In my post on the EHR Bubble, Don B offered this strong statement:
“Recognizing the non-structured information is more valuable to the practitioner than discrete researcher oriented data.”
I love people that make strong statements and this is no exception. This is a comment that will no doubt hit people the wrong way when you consider how much focus things like meaningful use have focused on discrete data. I can already hear the chorus of doctors asking why meaningful use wants all this discrete data if the non-structured data is where the value is for practitioners.
There are a lot of nuances at work that are worth discussing. I agree with Don B that at this point in time the non-structured information is more valuable to a physician than the discrete data. I’d also extend that comment to say that non-structured information will likely always have value to a practitioner. There are just certain parts of physician documentation that can’t be discrete or at least cost far too much to make them discrete. I’m sure the EHR narrative crowd out there will love this paragraph.
Although, even proponents of the EHR narrative realize the value of discrete data elements. That’s why companies like Nuance and MModal are investing so much money, time and effort into their various NLP (Natural Language Processing) and CLU (Clinical Language Understanding) offerings. The key question for these companies has never been whether there was value in discrete healthcare data, but in how you capture the discrete healthcare data.
When thinking about discrete healthcare data I hearken back to a post I did in 2009 that asserts the Body of Medical Knowledge Too Complex for the Human Mind. This concept still resonates with me today. The core being how does a physician take in all the patient data, device data, lab data, medical data, research data, etc and provide the patient the best care possible. This will never replace the physician (I don’t think), but I expect the tools will become so powerful that a physician won’t be able to practice medicine without them.
Much of the power required for computers to assist physicians in this way is going to come through discrete data.
Over the next 2-3 years we’re going to start seeing inklings of how healthcare will improve thanks to discrete data (often captured through and collected by an EHR). Then, in the next 5-10 years we’re going to see how healthcare couldn’t survive without all the detailed healthcare data.