Courtesy of BBC
Wearing his now-iconic hat, clamping a pipe between his teeth, Sherlock Holmes endures as the very definition of deductive reasoning. His encyclopedic knowledge and diamond-sharp observation skills make him a larger-than-life figure that continues to fascinate audiences on both the small and big screens.
Originally penned by Sir Arthur Conan Doyle, a physician, the character of Holmes has undergone various tweaks and changes over the years as new writers and actors have put their own spin on the famous detective. However, his ability to gather, manage and analyze many snippets of information to draw conclusions about the motives, methods and outcomes of major crimes remains constant.
It is alleged that Conan Doyle found the inspiration for his most famous character in Dr. Joseph Bell, one of his medical school professors. Dr. Bell was considered an excellent diagnostician who impressed Conan Doyle with his ability to correctly “guess” professions, daily routines and medical diagnoses of patients, students and colleagues using bits of information that others might ignore or find irrelevant.
As a childhood fan of the Sherlock Holmes franchise and as a physician with years of medical training, I find familiar the concept of deductive reasoning using data-gathering and hypotheses-testing. Following on the heels of this deductive process is a plan of action that is both meaningful to the patient and effects a change in status. Without this chain of events – including information gathering, analysis, decision-making and action – diagnosis and treatment would be rather monochromatic and much less effective.
The entire concept of useful health information, until quite recently, has centered around complex, specialized tests such as CT and MRI scans, ECGs and other laboratory tests. The actual function of an individual has only been measured to a small extent and at infrequent intervals. In short, we aren’t looking at the whole picture.
Let us reconsider Sherlock Holmes’ approach. Had he been asked to determine the level of someone’s health and wellness, he would closely observe the way the person walked, where he lived, who he associated with, what kind of food that person ate and so on. He would not have limited his observation to a few specific tests that are done at a single point in time, because he understood that there just wouldn’t be enough information to paint a complete picture of that person’s overall health.
However, doctors have had to limit their patient assessments, unable to process the multitude of possible sources of information related to a patient and measure physical, psychological and social functions. Although these factors are each important to a person’s well being, the sheer magnitude of information is overwhelming, and if the physician does not have the built-in CPU that Sherlock Holmes had, this huge trove of information is usually ignored, or only partially assessed.
Humans are comprised of a complex network of interacting factors – much more than a medical test can show. We have physical contact with places, people and our environment. We have less physical, although also very “real,” relationships with organizations, people and our emotional and psychosocial world. We also have internal relationships with our body and we define the sum of all of these interactions as health and wellness.
With the advent of wearable devices, more of this information can now be measured. Internal information, such as our activity level and heart rate, provides one facet for understanding our health and wellness, but other interactions we have with the world are also important. Interactions with others – both in-person and over the Internet – and information about our mood, diet and other experiences are all being collected as well.
Depending upon the parameters, we can see a person’s internal health, psychological health, social health and other aspects of their personal wellness. This body of information becomes useful and applicable to health and wellness when it’s managed, analyzed and conveyed in concise, meaningful and engaging ways.
Gaining visibility and clarity into what the patient is doing and not doing, how they are reacting and not reacting, is the first step in gaining a deeper knowledge of the individual. Certainly, the next steps in engaged health are coming and it is our collective responsibility to guide these developments in ways that prove beneficial and valuable to the patient.
Solving mysteries, both criminal and medical, requires good data – including data that is often overlooked or has not previously been available. It’s fun to imagine what a modern Sherlock Holmes could do with the data provided by wearable devices. Fortunately, we don’t have to do too much imagining when it comes to the many formerly missing pieces of health information that are now available to physicians to assist in a more holistic patient assessment. The more information doctors have, the better able they are to reasonably deduce the best plan for individual patient health.
Dr. Richard Hu is founder and CEO of Vivametrica.
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