Clinical Decision Support System (CDS) versus the Art of Medicine

The design and implementation of clinical decision support systems is not intended to take the place of human decision making. The intent is to complement the human decision making process. I believe that is called the principle of complementarity. Computers do well what humans do poorly. Computers are good at remembering and humans are good at analysis.

 CDS is design to combine patient data with knowledge based on certain rules to produce patient specific options or recommendations for diagnosis and treatment.

Human beings by composition are analytical and judgmental. These are values that are developed over time through upbringing, training, and life journey experiences which collectively transform into what we can call wisdom.  

CDS is cut and dry – things are either white or black and it lacks the ability to read between the lines. It is unable to take the individuality of a human into consideration. On the other hand, humans are able to come to a decision by evaluating factors as in the individuality of the patients drawn from the wisdom acquired over the years.

Does using CDS eliminate the “Art of Medicine”?

I consider the art of medicine as the human factor in the provision of care. If this explanation is accepted, I will conclude that at the current state of CDS development, it does eliminate the art of medicine because of the impersonal nature of the machine. It lacks empathy and cannot share with a patient any similar observation or personal experience close to what the patient may be going through.

The advances in machine learning as we fast forward into the future will create the ability of new generation CDS to acquire the skill set to practice the art of medicine. Recently, it was announced in one of the TV news channel that an Avatar competed in the show – Jeopardy against the best players and won. But in health care, the current generation of CDS is deficient in the “Art of Medicine.”