CKM and Serenity

Clinical informatics and electronic health records are often offered as the path to high quality medical care and reduced adverse events. However, technology can only help deliver the best care medical knowledge can achieve. Frequently, even with the best implementation, technology can only get adverse events and complications of care to an irreducible minimum. After that new medical knowledge is needed. This is where CKM can be extremely important. Even when CKM doesn’t provide new knowledge for medical advancement, it can provide a clear indication if an irreducible minimum has been meet.

When considering this, I often think of the Serenity Prayer.

God grant me the serenity 
to accept the things I cannot change;
courage to change the things I can;
and wisdom to know the difference.

CKM can help provide the wisdom to know the difference. Well designed CKM can determine if patients received ideal care for specific disorders, i.e. early goal directed therapy for sepsis. If 100 patients all received perfect care and 20 died then there is nothing to change. However, if 100 patients received less than perfect care and 30 died, we need to have the courage to change the system.