Health Foo 2015 – Ignite

About this course

I'm gonna tell you about a patient that I saw in the ER at my hospital now when most people think about the ER they think about blood and guts and George

Clooney and the reality is usually less dramatic and often less attractive it looks more like this the patient I'm going to tell you about is a young woman with abdominal pain she was like a lot

of patients that you just need to see and move through after you've made a decision on and when the resident told me about her he said 29 female abdominal pain vomiting for six weeks needs a cat

scan and all of that seemed like a very reasonable thing to do and even when I play this case back in my in my head all of that seemed extremely reasonable the data collection was done properly the

exam was done properly the medical reasoning was done properly and despite all of that being entirely correct we were about to make an enormous mistake not to understand the mistake that we

were about to make I want to take you back probably about 50 years to what was a simpler time in medicine it was a time when penicillin was a fairly new drug we certainly didn't have a lot of axial

scanning and we wore these really funny flashlights on our foreheads which I've always wanted to get for myself but I'm afraid I wouldn't be taken seriously when a similar patient would have walked

into this man's office the disturbing thing that I realized is that that mistake that we were about to make would probably not have happened what would have happened is she would have sat down

he would have spent a really long time talking to her like almost 10 or 15 minutes which in my world is an eternity and there's a there's a fairly good chance that this doctor would have

actually gotten to the bottom of the problem in a way that almost escaped us the bottom of the problem for this particular patient was actually not her or vomiting or anything it was that six

weeks before around the time she'd started vomiting she discovered that her boyfriend was sexually abusing her daughter our mistake would have been doing a CT scan seeing that it was

negative and then sending her home without compassion without resources to help her or her daughter and without closing the loop on this social issue that we only could have gotten to the

bottom two if we'd actually talked to her that's really hard when you only have three minutes to spend with the patient 40% of which is spent interacting with a computer now it's

easy to see how a lot of doctors would look at this situation and say let's get rid of the computers let's go back to that simpler time and throw out all of this cat scan and EMR stuff and move

backwards but we need to actually move forwards computers got us into this mess and computers can also get us out of this mess but only if we do it properly so I want to play it forward and imagine

what would have happened to this patient if she had come into an ER 50 years from now she would have checked into a triage desk where we would have immediately started monitoring her vital signs and

maybe even her emotional state a algorithm would have already sifted through all of her medical records and told the resident that based on her to prior abdominal imaging studies her

probability of having appendicitis or ovarian torsion or ectopic pregnancy was very low if the resident had not asked her about mood or anxiety or social issues it would have prompted him to do

so and there certainly wouldn't have been time taken with the resident writing on a computer while he was trying to talk to the patient so all of these technologies are here and ready to

be incorporated into the doctor-patient relationship technology is that will collect data that actually humanize us and acknowledge the complexity of the body and the mind and technology to help

us understand these data in an analytic way so in a funny way incorporating computers into medicine is actually going to make medicine more human not less thank you

you