Sunday, October 4, 2015

Information Technologies Alone Will Not Solve Mankind’s Health Imperfections

Whoever thinks a faultless piece to see
Thanks what ne’re was, nor is, nor e’re shall be.

Alexander Pope (1688-1744) , An Essay on Criticism

It ‘s Sunday, my reading day. I’m reading The New York Times Book Review, Paul Theroux’s Deep South: Four Seasons on Back Roads (2015, Houghton Mifflin), and a Healthleaders Media article, “Health IT Not Living Up to Promises”.

Everything I read strikes a similar theme, mankind is imperfect, and modern IT developments – the Internet, the global IT economy, and IT health reform – will not make everything perfect.

The Times
reviews two information technology books - Reclaiming Conversation: The Power of Talk in a Digital Age, by Sherry Turkle (born ins 1948), an MIT sociology professor in close touch computer engineers; and Changing The Subject; Art and Attention in the Internet Age, by Sven Birkets (born 1951) , a American essayist filled with dread and terror of how the Internet is damaging human values and who has collected 17 impassioned essays to justify his dread. Both authors express concern that “infoglut” is demeaning human values , and causing humankind is becoming isolated, obliterating the art of human conversation, and creating immunity to human empathy in a depersonalized world.

Paul Theroux, who has written 48 fiction and nonfiction books, writes of travelling by car on back roads through the Deep South. Theroux is a Yankee who lives in Cape Cod, but he is sympathetic to those caught up in the poverty of the rural South, particularly blacks. He speaks of the loss of manufacturing jobs to lower paid foreign workers, of the influx of India-trained physicians who are now the chief source of primary care in much of the South, of the openness and willingness of Southerners to tell their stories and share their grievances and biases without a shred of guilt. In the October 4 New York Times, “The Hypocrisy of ‘Helping the Poor,’ he laments the fact that America’s IT multibillionaires, who make products in China, like , Apple, Microsoft, and other Silicon Valley IT firms, rather than risking making less , should pay Southerners fairly and bring jobs back to America. Theroux does not mention part of the problem may be that the U.S. has the highest corporate income tax in the world and a raft of corporate regulations, including health care mandates.

In the Healthleaders Media , “Health IT Not Living Up to Promises, “ the author reports that 5% of patients experience diagnostic errors and wonders why IT technologies – electronic health recorders, clinical decision support, patient IT engagement through social media, CPOE (Computer Physician Entry Ordering), electronically-driven laboratory and imaging, and health information exchanges - have not reduced diagnostic errors to near zero.

That computer programs require human imput, that patients do not always relate truth-proof stories relating everything diagnosticians need to know, and that entering and gathering all the data demands time away from gathering the needed information or holding the necessary conversations, seems to escape the attention of IT zealots .

Computer algorithms are only as good as the completeness and accuracy as the human information entered. Its GIGO – “Garbage In, Garbage Out,” a computer users’ aphorism from the 1970s. IBM’s computer Watson may be able to beat human competitors as on Jeopardy. Clinical diagnosis is a jeopardy game, but unlike TV Jeopardy, the requisite comprehensive information is not necessarily there.

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