T1-158

In reply to Purley http://cmatalks.blogspot.com/2010/12/t1-117.html

RE: +train the physician to perform in this arena in a "Z" structure under his/her management

Is is worth explaining that the vertical line is the physician as the knowledge worker connected to the " system" ( the top horizontal line) and his/her client base ( bottom horizontal line)

Technology has birthed the necessity for the TOP horizontal line to connect DIRECTLY with both the non-medical care provision needs of the client/patient AND for the physician to connect directly with IT related to funding for primary care services.

It is the purview of the physician to grow into how he/she performs as mainly a knowledge worker assisted by technology to serve a larger client base. It is the traditional role of the physician to lead the development of the BOTTOM horizontal line where medical provision of services is delivered.

It is the responsibility of the payor to update/create legislation that governs the TOP horizontal line.

It is the responsibility of the physician to justify to his investors ( government and client payors) how his practice meets their requirements.

This TOP horizontal line is where the " feeding frenzy" is ........... PRIMARY care

Note:

The vertical line of the physician is oblique ...where the patient accessing the physician from a top down approach does not necessarily connect with medical care as a first step.
[This position must also be supported by an algorithm]

Therefore in order to access the physician directly the patient is bypassing the topline already and going straight to guaranteed access to physician care....i.e. SECONDARY care levels

This secondary care level is in it's first stages of restructuring to embrace the client/patient who refuses to use the jumble of primary care portals .
[politicos better hasten to adjust this structure into "program cells that float in a medium" in order to prevent rapid escalation of cost in secondary care levels ]

Who will clean up the TOP horizontal line?... it must be the politician..... not the physician.

KEY: It must ultimately be structured so it's success can compete internationally as " care" offsets become as valuable as " carbon" offsets in trading value.
It is the TOP line that deals with the " dependent" variable...which is NOT the client/patient... is NOT medical care.....
IS..... the service delivery structure itself.

http://www.healthcaretransformation.ca/en/topics/view/id/1#comment-158