Saturday, December 16, 2006

Sharing and playing with models: A practical example

In my last post, I discussed the value of sharing and playing with models in loosely connected networks of people. In this post, I’ll give an example of this process.

One type of model is a patient profile report (from an EMR/EHR). These reports may be designed to assist providers in making diagnostic and treatment decisions, as well as tracking treatment progress and outcomes. As such, providers in different healthcare disciplines require different information about their patients. A primary care physician, being a generalist, would benefit from a broad spectrum of information, covering biomedical, psychological, and environmental factors. While all providers would benefit from information about current medical conditions, medications being taken, alergies, vital signs, basic lab results, medical history, etc., a specialist would benefit from a more in-depth sub-set of information related to their area of specialization.

For example, a cardiologist would benefit from data related to heart functioning, such as location of chest pain, ST elevation or depression, Q waves or left bundle branch block, T wave inversion or hyperacusis, CKMB and Troponin T or I levels, and heart imaging studies, etc. A dentist would benefit from information about previous dental work done, dental x-rays, exiting medical conditions affecting teeth and gums, etc. A mental health practitioner would benefit from detailed information about the relationship between a patient’s thoughts, emotions, and behavior, as well as psychosocial data, etc. An integrative/integrated medicine practitioner would benefit from addition information about the mind-body connection, metabolic functioning, etc. And a personal health profile report (from a PHR) would benefit the patient most if it included risk appraisal and self-management information in lay language. And so on … Different models for different folks.

So, what’s the best way to decide what the contents of specific typpe of a health profile report model should be? I suggest I good way to do this is with loosely connected groups of individuals connected through virtual communities who collaborate to develop useful models. They would create, exchange, compare, discuss, debate and evolve the models, as I discussed in the previous post.

As way of example, here’s a link to a holistic (mind-body-environment/biopsychosocial) personal health profile report model I developed. Imagine how much could be accomplished if networks of loosely connected healthcare professionals and consumers were to collaborate around such models by ripping it apart, modifying it, and rebuilding it meet their particular needs.

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