In designing an “economic transformation of American medicine,” did Dr. Berwick and the ObamaCare bureaucrats conceive of the computer as the transitional tool of choice? It is possible that, by government edict, there will be a universal medical history computer program. Physicians would be required to enter all information via a touchpad, selecting from the menu of pre-programmed choices. The efficiency of typing in observational comments is dependent on the typing skills of the physician; a touchpad menu of choices would be less time-consuming. Would there be room for individualized side comments or observations, and how would they be fitted into the master paradigm and multiple-choice format? It becomes simpler to fit the patient to the computer rather than the converse.
When entered, the physician’s choices would trigger a diagnosis based on pre-programmed, best-fit algorithms. Once the computer has made the diagnosis, the treatment plan would be offered from the corresponding “best-evidence-based” program. Much like the software licensing agreements common on our computers, the computer might require the physician to click on “yes” that he agrees with the treatment plan. If he clicks “no,” he will be informed that he will be personally and financially responsible if his alternate diagnosis/treatment fails or costs more than that of the government’s computer.