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NICE relaxing guidelines
These findings, if indicative of patient views, are significant. Recently, the National Institute of Health and Care Excellence (NICE) issued new draft guidelines to make more people eligible for weight-reduction surgery. According to NICE, such surgery would reduce the debilitating complications associated with type 2 diabetes.

Until now, people with type 2 diabetes only could be considered for weight loss surgery at a BMI of 35. The new guidance could mean that more than 850,000 people could be eligible for a stomach-reduction surgery if their doctors think they are suitable.

A costly therapy
Over the past five years, there has been a significant increase in the number of people receiving weight loss surgery. According to the UK's Health and Social Care Information Centre's latest report: in 2012-13, about 8,000 people received stomach-reduction surgery for potentially life threatening obesity when other treatments failed.

A mounting body of evidence suggests such surgery improves symptoms in around 60% of patients, which in turn, may result in a reduction in people taking their type 2 diabetes medications, and even in some cases needing no medication at all.

Stomach-reduction surgery, which costs between £3,000 and £15,000, does not mean that type 2 diabetes has been cured, and there are raised concerns that the NHS will not be able to afford the treatment, even if there are savings in the longer term. Furthermore, an irreversible procedure that does have surgical risks attached to it does not make it an attractive option for everyone. 
 
Takeaways
"We know about the escalation of the diabetes burden. We know that established therapies, diets and lifestyles could effectively reduce the burden of diabetes. And yet the burden shows no signs of slowing. IF patient data from the Wandsworth Medical Centre are indicative of the situation more generally, we should seriously consider the way doctors communicate with patients. Doing 'more of the same' is not the answer. We need to find new innovative solutions to engage, interact and motivate as many people as possible," says Dr. Hussain.

"The next ˜big thing" in healthcare . . . . is IT, which will dramatically change the way health professionals interact with patients. Every step of a patient's care will be determined by protocols on a hand-held device. This will make healthcare safer and shift many hospital activities into the home," says Dr Devi Shetty, world-renowned heart surgeon, founder and chairman of Narayana Health, India's largest multi-purpose hospital group and the person said to have, "the biggest impact on healthcare on the 21st century".

Shetty also warns that, "Despite the advantages of such technologies, the medical community is reluctant to accept them."

Although doctors and patients have iPads and smartphones and use social networks, the healthcare community, "fights like mad to resist change", and fails to embrace life-saving technologies, which would improve patient care and reduce costs. ld improve patient care and reduce costs.

 

Open systems
In 2012 UK Health Secretary Jeremy Hunt issued a Mandate that by 2015, modern communications technology would play a substantially bigger role in the UK's healthcare system. The NHS remains a near bankrupt, inward looking public monopoly driven by proprietary systems rather than customer needs.

Saving lives didn't invoke change
Healthcare professionals invariably refer to privacy and security issues to protect the status quo, but these are equally applicable to other sectors, such financial services, which have embraced change and open standards.
 
An explanation why healthcare systems resist change is in a 1970 BBC Reith Lecture by Donald Schon, formerly Professor of Philosophy, University of California.
 
Schon borrowed a story from Elting Morison's 1968 book, Men, Machines and Modern Times, to describe entrenched social systems' resistance to change. 
 
During wartime, a young Naval officer named Sims invented a device that improved the accuracy of guns on ships by 300%, but the US Navy rejected it.
 
The device, "continuous-aim firing" used a simplified gearing mechanism that took advantage of the inertial movement of a ship. What previously a whole troupe of well-trained men had done, now one person, keeping his eye on the sight and his hands on the gears - could do.

The silent killer
AKI relates to the rapid loss of kidney function. Often it has no symptoms and frequently goes unnoticed by medical staff. AKI's most common in people over 65, and may affect as many as one in six hospital patients who are admitted as an emergency. If left untreated, the condition can result in permanent kidney damage and death.
 
AKI usually develops before patients enter hospital, and is often caused by dehydration, or an adverse reaction from seriously ill patients to over-the-counter medicines such as ibuprofen. AKI also can develop after some heart surgeries when the kidneys may be deprived of normal blood flow. 

Chronic kidney disease (CKD)
Chronic kidney disease (CKD) is a condition in which kidneys are damaged and can't filter blood as well as healthy kidneys. Because of this, wastes from the blood remain in the body and may cause other health problems.
 
Various chronic diseases have detrimental effects on the kidneys. Rapidly rising global rates of chronic diseases portend a consequent rise in kidney failure and end stage renal disease (ESRD). Over the past two decades, worldwide there has been a 165% increase in dialysis treatments for ESRD.
 
Despite the magnitude of the resources committed to the treatment of kidney disease and the substantial improvements in the quality of care, kidney patients continue to experience significant rates of mortality and morbidity. Partly, this could be the result of poor delivery of medical information.

The Quality and Outcomes Framework (QOF)
The Kidney Care Atlas underlines the importance of GPs providing quality healthcare information to patients in formats they prefer. GPs in England are incentivized by the Quality and Outcomes Framework (QOF), which rewards "good practice".
 
Under the QOF system, doctors are incentivised to establish and maintain a register of patients with CKD and provide them with information about their condition. Ninety per cent of GPs provide such information in leaflets, whereas increasingly patients prefer healthcare information online and in video format.
 
Data in the Kidney Care Atlas suggests that kidney patients need to be more effectively informed about readily available, inexpensive therapies that can slow and prevent the progression of CKD.  This could be achieved by simply substituting videos for leaflets and integrated into the QOF system.

Takeaways
Videos, unlike doctors, never wear out and can be accessed by thousands of patients simultaneously, 24-7, 365 days a year from anywhere, at anytime and on any device. Doctors who use videos to inform patients suggest this relieves pressure on GP surgeries and A&E departments. 

Ten short videos could reduce kidney disease by encouraging people at risk of CKD to: