Table of contents

Re-engineering Computational Research to Improve Medical Care

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Outline

“Medicine and the Computer: The Promise and Problems of Change” --W. B. Schwartz, NEJM 1970

Practice of Medicine is …

Consider the following:

Reasoning Tasks

Medicine provided challenges for AI, and AI responded

Diagnostic Reconstruction

So why aren’t computers in your medical life today?

Current Challenges/ Opportunities

IOM “To Err is Human” report

Problems

Process Errors

Suboptimal performance everywhere

Why?

Computerized Clinical Decision Support

Computerized Clinical Decision Support: necessary but not sufficient to overcome opinion

Short-term solutions

The communication space

How big is the communication space?

What happens in the communication space?

ER communication study

Implications (Coiera)

Communication options

Communication channels

Hijacking Administrative Computing

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NEHENlite and Integrated Options

Real-Time and Batch Alternatives

NEHENLite – Specialty Referral Submission

NEHENLite – Claim Status Inquiry

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nMesh

Current Opportunities

DCCT: Diabetes Control and Complications Trial (’83-93)

Home Care for Chronic Illness

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Long-term

Autonomous Witness

Automated messages

Notification systems

Effects of notification systems

Interpretation 1 - communication is replaceable

Interpretation 2 - the necessity of communication

Choosing Channels

Thanks

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