BACK of the BOOK
Diagnosing Through the Social Network
“ The world is becoming one big clinical trial . Humanity is generating streams of data from different sources every second . And this information , continuously flowing from social media , mobile GPS and wifi locations , search history , drugstore rewards cards , wearable devices , and much more , can provide insights into a person ’ s health and well-being . It ’ s now entirely conceivable that Facebook or Google – two of the biggest data platforms and predictive engines of our behavior – could tell someone [ he / she ] might have cancer before [ he / she ] even suspects it . … Using social media cues to help someone recognize that [ he / she ] may have the flu could prompt users to seek testing or treatment , both relatively benign and inexpensive interventions . But a cancer scare suggested under similar circumstances could carry more serious consequences , ranging from emotional trauma to expensive and potentially harmful tests and treatments . … Sharing these insights and predictions could save lives and improve health , but there are good reasons why data platforms aren ’ t doing this today . The question is , then , do the risks outweigh the benefits ?”
— Sam Volchenboum , MD , on the implications of using social media cues to make predictions about health and disease , in Wired
EHRs : Helping or Hurting ?
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Electronic health records ( EHRs ) were developed to help clinicians share information and coordinate patient care , but many clinicians worry that EHRs now function as documentation for billing and quality reporting , rather than as an aid to doctors . On NPR and KQED ’ s “ Future of You ” blog , people express their frustrations with the EHR system , which appears to be hurting doctor-patient communication .
“ There is nothing more frustrating to a patient than talking to [ a ] doctor , wanting advice , and that provider is typing away and looking at a computer screen instead of the patient . That most fundamental aspect of human communication , which is eye contact , now is being robbed from the medical encounter because of the EHR . … As a provider , you ’ re thinking about the mechanics of the documentation , rather than the implications of the symptoms and findings .”
— Lloyd Minor , MD , dean of the Stanford University School of Medicine
“ It ’ s important to note that the EHR is an incredibly powerful tool . There are tremendous things you can do with the EHR . You can automatically alert patients about their conditions , for example . The lesson I ’ ve learned is that the EHR requires work to make it work . I remember back in the old days of paper medical records … not being able to find a patient ’ s chart was just maddening . We don ’ t have that anymore .”
— Albert Chan , MD , a family practice physician and the chief of digital patient experience for the Sutter Health Network
“ EHRs took a turn for the worse after Congress tried to get physicians to prove they were meaningfully using them in the HITECH Act of 2009 . Those arbitrary rules … transformed all of this into busy work and nonsense . Documentation is still there , so blaming the computer for what insurers and the government are requiring you to do is misplacing the blame .”
— Will Ross , a project manager at Redwood MedNet , a nonprofit health information exchange in California
Medical School Without the “ Sage on a Stage ”
Medical schools across the country are adopting active learning methods – dividing students into small groups and having them solve problems , instead of having students take notes from “ a sage on a stage .” In The Washington Post , medical students and professors discuss the advantages and challenges of the “ no-lecture ” curriculum .
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“[ In our model ], you ’ re expected to learn the information prior to attending [ a class ]. You do your homework first . Then you come and work , usually in groups , to solve a problem based on that knowledge . [ Active learning ] creates a stickier learning environment where the information stays with you better and you have a better depth of understanding .”
— William Jeffries , PhD , senior associate dean for medical education at the University of Vermont ’ s Larner College of Medicine
“ The real meat of these sessions , if you ask me , is really in the reasoning through different answers . The main complaint I have is when active learning sessions aren ’ t run particularly well , the atmosphere becomes a little chaotic . Instructors sometimes struggle to maintain control , [ but ] if the class is run well , you genuinely do not have to revisit that material .”
— Collin York , a medical student at Larner College of Medicine
“ Retention after a lecture is maybe 10 percent . If that ’ s accurate , if it ’ s even in the ballpark of accurate , that ’ s a problem . When you go into a lecture in medical schools across the nation , you will find a minority of students actually present . Medical students are adults . One generally believes that adults try to make decisions that are in their best interests . They have seemingly made the decision that it is not in the lectures .”
— Charles G . Prober , MD , senior associate dean for medical education at the Stanford University School of Medicine
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