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RE: hum
Excellent post Horst. Tom, Horst practices in a rural area (although by no means the remote Australian outback) and as such has some additional problems not faced by GPs in urban areas. However, as a urban GP (part-time), I identify with and corroborate his replies to your questions/requirements. Peter Schloeffel -Original Message- From: Horst Herb [mailto:[EMAIL PROTECTED]] Sent: Friday, 21 September 2001 01:04 To: [EMAIL PROTECTED] Subject:Re: hum On Thursday 20 September 2001 23:55, Tom Culpepper wrote: b) Is willing to provide a free service to maintain my medical records If I see you once for a single short encounter, you pay U$14. But I will have to keep your records for 20 years or more, depending on in which country I work. I will have to be able to prove that nobody tampered the records, and I have to protect them against anybody elese accessing them without your consent. Ad I have to keep them accessible for you as well as provide a copy on request. That is, essentially I keep your record for free as keeping them will cost me far more (in your case) as what you paid me. I am not allowed to hang a disclaimer in my practice saying Records only kept for practice subscribers c) Is willing to look at other medical reports I have from other clinicians I am legally obliged to do so, and I do it all the time d) Will continue their education of their particular discipline so that I can continue to get the best possible care for free I do not get an extra cent for continuing my medical education, I do not even get a competitive edge by doing so as our practice has a monopoly for a vast area, yet all of us sacrifice about half our holidays for unpaid medical education (we even pay for some out of our own pockets). It's called ethos and professional pride. e) Can provide all the necessary tools of their trade to perform their job for free Which we do quite often. When our bush hospital decided to not modernize X-Ray and rather scrap it, our doctors invested in a new equipment knowing the practice will never even come close to getting a return for the investment. Just to provide a better service to an underserviced area, to prevent that patients have to drive an hour or more by car with fractured limbs. Same with the new $100,000 high res ultrasound and a lot of operating theatre equipment for operations we rarely perform. f) Will make sure that all my medical information can be accessed (securely) and from anyone of my care givers to ensure that I can be treated correctly from any geographical location I may be in We are legally obliged to do so. Access might not be instant (yet), but we are working on it. For free. g) Has implemented Quality Assurance measures so that I am assured that I am getting error free care for free again, we are legally obliged. I am getting worried. In what country do you live? Don't you have any standards? No quality assurance? No independent practice accreditation? h) Will provide detailed documentation of all my procedures, reports, office visits, lab results, prescriptions at a level I can understand Any time. I have to. Legally obliged. i) Along with other OpenCare Physicians can provide me a team of free individuals to perform all necessary analysis, design, implementation, evolution, modification and support in terms of medical care Don't laugh, but the majority of our consultations with specialists when we are stuck with a case happen via a quick phone call. The specialists do not charge for this. Never did. IN fact, I doubt there is any country in the world where a doctor can't ring a specialist at a universoty clinic and get free advice at any time of the day. It is called professional courtesy. Do these folks exist? If so, can someone point me in the right direction? Cohuna Clinic 111 King George St Cohuna, Vic 3568 Australia I am also looking for the following books: 1) Learn to be a Heart Surgeon in 7 Days 2) Psychiatry for Idiots 3) 7 Easy Steps to Family Practice Sorry, we do not trade snake oil. You must confuse us with another profession. Maybe you are looking for C++ in 24 hours? But you can borrow my 12 volumes of introduction into general surgery at any time. Horst
RE: Question of naming in GEHR, CEN etc
Thomas Beale wrote: I like the hard sound of transaction I have to admit, because all sorts of rules in GEHR are associated with it - it's the lowest granularity of transfer, committal, access control settings and so on. I like the hard sound of transaction too but this is probably because I am so familiar with it in a GEHR context for so long and I do admit that it is often confused with the more common usage of transaction as a two way exchange. I do not particularly like either contribution or submission. Neither of these words really capture the essence for me. Can I therefore make two other suggestions after having consulted Roget's Thesaurus for assistance. The first and the one I prefer is commission since for me, it captures the idea of committing something to the EHR (whether from human, software, or medical device) and also captures the concept of attribution which is an important component of the GEHR transaction. The second word is act which is a deed or thing done. I like this less than commission but it has the virtue of brevity and is also widely used and understood in the world of messaging (which may or may not be a good thing). Peter Schloeffel Dr Peter Schloeffel Director openEHR Foundation (Asia-Pacific) 30 Winchester Street St Peters SA 5069 Australia Tel:+61 (0)8 8363 1642 Fax:+61 (0)8 8363 4349 Mob: +61 (0)414 669 899 E-mail: [EMAIL PROTECTED] www.gehr.org www.openehr.org -Original Message- From: Thomas Beale [mailto:[EMAIL PROTECTED]] Sent: Friday, 21 September 2001 08:13 To: [EMAIL PROTECTED] Cc: [EMAIL PROTECTED] Subject:Re: Question of naming in GEHR, CEN etc Karsten Hilbert wrote: Yep, I agree that most would equate EPISODE to what you describe, and that a TRANSACTION does not map to that. How about ENCOUNTER ? The newer Dutch reference models for GP information systems call this a partial contact if I understand correctly what is being said here. Possibly several of those make up an encounter. http://www.phcsg.org.uk/conferences/cambridge1998/westerhof.htm I think we have the problem of being stuck inbetween. TRANSACTION is too database, encounter or consultation are too medical. The thing we are looking for can map to one database exactly right. Also, if test results come in from a path lab, they will create a transaction of their own. It doesn not have to due to a human being seeinng the patient, it has to do with a health care agent (which may be a human being) committing an addition to the record at a point in time. transaction but does not necessarily include only one. It may also map to one consultation - again, it need not. It could be the submission of the information of just a part of a consultation. I think we need to focus on finding a good name for the act of submission of a body of information to a (possibly storage backed) kernel. This is neither a purely medical nor purely IT task. So why not call it contribution (as suggested earlier and taken from another project) or submission ? I suspect these are about as good as we'll get in the English language. I like the hard sound of transaction I have to admit, because all sorts of rules in GEHR are associated with it - it's the lowest granularity of transfer, committal, access control settings and so on. - thomas beale
RE: Question of naming in GEHR, CEN etc
Thomas Beale wrote: I like the hard sound of transaction I have to admit, because all sorts of rules in GEHR are associated with it - it's the lowest granularity of transfer, committal, access control settings and so on. I like the hard sound of transaction too but this is probably because I am so familiar with it in a GEHR context for so long and I do admit that it is often confused with the more common usage of transaction as a two way exchange. I do not particularly like either contribution or submission. Neither of these words really capture the essence for me. Can I therefore make two other suggestions after having consulted Roget's Thesaurus for assistance. The first and the one I prefer is commission since for me, it captures the idea of committing something to the EHR (whether from human, software, or medical device) and also captures the concept of attribution which is an important component of the GEHR transaction. The second word is act which is a deed or thing done. I like this less than commission but it has the virtue of brevity and is also widely used and understood in the world of messaging (which may or may not be a good thing). Peter Schloeffel Dr Peter Schloeffel Director openEHR Foundation (Asia-Pacific) 30 Winchester Street St Peters SA 5069 Australia Tel:+61 (0)8 8363 1642 Fax:+61 (0)8 8363 4349 Mob: +61 (0)414 669 899 E-mail: [EMAIL PROTECTED] www.gehr.org www.openehr.org -Original Message- From: Thomas Beale [mailto:[EMAIL PROTECTED]] Sent: Friday, 21 September 2001 08:13 To: [EMAIL PROTECTED] Cc: [EMAIL PROTECTED] Subject:Re: Question of naming in GEHR, CEN etc Karsten Hilbert wrote: Yep, I agree that most would equate EPISODE to what you describe, and that a TRANSACTION does not map to that. How about ENCOUNTER ? The newer Dutch reference models for GP information systems call this a partial contact if I understand correctly what is being said here. Possibly several of those make up an encounter. http://www.phcsg.org.uk/conferences/cambridge1998/westerhof.htm I think we have the problem of being stuck inbetween. TRANSACTION is too database, encounter or consultation are too medical. The thing we are looking for can map to one database exactly right. Also, if test results come in from a path lab, they will create a transaction of their own. It doesn not have to due to a human being seeinng the patient, it has to do with a health care agent (which may be a human being) committing an addition to the record at a point in time. transaction but does not necessarily include only one. It may also map to one consultation - again, it need not. It could be the submission of the information of just a part of a consultation. I think we need to focus on finding a good name for the act of submission of a body of information to a (possibly storage backed) kernel. This is neither a purely medical nor purely IT task. So why not call it contribution (as suggested earlier and taken from another project) or submission ? I suspect these are about as good as we'll get in the English language. I like the hard sound of transaction I have to admit, because all sorts of rules in GEHR are associated with it - it's the lowest granularity of transfer, committal, access control settings and so on. - thomas beale
