In this issue: Time to replace doctors’ judgement with computers

Abstract

Informaticians continue to rise to the challenge, set by the English Health Minister, of trying to replace doctors' judgement with computers. This issue describes successes and where there are barriers. However, whilst there is progress this tends to be incremental and there are grand challenges to be overcome before computers can replace clinician. These grand challenges include: (1) improving usability so it is possible to more readily incorporate technology into clinical workflow; (2) rigorous new analytic methods that make use of the mass of available data, 'Big data', to create real-world evidence; (3) faster ways of meeting regulatory and legal requirements including ensuring privacy; (4) provision of reimbursement models to fund innovative technology that can substitute for clinical time and (5) recognition that innovations that improve quality also often increase cost. Informatics more is likely to support and augment clinical decision making rather than replace clinicians.

Use of a software in the ICU

“…[3] Built-in Electronic Decision Support (EDS) systems have the potential to help the clinician to analyse the data if the customisation is done correctly, but as of today, we still need more improvements in EDS technology to replace human judgement. [7] Most of the EDS modules are focused on specific, clearly defined problems based mostly on one parameter and cannot be relied on in complex scenarios compared to a clinican's reasoning. For example when the heart rate of a patient rises above 100 beats/min the EDS still cannot do the differentiation between agitation, seizure, fever, sepsis, electrolyte abnormalities, e.g., because to do that, it needs much more than complex algorithms: Clinical observation, physical examination and experience are still important tools in the arsenal of an intensivist.…”

The robot will see you now?

“…These systems could be enhanced by employing computer-aided decision making with these data,5 but it is important to ensure that proper governance with regard to data security and access is maintained 6…”