Task Guide: Additional Resources was: checklist vs. checklist

Lorri Zipperer Lorri at ZPM1.COM
Fri May 3 14:32:09 UTC 2013

From: Samuel, Rana [mailto:Rana.Samuel at va.gov] 
Sent: Friday, May 03, 2013 8:13 AM
Subject: RE: checklist vs. checklist


I think there are already a lot of resources available (uptodate is one that
I use frequently) that take just a few moments to review and are excellent
at alerting me to differential diagnosis alternatives or unusual
presentations. The problem is that most physicians choose not to use these
resources (again: time constraint vs lazy). The challenge seems to be: how
do you engineer a system to ensure the use of additional resources beyond
individual training and memory?



From: Harold Lehmann [mailto:lehmann at JHMI.EDU] 
Sent: Thursday, May 02, 2013 10:50 PM
Subject: Re: checklist vs. checklist


I have been thinking for a while of the concept of a "Task Guide"---where an
authority (faculty member; a crowd) sets up the sequence of steps required
to accomplish a task and, for each step, suggests a number of resources that
could help the user. The classic use case is evidence-based medicine, where
the steps are "Find appropriate guideline; find appropriate systematic
review; search PubMed Clinical queries," etc. At each step, there are links,
e.g., to databases of guidelines, to appraisal guides.


So when I look at this list that Ross has assembled, I am thinking, can we
assemble resources that speak to each step? They may be System 1 or System 2
oriented, I suppose.


E.g., I can imagine a user asking, "Can you help me think of other known
causes of this problem?" [Yes, these are differential-diagnosis lists from
textbooks, review articles, or diagnostic decision support systems.] "Can
you help me maintain an open mind?" [Probably the same list.] "How do I know
when the timing is complete?" [Resources on good interview technique]. Etc.


Such a resource list yoked to good practice might provide a way of us
projecting to the larger community what we know about overcoming barriers to
improving diagnosis in medicine and providing direct help.






Harold P. Lehmann, MD PhD

Interim Director, Division of Health Sciences Informatics

Johns Hopkins University School of Medicine


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