Sunday, March 13, 2011

Memory and Disease Management: Moonwalking With Chronic Illness

The Disease Management Care Blog has just finished reading Joshua Foer's Moonwalking With Einstein. In it, Mr. Foer describes his journey from being a freelance news writer hanging with a group of memory contestants to becoming a world-class "memory athlete." Unable to remember any family birthdays or his social security number, Mr. Foer "trained" to the point where he was able to memorize decks of cards, pages of numbers and lines of poetry within minutes.

While Mr. Foer's descriptions of marshaling spatial memory and storing facts in "memory palaces" are fascinating (and, after a brief test drive, really worked), it was Mr. Foer's insight about modern society's "outsourcing" of memory that really caught the DMCB's imagination. Until relatively recently, the mark of a learned person was the ability to store facts away in the brain. While the printing press started to change that, it is the advent of limitless electronic media that has enabled humans to store everything they need to know in an external information cloud.

Foer argues that the retention and recitation of "facts" are not sufficient for true actionable insights to occur, but they are necessary. This has implications for disease management, where naive health professionals may be tempted to assume that patients will simply internalize the basic information they need for chronic illness management, such as a target blood pressure of "140," what "LDL" actually stands for and what the why "protein" in the urine is bad. Without being able to easily mentally"access" these facts, patients could drift in a fog of disconnected lab tests and treatment options. Think the average high schooler unable to connect a U.S. President with the abolition of slavery or why a "9" earthquake is ten times as bad as an "8."

As a result, care management programs may need to assume nothing and commit more resources toward helping participants "remember" key facts about their condition. In addition, they may need to make these facts easily and "externally" retrievable and reviewable using whatever media best suit the participants' needs.

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