‘Modest’ feedback

A couple of months ago, I posted, “A modest proposal,” my observations about a session on clinical decision support from the American Medical Informatics Association annual meeting. In it, I argued that medical informatics needed a rock star of sorts to help humanize the issue of clinical decision support and communicate the benefits of such technology to the general public.

I got three comments on that post—actually pretty high for this blog—as well as several e-mails. One correspondent said we need more than a rock star, we need the whole band. I passed that comment on to Dr. Bill Bria, CMIO of Shriners Hospitals for Children, who was part of the panel at the AMIA meeting, who told me that he once led an all-physician rock band called the Straight Caths. It still may take the Rolling Stones or perhaps an entire Woodstock to make some of the changes American healthcare needs. Then again, Thursday is Elvis’ birthday.

One non-physician wrote: “That was terrific. Thanks! Except, while I don’t disagree, maybe if they learned to speak English, too, it would help.” Actually, Joan Ash of the Department of Medical Informatics and Clinical Epidemiology at Oregon Health and Science University made a similar point in said AMIA session.

CareGroup Healthcare System CIO Dr. John Halamka, himself a rock star in health IT circles for his incredible ability to juggle so many responsibilities (and perhaps for his Johnny Cash wardrobe), pointed me to one of his blog posts about his idea for ASP-style “decision support service providers”

One vendor executive wrote: “Its a shame that these guys seem to believe that CDS just means medication decision support when there are many other steps that use and benefit from DS.” This writer said there should be more of a focus on diagnosis decision support. The e-mail also included a quote from Dr. Donald Berwick: “Genius diagnosticians make great stories, but they don’t make great health care. The idea is to make accuracy reliable, not heroic”

Just think, a well-implemented clinical decision support system could finally give Cuddy a reason to fire House. I think about that every time I watch that show. It’s sad that trial and error can produce such great television.