Saturday, June 29, 2013

What Can Logisticians Learn from Emergency Room Doctors - The idea of "Thin Slicing"

I have read a lot about "control towers" and "big data" lately as I am sure many of you have.  This has led me to ask myself, "What will I do with all that data"?  More so, I also ask myself, "does more data really result in better decisions or does it get in the way  - create so much "noise" that I cannot even see what is really going on"?  In previous times we would ask ourselves if we could see the forest through the trees?

Back in 2011 I had actually wrote about the idea of control towers and said I was a big fan - as you can see my ideas and thoughts are "maturing".

As I thought about that question I was also, luckily, listening to the audiobook called Blink by Malcolm Gladwell ( of Tipping Point fame) and he talked about how too much information can, indeed, get in the way of good decisions.  In an example of the Cook County (Chicago) emergency room he talked about the idea of "thin slicing".  Thin slicing is the idea of taking just a few critical points of data and using those to make swift and accurate decisions.  Let's follow his example of the emergency room.

Before thin slicing, if a person came to the ER with chest pains (a very common issue in emergency rooms around the country) the doctors, nurses and technicians would run a battery of tests - height, weight, blood pressure, etc. etc.  Tons of tests and the idea was to get as much data as possible - Big data".  However, the success rate of diagnosing whether those chest pains were in fact a heart attack or were they just something else less important was not very good.

So they tried something different.  What they did is reduce the amount of data the doctor saw.  They realized most of the tests and the data coming from those tests were just noise and were not pertinent to the decision of whether the chest pain was a heart attack. In Gladwell's own words:
One of the stories I tell in "Blink" is about the Emergency Room doctors at Cook County Hospital in Chicago. That's the big public hospital in Chicago, and a few years ago they changed the way they diagnosed heart attacks. They instructed their doctors to gather less information on their patients: they encouraged them to zero in on just a few critical pieces of information about patients suffering from chest pain--like blood pressure and the ECG--while ignoring everything else, like the patient's age and weight and medical history. And what happened? Cook County is now one of the best places in the United States at diagnosing chest pain.
By reducing the amount of data provided, the doctors actually were able to make better decisions.

What does this have to do with logistics?  I am consistently inundated with requests and ideas on Big data, collecting tons of data, control towers to see "everything", full visibility etc. etc.  and I ask myself, do I really need all that data and if I had it what would I do with it?  Then I come back to this example above and see the real secret in all this is not big data but pertinent and actionable data.  In fact, I am starting to think big data may be a front for intellectual laziness.  Because a logistician can't figure out what they really need they just say "let's capture everything".  And, of course, software providers are quick to jump on as Big Data translates into Big Sales and Big profits (first few hits on google when I queried Big Data and logistics were from SAS and Oracle).

My lesson is this:  Take the time up front, a lot of time, to determine what you really need, what will really give you the signal you need to determine what is going on, and what you need to actually do something.  Take the rest of the data and throw it away - not only is it noise but because it is so noisy and full of static it will actually slow down your decision making rather than speed it up.  Big data may actually not only be a waste but it could actually be harmful.  So much data will drive you to be parallelized versus taking action.  The article I cited above about control towers brags about collecting "mountains of data". - I don't need mountains, I just need the vital few.

It turns out, we logisticians have a lot to learn from emergency room doctors.

1 comment:

  1. Nice post Kevin. A couple of years ago I submitted to the NHS in the UK a concept for a hospital-based shift handover platform, based on this data approach around the value of 'less is more'. The proposal was rejected, but my understanding of thin slicing has been refined, most recently working on social data analysis at Sony EU.

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