Body of Medical Knowledge Too Complex for the Human Mind

In a recent comment, Steven suggested that an EMR and HIT in general might be necessary because the volume of medical knowledge is so large and complex that it’s too complex for the human mind. Here’s a short section of his comment:

Another set of reasons to adopt EMR, and sooner rather than later, are the reasons that are beyond the horizon. With the rate of change continuing to accelerate in the health care industry, along with our body of medical knowledge, I see a day where a person’s care plan is simply going to be too complex for a human brain alone to work out all the contributing factors. Sometimes I think we’ve already reached that point and haven’t quite realized it yet.

I absolutely love this concept of the body of medical knowledge being “too complex” for us to work it all out on our own. The idea that we need good clinical decision support systems, EMR and other technology we might not have even developed is really intriguing to me. Reminds me of my previous post about not knowing the true benefits of EMR.

The basic concept being that we won’t know the real benefits of EHR adoption until we have a platform for smart people to be really creative. Think about the Apple iPhone. If you look at the creativity that’s come out of the iPhone platform, it’s amazing. However, we would have never seen all this creativity until the platform was adopted in a broad way.

I believe that being able to managing and delivering all the medical knowledge out there is going to be one of those long term benefits we can’t realize until we have broad EMR adoption.

About the author

John Lynn

John Lynn

John Lynn is the Founder of the HealthcareScene.com, a network of leading Healthcare IT resources. The flagship blog, Healthcare IT Today, contains over 13,000 articles with over half of the articles written by John. These EMR and Healthcare IT related articles have been viewed over 20 million times.

John manages Healthcare IT Central, the leading career Health IT job board. He also organizes the first of its kind conference and community focused on healthcare marketing, Healthcare and IT Marketing Conference, and a healthcare IT conference, EXPO.health, focused on practical healthcare IT innovation. John is an advisor to multiple healthcare IT companies. John is highly involved in social media, and in addition to his blogs can be found on Twitter: @techguy.

7 Comments

  • John,

    Thanks for highlighting my comment. Your great post mentions a few of the big ones from a public health perspective. I am not a salesman and this is all “someday” stuff I’m talking about. Someday, we will have real time epidemiology tracking. Someday, hopefully, all of our medical records will be perpetual longitudinal clinical trials for the efficacy and adverse effects of all medication. Someday, individual medication and vaccine batches can be flagged for review or recall in real time, based on the outcomes of those medications.

    The reality of the health care industry has been putting pressure on everybody to work at the top of their licenses, because of the sheer amount of things to do and factors to keep track of. That’s now, and we ain’t seen nothin’ yet. Nobody can keep track of more factors than a computer.

    I’m thinking also of the ideas being bounced around now about personalized health care and genotype/phenotype specific treatment as genetic research continues to mature. That kind of health care is bound to be incredibly complex and multi-factored.

    Also, robots are about to come on the scene in some health care settings, nursing homes foremost, in a big way. Robots “like” to read and write standardized data in standardized formats.

    With the potential for great good always comes the potential for great harm. As we develop this technology, we must always put people’s privacy first, and safeguard against immoral, unethical, and illegal uses of this data. Think how major an event it is when the security of your credit card number is breached, how seriously the incident is treated, and how many disclosure rules and regulations there are. That number can be changed in a manner of minutes with a call to your credit card company. That’s a good reference point for thinking about the security and privacy of everyone’s most intimate and permanent medical information.

    We could look even further down the horizon, but this post is long enough. All this potential is what motivates me to get out of bed and go to work in the morning.

  • I think your comment does a great job highlighting the potential of what technology can do and for that matter really has done for healthcare. No doubt we’re going to see some amazing things happen over the next years as technology is applied in healthcare.

  • The health world of the 21st century is fast-paced. Even in medical practices, speed equals ability to compete, especially when managing information. That is why an electronic medical record system, or EMR, is used by most medical practices.A well written article.

  • Unfortunately this fits the definition of a “Fallacy of division” – assuming that something true of a thing must also be true of all or some of its parts.[Wikipedia). That is, CDS is needed and is under the realm of HIT. EHRs are part of HIT but EHRs are not capable of CDS.
    useful and comprehensive CDS and will not be for years. Because something its true of HIT does not make it true of EHRs.

    Yes medicine is too complex for the human brain
    Yes we need CDS
    Yes CDS fits under the rubric of Health Information Technology

    NO, this does not mean that EHRs are good or even necessary.

    EHRs are a subset of HIT. They lack CDS capabilities except at the most rudimentary level. Almost all useful CDS resides OUTSIDE the EHR. To go a step further, it is patently ridiculous that 600 monolithic EHRs will each develop 600 different CDS solutions to each of the thousands of medical areas requiring CDS.

    What we need is good specialty specific CDS systems built outside the EHR, and for EHRs to open their architecture to allow Doctors to use these useful CDS systems while placing a note in the EHR.

    I suggest you read:
    Drohan B, Ozanne EM, Hughes KS. Electronic health records and the management of women at high risk of hereditary breast and ovarian cancer. Breast Journal 2009 Sep-Oct;15 Suppl 1:S46-55.

    and our chapter on CDS in genomics in:
    Clinical Decision Support, 2e The Road to Broad Adoption
    Edited by: Robert A. Greenes Arizona State University and Mayo Clinic, Phoenix, AZ, USA

    Reader’s Digest version, CDS is critical for incorporating genomics into healthcare. EHRs wil not be ready for incorporating genomic information for 3 to 5 years. We need CDS systems outside of EHRs

    Lets stop giving the document management systems (EHRs) every capability of good HIT. They are a subset of HIT with very limited capabilities.

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