FEB 24, 2014 5:00am ET

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Before the Affordable Care Act (Obamacare) became the law of the land, proponents marketed it to skeptics as an amalgamation of Republican and Democratic proposals in one package. The most widely used example was Massachusetts’ state-wide health care initiative implemented under a Republican governor. One fact that gets overlooked, however, is that it was actually George W. Bush’s administration that first promoted a national mandate for an electronic health record system. “In 2004, President Bush set as a goal that every American would have an electronic health record by 2014.” 1In 2014, it’s now standard practice for a physician to greet his patients with a handshake and a computer tablet. By encouraging physicians to create EHRs for each of their patients, Bush’s administration set in motion a practice that would, 10 years later, prove invaluable in providing some of the big data necessary toward understanding and treating complex diseases, developing more effective, individualized patient treatments, and reducing costs.

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Comments (3)
More of a question(s) than a comment. According to "Figure 2: Medical decisions becoming more complex", "Human cognitive capacity" is about 5 facts per decision, but over a 1,000 facts will be available by end of decade. If so, and predictive analysis is making way for prescriptive analysis, then, assuming integration challenges are resolved, why need a physician, at least as they are now needed?

Is "Human cognitive capacity" suggested here, universal or only in medical circles? If universal, and 1,000 facts per decision in any realm, then why need humans to make decisions at all?

It would seem lots of other important issues on the table than just challenges associated with combining data stores, including: is there some other element that humans bring to a decision than raw computing power?

Posted by Peter P | Monday, February 24 2014 at 3:27PM ET
In response to the above comment: although the article is focused on decision making in health care, having as much information available to make decisions spans all industries and human actions. I focused on health care in this article to point out that medical science is making amazing progress and the easier it is for physicians to leverage more information, the better it will be for us people going to physicians for treatment. I think it is safe to say that everyone who sees a physician wants that physician to make the most informed decision possible about our treatment options.

Gathering information to inform decisions is not limited to just health care. Discussions about decision making cover just about every topic imaginable and can be found back as far as the writings of Sun Tzu (regarding politics and warfare) and even earlier.

So with all this information available that is far beyond the capability of humans to utilize at the time it is needed, why don't computers make all our decisions? The answer is because humans are sentient and computers are not. The human mind, with all its short-comings and quirks, still performs many tasks vastly better than machines can. Humans can connect dots in new and creative ways where computers must follow predetermined algorithms. Humans are often wrong and get chastised for being wrong, or do something new and creative that turns out to be interesting and are called geniuses. Remember that Thomas Edison was wrong about the light bulb hundreds of times before he got it right. His genius was a combination of a good idea along with lots of mistakes and persistence. One of my favorite quotes about human creativity and genius goes something like, "The phrase that usually precedes most great discoveries is not 'Eureka!' but rather "Hmmm, that's strange.'"

An example of where a human doctor will always be superior to a computer is a story I remember about a relative that was an old country doctor. The doctor walked into his small office one day and noticed on person sitting in the waiting room. The doctor met with the patient and heard about the several seemingly unrelated symptoms the patient was experiencing. Then the doctor recalled that when he walked into his office and glanced at the patient, he noticed a coppery reflection where the light in the room had caught the eyes of the patient just right. That reminded of a disease he had run across years earlier (it may have been Wilson's disease). Turns out the doctor's noticing the color of the reflection in the eyes of the patient along with the symptoms helped him make an accurate diagnosis and successfully treat the patient.

It would be nearly impossible to program a computer to arrive at a similar conclusion. Who knows if the doctor really even saw that particular reflection in the patients eyes? Maybe he just imagined he did because of some old memory that happened to surface at a fortuitous moment.

However, it will be much better for the decision making process (in all situations) when as much easily understood and relevant information as possible is made available, then summarized in a way that can be consumed by the human mind at the time it is needed.

Posted by Todd S | Thursday, March 06 2014 at 10:31AM ET
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