October 23, 2004

Bush and "changing the language"

In one of the presidential debate discussions here on LanguageLog, Mark comments on an odd mention of "changing the language" in Bush's response to a question about health care costs:
There's just one point that still puzzles me. What did the president mean by saying that "we're changing the language"? I don't understand what that has to do with cutting costs by introducing high technology into the health care industry.
He conjectures that perhaps "changing the language" is a slogan of some kind, but that's not it.

Since I live ten or fifteen minutes from the National Library of Medicine, and have a student who works there, it only took a minute for the correct brain cells to click. Within the healthcare arena there is a large push toward language standardization in order to move toward electronic medical records. For example, NLM's Unified Medical Language System (UMLS) has been around for years as a knowledge source for biomedical natural language processing, and it incorporates terminological resources such as the International Classification of Diseases (ICD), the Physicians' Current Procedural Terminology (CPT), and, as of more recently, a standardized clinical terminology called SNOMED-CT. Now, the president has a high level information technology advisory committee (whose membership even includes a computational linguist, I'm happy to say), and recently that committee provided a report with recommendations that included a discussion of language standardization and electronic medical records. So when Bush said, "we're changing the language, we want there to be, um, electronic medical records to cut down on error as well as to reduce costs", it seems clear to me that he was responding from a recollection of a briefing on their report. (From the sound of it, a pretty vague recollection, but who can say?) Puzzle solved.

Mark goes on to wonder:

As a part-time computer scientist and full-time taxpayer, I'd be happy to believe that better automation of patient records would save 20% of health care costs -- but can this really be true?

My own two cents' worth: more automation in the handling of clinical language will be a huge win, given the amount of text out there, to say nothing of the medical research literature. That's one of the reasons biomedical informatics is such a booming field. But getting people to change the way they use language is likely to be a long, slow process, and not one easily accomplished by mandate.

Posted by Philip Resnik at October 23, 2004 01:09 PM