CHARTSaaS RA enables Dr. Gawande's vision of modern medical practice

“Here are six insights from Dr. Gawande.

1. On using artificial intelligence to diagnosis patients: ‘[U.S. Healthcare] is massively far [from using AI in the diagnosis process] … people imagine [the diagnosis process as] people [coming] to you with a crisply defined problem. … The reality is, first of all, people come to you often unable to explain what their problem is. … The second part of [the process] is that it changes over time, and you’re adding data along the way. You’re integrating it with a little bit about your view of the understanding of the person and their likelihood to even say that something is a major symptom or not. There is no question that you can augment the human capability. But the idea that you pull out your phone and it would give you the diagnosis — it is still one of the hardest problems in reducing error in medicine, is the fact that we still have a high rate of error, and the sources of the error have to do with the human being rather than the calculation.’

3. On wearable technology: ‘What the problem is, is that the wearables have not been able to be integrated into the practice of medicine in a really critical way. Right now, the way a wearable is used, whether it’s for tracking cardiac events or your mental state or other things like that, is that then it says, ‘Notify your doctor.’ Or it’s a dump of a ton of data that a clinician is supposed to use and know how to integrate into practice. It hasn’t been able to be used in such a way they’re actually demonstrating major improvements in people’s outcomes. However, we are entering this phase where we are now starting to be able to track — take your genomic data, take your laboratory data, take your imaging scans you’ve done — [and] couple it with information from wearables, like how you’re doing over time [or] whether you’re getting the medications you should be getting.’

4. On what’s ‘missing’ in medical education: ‘[The medical profession is] no longer an individual craft of being the smartest, most experienced and capable individual. It’s a profession that has exceeded the capabilities of any individual to manage the volume of knowledge and skill required. So we are now delivering as groups of people. And knowing how to be an effective group, how to solve problems when your group is not being effective, and to enable that capability — that, I think, is not being taught, it’s not being researched. It is the biggest opportunity to advance human health, and we’re not delivering on it.’ …”

 The foregoing excerpts from an article by Alyssa Rege entitled “Dr. Atul Gawande says US healthcare is ‘massively far’ from using AI to diagnose patients” in the August 14, 2017, edition of Becker’s Hospital Review ( highlights some challenges and conditions that lead to the root cause of medical mistakes — cognitive overload. However, these circumstances can be addressed in a manner that recognizes and rectifies Dr. Gawande’s observation of modern medicine as “… no longer an individual craft of being the smartest, most experienced and capable individual … [but, rather] a profession that has exceeded the capabilities of any individual to manage the volume of knowledge and skill required.”

Using an information technology (IT) solution compliant with the Cloud Healthcare Appliance Real-Time Solution as a Service (CHARTSaaS) Reference Architecture (RA), healthcare provider subject matter experts (SMEs) can create mobile apps to provide real-time cognitive support with little or no impact on provider resources and facilities and at minimal operating expense. These apps can operate as systems of engagement with  professional providers and their patients to leverage the on-premise legacy systems of record referred to as electronic health record (EHR) or hospital information systems (HIS) using secure intelligent interoperability. CHARTSaaS-built apps can automate such problematic and error-prone use cases as differential diagnosis and treatment planning, and alarm/alert fatigue mitigation. Furthermore, such apps are easily modifiable as they must be to meet the accreditation standards for continuous process improvement and optimization of The Joint Commission.

Please validate these CHARTSaaS RA propositions to your own satisfaction by reading the white paper at, viewing the tutorials posted on YouTube ( and and also by reviewing the details of CHARTSaaS™ and the CHARTSaaS RA™ in these presentations:

Healthcare providers will benefit significantly from appreciating and then applying a CHARTSaaS RA-compliant IT solution. To do so will mitigate medical mistakes (currently the third leading cause of patient deaths. per Makaray and Daniel (; thereby minimizing patient adverse events and optimizing clinical case outcomes while maximizing the cost-effectiveness of care and treatment, and also accelerating the accrual and facilitating the application of medical knowledge.

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