“Addiction, poverty, hunger, the absence of a social safety net, and lack of access to adequate health care are all routine parts of my work week. No single detail of that baby’s parents’ lives was outside my norm. Yet for some reason, the tears came when I sent that particular baby out into the world. I’m not usually found crying in the corner these days, but I had to stop and wonder why not? How did discharging infants to homeless shelters get to be my normal? More importantly, how did we get here as a country? How does one of the wealthiest nations in the world ignore so many children living in poverty? Nearly 20% of the US population younger than 18 years is assessed by the government to be living in poverty.1 Everyone on the street can cite the fact that 30% of Americans are obese, but nobody seems to know that nearly the same number are living in food insecure households. Or what about the fact that nearly half of US children rely on Medicaid or the Children’s Health Insurance Program (CHIP).2 And to be clear, these are not overly generous programs. Federal poverty levels are stringent (about an annual income of $20 000 for a mother and two children). If you are a pediatrician in this country, at least half of your patients are likely to be economically distressed. Isn’t that just a little bit astonishing?
So many things have changed in the decades since I was an intern, but here is one telling detail. I no longer start my history and physical with the chief complaint. I start most encounters with an offer to bring food. Because I take care of hospitalized children, by the time they get to me most patients have been waiting for many hours or have traveled long distances, and they often don’t have enough money to purchase food in the hospital. It’s a little thing, to offer food, but it has been a game changer for me in terms of improving communication with my patients’ parents—a simple acknowledgment that they are tired and hungry and doing their best to hold it all together as it all just keeps falling apart.”
The foregoing excerpt from an A Piece of My Mind article entitled “Normal” in the October 16, 2018, edition of JAMA Network article by Shawn L. Ralston, MD, MS () exposes the critical socio-economic situation of a significant portion of the pediatric patient population in the United States of America today. Unfortunately, I think, the Cloud Healthcare Appliance Real-Time Solution as a Service (CHARTSaaS)© information technology (IT) reference architecture cannot contribute to mitigation of this matter; but I would be ecstatic to be proven wrong through an insightful post you may be moved to make.
Please validate this proposition to your own satisfaction by reading the white paper; or by viewing a presentation.that describes the background, purpose and scope of CHARTSaaS©; or by viewing a presentation that describes how SMEs can use CHARTSaaS© to create a mobile app for handoff communication mistake mitigation. CHARTSaaS©-built apps can mitigate medical mistakes (currently the third leading cause of patient deaths in the USA, per Makary and Daniel); thereby minimizing patient adverse events and optimizing clinical case outcomes while maximizing the cost-effectiveness of care and treatment and also accelerating the accrual and facilitating the application of medical knowledge. Please contact me, Pete Melrose, at firstname.lastname@example.org or +1 (612) 201-2301 to discuss and decide re how you or your organization can participate in development completion and launch of CHARTSaaS©. Patient lives may depend on your decision. Thanks for your consideration and hopefully your support, and good wishes for another great day!