DISEASE management systems are not well known in Australia but West Perth psychiatrist Dennis Tannenbaum is aiming to change that.
The executive chairman of InfraPsych is a leader in the development of Internet-based management systems for mental disorders.
Based on trends in the US and the prognosis of respected consultants such as McKinsey and Boston Consulting Group, Dr Tannenbaum believes such systems will be in common use in a few years.
InfraPsych’s system is based on process improvements, drawing on Dr Tannenbaum’s earlier training as an engineer, and is designed to produce efficiency gains in diagnosis, treatment and monitoring.
“The problem you have currently got is that you have perverse incentives that make the system intrinsically inefficient,” Dr Tannenbaum said.
For instance, GPs who are paid on a fee-for-service basis have no financial incentive to look after patients with chronic problems.
Often these patients end up in hospitals.
US research has found that patients with chronic illnesses, such as diabetes, cardiovascular disease and respiratory disorders, account for 70 to 80 per cent of hospital costs, yet hospitals are set up for acute care.
Dr Tannenbaum said a challenge for the healthcare system was ensuring consistent standards of treatment in a cost effective manner.
Another challenge arose from the failure of many patients to maintain their prescribed treatment, meaning they end up back in hospital after their condition worsens.
Against this backdrop, Dr Tannenbaum’s on-line system helps to identify the optimal process for patient care, implement those processes and measure outcomes.
The system is designed to complement the work done by clinicians, providing a wealth of information on disorders generally and patients specifically, and helping to verify adherence to care plans.
The system can also empower individuals by providing information on their disorder, reports on their progress, reminders to take medication and even remote consultations.
The reports are based on a series of questionnaires that each patient is able to complete remotely.
Dr Tannenbaum said this was consistent with the need for chronic disorder sufferers to take some degree of responsibility for their treatment.
InfraPysch has been trialing an online system for depression for just over a year, and is about to roll out larger government-funded trials at Sir Charles Gairdner and Fremantle hospitals and two psychiatric clinics.
Dr Tannenbaum has personally funded development of the online system because of the lack of venture capital support.
He remains hopeful of obtaining financial support, in part to utilise the architecture of the current system to construct modules for other chronic conditions.
He emphasises that implementation of the online system requires significant changes to back-end clinical systems.
“It’s not just the Internet, it’s how you deliver behind the system to ensure it works,” he said.
Dr Tannenbaum’s work with InfraPsych builds on earlier initiatives he developed at two psychiatric hospitals, the Mount Clinic and Perth Clinic.
He describes the Perth Clinic as a “process driven” hospital that ensured best practice was achieved in all aspects of its business.
Perth Clinic was rated the best psychiatric hospital in Australia and achieved big efficiency savings, with the average length of stay reduced from 26 days to 11 days.
InfraPsych seeks to apply similar process improvements to an online environment.
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