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
To: 'IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG'; 'Harold Lehmann'
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?

Rana

 

From: Harold Lehmann [mailto:lehmann at JHMI.EDU] 
Sent: Thursday, May 02, 2013 10:50 PM
To: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG
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

 

-- 

***************************************************************************

Harold P. Lehmann, MD PhD

Interim Director, Division of Health Sciences Informatics

Johns Hopkins University School of Medicine

 








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