SOURCE: VisualMED Clinical Solutions Corp.

March 14, 2007 02:00 ET

Using Clinical Systems to Support a Community of Practice: New Vistas for VisualMED

MONTREAL -- (MARKET WIRE) -- March 14, 2007 -- VisualMED Clinical Solutions Corp. (OTCBB: VMCS) (FRANKFURT: VA6) -- The development of communities of practice in healthcare, the foundation for a training method for doctors developed just within the past decade, is poised to spur interest in the few tools suitable for regional and supra-regional standardization of best care.

Physicians and others whose professional life revolves around the transmission and transference of knowledge can be said to belong to communities of practice, as described by Etienne Wenger in his 1998 publication of the same name. Over time the sharing of knowledge through community of practice results in improved baseline standard practice. As "conventional wisdom" catches up with what is now technically available, an increased interest in the marketplace for the VisualMED Clinical System is predictable where jurisdictions are promoting this concept.

Such improved baseline performance will have very real effects at regional levels with decreased costs due to decreased medico-legal risk and decreased length of stay, as well as due to more narrowly-defined diagnostic pathways. An added benefit will be that such improvements will not be top down, driven by HMO administrators, but by the actual care-givers themselves, in conjunction with their own patients.

These communities are dynamic in that they share a knowledge base that evolves over time. The success of the community -- be it a community that designs and constructs automobiles or airplanes, or husbands the public health -- depends on the efficiency at which critical knowledge is disseminated among the members of the group.

In the area of public health, effective dissemination of new knowledge would be expected to result in improved patient outcomes, fewer adverse clinical effects of therapy, and more effective use of available healthcare resources. These goals, among others, are achievable and have been addressed by a number of ineffective as well as partially effective strategies in the past. However, strategies likely to result in the greatest improvements in these areas have not been well developed, in part because they touch on "wild cards" of behavior and personality that come into play when the knowledge base of the professional group, as a community, must evolve. This theme has been addressed in publications on the subject by Dr.Robert Thivierge of the University of Montreal.

Physicians present interesting challenges with respect to the maintenance of professional knowledge. Regular reading of segments of the professional literature is at the foundation of the maintenance of competence, and recently formulated requirements for continuing medical education (CME) credits are an important step forward. Academic conferences are available at university-affiliated hospitals as well as at professional conventions. However, no existing method for knowledge transfer effectively addresses the nuances of care that are routinely handled on a case by case basis, in real life. These "nuances" may result in unforeseen, non-trivial outcomes.

Apart from regular reading, most other methods of physician data transfer are "top-down" in nature. In an academic center, conferences may be more or less collegial, but "top-down" addresses by experts dominate the professional convention, even at the workshop level. This approach leads to problems which impede the evolution of the community of practice: Firstly, the "receivers" of the knowledge are passive and not in a position to "experiment" with the new information to see how it works outside of the conference "laboratory." Secondly, the physicians seeing the largest numbers of patients -- generalists and family practitioners specializing in ambulatory care -- are those most likely to have the fewest ties to centers where they can see new knowledge at work, and thereby gain confidence in its use.

Data suggests that physicians, even in group practices, remain insular with respect to the their capacity to accept new knowledge, unless a serious effort is made by the group to behave otherwise. The complexity of modern medical therapy will require something other than top-down knowledge transfer if the most is to be made of the promise of the current literature.

Knowledge transfer through a tool shared by a community of practice should represent an effective method for knowledge dissemination among the members of the group. Participatory in nature, through the direct integration of the learning process with patient care, the tool gives feedback to the participant so that he or she understands his/her performance with respect to the performance of the group. There is no "leader," per se; all participate as equals. In fact, the behavior of the entire group affects the standard of practice at any given local community.

Because training occurs during the delivery of direct patient care, training "scenarios" are real, and have a direct effect on patient outcomes. The clinical status of each individual case colors the transmitted knowledge so that it applies to an individual practice. A pediatrician may need to know about the risks of certain medications with respect to his patient, risks which may be quite different from those associated with the use of the same drug for a sixty-year-old individual with liver disease.

The knowledge base at the heart of such a tool is appropriately maintained by a medical university with expertise in the area of continuous medical education. Physicians accept the introduction of the tool into their day to day practice as its regular use will earn educational credit for participating medical staff, at no additional time-expense to them. We have used such a tool in an inpatient environment and have demonstrated its utility in behavior modification for resident physicians with respect to both quality of care and cost-effectiveness. This tool is currently available for general application in the form of the VisualMED Clinical Information System, developed by VisualMED Clinical Solutions Corp. of Montreal.

"A set of clinical tools such as offered by VisualMED has already been assessed by leading medical educators as providing an efficient platform for sharing knowledge," says Chairman Gerard Dab. "Our technology can be a powerful driver in creating and sustaining community of practice, a cutting edge notion that is being seriously promoted by some of America's leading academic institutions. It is a reworking of an age-old concept, that of learning in the workplace."

As medicine becomes increasingly complex, technological use of clinical systems like VisualMED will become the standard, providing benchmarks for both therapies and outcomes.

About the company and its products

The VisualMED Clinical Information System (CIS) is a unique software application built to conform to the way doctors and nurses provide and document patient care. The VisualMED CIS is the only solution of its kind to have been wholly designed by practicing medical staff in terms of both workflow and user interface. State-of-the art design is at the basis of product scalability -- the only CIS that can be implemented across a single care unit, hospital, or region. Unique design features allow system decision support to conform to local practice, yet incorporate "best practice" guidelines across a region as a turnkey solution, depending on needs of individual clients. From a purely technical perspective, object-oriented design and table-driven programming allows for cost-effective development that can rapidly respond to advances in medicine and surgery and informatics, itself.

VisualMED Clinical Solutions Corp. markets and distributes clinical management solutions that help hospitals and healthcare authorities reduce medication errors, increase personnel efficiency and bring down operating costs. One of its key decision support components is a core solution in the new agenda to promote greater patient safety and reduce risks due to medication errors.

Detailed information on our company and its products is available on our web site at

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