Health Care Context and its untapped Potential
A patient’s ailments are the result of countless factors coming together. Context enables doctors to put together the puzzle- if they understand the pieces. But how is health information validated, how is it useful, and how do we interpret it?
Medical context: How is information validated?
Validating medical information is extremely important, but it is also an obstacle course. Various information types come together and overlap. Subjective information is what the patient tells their doctor, objective information includes measurable things such as a fever of 38.5, confirmed information includes proven facts such as anemia from sickle cell disease, and a differential diagnosis shows possible diagnoses for conditions with similar symptoms. The information flow even continues after death- in 50% of obductions significant new problems can be described. Validation is a complex issue dependent on multiple information streams.
Health information should have relevant and reliable data. A Patient Chart helps decipher and understand the state of current health. Medical context can affect two similar patients with the ‘same’ problem in very different ways. Prescribing a medication which a patient can’t afford or referring another to a facility they can’t access are common mistakes resulting from a lack of context. Missing patient context not only harms patients but also increases the cost of care. The cost of such errors has been shown to be nearly eight times higher than that of a biomedical error, such as an adverse drug interaction ($231 vs. $30).
An average of 1.5 contextual “red flags” are present during each patient interaction but patients are only questioned or probed on those issues 35% of the time. Context is considered when developing care plans only 68% of the time. Although our bodies accompany us through life, people are often forgetful regarding their health. Questionnaires need to probe for answers in different ways to validate the information. For instance, a patient may not immediately recall he had heart problems, but when asked about operations he will remember his heart surgery.
Medical context: How can this information be useful?
Context directly impacts health; patients living in poor economic conditions have lower life expentancies2, genetic background plays a major role in the health of individuals3, individual behaviors affect survival rates significantly4, the physical environment affects the quality of health5, and so does the quality of available medical care6.
Medical context vs. the human mind
How to interpret medical information and avoid cognitive bias
To avoid being overwhelmed and drowning in information, our brains fill in gaps conveniently with past experiences or assumptions. People are instinctively looking for patterns and similar structures to make sense of their surroundings, leading to cognitive bias.
Time pressure causes many doctors to skip patient social context. The temptation to fill in patterns is grand. For example, a GP with 30 patients queueing up during flu season may diagnose the next serious headache as the flu, prescribing paracetamol and bed rest. However, a brain hemorrhage may be the actual cause of patient 31’s headache. A patient chart with crucial information confronts the issues of time and cognitive overload.
A lot of information from patients becomes available during personal contact between patient and doctor. MediPrepare tries to complete this information by providing validated clues and specific elements of medical context, like if the patient is divorcing, suffered the loss of loved one, is a carpenter or a CEO, Caucasian or of Maori descent. Patient context can provide indications about diseases, for example, sickle cell anemia in black people, skin cancer in white people, or mercury intoxication in hatters.
Patient context involves a myriad of things, from objectively quantifiable factors such as air pollution in a certain part of town to more subjective things machines cannot empathize with, such as the loss of a family member. Data not only provides doctors with a clearer picture but also empowers patients by showing them what kind of information is important. Patients who are aware of their own health context help both doctors and themselves. Medical context provides a bigger picture, but it also gives a complaint a face.
MediPrepare’s smart questionnaires provide a quick but complete overview of the Patient Context, opening the doors for humane communication in the doctor-patient team