Monday, January 30, 2012

Medical Information - Differentiating Old vs New

It is better to fail in originality than to succeed in imitation.
- Herman Melville
Medical information overload risks harming our patients.

At no time in medicine has information flowed so freely to our doctors. Imagine: CT scans in the palm of your hand, realtime EKGs telemetered to Emergency Rooms from the field, instantaneous text messages between collegues, literature references easily recalled...

... and 17-page progress notes containing volumes of rehashed information of no clinical value that must be scrolled through, tweets that are re-tweeted, blog posts that are shared from blogs to mainstream media and back again -- all because we can.

We are seeing an exponential growth, not of new, original information, but of rehashed, re-processed, re-published information. We promote this. We see this in our electronic progress notes that MUST contain the same old "same-old" time and time again because, quite frankly, we won't get paid if it's not there. It's as if we say, "the more the merrier!"

But the more there is, the greater the potential for doctors to miss the new stuff: those critical (and sometimes subtle) game-changers.

Finding what's new in the pile of old is becoming one of today's doctors' biggest clinical problems. Increasingly I find I consume chart notes like a bad sandwich, read the first paragraph and the last while ignoring everything in between: there's just too much worthless "filling" in between.

The problem goes well beyond mere EMR note bloat: from twitter feeds, to republished blog posts. Sure we want to get the word out, but the republishing and re-tweeting beast is eating us alive. Why do I need to see a link to a post from three months ago again?

Original thought takes time and careful consideration. Yet we insist that plagiarism has value in our medical records and electronic communications.


We need an urgent push to simplify information flow to doctors, otherwise we'll compromise their ability to separate signal from noise. Maybe color code it, hyperlink the redundancies - whatever - but please, dear legislators and information technology professionals, appreciate the beast that is eating us alive.


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