Triggering Questions> was: Lack of time, knowledge or just sloppy thinking?

Ross Koppel rkoppel at SAS.UPENN.EDU
Thu May 2 19:11:02 UTC 2013


I should hope that a radiologist would not need to look up a list of 
common things associated with a fracture.....be it in a book, a 
computer, or a voice-activated computer.

Ross Koppel, Ph.D. FACMI
Sociology Dept and Sch. of Medicine
University of Pennsylvania, Phila, PA 19104-6299
215 576 8221 C: 215 518 0134

On 5/2/2013 2:04 PM, Stefanie Lee wrote:
> Firstly, pleasure to be part of this group and discussion.
>
> In response to this and the other thread on satisfaction of search in 
> radiology, I envision a solution based in the technology we use to 
> produce reports.
>
> With the advent of voice transcription software, a dictation of 
> "positive for fracture" could trigger the system to prompt the 
> radiologist about other findings commonly associated with fractures - 
> e.g. are there any additional fractures? any evidence of dislocation? 
> - and to address them if not already explicitly mentioned in the report.
>
> There may be a role for structured reporting as well - for example, a 
> trauma hand radiograph template with fields for fractures, 
> dislocations, additional findings, etc.
>
> As a soon-to-be radiologist, I am interested in exploring such 
> potential solutions further. Is anyone here involved in SIIM or 
> imaging informatics more generally?
>
> All the best,
> Stefanie
>
> On 2 May 2013 09:25, Lorri Zipperer <Lorri at zpm1.com 
> <mailto:Lorri at zpm1.com>> wrote:
>
>     *From:*Diane Zuckerman [mailto:diane at ebsolutions.com
>     <mailto:diane at ebsolutions.com>]
>     *Sent:* Thursday, May 02, 2013 6:05 AM
>     *To:* Society to Improve Diagnosis in Medicine; Peggy Zuckerman
>     *Subject:* Re: Lack of time, knowledge or just sloppy thinking?
>
>     Well stated, Peggy.
>
>
>
>     Now we need a simple solution to trigger those questions and
>     cognitive support that is particular to the diagnosis presupposed
>     - not just a laundry list of differential diagnosis.
>
>
>
>     Diane Z
>
>     On May 1, 2013, at 3:25 PM, Peggy Zuckerman wrote:
>
>
>
>     The reality is that our various strengths and weaknesses have led
>     us to be the biologically advance and DIVERSE kinds of creatures
>     that we are.  With that diversity comes the obvious physical
>     differences, but also includes diverse ways of processing
>     information.  One can call that "types of intelligences", with
>     some people having greater spatial skills, others greater
>     mathematical processing or insight, others more skilled at
>     learning foreign languages, and so on.
>
>     The great weakness in this codified system is that the
>     practitioners often have the same type of thinking--it does
>     require a lot of similar skills to get through medical school vs
>     art school--and that can become a self-limiting approach in making
>     a diagnosis.  In the case of a difficult diagnosis, we can all
>     certainly bring a cognitive skill to this by asking, "What am I
>     missing here?" or "How else can I approach this problem?".  That
>     is essentially asking for a reset to "start" at a time at which
>     there seems a need for a decisive action.  The decisive action
>     could also be that return to the basics, to start again, while
>     acknowledging one's own tendencies and style of thinking.
>
>     Peggy Z
>
>
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> Moderator: Lorri Zipperer Lorri at ZPM1.com, Communication co-chair, 
> Society for Improving Diagnosis in Medicine
>
> To learn more about SIDM visit:
> http://www.improvediagnosis.org/
> Save the date: Diagnostic Error in Medicine 2013. September 22-25, 
> 2013 in Chicago, IL.
> http://www.dem2013.org 








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