First Draft of Business Proposal (Assignment No.

6)

Abdullah Amjad (---), Santosh Arora (----), Venkatsare Rao Patini (----) Hunaz Pazouki

(1917411)

University Canada West

MBAF 501- Business & Academic Writing

Dr. Mostafa Nazari

December 10, 2020

Introduction:

This report's main objective will be to propose local hospitals and clinics in

Canada to set up a platform to perform preliminary checkups on patients. These patients who

would typically go to their local hospitals and clinics will be able to talk to their doctors and

physicians virtually without the fear of spreading or contracting illnesses and diseases, which is

very common in hospitals worldwide. These diseases and infections are called HAI's

(Healthcare-Associated Infections). Providing such a service will also reduce the costs of

cleaning, disinfecting, and providing other miscellaneous services to patients. Moreover, this will

significantly reduce wait times and queues, especially for 70 to 80% of patients with minor and

common problems and conditions and only require primary care and standard over-the-counter

medicine.

Risk is the probability of damage, injury, and liability loss that is caused by

vulnerabilities that may be avoided through pre-emptive actions. The interactions of humans

with health systems pose a threat to them, mainly because of the intense and complex procedures

and the high demand for services. A hospital is commonplace for acquired conditions due to the

patients' clinically compromised states admitted to the hospital and the high volume of care

transactions during the stay in the hospital. Moreover, the pandemic effects on the world are

among the primary reasons behind these preliminary checkups, which easily evaluate the risks

before they spread in humankind. According to this, there are a few problems and solutions to

overcome this situation and some research on it, making the preliminary setting easier.

The primary need for these preliminary checkups will be for those with minor

problems and symptoms for which they may not need to come to the hospital for an in-person

checkup. Many people also have a fear or concern about going to the hospital for such minor
afflictions. Setting up this kind of online platform allows such patients to have ease of mind

while consulting with a professional doctor about their worries and needs. This service will also

greatly help patients who are elderly and/or people with children who cannot easily access a

hospital or clinic. Furthermore, it will allow people with anxiety, depression, and other mental

health problems to communicate with professionals and get help more easily and readily.

Problem:

Our main problem or focus is the major drawbacks and limitations of unnecessary in-person

appointments in hospitals.

The CDC (Centre for Disease Control and Prevention), which is a national public

health institute funded by the government of the United States shows that one in every 31

hospital patients has at least one healthcare-associated infection (CDC, 2018). This is not a small

number considering that there are hundreds of thousands of patients that visit hospitals every

day. This pandemic, especially, has proven to us how necessary it is for us to prevent such

transmittable diseases. It has also shown us that there are ways in which we can limit gatherings

and concentrations of people, and come up with innovative ideas and solutions for our future

generations. Furthermore, we know that most patients who arrive at a hospital and are appointed

to a physician for a check-up simply do not need a physical examination. In fact, many

researchers and medical practitioners advise against it. A society of physicians and health

practitioners (SGIM) states that “Annually scheduled general health checks, including the ‘health

maintenance’ visit, have not been shown to reduce morbidity, hospitalizations, or mortality, and

may increase the frequency of non-evidence based testing.”

Physical examination and appointments have been the primary source of

diagnosis in medical practice for years, this has been partly due to the simple fact that the
information and resources we have today were not available to us even ten years ago. The

primary method of evaluation has been in-person checkups because of the underlying reality that

this has been the way that medical institutions have worked for so many years. Even if a patient

has a minor problem, doctors and hospitals will sometimes over-treat patients, just to be sure that

they do not have an underlying condition. Even though this is a valid concern and justification

for hospital appointments, it has been shown that 20.6% of all overall medical care has been

unnecessary. Moreover, the reasons for these overtreatment have been mostly ‘fear of

malpractice’ (84.7%), patient pressure/request (59%) and difficulty accessing medical records

(38.2%) (NCBI,2017).

With the revolutionizing of the economic industry after the pandemic this year, I

think we need to re-evaluate our medical practices and methods as well, not only because of the

pandemic, I believe this system needs to be changed for the betterment of our society in general.

Even though hospitals and medical institutions are one of the most highly respected and essential

part of our society, we need to make this component of our life at least a little more efficient and

resourceful. We spend roughly around 200 billion dollars every year on unnecessary treatments

and tests which are believed to cause around 30 thousand deaths each year, and that is not

including the HAI consequences, costs of travel, maintenance and mental stress that patients

receive during this whole process (BUI, 20204).

Solution(s):

The main approach for researching possible solutions has primarily been

analyzing the methods used in different countries to minimize HAI’s and make it easy for all

kinds of patients to seek consultancy on medical concerns. We wanted to see if any other country

has ever attempted to solve this and what kinds of approaches and measures they have taken. Our
research plan also included looking into the feasible methods of conducting safe and convenient

appointments which could be easily managed by medical institutions. Furthermore, we also

wanted to learn more about the different diseases that can be transferred through various means

in waiting rooms, offices and clinics, as well as the diseases, infections and treatments which fall

into the category of ‘primary care’ and can be dealt with virtually or without physical

examinations. Lastly, we devoted some time to finding out about the Canadian medical

environment and how they have been operating and conducting safe, reliable and efficient

healthcare across the country.

Surprisingly, the amount of research, studies and solutions we found were so

extensive and vast that it was a bit overwhelming. Firstly, we found out many countries,

including Canada, have done these types of experiments and trial runs of virtual appointments,

which are also known as ‘e-visits’, ‘teleconsultations’, and ‘virtual visits’. One of the major

contenders in this type of research has been China, conducting successful trials of both virtual

online appointments as well as the use of telemedicine. The study performed in 2017, the meta-

analysis and systematic review of the use of telemedicine for treating chronic heart failure found

benefits, which included lower admission rates, shorter hospital stays and fewer deaths.

Telemedicine not only makes it easier for people with disabilities to access care but can also

improve access for the elderly and for people who are geographically isolated (2017). But

perhaps our most valuable find was a small scale study done in BC, Canada itself in which a

survey of 399 virtual visit patients and their experience was held. I was reported that 93.2% of

patients found their virtual visits to be of high quality and 91.2% reporting that their visit was

“very” and “somewhat” helpful. Another notable area of research that we stumbled upon while

looking for ways to make healthcare simpler and more accessible was the many researches and
studies done of the concept of a global HIS (Healthcare Information Systems). These systems are

basically computer based platforms that are primarily used to enter, store, process, communicate,

and present medical information about patients, to be used by healthcare professionals or by

patients themselves when needed (UMIT, 2005).

After carefully analyzing all of our collected data and research ideas, our final

decision for the proposed plan was concluded as being a proposal for the ministry of health in

Canada to implement a platform for online virtual appointments for one or two hours a day in the

primary care departments of all hospitals and clinics in Canada, so that people living in Canada

can book an online appointment with their personal doctors and physicians who are aware of

their medical background and history.

As with any concept, there are some limitations and potential risks that can occur

with this proposed model, but if we handle them with caution and care, it is not something which

can become unmanageable. As physicians and healthcare providers will require a transition

period to get accustomed and adapt to virtual sessions. There might also be cases where a

patients’ vital signs or other medical signs are required, but for these cases a follow up physical

can be requested. Nevertheless, the benefits of our proposal far outweigh the negatives. For

example, this platform will provide a base for many preliminary checkups for patients with

minor problems and conditions, so that those which actually require an in-person examination

can be filtered out of the unnecessary minor conditions which can be evaluated and diagnosed

virtually. This platform will also benefit elderly, disabled and people with infants by making it

more accessible to clarify any medical concerns and put their minds at ease. Finally, it will also

reduce the costs and expenses of the patients as well as the medical institutions. As shown by an

extensive study (NCISD,2222), patients were taken to their known healthcare providers a
number of times before a virtual visit and the study clearly showed that the patients were

spending an increasing amount of money every time they visited their known providers before

the virtual visits, and their costs decreased dramatically due to the virtual sessions.

As Farzandipour (2020, p.1) says, "Modern advances in information technology (IT) have

completely transformed the face of the world, and IT-based services have significantly improved

healthcare services." therefor, it is obvious to use this technology to improve facts in medical

services in Canada. As the healthcare system in Canada is kind of sophisticated health and

medical service which is available for everyone and its different form some countries which the

medical services are fee-paid base so its crucial for the government to reduce the costs as the

government is responsible for affording, funding, and maintaining most health-related services.

This cost reduction would be beneficial for both the government part and the community

members. 

Applying some alterations in even a tiny part of Canada's medical services process would have

many advantages. The idea of having a virtual appointment for the primary visits of patients

would cause crucial gains to the government, medical centers and even patients. The referral

model sometimes dissipates the medical sources for some unnecessary problems that patients

face. According to Haq (2008), In the United States, the average of visiting a doctor in a year is

three times. These appointments are usually for general medical checkups, checking blood

pressure, and upper respiratory tract infection (URTI). In a study about China's hierarchical

medical centers, they divided the patients into three separate groups based on their disease and

their treatment difficulty. In this classification, patients with general problems and diseases had

an online appointment, and their treatments started in this way; the second group and the third

group were patients with more serious problems which directly sent to hospitals for their
treatment after the consultation appointment. In this way, they found out that they have benefits

in cure rate, cure rhythm, hospitalization speed, service radius and so on (Shen, Yang, Sun,

2019). On the other hand, due to Covid-19 and its impacts on everyone's life, the importance of

reducing unnecessary in-person visits to medical centers has become a must. According to Locke

(2020), Many doctors closed their offices after a while and in order to facilitate the healthcare for

patients, they started having phone visits, so in this way, they were following the safety rules

which WHO maintained and also the necessity of patients for checkups would be observed. In

this study, people who needed any medical visits had their appointment with the doctor by

phone, and after that, they just received an email in which they needed to answer the

questionnaire. The result of this survey was amazing. Totally 102 people participated in this

survey, and 96% of participants agreed with this new method, other participants who lived more

than 75 kilometer’s far from the medical centers preferred to have telephone visits but the local

patients preferred to have walk-in visits.

Obviously, this method cannot be used for all the patients; for some diseases this method can be

used such as mental health issues, many skin problems, sexual health, sore throats, reviewing the

test results, and renewing the cure and medicine; on the other hand, there are many health

problems which needs physical examinations by the physicians such as pain in the chest, loss of

hearing, loss of vision, cough, injuries. So first of all, it is important to have a form in which the

patients can fill it online on the generated portal, then the bots will process the answers based on

the given information about the group of disease. For instance, if the problem was from the list

which didn't need physical examinations, so the next step is setting a virtual appointment for the

patient. By this appointment, the whole process of visiting a doctor will be virtual. In this virtual

visit, there are some rules which is necessary to be obtained by the patient. If the patient is
visiting this particular doctor for the first time, so it's necessary to give the doctor some

background information about the diseases, allergies, past surgeries or hospital examinations and

so on, but if the doctor is the family doctor so the history of patient would be available on the

portal as well. after the visit patients can receive a note from the doctor who is a summary of the

appointment.
 References

Farzandipour, Meidani, Nabovati, Sadeqi Jabali, Dehghan Banadaki, (2020). Technical

requirements framework of hospital information systems: design and evaluation.

https://doi.org/10.1186/s12911-020-1076-5

Farzandipour, Meidani, Nabovati, Sadeqi Jabali, Dehghan Banadaki, (2020). Technical

requirements framework of hospital information systems: design and evaluation.

https://doi.org/10.1186/s12911-020-1076-5

Haq, (2008). Virtual Clinic for Medical Practice. Patent No.: US 7.412,396 B1

Haq, (2008). Virtual Clinic for Medical Practice. Patent No.: US 7.412,396 B1

Locke, Herschorn, Neu, Klotz, Kodama, Carr. (2020), Patients’ perspective of telephone visits

during COVID-19 pandemic, Sunnybrook Health Sciences Centre, University of Toronto,

Toronto, ON, Canada, http://dx.doi.org/10.5489/cuaj.6758

Locke, Herschorn, Neu, Klotz, Kodama, Carr. (2020), Patients’ perspective of telephone visits

during COVID-19 pandemic, Sunnybrook Health Sciences Centre, University of Toronto,

Toronto, ON, Canada, http://dx.doi.org/10.5489/cuaj.6758

Shen, Yang, Sun, (2019). Analysis of the Impact of China’s Hierarchical Medical System and

Online Appointment Diagnosis System on the Sustainable Development of Public Health.

Business School, University of Shanghai for Science and Technology, Shanghai 200093,

China. https://doi/10.3390/su11236564

Shen, Yang, Sun, (2019). Analysis of the Impact of China’s Hierarchical Medical System and

Online Appointment Diagnosis System on the Sustainable Development of Public Health.

Business School, University of Shanghai for Science and Technology, Shanghai 200093,

China. https://doi/10.3390/su11236564