Medicine, the science of uncertainty

In a recent article, it was estimated that at least $200 billion is wasted annually on excessive testing and treatment. The impact of the overly aggressive, extraneous care is not only financial in nature but also generates mistakes and injuries believed to cause 30,000 deaths each year. In 1979 the founders of the field of behavioral… Continue reading Medicine, the science of uncertainty

Desktop Medicine

As I discussed in my last post, Claude Shannon defined information as the number of bits needed to communicate an arrangement or state of a system. The fundamental problem of communication is not to make oneself understood, but to reproduce “at one point either exactly or approximately a message selected at another point.” The destination… Continue reading Desktop Medicine

It from Bit

The universe is composed of energy, matter, and information. However, it is not energy nor matter that makes the Earth unique, but information. No known place in the known universe holds more information than Earth.  It is said, our planet is to information what a black hole is to matter and what a star is… Continue reading It from Bit

A Bayesian EHR

As an Emergency physician, my job is to make predictions. Throughout the day (and night), I make predictions related to treatment outcomes, management plans, and patient dispositions. These predictions are often fraught with risk (but mostly uncertainty) and I am constantly aware that every decision I make is inherently probabilistic. The framework that most physicians lean… Continue reading A Bayesian EHR

Brain Drain

Data, information, and the patient physician encounter are at the heart of medicine and health. William Osler (the father of modern medicine) recognized early the role of patient focused data driven decision making when he stated that, “the practice of medicine is an art, based on science.” Translated into modern medicine, the physician gathers information… Continue reading Brain Drain

The ‘exposome’ exposed!

How can we explain the observation that Pima Indians living in the Southwest United States have a five fold higher prevalence of diabetes than their counterparts living across the border in Mexico? Not only are these populations genetically identical, numerous studies have been unsuccessful in identifying chromosomal regions with a strong linkage to the trait.… Continue reading The ‘exposome’ exposed!

Technology Driven Triple Aim

The triple aim is a framework developed by the Institute for Healthcare Improvement that describes an approach to optimizing health system performance. The goal is to improve the quality of care and the health of population while decreasing the cost of health care. The Patient Protection and Privacy Affordable Care Act (PPACA or ‘Obamacare) was… Continue reading Technology Driven Triple Aim

The Digital Divide

The idea of precision or personalized medicine is gaining a lot of attention. In his State of the Union speech, President Obama launched the Precision Medicine Initiative “that will help deliver the right treatment to the right patient at the right time.” Additionally, I recently came across a press release announcing the appointment of a… Continue reading The Digital Divide

Data rich but Information and Knowledge poor

The processing capacity of the conscious mind has been estimated at 120 bits per second. To put that in context, in order to understand one person talking to you, we need to process 60 bits of information per second. Primary care physicians on an average deal with three problems per patient and it is estimated… Continue reading Data rich but Information and Knowledge poor