Greg Twyford wrote:
> Tim Churches wrote:
>>
>> I suggested to Jon a few weeks ago that a skill which every medical
>> student and intern quickly learns is how to take the masses of detail
>> and data points about each patient and distil that into a 15 second
>> summary of only the situationally relevant information for the ward
>> round (maybe a 1 minute summary if it is the first time the patient is
>> being seen by the honorary). Computers are great at storing and
>> regurgitating the masses of information, but are currently hopeless at
>> working out which bits of all that information are relevant in a
>> particular situation or point in time. Teaching computers to do that is
>> a deep problem, but one which needs to be tackled.
> 
> Tim,
> 
> this is part of the AAPS whinge, recently referenced on this list, about
> being forced to use an EHR.
> 
>> http://www.aapsonline.org/confiden/nhincomments.htm 
> 
> One view might be that decision support should pick the abnormal
> results, but, in a hospital setting there may be great complexity in the
> data.
> 
> Maybe doctors will always have this role?
> 
> Then again, when my father in law was in and out of hospital last year
> in the months before his death, on one aoccasion he was taken back to
> A&E 2 hours after discharge, and A&E had no knowledge of his previous
> week's in-patient treatment, and no way of accessing information about it.
> 
> The nurse doing the initial work-up was very grateful when I showed her
> the bag of discharge medications. We, unfortunately, had left the
> summaries at his home in our anxiety, as it was a crisis re-admission
> and his survival looked dubious.
> 
> So, there are lots of much simpler 'in-fill' to do, I'd suggest, before
> trying to automate clinical acumen. Just making accessible what is known
> would be a great leap forward in these sort of circumstances.

Yes, absolutely, I agree - there many much bread-and-butter information
problems to be solved. But working out how to build smarter health
information systems (not just bigger ones) also needs to be a longer
term gaol.

Tim C

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