Digital Disruption at the Clinician/Provider Level

• Posted by Dr. Eddie Price
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When x-rays were discovered, there was a major advance in medicine and healthcare because we could now see things that were invisible, inside the body. Now, with the combination of advanced IT and Clinimetrcs, we can see and accurately measure "invisible items" at the personal and individual level. These newly visible items are, in fact, the most important health parameters that truly reflect or measure a person's whole person health status and truly reflect healthcare's aims and objectives.

What are these newly visible items that will change healthcare and Medicine?

To understand what they are we must first look at why they are so important. This is based on the following

The objectives or aims of healthcare were set out by Lembcke, ,in 1952 and by Price in 1980. These aims are to:

1. Prolong life
2. Restore healthy functioning
3. Prevent disease and disability
4. Relieve distress

Up until today measuring lifespan or prolonging life has been readily quantifiable and was the only way healthcare was measured i.e by having a human body present or not. Lifespan and life expectancy were the only way the effectiveness of health services was measured.

However, now with the advances of IT and what is known as clinimetrics, we can measure and show visibly ;

1. The amount of(a) healthy functioning loss and (b) the amount by which it is restored by appropriate healthcare.
2. The (a) amount, or number of risk factors present in each individual, the severity of each risk factor in causing illness, can now be also accurately measured and (b) the amount it by which it is being reduced by appropriate healthcare
3. Furthermore, we can now measure(a)the extent to which distress was present and (b) the extent it was relieved.by appropriate healthcare

This new methodology commenced in psychometrics, but when these biometrics were applied to the human body, this part of science was called clinimetrics (Feinstein, 1982). These modern methodologies of measuring these items allowed us to make the non-material (functioning, level of risk factors, and the individual's social supports) measurable and visible.

As Xrays allowed us to measure or assess organs that were invisible to see, IT/Clinimetrics enables us to see and measure these invisible parameters that reflect life and health.

Three Sources of Items That Required Measurement

1. The Lembcke/Price conclusions on the four objectives of healthcare: prolonging life, restoring healthy functioning, preventing disease or disability, and relieving distress or caring was one major source.
2. The second major source is the WHO's Definition of Health, which states that ; Health is a complete "state" of physical, mental, and social well-being, not merely the absence of disease or infirmity.We can now measure a "State of Being".
3. The International Classification of Functioning, Health and Disability,(ICF) accepted by the WHO in 2001, included amongst the causes of ill health: change in structure, change in function, and change of activities within the body, but also included the extent of participation of the individual in society, their lifestyle, and the environment in which they lived.We can now measure the individual`s (a) participation in society,(b)their lifestyle i.e.risk factors and (c)the impact of their environment on the individual.

Price in 1980 calculated that from a GP looking after the whole person's perspective, 10% of their activities were taking up prolonging life, whilst 40% was involved with restoring healthy function, 30% was relieving distress or caring, and 20% was preventing disease and disability.

Although preventing disease or disability only makes up 20% of the function, the effectiveness of improving lifestyle and environments would potentially prevent 80% of modern illnesses.

Health is a complete state of physical, mental, and social well-being, not merely the absence of disease or infirmity.

World Health Organization (WHO)

Conclusion

Up until today 90% of what constitutes health was and still is minimally measured, almost ignored.

Clinimetrics measures activity, processes, functions, experiences, interconnections, and movements that made up that 90% of the activities of the healthcare system. Now that we could accurately, quickly, and effectively measure these invisible items,(because of the advances of IT) there will follow a significant disruption or change in how we practice healthcare and medicine to the benefit of Western society.

This change will be hard to grasp, but when understood at the clinician level, there will be a major disruption of healthcare with significant improvement in patients` health statuses.

There will be many new assessments of each individual`s health that measure their current health functioning, their level of social support and the level of risk factors simply,quickly and accurately.

In fact the clinician will have these results much more speedily than from blood tests or x-rays

Just as there will be new digital assessments, there will be multiple new digital therapeutics as evidenced by the already existing digital therapeutic alliance.

What these new assessments are will be the subject of a later short course.