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Comment by nradov | Hacker News Reader

Well then who is going to do the clinical observation, coding, and data entry? That work doesn't get done for free and in most cases it would actually take the healthcare providers more time to do.

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Do you need to spend 7 or 8 years training someone to do that? If I'm not mistaken, that's already largely done by nurses and patient care technicians.

You are mistaken. In most cases that's not done at all by anyone. Most of the data entry done by medical coders (not programmers, the other kind of coders) is for billing and insurance claims purposes. That claims data isn't detailed enough to be useful for diagnosis. And in most cases it is done hours or days later, not immediately at the point of care where the doctor is expected to make a diagnosis and decide on the course of treatment.

> And in most cases it is done hours or days later, not immediately at the point of care where the doctor is expected to make a diagnosis and decide on the course of treatment.

So does that mean it's not important to the doctor's job? Or would having this information right away allow doctors to do their jobs better? If so, why isn't it done that way right now?

Here is a list of the most common diagnoses from a few years ago. http://www.hcup-us.ahrq.gov/reports/natstats/commdx/table2a.... Doctors already do quite well diagnosing those in almost all cases so there isn't much room to improve on the diagnostic side. Once the doctor takes the patient history, observes the symptoms, and reviews the lab results then the diagnosis is usually fairly obvious (to an experienced professional). If the doctor had to enter all her detailed observations into a computer it would just slow the process down and increase costs.

> If the doctor had to enter all her detailed observations into a computer it would just slow the process down and increase costs.

On the other hand, paying someone working for/requiring much less money/training than the doctor (say, a BS & $20 or $30/hour) to enter the data would lower the overall costs, would it not?

No that really wouldn't lower overall costs because it wouldn't immediately add much value in most cases. There would be some long term value later since that additional coded clinical data could be mined for clinical research to determine which treatments are most effective. But no one is willing to pay an additional $10 (or whatever) per patient encounter to get that data.

If there wasn't so much bureaucratic red tape surrounding the healthcare industry, that would be a great opportunity for an enterpreneur. Correcting the smallest inefficiencies can dramatically increase profit.

There's (going to be) an app for that! Input data -> output diagnoses!

Ha ha. Seriously, clinical data entry is not quick or easy (outside a few limited special cases) regardless of how well you design that mythical app. Even perfect speech recognition would only get you part of the way there, and we aren't likely to get that any time soon.

I really don't think perfect speech recognition is that far away. 10 years and we're gonna have something that can work. 10 years and we'll have an advanced Google Goggles that can help with diagnosis. Ask the question "What are the limits of human input?" Nothing besides touch, taste, hear, see and smell, and we're getting closer and closer to being able to input that data and process it as humans would.

"Even perfect speech recognition would only get you part of the way there, and we aren't likely to get that any time soon."

We're working on it, though.

http://www.mmodal.com

Most of the time, there is still a transcriptionist in the loop. Or the doctor has to make his own edits.

I know, we use your service. :-) It works well for increasing the productivity of our human transcriptionists but it doesn't really solve the automated diagnosis data entry problem that others were asking about.

and a Mobile Diagnostics X-Prize to incentivise you to get there: http://www.technologyreview.com/biomedicine/37596/?p1=A4

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