Towards Keeping the Hippocratic Oath (Six Sigma)

INTRODUCTION AND OBJECTIVE: Stone disease has a fascinating history and a bright future. Based upon our current understanding of this rather complex disease, the knowledge that is currently being generated in the basic science of stone disease offers the promise of minimizing patient suffering. But the technology and information are expanding at incomprehensible rates. METHODS: This is a history of technology and information systems themselves. This history is absolutely fascinating and deserves a spot in the lexicon of the history of urolithiasis because it is the future of management of this ancient malady and best hope for the future. A review of the errors of complex systems and the application to medicine and surgery centers on the notion of six sigma (six standard deviations from the norm). This is a statistical reference to improving outcomes. RESULTS: This chapter jumps to the history of modern electronics, computers, the rise of the Internet, and artificial intelligence and how it might be applied to urolithiasis. By necessity, complex systems in turn tend to focus on the complications and unintended consequences of the technology. Therefore, some attention will be paid to complications, medical malpractice, and the notion of human error. CONCLUSIONS: This concluding chapter brings us up-to-date in the technologies that will evolve and modify our current perceptions of stone disease. This includes the surgical and medical methods that will evolve in conjunction with the technologies that will drive all of the future of medicine, intelligent technology. The notion of convergence will be developed and presented and why such luminaries as Bill Joy have become so pessimistic about the future.