Monday, February 6, 2012

Revealing Bias in Healthcare Decision Making


I've recently been reading the Song of Ice and Fire series (Game of Thrones) by George R. R. Martin. While the plot is engaging and intriguing, one of the things I enjoy about the book is that it is written from the third person multiple perspective. Each chapter is limited to a specific character's perspective, but many characters get to tell the story. With this narrator point of view, the story develops with more layers and nuance than other perspectives. Each character's biases are revealed, and the reader is able to develop their own opinion of the events in the story.

Bringing the bias of each character to the surface through the third person multiple perspective deepens the understanding of the setting of the book. Similarly, bringing the bias to the surface in healthcare decision making helps us develop better knowledge and make better decisions. Just as each character in the novel is limited by what they can sense and feel, so each type of healthcare knowledge is limited by the constraints of its data.

These constraints make the exclusive use of any single type of healthcare knowledge unwise. We need to use multiple types of healthcare knowledge to better understand the current environment. For instance, in any single healthcare decision making process, knowledge can be garnered through:

  • Institutional knowledge
  • Quality knowledge
  • Research knowledge
  • Financial knowledge
  • Operational knowledge
  • Medical knowledge
  • Direct Care knowledge
  • Transactional knowledge
  • Analytical knowledge
When we combine multiple types of healthcare knowledge we are able to develop a more layered and nuanced understanding of the challenge facing us and thus make better decisions and take more appropriate actions.

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