PKC Philosophy

Empowerment in healthcare.

7 principles

Upon this gifted age, in its dark hour,
Rains from the sky a meteoric shower
Of facts...they lie unquestioned, uncombined.
Wisdom enough to leech us of our ill
Is daily spun, but there exists no loom
To weave it into fabric...
Edna St. Vincent Millay

There is no shortage of information in healthcare.

Nowhere in our endeavors to contain the current information, data, and cost explosions is the task more intractable than in healthcare. Journals proliferate beyond our capacity to absorb the information in them; patient data is generated literally in reams during single encounters. Through our inability to use information wisely, our presumed needs outstrip our resources, and the cost of care escalates beyond our insurers' and our own ability to pay for it.

PKC believes the keys to empowerment in healthcare to solve these problems are the tools we use to weave together our general knowledge base, embodied in the medical literature, with the details of each unique patient's health status. With the proper tools, we can deliver precisely and ethically the necessary and sufficient care each patient requires.

There will never be perfect knowledge, or perfect tools. But some tools are designed to evolve, to become increasingly more useful and powerful. Problem Knowledge Couplers are just such tools.

PKC invites you to begin a dialogue with us about empowerment in healthcare by weaving together the wisdom we already possess, and creating new wisdom, through the use of new information tools...Problem Knowledge Couplers.

Man is a tool-using animal...Without tools he is nothing, with tools he is all.
Thomas Carlyle

1 Provide the best information tools available.

Build the parameters of guidance and the currency of information into the very tools the healthcare provider uses for every patient encounter.

The tools we use define in large measure the quality of the work we perform, and our productivity. All providers must be given information tools that maximize their individual contributions to healthcare quality and productivity.

Problem Knowledge Couplers empower every provider to fully contribute to the discovery, definition, and management of unique patients' problems by coupling current medical knowledge to patient data. Designed to create structured input to computer-based patient records (CPRs), Couplers also provide substantial benefits to those who are still in the paper paradigm.

Time is money.
Benjamin Franklin

2 Maximize the contribution of every provider.

Optimize the tools to assure complete, thorough, standardized inputs no matter who is using them.

Efficiency dictates that your most costly human resources be reserved for the tasks no-one else is equipped to do.

Problem Knowledge Couplers equip the extender and patient to generate a complete, thorough data base, identify and fully characterize the patient's problems, and identify possible causes and management options based on that patient's uniqueness. The questions that need to be asked and the observations that need to be made are built into the tools themselves. The physician no longer has to spend precious time gathering baseline data.

The great end of life is not knowledge but action.
Thomas Henry Huxley

3 Couple knowledge to action on the patient's behalf.

Tailor the guidance elicited from the relevant published literature on a problem to the details elicited from the unique individual having the problem.

It is truly a tragedy that patients do not always receive the benefit of the best knowledge already available to us.

It is not enough to provide access to current medical knowledge in raw form; there is literally just too much of it. The difficulty in ensuring that every provider keep up with the literature is compounded for primary care physicians and managed care gatekeepers, whose "specialty" is all of medicine.

Problem Knowledge Couplers incorporate current relevant medical knowledge, extracted and periodically updated from a broad spectrum of core and specialty journals and texts, providing vital connections from it to the patient's problems. Each individual provider is not left to scan, read, digest, interpret, remember, assess the relevance of, and apply an avalanche of medical literature to each unique patient at the point of care. There is no voltage drop from the information source to its application.

If I'd known I was going to live this long, I'd have taken better care of myself.
Eubie Blake

4 Put the patient at the center of the healthcare process.

Without the confidence and involvement of an informed patient, everything the healthcare system endeavors to do for him will be fruitless.

True patient-centered care recognizes the patient as the prime mover in the healthcare process, tailoring care strategies to the unique needs of the patient, listening to the patient's concerns and desires, and involving the patient in his or her own care.

Informing and involving the patient in choosing among care options removes the terrible stress of doubt, improves compliance with care strategies, improves confidence in the care system, and increases satisfaction with the quality of care.

Patients themselves identify provider skill, knowledge, and thoroughness as the most important criteria in their care. Problem Knowledge Couplers help ensure these criteria are consistently met while empowering the patient as a participant in the selection and implementation of personal care strategies.

The whole of science is nothing more than a refinement of everyday thinking.
Albert Einstein

5 Provide real means for the continuous improvement of quality.

Quality is a calculus of many small decisions logically made to reach a well-defined goal.

Quality outcomes, and outcome studies, depend on quality inputs.

Problem Knowledge Couplers provide structured, standardized, and complete patient data input into the record to allow both the delivery of quality care and the improvement of care quality over time through meaningful outcome and population studies. The data generated in day-to-day healthcare and recorded in problem-oriented CPRs capable of generating these studies electronically can at last be used directly to improve medical science.

It may seem a strange principle to enunciate as the very first requirement in a Hospital that it should do the sick no harm.
Florence Nightingale

6 Remove the risks associated with variation among providers.

Guarantee the same knowledge base and guidance is brought to every provider for every patient.

Quality of care should not depend on the individual provider: every patient is entitled to the best possible care. Equally critical in this age of liability and litigation, every provider must consistently perform to the highest care standards, and an audit trail must be built to document and support care decisions.

Problem Knowledge Couplers bring the same knowledge base and decision support to every provider for the care of every patient, creating logically structured records and implementing organization-wide guidance parameters for defensible care.

To go beyond is as wrong as to fall short.
Confucius

7 Deliver precisely and ethically the necessary and sufficient care each patient requires.

Make information linkages visible to all providers to facilitate responsible and informed action.

Every health care organization runs the dual risks of overlimiting resources and its complement, overutilization. Necessary and sufficient care, the safe path between them, can only be achieved by revealing all care strategies that may be appropriate for each unique patient while ensuring that none is pursued without documented justification.

Problem Knowledge Couplers guide and document the decision process indicating and supporting necessary referrals, testing, and intervention. Key patient data may then be passed on to the specialist or lab so it doesn't have to be discovered all over again. Patients get what they need, and time and money are conserved.

Civilization advances by by extending the number of important operations which we can perform without thinking about them.
Alfred North Whitehead