- Introduction
- Performance and Disease
- Business Requirements
- Medical Analogues
- Lab Tests and Record Keeping
- Traps and Pitfalls
- Where Does the Time Go?
- Diagnostic Strategies
- Selected Tools and Techniques
- References
- Third-Party URLs
- Acknowledgments
- About the Author
- Ordering Sun Documents
- Accessing Sun Documentation Online
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Medical Analogues
It would be easy to dwell too long on colorful analogies between medicine and performance analysis, so we will try to be brief here. For some of the medical terms given here, only the medical image is discussed, leaving the reader to relate the principle to prevailing practices in performance analysis.
Philosophy
Medical doctors usually subscribe to some variant of the Hippocratic Oath. It can be a very quick and worthwhile exercise to look up the oath on the Internet and give it a full reading. Upon reading the oath, most will be happy that doctors are guided by it, and many may wish for similar disciplines to spread to other fields.
Process and Protocol
From the writings of Hippocrates (around 400 BCE), it is clear that the distinct topics of medical practice and medical science have had a very long time to mature.
Modern doctors are subject to an enormous body of laws and ethical constraints, and they have well established paths for escalating patient issues. Much of the medical process is defined and monitored by medical professional organizations and license-granting agencies. Medical process and protocol are aimed at improving the timeliness and consistency of results, as well as towards managing costs.
In the computer industry, structured problem solving methodologies, such as the Kepner-Tregoe and Six Sigma methods, are seeing a great rise in popularity. Widespread adoption of these methods might rapidly mature the practice of computing to rival long-established medical processes in terms of timely positive outcomes and cost containment.
Roles
In Section One of Aphorisms, Hippocrates wrote that "Life is short, and Art long; the crisis fleeting; experience perilous, and decision difficult. The physician must be prepared to do what is right himself, but also to make the patient, the attendants, and the externals cooperate." While the roles of the doctor and patient are certainly preeminent, the roles of nurses, emergency medical technicians, and administrative staff are also very well established.
In computing, there are often many diverse players invested in performance issues, ranging from executive management to the application owners and operations staff. Frequently, the scenario is further complicated by the involvement of multiple vendors. The performance analyst should be prepared to act as the physician, but there is rarely any clear protocol for coordinating the activities of all of these parties!
Primary Care
Total health care costs are minimized by a good program of preventative medicine. Thomas Edison is commonly quoted as forecasting that "The doctor of the future will give no medicine, but instead will interest his patients in the care of the human frame, in diet, and in the causes and prevention of disease." Quality of life depends greatly on the skill of the primary health care provider, who should take a holistic approach to patient well-being.
Emergency Care
The first order of business in a medical crisis is to stabilize the patient. Then, the doctor must assess the proximate cause and potential severity of the patient's condition. Attention is focused on patients in rough order of the severity of their complaints during the process of triage. Priorities are also influenced by the likelihood of a favorable outcome. Detailed diagnosis and treatment is usually left to an appropriate specialist, while lesser complaints might be quickly solved with a bandage or some aspirin. The accuracy of the approximate diagnosis made during triage can have a significant impact on the overall time to resolution. Hospital emergency rooms deliver great consistency in handling crises, but are not geared towards delivering holistic or total patient care.
Science and Causality
There is some art in the accomplished diagnostician's practice of weighing clinical signs in the context of a patient's history and in the light of the diagnostician's medical training and experience. One might say that neither medical science nor computer science is an exact science. However, no matter if the science is exact or not, what distinguishes credible diagnostic hypotheses from guesswork is the notion of a plausible chain of causality.
In the absence of a clear chain of causality, guesswork may sometimes succeed at alleviating symptoms, but such guesswork does not tend to yield confidence that the correct issues have been identified and repaired. Just as the over-prescription of antibiotics can lead to insidious drug-resistant strains of disease, failure to make accurate diagnoses with computer systems can delay the identification and repair of latent issues. The motivations to make accurate diagnoses are strong, and the dangers of treating symptoms are universal. Of course, notwithstanding clear causality, proper diet and exercise will predictably lead to a reduced frequency of complaints.
Specialization and Collaboration
The complexities of medicine and computer technology each require specialization as a practical matter. The Hippocratic Oath essentially mandates collaboration as a corresponding ethical matter. While a licensed general practitioner of medicine will at least know what all of the specialties are, this is not so consistently the case among the general practitioners of computer technology.
So What?
The analogues between medicine and performance analysis are so sweeping that we may as well just borrow liberally from the medical language. That is just what we will do going forward.