Less COWs, better conversation

A JAMA research letter found "a reduction in simultaneous conversations and difficulty hearing" when rounding with fewer computers on wheels. They speculate that without individual access to the patient record, team members turned to the rounding conversation for information, increasing engagement. 

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A Model of Situational Awareness


Today's figure is from Understanding diagnostic errors in medicine: a lesson from aviation. Improving a clinician's situational awareness of a patient is one way for clinical decision support to lead to improved patient care. A clinician with high situational awareness perceives the details in a patient case, comprehends them, and uses them to project the future status of the patient. Projections are augmented by the different treatment options under consideration. Tweet reply to comment. 

Context Taxonomy

Context is the problem and the solution to improving AI systems. I will specify what I mean in future posts, but for now, I offer an introduction to how context is used in context-aware systems. 

 From Perera, Charith, et al. " Context aware computing for the internet of things: A survey ."  IEEE communications surveys & tutorials  16.1 (2014): 414-454.

From Perera, Charith, et al. "Context aware computing for the internet of things: A survey." IEEE communications surveys & tutorials 16.1 (2014): 414-454.

Weekend Reads: Designing better clinical decision support interfaces


You end of April weekend read will teach you how to design better interfaces. Miller et. al.provides recommendations on three fronts: interface (presentation), Information (content), and interaction (function). 

Which recommendation surprised you?  As always, Tweet reply below to comment.

Self-driving fatalities to become more frequent in the years ahead


Sad news out of Tempe, Arizona: a self-driving care has struck and killed a pedestrian.

Self-driving fatalities will become more frequent in the years ahead. This is not a critique of the technology, but a hard truth. There are over 30,000 traffic related deaths in the United States every year. So, even if self-driving cars were 1,000 times safer than human drivers, they would still be involved in 30 deaths a year.

The current automotive death toll is important to keep in mind as we look at the safety record of self-driving cars. Would it be better to have self-driving cars kill 10,000 people a year or human-driven cars kill 30,000?

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Interoperability, encouraging signs from the white house

At HIMMS, Jared Kuschner mentioned interoperability as a means to save lives. In addition, he posed customer (patient) ownership of healthcare data as a key principle of the Administration's strategy.    

Perhaps this will be the focus of any changes to the VA EHR upgrade. I wonder if industry contacts, such as apple, have the presidents ear? No matter the reason, we should be encouraged.  


Weekend Reads (Emphasis Framing)


A new Weekend Reads is hot off the press: Quality and Efficiency of the Clinical Decision‐Making Process: Information Overload and Emphasis Framing. Laker et. al.  look to address information overload through emphasis framing--highlighting some aspect of the information being exchanged. They report a laboratory study where a detail in the patient’s record was highlighted by bolding a line of text. Their results show that the highlighting significantly improved the quality of clinical evaluation. Interestingly, it also increased time to task completion. The authors speculated this was due to the highlighted detail leading to System 2 thinking because the correct plan of action for the simulated patient case is a divergence the usual plan of action.