Flipping the clinic

Flipped icicles

How can we use the internet to transform the way care is given? Only really new ideas will make a difference to the overburdened health and care system, which is creaking under the seams of an ageing population and increasing ability to treat and remedy any condition.

Private GP services available on demand, health monitors worn around your wrist and online peer support for doctors and patients have all shown the role technology has to play.

Coming from the education sector, I’ve seen a lot of parallels and ideas that could be applied to reduce the burden on the health and care professions while empowering and engaging the citizen… and, ultimately, activated patients show improved patient experiences and better outcomes.

One idea is to reshape a clinical consultation so it can be used as part of a joint conversation based on prior knowledge and understanding. The Khan Academy pioneered this idea in education and called it ‘the flipped classroom’.

The idea of the flipped classroom was that, in this internet age, learning could be more deeply embedded by asking students to learn online via video lectures in advance and use the classroom setting to have a more in-depth discussion and answer questions together.

Flipped learning has proved to be a popular addition to the pedagogical repertoire, with some evidence that it can improve learning outcomes. In some ways, the flipped classroom is an exemplar of active learning methodologies, proven time and again to result in more recalled, enjoyed and understood educational experiences.

So what if patients were asked to discover their health care needs online and use the clinical consult for fact checking and expert input? In many cases, Google is the first diagnosis anyway.

The Robert Wood Johnson Foundation in the US has picked up the idea and called it ‘flip the clinic‘. They’ve set up an open experiment inviting the community to submit flip ideas and test them out. Since launch in 2014 they’ve captured 81 flips (and counting) and have a network of allies who’ve contributed to finding out how things could be done in a different way.

Flip ideas have ranged from mining data about clinic efficiency or using non-clinical staff to deliver quicker responses for patients, or more efficient updating of the health record, to actively inviting patient feedback, Apple Store style greeting at the door, and incorporating patient-reported data into workflows.

Health care clinics are looking at innovations that improve the patient experience, use data and open up the health record, but of course the most powerful and hardest changes will work across the whole healthcare system.

This approach starts the conversation about rethinking the experience and takes what we can learn from other sectors in order to drive self care and embrace the power of the patient.

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