Date: Mon, 13 Feb 2006 15:13:18 +1000
From: Dr Nigel Brown <[EMAIL PROTECTED]>
> -----Original Message-----
> From: Jon Patrick [mailto:[EMAIL PROTECTED]
> Sent: Monday, 13 February 2006 2:23 PM
> To: General Practice Computing Group Talk
> Subject: Re: FW: [GPCG_TALK] Putting SNOMED to work
>
>
> Hi Nigel,
> I'm unclear as to the nature of the approaches taken to
> harness SNOMED CT
> (SCT) in the past as all the literature is decidedly vague.
Hi Nigel
Hi Jon,
I based my comments on sentiments and experiences expressed by anatomical
pathologist colleages who have evaluated various commercial SNOMED-ing
options (not SNOMED-CT) and despite rosey promises currently have settled o
n
a system of clerical staff adding (very efficiently) SNOMED codes after
their text pathology report is dictated.
that i worthwhile knowing
I made the deduction that 'no one puts up the money' because I feel it is a
do-able task that has not yet been done, which implies that insufficient
resources have been allocated for its completion. Perhaps it is really that
only relatively recently is enough computing power/memory routinely
available to make the task economically feasible? Although it seems do-able
I'm sure a few years of competing alternative approaches and fasle starts
are before us before we have a robust automatic system available.
I hope we can bring that forward a little for you.
> Most articles just
> say "we used SNOMED for terminology". Hence it is difficult
> for me to engage
> in your comment 'no one puts up the money". We are setting
> ourselves the goal
> this year of creating an ED system prototype that has an
> instantly updatable
> (SCT) terminology. I hope through that experiment we can shed
> some light on
> the way forward to solve these problmes.
> My view is that we have get on top of the problem of the automatic
> distribution of SCT to all information systems to make it
> readily usable. In
> some ways that is saying that the terminology is the heart of
> Health IS, the
> rest of the data storage dimension is relatively straight
> forward. Data
> Capture is seriously difficult at some level, as you say we
> have to deliver
> coded data capture of clinical notes at the level of no
> time-cost - that is
> what we are working on. we can't do it be ourselves -that
> would fail and
> justify your overly negative view. we do need your help,
> especially with the
> supply of realistic case notes to test our systems on.
The real test is, of course, not case notes but how it interfaces with a
real-time consultation process in a busy practice. It may be that a system
that learns each doctor's quirks and helps them with the case note process
while deducing the SNOMED-CT coding as an epiphenomenon will be the final
goal.
We categorise this as a wider term called "localisation" , usually reserved
for the problem of shifting from one language to another say from English to
Basque. I'm using it here in terms of sociolects that is the different ways
of talking that different social groups have including groups of one or two
such as a medical practice. This is important in our thinking and has not been
left aside in our plans for building prototypes.
cheers
jon
Regards
Nigel
> cheers
> jon
> Date: Mon, 13 Feb 2006 12:07:29 +1000
> From: Dr Nigel Brown <[EMAIL PROTECTED]>
>
>
>
> > -----Original Message-----
> > From: Jon Patrick [mailto:[EMAIL PROTECTED]
> > Sent: Monday, 13 February 2006 8:55 AM
> > To: General Practice Computing Group Talk
> > Subject: [GPCG_TALK] Putting SNOMED to work
> >
> >
> > I think there may be some misconceptions about the difficulty
> > of making a
> > terminology readily available for routine work. Some comments
> > interspersed
> > below.
> ...
> > Automatic and semi-automatic methods of data capture at the
> > point of care
> > should add little if any time cost if the systems are well
> > designed.
>
> Jon (apologies for the earlier mis-spell),
>
> This is the proposition that so far has not been demonstrated as
> economically do-able. No one puts up the money to develop
> an automatic
> system and semi-automatic ones have not met the 'little
> if any time cost'
> criterion. I look forward to being proved overly negative.
>
> I agree with you later statement:
> "> There is a big opportunity for the development of
> > home-grown technologies to do this which don't cost a
> > bomb, and which
> > can be incorporated in next-generation clinical
> > information systems or
> > retro-fitted to existing ones."
>
> Go for it!
>
> Nigel
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