Colossal misdirection play?

We have learned of the games held in the Roman Colosseum, either through recorded history or as replicated by Hollywood and embellished for the viewer’s pleasure. To outshine their predecessors, Roman emperors would expend vast sums enhancing the imposing structure. There is evidence, according to some archeologists, that it was even modified to enable flooding for the purpose of reenacting victorious Roman sea battles. And, as people watched the games, for which no expense was spared, that great society fell into decline.

Sound familiar in a scary way? It does for me, too. It’s called the “misdirection play.” I learned it in fourth grade while playing “the game” of peewee football. It scared me then, too, just as it does today, because every time I was deceived by the misdirection play, I got hurt.

As I observe the world today, I wonder if I am witnessing the undoing of another great society. There are certainly many parallels that can be drawn between today and Roman times, and there are certainly many more coliseums. If history is on a path to repeat itself, what will the role of technology be? Savior or contributor to the destruction?

As people watched the games, for which no expense was spared,
that great society fell into decline.

The reason I ask this question is because of a recent vacation experience I had with two children, of whom I am not the parent. The purpose of this vacation was to expose these kids—ages 6 and 9—to the “Great Outdoors.” I applaud their parents for choosing this option over a theme park-based trip. But, as it turned out, when given a choice between going inside to play with technology or going outside to take a walk in the woods and experience nature—perhaps to see real animals in lieu of stuffed ones at gift shops in town—they chose technology.

As I processed these children’s interactions with technology, my mind was flooded with questions: Will they use it to cure cancer? Will they use it to go to Mars and back? Will they use it to find a way to solve the problem of the world’s ever-increasing demand for energy? One could ponder many other questions about the dark side of technology. But the question I kept coming back to was not how they might use technology, but how technology would be applied to them?

Recent events reported in the media have put “Personal Big Data” front and center in the public eye. There is no doubt that social media with all its underlying and associated technologies—one source of big data—have been demonstrated to have positive social benefits. But, in all fairness, we have also seen its negative social impact. So, two questions: 1) “Is technology in the hands of future generations going to have a net positive or negative effect on the future?” And 2) “Will technology, in this coliseum of the future, be a big misdirection play where everybody feels like they are in the game, but where no one goes outside to see the animals until, finally, they’re not there to see?”

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International. Comments are moderated. Those that promote products or services will not be posted.

The provider side of big data

We have entered the age of “Big Data.” I’m not certain how this age differs from the Information Age, but a statement by Dan Ariely, James B. Duke Professor of Psychology and Behavioral Economics at Duke University’s Fuqua School of Business and director of Duke’s Center for Advanced Hindsight, provides an interesting perspective: “Big Data is like teenage sex: everyone talks about it, no one really knows how to do it, and everyone thinks everyone else is doing it, so everyone claims they are doing it.”

So, if we are in the prepubescent stage of health care informatics, what does the future hold?

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The focus of big-data analytics today is on what I like to refer to as “patient-side data.” Investments being made to analyze patient-side data, evidenced by IBM’s recent agreement to implement natural language processing (NLP) in Cerner’s electronic medical record (EMR), are staggering. These data analyses run the gamut from genomic deconstruction for the purpose of individualized chemotherapy intervention to population-based trending of indicators beyond imagination. If these analyses result in actionable information, which I have no doubt they will, the actions required will not take place in a vacuum. More data is needed if these new discoveries are to reach their full potential.

I am a believer in Occam’s razor, a principle of parsimony. To paraphrase, the solution with the least number of variables is usually the one that should be employed. The Synergy Model, just one such parsimonious exemplar, provides a framework that may help us think about the other side of the big-data coin—“provider-side data.” The Synergy Model tells us that both patient and provider have specific characteristics which, when aligned, optimize patient outcomes.

We’re just beginning to scratch the surface in capturing and interpreting patient-side data, but we’re even further behind the curve when it comes to the provider side of the equation. Not long ago, the most we knew about members of our staffs is that they had licenses and could fog mirrors. With the advent of learning management systems (LMS), we can now track employee education. However, this remains a highly compliance-driven function. 

With the advent of the EMR, we’ll be able to aggregate provider-patient interaction data, such as the number of specific procedures completed by a practitioner. Data like this can be used for purposes such as credentialing and certification—in other words, quantitative data generated to support compliance-driven activities. Will the holy grail of improved patient outcomes be found in the check boxes of an EMR or the compliance report of an LMS? I think not.

Just as patient characteristics described by the Synergy Model relate to data found in the patient narrative, so too provider characteristics relate to data found in the provider narrative. Whether the professional narrative be found in the EMR (through documentation of patient interactions) or the professional’s development record (a narrative resource as rich as the patient's narrative), they are equally important in influencing patient outcome.

So, as we mature in the age of big data, what will the role of provider-side data be? Will it be purely regulatory, or will it begin to capture today the qualitative provider-side data we need to influence patient outcomes in the future?

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International. Comments are moderated. Those that promote products or services will not be posted.