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FUTURE OF HEALTHCARE

Dr. Chris Colquhoun

Chief Medical Officer, icare

Overview Paradigm shift Patient journey Considerations

what is health?

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

Healthcare Technology

AI/Big Data/Machine Learning

healthcare paradigm shift

empowered healthcare recipients

Reactive to Preventative Care

•Acute coronary syndrome (heart attack) (need previous ECG to compare)

•Aortic dissection

•Pulmonary embolism

•Tension pneumothorax

•Pericardial tamponade

•Mediastinitis – (eg oesophageal rupture)

•Pneumonia/pleuritic pain

•Asthma

•GIT causes:

•GORD

•Oesophageal spasm

•Musculoskeletal – rib contusion, fracture, IC muscle strain, costochondritis

•Psychiatric: anxiety, panic attack

•Other : shingles, lupus, sarcoid, scleroderma, Kawasaki’s disease, polyarteritis nodosa

chest pain… what could it be?

1. Presenting symptom

2. history of presenting illness?

•Onset, duration, character,

radiation

•Aggravating and relieving

factors

•Associated factors

•Risk factors

•Previous episodes

3. Past history:

•Medical and surgical

•Comorbidities

4. Family history

5. Social history:

•medication, allergies,

•Work, family, social supports

•drug/alcohol, sexual health,

psychological factors

6. Systems review

chest pain: take a history

examination - currently

Examination - future

investigations - now and future

Pre test probability

Sensitivity/Specificity

False positives/negatives

Interpreter bias

Unconscious bias

provisional and differential diagnosis – now and future

Evidence based vs intelligence based medicine

TREATMENT – Personalised

Artificial and Emotional intelligence

Risks

Risks - ethics

Risks – augment vs replace

Knowledge vs Wisdom

summary• Healthcare – the whole person, biopsychosocial

• Shifting relationship between patients and healthcare providers

• Predictive/preventative/proactive care vs sickcare

• Technology is an enabler to augment decisions and interventions

• Ethical considerations - requires governance

• Emotional intelligence is an important component in assisting decision making for each individual