Researchers want a better system for fixing bad science | The Verge

Bob Latino blatino at RELIABILITY.COM
Tue Feb 9 12:50:03 UTC 2016

The U.S. spends ~17% of its GDP on Healthcare or about $3 Trillion/yr (or ($9,323/person).  It is hard to believe we do not throw enough money at it.  It is how we use the monies so inefficiently and ineffectively that is the problem.  For all of the money thrown at HC, our mortality rates as compared to the rest of the world do not demonstrate ours was money well spent.  Why not?

To put this into perspective France and Switzerland spend 11% of their GDP on healthcare.  The Middle East spends much less (see below).

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Definition: The crude death rate is the number of deaths occurring among the population of a given geographical area during a given year, per 1,000 mid-year total population of the given geographical area during the same year.

Because the manner in which death rates are collected, deaths due to 'medical' error are not uniformly collected or collected at all in many countries.  So the only uniform measure of death is called the 'crude death rate' around the world (see definition above).  Deaths due solely to medical error are included however, the split (%) is not discernible.  Regardless, when you look at the investment in HC as opposed to GDP, and overall crude death rate/1000 total population, the numbers are varied and quite startling.  Why do these countries with the lowest investment in HC as a % of their GDP, also have the lowest crude death rates in the world?

I know there are many researchers on this forum who will chew this up and explain to us the reasons; but as a layman, I am interested in learning why.

Irrespective of what the studies in the link Rob provided conclude, just sitting in any hospital for a day and observing, one can make a list of errors for themselves.  To me, it is hard to imagine a hospital stay without an error occurring the course of the delivery of care.  Both of my parents passed in the last 9 years and both were in ICU's for 2 - 4 weeks.  We stayed with them 24/7 during those stays.  I kept daily lists of the errors and worked with the Risk Managers to resolve.  I know what I am looking for, just think of those who do not and just 'trust' their care givers and their delivery of care systems. Are they told of these errors?

I believe Rob's point is not that the errors are not occurring, but what is the scope and magnitude of them?  How do we accurately identify, quantify and prioritize them so we can focus on solving them in a logical manner?  How do we do this in a fashion where actions replace words and change can be observable in the near term (instead of during our lifetime)?  Certainly there are more complex issues that will take longer to resolve but I believe the 80/20 applies here as well.  I suspect that 20% or less of the error types (Failure Modes we call them in my business) account for 80% or more of the total occurrences.  Certainly we can act on this 'low hanging fruit' in the 20% range (or what we call the Significant Few).

Bob Latino

Robert J. Latino, CEO

Reliability Center, Inc.


blatino at

-----Original Message-----
From: Robert Bell [mailto:0000000296e45ec4-dmarc-request at LIST.IMPROVEDIAGNOSIS.ORG]
Sent: Monday, February 08, 2016 10:09 PM
Subject: [IMPROVEDX] Researchers want a better system for fixing bad science | The Verge

This supoports the concept that the diagnostic infrastructure is overall in a bad state. Is money the big problem - too much or too little?

Rob Bell

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