Dr. Doug Krell is a veteran obstetrician and a new healthcare IT blogger. His recent post on how he could envision helping patients by accessing their entire medical profile via the kind of rich multimedia displays featured in the film Minority Report, is an interesting challenge. What kind of bold and imaginative interface would it take to give doctors a way to "see" the array of data assets that we expect healthcare IT to deliver, and use the information in powerful new ways? The future of such "clinicial decision intelligence" is wide open. Researchers at Purdue are working on one aspect of the challenge. (Image: prototype at Purdue of a Minority Report-style "datacave")
Guest Blogger, Doug Krell, M.D., KrellMD
I was watching an old Tom Cruise movie last week after a long night on call.
Minority Report. It takes place in the future when technology has harnessed the ability of a group of psychic "Pre-cogs" to predict when murders will take place. The Pre-cogs are hooked up to an array of translucent heads-up displays and computer data bases. When one of them gets a dream-like vision of an impending homicide, the machines light up and the names of the involved parties are spit out a gumball sized marble along with the exact time and date of the "Pre-Crime". The whole idea is that the police can stop the crime before it happens.
Tom Cruise as Detective John Anderton springs into action. Standing in front of this giant, no-touch sensitive display monitor, he can call up the visions of the Pre-cogs, graphics and text information about the persons and places involved, and he's able to wave his arms around and orchestrate all this data, until it appears to make enough sense to tell exactly when, where, and to whom the crime will take place. Usually there are precious few minutes between the visions and the crime and Tom Cruise rushes to review the data, solve the puzzle, and get to the crime scene before the person is killed.
While watching this movie, I was struck with the metaphor...this is just what I'd been doing at the hospital for the past 24 hours. A patient arrives with a complex of symptoms. I rush to gather all available data to make a diagnosis and intervene in a timely way. The problem of course is not only how to gather the prior medical information, but also how to document the current encounter and coordinate care in the most efficient way. Our hospital is like the majority of american hospitals with a gaggle of uncoordinated data systems.
Wouldn't it be great if when a patient came in, I could have all the data literally at my fingertips. Call up the x-rays, the ultrasound reports, the current EKG, order some tests and have all prior data, current data, and all interventions on a big screen right in front of my face and be able to wave my arms around and re-arrange all the information instantly just as I'd like to see it. Then be able to make a decision and document why that decision was made. One of those large computer displays like in Minority Report would be perfect.
So how do I get one of those "decision boards" like in Minority Report? Right now our computers are so cumbersome. A small screen just doesn't do it. Typing is time consuming. Even the mouse is less than optimal. You have to click here, close this and open that. Then it's hard to move data and images all around like a story and put it in a format that other Doctors can understand and it takes too much time. So then what ARE the right devices for physicians for data input, data display, and documentation?
For one thing, I believe that larger or multiple screen displays would be better for medicine. Voice recognition and transcription software needs to continue to improve. Touch-screen technology needs to be employed. If I could design software for medicine I would develop modules that would mimic the way physicians think and the way we like to see data. These modules would be like elements of a history, physical findings, test results, treatments and outcomes. Any or all elements could be combined at a particular patient encounter to support a diagnosis or treatment recommendation.
For now we must limp along, but we should always be keeping an eye on our ultimate visions of the future of healthcare. And to what extent the physician can help drive technology, we should continue to provide our input and thought process in order to put better tools in the hands of the doctor.
By way of a nice coincidence I was thinking about something parallel to this - a flexible kind of virtual wihteboard, where you could place items of info, and link them together - basically complexity in action. See the post at: http://www.stuart-hall.com/blog/_archives/2006/2/13/1758337.html
Posted by: Stuart G Hall | February 14, 2006 at 05:14 AM
Stuart:
Thanks for the link. The subject of advanced displays for medical data is an interesting way that the tail of healthcare transformation could wag the dog of medicine.
If doctors and patients could "see" the possibilities of how electronic health could benefit practictioner and patient, we'd go a long way toward building the infrastructure to make it a reality.
Posted by: Jack Mason | February 14, 2006 at 11:34 AM