Primary care is going through a painful transition. The old system of fixed bookings, long hours, long waits in the physician's office and limited access are being challenged by new models of care. One group that is thinking outside of the box is 'Hello Health'. The group will be launching their first 'Node' in New York city shortly. Even the term 'Node' conjures up something a little mystical from the realm of an IT think-tank or perhaps a disseminated malignancy. I am sure the word was well thought out before it was used. The company believes that healthcare delivery is inefficient (true) and costly (true - in the US in particular) and is seeking to provide mobile technology enabled physicians who will provide consultations via tele-health or instant messanging or e-mail. New York is also a good choice for the launch of this model. High density, large numbers of potential patients and good public transportation. The model is a novel approach to a complex problem. It will not solve all of the issues related to access, but these physicians and their team are pioneers and I think that the model deserves further investigation by more traditional providers of care.

Some time back, I posted a story on Dr. Jay Parkinson, who is now the chief medical officer for Myca, the company that has developed an EMR system and platform to support this model of care. The company is Canadian and based out of Quebec City and intends to offer real-time video conferencing between physicians and patients when it launches.

Complex disease such as cancer may not be ideally suited for this type of care delivery, however in a world of connected devices, home monitoring and ubiquitous internet access delivery of care using these types of tools should not be impossible. However it does require a change in mind-set and a different approach.

As we build new healthcare models including Open Access and Shared Care, could we be simultaneously implementing new tools and processes?

I am not sure how this all fits together in an integrated model of care. The objective should not be a handful of physicians who are seen by their colleagues to be on the fringe of healthcare delivery, but a well defined model and value proposition that allows the large majority of physicians to adjust their practice styles and realistically incorporate advanced technologies to provide high quality and efficient care.

Do you agree with this type of approach to care delivery? Could you see it as an extension of your current practice? If you had to start again, with today's technologies would you emulate Dr. Jay Parkinson?

Alan Brookstone
Canadian EMR