Health IT Conference. Scribe (www.scribeofegypt.com)

1. Egypt: Impact of Health IT on Medical
Practice
C. William Hanson III MD

2. The old world
 The doctor was the „high priest‟
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3. The old world
 Medical knowledge was kept by the high priests on sacred
scrolls
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4. The old world
 The patient came to the „priest‟ for information
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5. The old world
 The physician-priest dispensed „magical‟ remedies
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6. The new world
 The physician is no longer the „high priest‟
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7. The new world
 Medical knowledge is on-line
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8. The new world
 The patient can do on-line “research”
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9. The new world
 Patients able to get information about their treatments on line
 E-prescribing
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10. The evolving medical record
 Historically – the medical record represented notes of a
private encounter between a patient and doctor
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11. Medical Record (the patient‟s record)
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12. Medical Records (the hospital‟s files)
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13. Evolving medical record
 A shared electronic document
• Loss of certain privacies
• Gain of transparency
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14. Patient portal
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15. Medical Record of the Future
 A metadocument with multiple owners, maintainers and
access rights
• Patient, doctor, hospital and industry
• Healthvault
• Pointers to data
• Family members access
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16. Evolving medical education
 Of the Human
• Textbooks and lectures
• Ingestion of facts
• Lectures
• Patient interactions
• Experience (zebras vs. horses)
• Mental map
• Wisdom
 Modern medical student education
• Electronic content
• Computer simulation
• Ipads and iphones
 Of the Computer
• Top down model
• Bottom up model
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17. Medical Prtctice: Expert systems
“Should I refer?”
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18. Decision support
X
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19. Expert Data
Based Derived
Knowledge Knowledge
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20. Information
Knowledge
engine
Recommendations
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21. The pyramid of electronic information
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22.  Data are discrete symbols that represent facts. You might
think of them as recordings or statistics.
• There is no meaning or significance beyond the data’s existence.
• Data may be clean or noisy; structured or unstructured; relevant or
irrelevant.
 Information is data that has been processed to be useful. I like
to think of it as adding the first bit of context to data relating to
“who”, “what”, “where”, and “when”.
• Information captures data at a single point in time and from a particular
context; it can be wrong.
 Knowledge is the mental application of data and information.
Most consider this as addressing questions around “how”.
• Some consider knowledge a deterministic process, which is to say the
appropriation of information with the intent of use.
 Wisdom is the evaluation and internalization of knowledge. It
applies insight and understanding to answer “why” and
“should” questions.
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23. The ability to leverage big data/computing
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24. Itunes Genius
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25. Amazon book recommendations
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26. Pattern detection
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27. Telmedicine (radiology)
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28. Telemedicine (dermatology)
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29. Telemedicine (ICU)
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30. War room
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31. Surgery
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32. Robotic surgery
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33. Telesurgery
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34. Telesurgery
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35. Summary
 New ways of practice
 New relationships between doctors and patients
 New providers
 New medicine
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