Article
Translating Medical Knowledge to Clinical Practice
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Published: | April 13, 2010 |
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As life science research progressed in the 20th century to create an undreamed-of body of clinical knowledge, no parallel thought was given to methods for translating the new knowledge base into clinical action. Indeed, we carried into the 21st the late 19th Century paradigm of teaching physicians all they needed to know to manage the range of patient problems presenting on a typical day. Absence of innovative approaches for translating new knowledge to practice has led not only to significant discrepancies between clinical outcomes and what could be achieved through evidence-based application of existing knowledge but also to rapidly inflating costs of care. These problems will not go away until we confront what is obvious. The knowledge-base for everyday practice is too large to teach, learn, remember and use. Simply stated, the translation problem requires expanded human cognitive capacity in the clinical setting. Computing is the tool for doing so. There already are, of course, a multitude of computer-based applications for medical practice. But these function at the edges of the clinical method and rely heavily on the physician’s cognitive input. Bringing the full power of computing to clinical practice depends on embedding computers as core components of the health care system and not thinking of computers as add-ons. Computers can be made core components of the health care process by enabling them to interact directly with patients, physicians and laboratories to collect, integrate, interpret and store clinical data in the context of state of the art knowledge bases, which depends in turn on formalizing medical knowledge in machine-readable form. Computers deployed in this manner can have a positive impact on clinical outcomes and clinical research. I will show a method by which these goals can be reached and present data demonstrating the value of the approach in real clinical settings.