Jonathan Woodson, MD, is the head of Boston University’s Institute for Health Systems Innovation and Policy and the Larz Anderson Professor in Management at the school’s Questrom School of Business. As U.S. assistant secretary of defense for health affairs from 2010 to 2016, he oversaw health care for all active members of the U.S. military.
In a landmark 2016 study Johns Hopkins researchers estimated that more than 250,000 Americans die each year from treatment-related mistakes, making medical error the third-leading cause of death in the United States. As a former military flight surgeon trained in aviation accident investigations, I know well the hazards of misusing or mistrusting instruments. In contrast to health care, aviation has been an early adopter of decision-support technology…”
The good Doctor points to a number of Aviation Advances (as a safety professional, isn’t it great to have other industries cite our work as an example of good practices). Having read the 2016 study, the medical profession has devoted considerable research into what might be called “Physician, heal thyself.”
The initial source for this field of study is the 1999 tome TO ERR IS HUMAN: BUILDING A SAFER HEALTH SYSTEM The point of Dr. Woodson’s paper has been put into language and a medium suitable for the general public in a documentary entitled “To err is human”.
The phrase was first coined by Alexander Pope in his 1711 poem An Essay on Criticism
What aviation “instruments” were found by Dr. Woodson to be relevant to Medicine:
- Though health care is still in the early stages of adopting AI and digital technologies, it is already making great strides. In radiology such technology will augment human competence in image recognition. Digital technology now assists with detection of diabetic retinopathy, heart arrhythmias, and dermatologic diseases. Diabetes care will be enhanced through wearable sensors and AI to detect or prevent harmful hypoglycemic episodes. Remote monitoring will prevent or detect deterioration in chronic conditions such as asthma, chronic obstructive pulmonary disease, and congestive heart failure, reducing costly hospital re-admissions. And technology has the potential to connect medical professionals across the continuum of care, reducing the potential for patients to fall through the cracks.”
- In medical education and professional development, cognitive computing and robust simulation platforms can shorten training times and provide safer environments for learners to make mistakes. Simulation platforms allow better training to standards and can be adjusted to the learner’s pace of learning. They also allow in-depth training in tasks, demonstration of cognitive knowledge, exercise of judgment, and improvement in team dynamics.
- Digital health assistants (also known as digital coaches and virtual assistants) can help doctors take a more complete patient history and augment patient education.
- AI-enabled technologies can help provide more accurate diagnoses earlier (studies have shown 20% to 30% of initial diagnoses are wrong) and provide more accurate treatment plans.
- AI technologies and digitization will also be critical for helping create the “learning health system” envisioned in the federal “Precision Medicine Initiative” inaugurated in 2015 (and now known as “All of Us”).
- Neural networks will be able to mine medical records, design personalized treatment plans, accelerate new drug discovery, and help mitigate social determinants — like housing, education, availability of nutritious food, neighborhood violence, and more — of adverse health outcomes.
- The virtual-reality and gaming technology will provide better and more efficient skills development and will also improve patient engagement in their own well-being.
- Wearable sensors will provide the platform for connected health systems and proactive management of chronic disease to prevent deterioration.
- The “internet of medical things,” connecting health care providers with medical monitoring devices, could make the home the front line in health care, where chemotherapy, dialysis, antibiotics, and other treatments could safely be delivered, using AI and digital decision-support technologies.
- Enhanced data analytics and modeling will open opportunities for personalized health-management strategies and better population-health management.
What is not really mentioned directly (INDIRECTLY? “Digital health assistants”…“learning health system”… “internet of medical things,”) is the aviation systems growing dependence on Big Data, FOQA, ASRS, VDRP and SMS.
SIMPLICITICALLY AND SUMMARILY: The numbers collected by the FAA from certificate holders through a variety of data portals are then analyzed to detect significant trends from predictors (sometimes based on small number of, but significant occurrences). Then a 3600 perspective of managers are tasked to develop solutions to the risks based on prioritization.
That systematic, integrated approach is not explicitly acknowledged in the Woodson paper. Symbolically, the dials used at the head of his paper are →as anachronistic to today’s digital instrumentation →as his recitation of the systems, which he says are being used now to today’s SMS preventative, data-based approach.
It would seem that the Medical Profession has more to learn from Aviation’s improvement in its management of risk.
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