University of Cyprus

As the quantity of medical information physicians need to access explodes, and as patient visit time shrinks, more and more healthcare providers rely on mobile devices and apps to quickly and efficiently access the information they need. But, how efficient is this process, and, even more importantly, how accurate is the information? The rapid growth and sharing of medical information has the potential to improve patient care, especially in areas where access to specialists is limited. However, it can also lead to medical errors and physician burnout. Consider these: Medical knowledge doubles every 3.5 years and is projected to double in just 73 days in 2021. General practitioners would need to read 20.7 hours per day to keep up with primary care literature. What a doctor learns during the first three years of medical school will amount to only 6% of what is known a decade later. Medical errors occur most often when doctors do not have quick access to evidence-based information. It may appear counterintuitive that greater access to information increases the risk of medical error, but with more than 800,000 medical papers published each year, there is no efficient way for any physician – or any human for that matter – to process it all, which means clinicians may not be current with all the latest drug and treatment recommendations. The relationship between medical error, information overload and physician burnout Medical errors are, in fact, the third leading cause of death in the United States. An estimated 251,000 to 440,000 deaths in the U.S. are attributed to medical error every year. To put this into context, 41,000 people died by suicide, 34,000 by firearms and 34,000 by motor vehicle accidents in the same period. Caring and conscientious healthcare providers are burning out as they try to manage information overload, meet excessive data entry requirements, and deal with the ever-present fear of missing an important detail or data point. I Information overload can lead to fatigue, increased stress, longer working hours and impaired decision-making. It's no surprise that today 64% of physicians report that they're burned out. The physician suicide rate is also double that of the public. First-generation software Using Google or PubMed to search for medical information may have sufficed when medicine first came online. However, the sheer volume of content available online today, much of it not peer-reviewed, only compounds the problem. Medical services that organize online data are a step in the right direction, but many of these services were introduced in the early '90s and are cumbersome to navigate when you only have minutes for each patient. Clinical decision support systems must be carefully designed and implemented, since they can easily turn from a blessing to a curse for clinicians. Mobile applications to process data and provide information To provide optimal healthcare, providers must have ready access to information in a format that can be easily processed and applied to imperfect medical situations. Here are some of the software options available to clinicians and the information they provide. Diagnosis When confronted with perplexing patient information and lab values, having access to a comprehensive list of potential diagnoses is essential. Medical mistakes can be due to a misdiagnosis, a missed diagnosis or a delayed diagnosis. Diagnostic software collects the patient's signs, symptoms and laboratory values and generates a list of potential diagnoses. The software may also justify its ranking and suggest any further studies needed to make the diagnosis. DXplain is a software platform developed at Massachusetts General Hospital that provides a list of potential diagnoses. DXplain currently includes 2,400 diseases and over 5000 clinical findings (symptoms, signs, epidemiologic data, and laboratory, endoscopic, and radiologic findings). Ada and Corti have developed AI-driven software to aid with medical diagnosis and triage at the enterprise level. Pathway provides differential diagnoses given certain clinical findings. The results are ranked by probability. Calculators Calculators are another useful tool for finding medication doses, using prediction formulas and determining intravenous fluid rates. MDCalc and Calculate by QXMD are free and widely used by practitioners. Pathway offers calculators that are contextually displayed under summarized guideline recommendations or within interactive care plans. Clinicians don't need to navigate to another screen or even another piece of software to perform calculations. Clinical reference tools Clinical reference tools are organized bodies of clinical information that medical providers can subscribe to. Reference tools like Medscape (free), Epocrates (freemium), UpToDate (paid) and BMJ Best Practice (paid) have been around since the Web 1.0 era. They bring the classic medical textbook to the browser and mobile app. These references are fairly comprehensive, but are organized as encyclopedic volumes of information. What is needed is software that provides knowledge, not information. Knowledge is contextual, personalized, time-bound and infused with value, according to Hari Tsoukas, an expert in organizational studies at the University of Cyprus. Pathway innovates on the traditional digital reference tool model by organizing medical knowledge using a structured dataset and presenting guidance simply and succinctly as integrated care plans. Landmark research summaries With over 800,000 new studies published per year, it's hard to sift through the minutia and identify the information that might improve practice methods and patient outcomes. Wiki Journal Club is free software that summarizes and reviews landmark studies across medical and surgical specialties. Pathway presents research in a summary format emphasizing high-yield information tailored for quick access and appraisal at the point of care. Drug reference Finally, all clinicians need a ready drug-reference application. Current choices include Lexicomp, IBM Micromedex Drug Ref, Pepid, Davis' Drug Guide, Pathway and Mosby's Drug Reference. Good references provide facts and comparisons, the ability to customize drug formularies, check allergies and provide patient education materials. The verdict Physician burnout and information overload contribute to medical errors and are two of the biggest challenges facing physicians today. Researchers at Stanford University discovered that physicians with burnout have more than twice the odds of self-reported medical error after controlling for other variables. Well-designed decision support technologies increase efficacy, reduce errors, improve quality of care and increase clinician, staff and patient satisfaction. Pathway is one such software. Adapted to the realities of 21st century medicine, it offers diagnostic support, calculators, clinical reference summaries, landmark research trials and drug references in a modern, intuitive and user-friendly format. According to Mayo Clinic researchers, unless information overload and other factors are addressed, physician burnout and medical error will continue to exacerbate one another. Decision support technologies have the potential to relieve pressure on clinicians if these technologies are well designed, easy to use and efficient. About the author Jay T. Ripton is a freelance healthcare, technology and biomedicine writer out of Scottsdale. He loves to write to inform, educate and provoke minds. Follow him on twitter via @JTRipton.