HCD Expo Keynote: Diagnostic Challenges in the New Era of Health IT
Dr. Gurpreet Dhaliwal, professor of medicine at University of California San Francisco, studies how doctors think, providing a unique perspective on what exactly takes place between the time a patient presents with symptoms and a diagnosis is finally reached.
However, the practice of medical diagnostics is complex, and the increasing reliance on technology in care delivery—specifically the electronic medical record—is only complicating matters. The appetite for metrics in healthcare and requirement for constant documentation is resulting in physicians and other care professionals bogged down by the stressors that come with it, all while breaking down the all-important doctor/patient relationship.
Dhaliwal shared his thoughts on how technology in medical practice is part of the problem but also opportunities for how it can become part of the solution in his Sunday opening keynote presentation at the Healthcare Design Expo & Conference: “How Do Doctors Think: Diagnostic Challenges in the New Era of Health IT.”
From looking at how data can be analyzed to predict a patient’s likelihood for readmission to scanning social media to determine whether a patient will provide a positive review of a hospital stay, a lot is already in the works for the role of computers in medicine. But Dhaliwal warned that computers aren’t quite advanced enough to step to the diagnostic plate because of one key characteristic that they lack: “the notion of common sense.”
Humans want to be happy and out of pain, for example. But a computer wouldn’t know that. “The computer has to know way more than medicine; it has to know about life itself,” he said.
That’s not to say we won’t see a shift in basic care coming soon—perhaps a kiosk that determines, based on available data, whether a patient is presenting with a viral sore throat or strep throat. “I think that would be great,” Dhaliwal said.
And while a real-life physician remains the best bet for diagnosis and treatment, his or her ability to perform that job adequately continues to be affected by the EMR, what Dhaliwal referred to as a “Christmas tree” where the industry hangs everything—malpractice, quality, safety, research, nutrition, or even central supply data.
But there’s no data entry clerk: “That person is a doctor,” he said.
In an industry that’s evolving to provide better outcomes over volume, Dhaliwal said it’s critical that physicians be given the space to properly communicate with patients about what they’re experiencing, and that that space is designed to include a computer as part of that interaction.
With health reform pushing the need for more efficient care—better outcomes with fewer procedures—and the need for data not going anywhere, the imperative is to support both while not getting away from what matters most. “We have to put the patient back at the center of the experience,” he said.