Power of Humanistic-HIT Technology Integration

It is in Apple’s DNA that technology is not enough – it’s technology married with the liberal arts, married with the humanities that yields us results make the heart sing.

Steve Jobs (1955 -2011), Inventor of Apple Computer and Developer behind IPad, IPod, and IPhone, Interview with Forbes, 2011

January 2, 2012 - I have a confession to make. I am a humanistic-HIT technology flip-flopper.

As you know, “flip-flopper” is a term derisively applied to politicians who change their opinion in the face of new information or political opportunities. For this conversion to new realities critics deride politicians as crass opportunists – as snakes in the political grass.

But, in my opinion, these late blooming conversions may also be a sign of maturity - Mitt Romney deciding Obamacare has its faults, Newt Gingrich abandoning the individual mandate, or even Barack Obama transforming himself from a political unifier to a political divider by attacking a do-nothing Congress.

In my case as a clinical pathologist through the years, I stoutly maintained that human use of information technologies was more important than the technology itself.

• In the 1970s, I came out with the idea of Diagnotes, list of diagnostic possibilities attached to abnormal lab tests, with the idea that the human mind could separate the wheat from the chaff.

• In the early 1980s, I used an early version of the Internet to organize lab reports into UNIPORTs (Unified Presentation of Relevant Tests), which displayed patterns of abnormal results into differential diagnoses, which doctors could sort through and choose the pick of the litter.

• In the mid-1980s, I developed a report called the Health Quotient, a computer algorithm converting ordinary body physical measurements, clinical historical information, and certain lab tests, into the HQ, the analogue of the IQ, except it applied to physical health rather than intellectual measurement.

• After 2007, in a book Innovation-Driven Health Care (Jones and Bartlett) and Medinnovation Blog, I insisted the primary value of Health Information Technologies resided in their humanistic value rather than in the technological achievements.

Certain developments have caused me to change my mind. I have slowly come to believe the technologies themselves contribute more to humanism than humanism itself.

These developments include:

• The use of clinical algorithms to convert the histories of patients into human narratives.

• The deployment of sophisticated computer applications to accurately digitize human speech into language speakers and readers recognize and understand.

• The application of computers to aggregate seemingly random information into integrated bodies of information with diagnostic, prognostic, and treatment import at the point of care.

I have, in short, become a believer that health information technologies yield humanistic opportunities beyond what I imagined.

In his book, Adventurers of a Bystander(1978), Peter Drucker (1909-2005), presented two prophets as representative of a technology-driven world.

--One, Buckminster Fuller (1895-1983) “Synergy means behavior of whose systems unpredicted by the behavior of its parts”;

--Two, Marshall McLuhan (1911-1980) “The new electronic interdependence recreates the world in the image of a global village/"

Drucker's message was this:

Suddenly, in the 1960s, technology was seen as a human activity; formerly it was always known as a "technical" activity, carried out by God knows whom or what, presumably by "elves in the Black Forest." Technology moved from the wings of the stage of history to which the “humanist” had always consigned it, and began to mingle freely with the actors and even, at times, to steal the spotlight. The first response to such a change in awareness is always violent rejection. It would be so much easier if the change could be made undone.

If only we could return to the nice “humanist” world in which ideas, values, aesthetics, and knowledge are disassociated from such grubby things as how people make a living, produce their tools, and above all in which they are divorced and disassociated from how men work.

And finally, David Blumenthal, MD, MPP, neatly wraps it all up the case for Health Information Technologies:

Information is the cornerstone of good clinical care and vital to all the objectives of our health care system. It is inconceivable that the health system will indefinitely resist a force that is transforming modern civilization and that offers almost infinite promise for improved and more efficient care.” (David Blumenthal, MD, MPP, “Implementation of the Federal Health Information Initiatives, New England Journal of Medicine, December 22, 2011).

Tweet: The greatest innovation in the 21st century will take place at the intersection between the humanities and information technology.