Tim Churches wrote:
> [EMAIL PROTECTED] wrote:
> 
>>Hi Geoff, I accept what you say about the GP world needing motivation. 
> 
> 
> The motivation will come when there are really good decision support 
> available - not just catching prescribing errors, but tools which genuinely 
> help with differential diagnosis, investigation ordering and care planning 
> and monitoring - but such tools can only ever be as good and as detailed as 
> their input data, which is why SNOMED-CT and the like are so important. Of 
> course, we have a chicken-and-egg situation (or since this is an informatics 
> list, I should say a bootstrapping problem): clinicians won't enter detailed 
> SCT-encoded data until there are reasons to do so i.e. good decsision support 
> tools, and the investment and R&D to create those tools won't happen unless 
> clinicians collect detailed, coded data.
> 
> Which is why Jon's projects to make SNOMED-CT encoding from free text and 
> other forms of natural or semi-natural language are so important. Ahh, you, 
> say, but that presumes that GPs will type all this stuff in... but see below.

A good example of this is the way in which people are currently using
the history items in MD.  You can currently use a DOCLE diagnosis
(picklist) *or* use a freetext uncoded diagnosis.

A number of GP's (thankfully a small number) down here use history items
as a way of writing what they feel are more useful referral letters
eg
Not OSTEOPOROSIS  (coded)
But OSTEOPOROSIS on Dexa  (-2.7)     (uncoded)

Usage follows purpose ...

As there are not perceived to be other uses for the History items (!)
then the whole point is lost.


Michael Tooth
GP Hobart

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