Machine Learning , some thoughts

Stefan Sauermann sauermann at technikum-wien.at
Wed Jun 27 05:57:05 EDT 2018


Dear all,
please be assured that myself and many others here and elsewhere support 
the need to record information, for the sake of treating patients, no 
matter if there is an archetype or not.

Probably this discussion circles around the fact that "informatics" 
types of persons always are looking for structures in information. This 
is their job. They care for information. This always starts with a 
well-defined use case, and introduces limits.

Doctors and nurses deal with information, in any way it comes. They care 
for the patients. They can not accept limits on the information they 
must store. I agree completely that it is not possible to know which 
information is relevant, and that all information is better recorded 
just in case (accepting only the limits of resources and time for those 
who do the recording).

Both is fine and exactly as it should be (to my mind).
We are lucky, in that all information can be stored and processed, no 
matter if structured or unstructured.
Again this confirms my observation that we need to cooperate across our 
disciplines, to get the most out of all fields. Great job for me!!

Looking forward,
Stefan

Am 27.06.2018 um 00:18 schrieb Bert Verhees:
> Thanks for supporting reactions.
>
> It is really typical in western medical science that it is very 
> problem oriented. All EHRs, even unconventional one, even the new 
> thinking, it is very problem oriented.
>
> All data are gathered around a problem and in relevance of a problem. 
> All datastructures are pointing to a problem. Without problem there is 
> no datarecording.
>
> It is historically grown like that. Medical data collecting is only 
> done by clinicians, and only when a patient has a problem, the data 
> around the problem, the diagnosis, and the treatment, that is 
> important. Data which do not have a known relevance are not recorded.
>
> And when the patient has a new problem, the only information available 
> are the problems in history. Information about lifestyle is unknown. 
> One can ask the patient, but some patients have a selective memory.
>
> But in sports this is different. Medical datarecording also happens 
> when there is no problem, but as daily routine. But now, many people 
> today, also no-sport people, I wrote before today, measure data many 
> times. Apple patented a blood pressure device in Applewatch. It is 
> cheap, easy to do.
>
> It will not take long and people have their own EHR at Google, Amazon, 
> Microsoft, Walmart or Apple, to record their daily medical data. They 
> maybe will be able to demand that GP's store their findings in that 
> EHR, so a more holistic view about the patient will become available, 
> and maybe insurance companies will reward access to that holistic view.
>
> We must prepare for that, the face of healthcare will change. Until 
> now it was problem-care, which we called in Orwellian tradition 
> Newspeak: healthcare. But it will change to really healthcare. It is 
> something completely different, and it happens fast.
>
> I learn also from this, while writing I learn. But I have said it all. 
> Now it would be nice to discuss how to implement healthcare instead of 
> problemcare.
>
> Bert
>
> Op di 26 jun. 2018 22:18 schreef Karsten Hilbert 
> <Karsten.Hilbert at gmx.net <mailto:Karsten.Hilbert at gmx.net>>:
>
>     > But the person should be seen as more then a medical complaint,
>     but as a
>     > complex of conditions and lifestyle.
>     > We need generic archetypes which can store machine generated
>     datasets to
>     > store information about the whole person, instead of only the
>     medical
>     > condition which is subject of conversation.
>     >
>     > I believe I am the only person in this list who thinks like
>     that. But
>     > that does not matter.
>
>     Actually, any worthwhile GP thinks like that (except we don't say
>     things like "datasets" or "generic archetype").
>
>     I rather doubt you are alone in this. Even on-list.
>
>     Karsten
>
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