Patient safety - and optimising clinic resources - Monitor reduces risk

Chapter 4

Whilst many patients have a treatment plan created at an MDT, many cases – probably ~30-50% of all cases discussed, are either discharged or more likely need monitoring with regular follow up tests before or following treatment.  For example, the liver lesion that looks likely benign, but might be malignant may need a repeat MRI in 3-6 months, or a patient successfully treated for prostate cancer needs a repeat PSA every 6 months for 2.5 years.  How are these monitoring tests organised?  Yes, you have guessed it, through outpatient appointments.  Thus, a prostate patient needing follow up following treatment might need a PSA every month for 3 months and then 6 monthly thereafter.  It does not matter, but each test has to be manually requested, reviewed and acted upon.  The safest way to do this currently is by repeat outpatient visits. 

And yet, these could be automated, with results and alerts to patients, hospital doctors and GPs – keeping everyone involved including the patient. The author was recently reassuring a patient about her liver function tests by phone, and having shared her blood results knew it would be an easy conversation.  “but why is my serum creatinine much higher than last time”, and when the author went back and checked he realised he had missed the fact that her serum creatinine had increased from 54 to 102, still within the “normal range” but indicative of acute kidney injury.  The author was horrified to have missed this. 

All was well for this patient and renal function returned to baseline, but it was missed.  We need software that does not just alert me of the results but indicates a significant drift or change from prior results.  We also need software that automates the monitoring needed, with alerts to patients and clinicians with patient initiated follow up.  And this is where Salutare’s Monitor kicks into gear.  Not only does Monitor automate the monitoring of the safety of medicines when needed, but it also automates the blood test requests or semi-automates the radiology requests needed for follow up of patients.  This one innovation alone will decrease outpatient follow ups by 20-30%, freeing up clinic time for new patients, as well as those that request patient initiated follow ups (PIFUs). 

But all is not doom and gloom for MDTs, software that can sort cases, create lists without the need to copy and paste, ensure no patients get lost in the system, provide all clinical information in a rapidly assimilable format and yet enable rapid and easy streamlining in real time can help solve many of these problems. Salutare’s Dialogue is such a solution, and together with Salutare’s Monitor can provide a comprehensive solution to the many patients who clog our current MDT meetings, but who importantly need to be kept safe with alerts and messages to re-engage and re-consider at future MDT meetings. 

It is time to be Healthcareful®