Day 1 :
Keynote Forum
Rabi F Sulayman
Chicago Medical School, USA
Keynote: Healthcare in the digital age: Impact on physicians and inpatient care
Time : 10:15-11:05
Biography:
Rabi F Sulayman has completed his MD from the American University of Beirut. He completed his Pediatric Residency at Boston Children’s Hospital, Harvard
Medical School and Pediatric Cardiology Fellowship at the University of Chicago. He is credited for the Building and Development of the Advocate Children’s
Hospital, Oak Lawn campus. He has demonstrated expertise in the development of Advanced Clinical and Educational Programs at the national and international
levels, with collaborative programs in many hospitals in East Africa and China. He is currently the Emeritus Chairman at Advocate Children’s Hospital, Oak Lawn
and Professor and Chairman at the Chicago Medical School-Rosalind Franklin University.
rabi.sulayman@advocatehealth.com
Abstract:
Healthcare in the digital age: Impact on physicians and inpatient care
Background: The digital revolution has infiltrated every aspect of our lives resulting in the medical transformation of how we
obtain and provide healthcare. Physicians today have access to computer-based systems designed to provide diagnostic support
and prevent mistakes. While it has been shown that these systems can be helpful, their actual impact continues to be a subject
of debate.
Objective: To demonstrate the impact of Differential Diagnosis Generators (DDX) and Decision Support Systems (DSS) on the
physician’s clinical reasoning, diagnostic capabilities, practice skills and patient outcomes.
Method: Literature review of published evidence and personal interviews with medical students, residents, and hospitalists
who provide care for most of the hospitalized patients.
Result: The reviewed literature revealed that these systems are a valuable source of information, but none provided a specific
diagnosis or prevented diagnostic mistakes. Their impact on care delivery and patient outcomes was marginal and, in some
cases, may have impaired clinical judgment and exposed patients to risk. These negative effects on the physicians were
recognized. Out interviews revealed that medical students and residents are more likely to utilize these systems than hospitalists.
They found them to be helpful in providing information, but not a diagnosis. It was also reported that use of these systems is
cumbersome, time-consuming and hence not helpful in emergency situations. Two interviewees reported increased confidence,
while one reported being misguided.
Conclusion: Available systems do not provide a diagnosis and do not prevent mistakes. They have a negative impact on the
physicians’ performance. Such impact requires further evaluation. Attending physicians rely on memory or obtain information
from other sources. Clinical reasoning skills continue to be critical and algorithms are not likely to replace the physician.
Recommendation: Critical thinking must be taught in the pre-clinical years and continue to be exercised in the post-graduate
years. Replace the systems with a more accurate diagnostic tool capable of providing structured, system-oriented problem solving
and pattern recognition. This will most likely be a paper tool (not electronic) available at the bedside to allow instantaneous
recognition of patient progress.
Biography:
Ravi Gutta completed his Internal Medicine residency, MD and Allergy & Immunology Fellowship at Cleveland Clinic, USA. He was a proctor for his internal medicine
board exams during his residency, chief fellow during his fellowship and graduated in the top ten percent in the country for both his Internal Medicine and Allergy and
Immunology board exams. He is American Board Certified in Allergy and Immunology and Internal Medicine.
Ravi.Gutta@mediclinic.ae
Abstract:
Food Allergy is a broad category entailing all adverse reactions to food which included IgE mediated true food allergy, oral
food pollen syndrome, systemic manifestations of food allergy I, e cow’s milk protein enterocolitis or proctocolitis, Heiner’s
syndrome, food protein-induced enterocolitis(FPIES), Atopic dermatitis due to food allergy, Celiac disease and finally food
intolerance. It is very important for nutritionists and pediatricians to have a thorough understanding of each of these elaboratively
about etiopathogenesis, clinical manifestations, natural history, diagnosis, treatment plan. It is important to understand the latest
LEAP Study recommendations on demining of the introduction of foods to infants. Peanut Allergy is the only allergic condition
with 400% increase in incidence and population prevalence is last decade along with an increase in other food allergies among
the general population. A food allergy is when body’s immune system reacts to a food protein, is considered as “food allergen.” The
response body has to the food is called an “allergic reaction.” A food allergy diagnosis is life-altering. People can be allergic to
any food, but nine foods cause most food allergy reactions in the U.S. They are: milk, egg, peanuts, tree nuts (such as walnuts or
pecans), wheat, soy, fish, and shellfish (such as lobster, shrimp or crab), Sesame seed. Unlike a food intolerance, food allergies
involve the immune system and can be life-threatening. It is very important for pediatricians and nutritionists to evaluate and
identify culprit foods which cause IgE mediated food allergy and completely avoid them in the patient’s diet, educate patient
about how to read labels, how to avoid cross-contact with allergenic foods, demonstrate to use EpiPen, explain indications for its
use storage and shelf life. Finally, it’s very important to explain patient or patient’s parents about anaphylaxis action plan, which
entails how to identify various allergic reactions to foods i.e. minor reaction, severe reaction or anaphylactic reaction and treat
accordingly based on action plan recommendations.