By Axel Fredrik Cronstedt
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Indd 23 2/12/15 12:43 PM 24 THE DIGITAL DOCTOR Relman was editor during a period of breathtaking scientific advances. Under his stewardship, the NEJM published the first reports of the disease that would later be called AIDS. A few years later, it published the first description of the discovery of HIV and, still later, the clinical trials that demonstrated the effectiveness of AZT in treating HIV infection. Relman’s NEJM published seminal papers on new ways to treat and prevent coronary artery disease, research that led to halving the American death toll from heart attacks between 1980 and 2005.
Indd 39 2/12/15 12:43 PM 40 THE DIGITAL DOCTOR CK’s; note: this enctr. took 65’ & inv. a hi deg. of complex. in dec. 3 The first note was clearly written by one human about another, but the second seems as if it were written by an automaton to please a robotic actuary. 4 Certain measures, such as whether the physician documented that she counseled the patient to stop smoking, are drawn directly from the medical record. The role of the note in measures like mortality or hospital readmission rates (in other words, how patients fared [“outcome measures”] rather than what we did [“process measures”]) is subtler and involves a bit of math.
Particularly with a reelection campaign just over the horizon, the president was eager to pivot to domestic affairs and anxious for an easy win—in an area that was not too politically contentious. S. president looking for a bipartisan domestic triumph would be wise to give healthcare a very wide berth. But there was a portion of the healthcare landscape that was ripe for change and appeared to have the support of both parties, particularly in light of the growing national anxiety about medical mistakes and the skyrocketing costs of care.
An essay towards a system of mineralogy by Axel Fredrik Cronstedt