Intended for healthcare professionals

Information In Practice

New connections between medical knowledge and patient care

BMJ 1997; 315 doi: (Published 26 July 1997) Cite this as: BMJ 1997;315:231
  1. Lawrence L Weed, presidenta
  1. a PKC Corporation, 1 Mill Street, Box A-8, Burlington, VT 05401-3078, USA


    Upon this gifted age, in its dark hour, Rains from the sky a meteoric shower Of facts … they lie unquestioned, uncombined.

    Wisdom enough to leech us of our ill Is daily spun, but there exists no loom To weave it into fabric Edna St Vincent Millay1

    The meteoric shower of medicine's scientific achievements can overwhelm a doctor's mind. A patient has no assurance that his or her doctor is able to take into account all relevant scientific knowledge and integrate it with detailed data about the patient's own condition. Yet few doctors, patients, or policy makers recognise that modern information tools can become the loom for weaving these two bodies of knowledge into a fabric. In fact, few recognise the dimensions of the problem.

    This state of affairs has one underlying cause: misplaced faith in the unaided human mind. Medical practice requires tools to extend the mind's limited capacity to recall and process large numbers of relevant variables, just as medical science requires the microscope to extend our capacity to see at the microscopic level. We must abandon the arrogance of professional “expertise” that shuns such tools. Instead, we must use the new tools routinely as they are developed for more and more diagnostic and management problems.

    Summary points

    Medicine lacks an information infrastructure to efficiently connect those who produce and archive medical knowledge to those who must apply that knowledge

    There are serious “voltage drops” along the transmission line for medical knowledge in the present healthcare system

    Good medical practice requires tools to extend the human mind's limited capacity to recall and process large numbers of relevant variables

    Knowledge should be held in tools that are kept up to date and used routinely—not in heads, which are expensive to load and faulty in the retention and processing of knowledge …

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