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delivered during the 31st World Congress of Audiology
Citation preview
Dr. Dr. h.c. Monika Lehnhardt
Moscow, May 1st, 2012
Scalability of post-operative care
for CI recipients
Situation Analysis
World population is growing World population is ageing Technological advances at an increased speed Open, easy, cost free access to information via Internet Participative decision making in health care Incidence of deafness unchanged Quality of life an important factor Need for life-long care for CI recipients indisputable Economical constraints
Consequences
Indication broadening constantly (e.g. elderly population,■ severely hearing impaired, single sided deafness …)
Awareness of availability of effective treatment for deafness spreading (candidates, parents, children of parents searching in the■ Internet for objective information and exchange experience on Social
Platforms) Self-confidence of candidates and their spokesmen improving based
on acquisition of knowledge and social interaction
Increasing number of CI candidates every year
Germany now 20 k – in three years 60 kWorldwide estimate now 240 k – in three years 720 k
Dramatic / exponential growth of existing CI recipients pool demanding life-long care
Would seriously damage the validity of CI as a cost effective and beneficial treatment for the deaf
Lack of trained personnel (training is time consumingand expensive, equipment is also expensive, requiresadditional space, which is difficult to create)
Options
Do nothing = unacceptable
Add personnel and equipment = unrealistic
Change the structure of the care-giving system fundamentally =
(John Niparko, G.O’Donoghue, 2008)
the evident solution
Expand service of CI manufacturers not economical
Accept the challenge and adapt the business model =
=
Options
Scalability is the Solution
a) achieve the same results with less effort
e.g. mobile working stations, less office space, people working from home, people with no fixed salary working on project basis, eliminate higher costs for printed media
by (partly) replacing them with digital information
b) achieve more /better results with the same effort
Definition:
Economy of scale = Adaptability of costs in relation to turnover =
reduction of fixed costs
Scalability successfully implemented
SKYPE (developed in Estonia) : people establish their own telephone base
Facebook: > 600 Million users
cost free, as efficient as Windows from Microsoft
Scalable software for hospital management suitable for highly varying numbers of patients
Cloud computing in health care –see SynXplatform presented by Microsoft in March 2011
Scalability of production
Introduction of automated processes to reduce manual work and herewith risk of human failure to improve the reliability of devices and reduce cost of production
Scalability in CI surgery
Techniques have changed significantly over the last 28 years
incision size, flap shape, approaches, insertion of the electrode array, suturing, imaging techniques, computer aided surgeryTime for surgery reduced from 3 hours to 1 ½
In the future possibly robots will “do the job” faster and more reliable
(David Proops, Suzdal, December 2011)
Application of scalability conceptin post-operative care for CI-recipients
Registration Online
■ no need of manually filling in cards, mailing, collecting, copying…
■ Central Computing of data at an independent organization to get reliable statistics about CI recipients (e.g. Switzerland, Belgium, Netherlands, Austria, UK)
Application
cooperation between clinic/operating room and fitting centre
experienced expert maneuvers the software programme on the hardware of the less experienced in another location
fitting of new speech processor via Internet connection between the experienced and less experienced audiologist
of scalability conceptin post-operative care for CI-recipients
Upgrades
Tele-fitting sessions
Share intra-operative measurement data to create first maps
Application
CI systems will report about their functionality and about eventual problems online and will receive online instructions how to fix the problem or suggest competent resources where to find a solution
of scalability conceptin post-operative care for CI-recipients
Failure Reporting Online
Exchange of experience amongst experts and parents in LiveOnline Rooms across countries and language barriers e.g. PORA! Training programme for Russian speaking therapists
Voskresnyj Poldnik – Sunday meetings for Russian speaking parents
Application of scalability conceptin post-operative care for CI-recipients
Re(Habilitation) Online
of scalability conceptin post-operative care for CI-recipients
Application
Online consultation of surgeons, therapists and other experts for parents seeking advice
Continue Conferences LiveOnline
Weblogs – Interactive Communication – Presentations –
Preparation of next conference
Increase the sustainability of conferences
by continuing in the Internet environment
Conclusion
Have the experts not waste their time in extensive and expensive travelling, in working with instruments and equipment, applying mainly their manual skills, but have them spend quality time in talking with their clients / patients to improve the level of care and with colleagues on an intra- and interdisciplinary basis to develop new ideas how to improve medical treatments for people in need.
Apply scalable processes and services to free human resources and have them concentrate on providing what can only be provided by human beings
EMPATHY
Thank you for your attention and please feel free to comment
in my personal weblog
www.monika-lehnhardt.net