F. LAU ET AL.
EMR interoperability. Physicians should lead the development
of these standards, but we cannot do so without CS fluency.
Medical students should drive the development of learning
platforms. Motivated and trained physicians will finally push
medicine into the third and fourth paradigms of computer sci-
enc e , perhaps perfecting applicati ons like the Arc himede s model,
a full-scale simulation model of human physiology, diseases,
behaviors, interventions, and healthcare systems (Eddy & Schl-
essinger, 2003).
Finance Benefits
In 2009, healthcare spending comprised 17.3% of the gross
domestic product (Truffer et al., 2010). This is projected to
grow to one third of national income by mid-century (Hagist &
Kotlikoff, 2006). A cornerstone of current governmental efforts
to combat the rising cost is EMRs. Girosi (2005) projects $80
billion per year of cost savings if effective EMRs are imple-
mented nationally. Given the current shortage of specialists
capable of supporting healthcare IT, the best strategy for driv-
ing this implementation is to broadly increase the number of
CS-proficient physicians.
This physician workforce would also allow for the imple-
mentation of additional, technologically sophisticated health-
care IT solutions. Examples include Cybercare, a proposed
distributed network-based healthcare system that shifts the
focus back to preventive care (Koop et al., 2008). Other tech-
nologies such as telemedicine, remote monitoring, and robotics
for telesurgery/telemedicine can increase patient healthfulness,
access to care, and systemic efficiency.
Building the Third Pillar
Integrating CS into the medical school curriculum is a mas-
sive undertaking. But it is no larger than the integration of ex-
perimental science that took place a century ago and the bene-
fits make it equally worthwhile. The proper development of this
curriculum should be undertaken by a national committee. Each
medical school should be evaluated to identify what is working,
and more importantly, what is missing. Schools that do not
uphold minimum standards need to implement a plan for get-
ting up to speed. We believe medical students should, at a
minimum, learn one scripting language, develop one database-
driven application, and create an extension for another program.
To maximize the medical relevance, this training must take
place in medical school.
The proposed process would capitalize on two theories of
education, namely social learning theory and constructivism.
Social learning theory would be most valuable during the stu-
dents’ introduction to a scripting language. Instructors, perhaps
in a virtual form, could model programming techniques while
demonstrating their applications to medicine (Ormrod, 1999).
In accordance with constructivism, the students will build con-
fidence through mastery of a scripting language. When chal-
lenged to develop a database-driven application, they would
cement their role as active participants at the intersection of CS
and medicine. By creating an extension for another program,
they would be responsible for refining their skills in a way that
they deem relevant. This merger of theories would ideally be
accomplished within learning and digital simulation platforms
(Sharma, Xiem Hsieh, Hsieh, & Yoo, 2008). Considering the
potential to blend learning theories with emerging technology,
the construction of this third pillar of medicine presents a wor-
thy yet manageable endeavor.
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