful to people with the condition but un-informed by their professionals.

I wrote this below but can't seem sto understand why only the edit button on the bottom inserts who contributed and not the top one! Not sure why that happens

I believe that Wikis can be used for collaborative problem solving inside the hospital. Lets say that inside of a hospital we have a goal of reducting Emergency department walkouts due to capacity....we can create a wiki to engage the minds of employees to offer and execute on suggestions! I believe Wikis allow us to engage minds while creating content... a person to put their stamp on an idea if you will and to become comfortable with people refinining ideas....using a Wiki can also open up the world to unleashing the power of minds in the hospital...for instance, create a wiki that asks all employees in the OR team how they could improve healthcare....

so why doesn't an "edit" track who edits but a comment inserts contributed by?

contributed by Todd Dunn on Nov 7 7:58pm