As GPs, we are managing more complex patients in the community.
Simon Hudson, founder director of Cloud2, says the most immediate benefit is that, because routine cases can now be dealt with over Kinesis, they have "slightly more interesting and more complex patients turning up at outpatient appointments".
"bread and butter" patients have disease processes that have gone untreated, and the natural history makes them into more complex patients, even though the disease process itself isn't rare - intern has primary responsibility for the care of these pts.
"bread and butter" patients have disease processes that have gone untreated, and the natural history makes them into more complex patients, even though the disease process itself isn't rare.
While the role for a progressive care, or step-down, unit is not new in health care, it is one we believe may be underutilized for elderly and more complex patients, especially when its cost advantage over the highly-resourced ICU has not been quantified.
This is in contrast with hospitals with more complex patients, where the ED length-of-stay can be more than 6 h due to ED boarding.
Comparing ICUs from the different types of centres is difficult as more complex patients are generally cared for in the larger hospitals.
In order to address this challenge, enhancing the provision of primary care by improving the ability of more primary care providers to offer care to more complex patients over the continuum of needs is seen as a promising solution.
This is not only imperative for the financial solvency of the institution [5], but it is also necessary to ensure that more complex patients with multiple comorbid conditions receive the care they need.
When she was a resident at Duke, she says, "I felt a heart tug to nephrology because these patients were sicker and more complex patients". Today, after completing a fellowship in Nephrology at Duke, she is a geriatric nephrologist, with the goal of making life simpler and better for these patients.
Randomized clinical trials examining the efficacy and safety of AF ablation are currently underway; however, such trials can only partially determine the safety and durability of the effect of the procedure in routine clinical practice, in more complex patients, and over a broader range of techniques and operator experience.
