Machine vs. Man – Are clinical decision support systems enough? September 2016 Healthcare IT Review

Sep 29, 2016

Machine vs. Man – Are clinical decision support systems enough? September 2016 Healthcare IT Review

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Dear Clients and Friends,

Click HERE for the September 2016 Healthcare IT Review.

For years we have been hearing about the potential of sophisticated clinical decision support (CDS) software systems that can assist doctors with their decision making process. These systems bring together a variety of clinical data which are analyzed through proprietary algorithms, aiming to improve outcomes and reduce costs. The promise of precision medicine, it is argued, can only materialize through the use of advanced CDS systems.

But the science of clinical decision support alone is not enough. What has been missing is the ability to combine the data and the algorithms with the wisdom of knowledgeable physicians. Medical crowd sourcing and physician collaboration can be one of the most effective ways to increase the benefits of clinical decision support. Regrettably, today there is no systematic way for doctors to tap the wisdom of their peers and collaborate on difficult diagnosis or treatments. In the era of digital communications, doctors are still using telephones, faxes and even mail to exchange data and consult with other colleagues.

We have seen collaboration work in other industries. In the technology sector, there are great examples of collaboration among open source IT developers who have worked together to “crowd source” solutions and turn out some of the best software systems in the world. This process of collaboration is automated, it travels around the globe in a structured fashion, and it has its own quality control mechanism. Why not in healthcare?

It is estimated that when doctors collaborate, particularly among multi disciplinary teams, treatments are changed between 20-50% of the time, depending on the condition of the patient. This is chilling when you think about the number of lives on the line.

The good news is that we are starting to see early signs of formal and informal digital channels that are emerging through medical crowd sourcing and physician networks. Companies whose membership is exclusively comprised of doctors are ideal platforms for peer to peer collaboration. These companies are using medical crowd sourcing, albeit in an ad hoc fashion, that have the look and feel of Facebook postings. We are quite encouraged by this development. But the ultimate goal should be building a more structured, HIPAA-compliant web-based collaboration networks where clinical data, radiology and pathology images can be shared amongst specialists in the U.S. and across the globe. Since the U.S. has 90% of the world’s sub-specialties, the responsibility lies on our shoulders and we are glad to see that a few companies are pioneering that effort.

In today’s fragmented and over burdened medical system, it does not surprise us that doctors are conditioned to rely on their own judgment and perhaps some type CDS system to solve difficult cases. But harnessing the wisdom of the crowd particularly for the cases which cross national borders into less fortunate countries, is empowering for both medical experts and patients. This is not a fight between man vs. machine. We need the knowledge embedded in the physicians’ brains as much as the algorithm embedded in the machine. It is time to democratize wisdom.

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