I was privileged to meet Dr. Lawrence Weed about 10 years ago in Burlington, VT. We dined in an organic restaurant there and discussed what he called "the problem-oriented medical record." This method was the first incarnation of medical IA.
The POMR was a diagnostic input/output system that gave the physician suggestions about possible diagnoses based on observations and testing. In a busy practice, a doctor may overlook possible diagnoses, so this system provides a list of suggestions for the doctor to consider.
We have just completed building something similar for root-cause medicine. We should not be too proud of our accomplishments because we are 50 years behind Dr. Weed, even though we have superior technology.
If you watch this interview found on YouTube, you may laugh, cry, or both!
Here is a journal article describing an interview with Dr. Larry Weed.
Interview with Lawrence Weed, MD— The Father of the Problem-Oriented Medical Record Looks Ahead
I first met Lawrence Weed, MD, in 1972 when I was a third-year medical student at the University of Vermont. To this day, I remember his passion for a disciplined approach to medical record documentation to optimize the care provided to each individual patient.
Now, 35 years later, I was privileged to meet with Dr Weed at his home in Vermont. We discussed when he was first alerted to clinicians' nonscientific approach to making patient decisions. The rest of the interview time was spent with Dr. Weed teaching me about the solution that he has spent the last 30 years designing and implementing.
This interview is published to complement the editorial in the most recent issue of The Permanente Journal (Spring 2009;13:85-7). We believe that in the era of health care reform and quality improvement initiatives, it is important that the medical community take a close look at Dr Weed's total approach decision-making information support defined in this interview.
— Lee Jacobs, MD
Wikipedia reference: https://en.wikipedia.org/wiki/Lawrence_Weed
Here is Dr. Weeds obituary found in the New York Times 2017.
June 21, 2017
Dr. Lawrence L. Weed, who introduced a system for organizing patient data in the 1950s that is now used in hospitals all over the world, and who led the way in developing a computerized method for aiding in the diagnosis and treatment of diseases, died on June 3 at his home in Underhill, Vt. He was 93.
His son Lincoln confirmed the death.
In the early 1950s, Dr. Weed was a professor of medicine and pharmacology at Yale, where he spent most of his time doing research on microbial genetics. On occasion, though, he would accompany students on their hospital rounds and watch as they struggled to interpret the often chaotic patient notes left by doctors.
It was a sobering experience. “I realized then — and it was very upsetting — that they weren’t getting any of the discipline of scientific training on those wards,” Dr. Weed told The Journal of the American Medical Informatics Association in 2014. “When I pick up a chart that is a bunch of scribbles, I say: ‘That’s not art. It certainly isn’t science. Now, God knows what it is.’”
He responded by creating the problem-oriented medical record, or POMR, a way of recording and monitoring patient information. Two of its features have become nearly universal in health care: the compiling of problem lists and the SOAP system for writing out notes in a patient chart. SOAP stands for subjective, objective, assessment and plan, reflecting the steps that doctors and other health care providers should follow as they move from an initial patient encounter to tests, diagnosis and treatment.
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