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No
Andrew
Dr. Andrew Magennis
M.B.,B.S. B.Sc (Hons) Dip. R.A.C.O.G.
Medical
Director
Health Communication Network
----- Original Message -----
Sent: Thursday, July 20, 2006 11:21
AM
Subject: RE: Re: [GPCG_TALK] SNOMED
Project Proposal
Again I ask the question: Were all the current software
companies contacted
& informed & feed back sought about this
? The same happened with PKI keys.
Was designed without asking the
current "experts" the best way to do it. We
now have a similar
situation. Change the way motor car tyres work, then
force the Dept
of Roads to change the way Roads look & work - a catch
22.
Cedric
______________________________________________________________________
-----Original
Message-----
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED]
On Behalf Of Tim Churches
Sent:
Thursday, 20 July 2006 9:36 AM
To: General Practice Computing Group
Talk
Subject: Re: Re: [GPCG_TALK] SNOMED Project Proposal
[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.
> As for migration tools I would hope that the
Text-to-SCT converter we
> have created would be seen as the start to
filling that role. Now with
> the release of the general license I
expect we will be able to a
> switch over to delivering SCT codes
on-line, so you will be all be
> able to see it working easily. I am
visiting NEHTA today to open
> discussions with them directly about our
work and how we might be able
> to collaborate with them.
Voice
recognition. Yep, mumbling at the computer, just like they do in Star
Trek
and every other sci-fi TV series. It is already being used in
specialist
fields with somewhat stereotypic and constrained reporting
requirements and
voabs eg radiology, endoscopy, but practical, affordable
systems running on
commodity hardware, which GPs could use, really are only
5-10 years away -
5 for early adopters. In that context, Jon's Text-to-SCT
stuff looks doubly
attractive. And general practice obeys Pareto's law: 80%
of the work
relates to only 20% of the range of conditions seen and managed.
Thus a
speech-to-text-toSCT(-to-decision support) system really only has to
cope
with the protean, and degrade gracefully back tot he keyboard and mouse
and
SCT code look-up systems for the rest in order to be useful.
Following
is a copy of the latest email tickler from E-Health Insider, a UK
health
informatics industry e-rag.
Finally, I think that Geoff's message is a
reminder that we cannot expect
private enterprise, which is necessarily
market-driven, to drive such
innovation. We still need our universities,
our CSIRO and perhaps even
private R&D facilities to work on such
things without immediate regard for
exactly how many GPs would use such
facilities in the next week or next
month. It is also why we need more
general practices which are affliliated
with universities or research
institutions and which are willing and able to
be funded to engage with
cutting-edge stuff like SNOMED-CT coding and the
use of the results for
advanced decision support. Alas, we have so few such
practices.
Tim
C
E-HEALTH INSIDER SPECIAL REPORT - VOICE RECOGNITION SYSTEMS July
2006
**********************************************************************
Nuance
The
world's leading provider of speech recognition, dictation,
and
transcription systems
http://www.e-health-insider.com/o.cfm?o=8,0,4194,3773,3774
**********************************************************************
TALKING
ABOUT A REVOLUTION
What's new in speech recognition and digital
dictation? Neil Kelly talks to
users and suppliers about recent
developments in voice technology.
http://www.e-health-insider.com/o.cfm?o=8,0,4194,3773,3776
**********************************************************************
Talking
Point
The complete speech recognition system
See bottom of e-mail for
details.
**********************************************************************
Philips
Speech Processing
Digital Dictation, PC-Connected and Mobile.
http://www.e-health-insider.com/o.cfm?o=8,0,4194,3773,3778
**********************************************************************
SUPPLIER
UPDATES
CRESCENDO PRESENTS FOREGROUND SPEECH
RECOGNITION
Crescendo front-end speech recognition powered by Speech
Magic is a
particularly attractive feature for physicians who prefer to
look after the
full report generation process. It enables them to edit and
finalise
documents on-screen in real-time, without the involvement of
a
transcriptionist: fantastic on weekends or for highly
confidential
documents.
It is also best suited for environments
such as Radiology, Pathology and
Emergency Medicine, where reports are
relatively short and usually "normal"
(negative findings) and experienced
medical transcriptionists are more and
more difficult to find. Crescendo's
front-end speech recognition can also be
implemented in combination with
their back-end solution, leaving all
document correction options open for
healthcare
facilities.
Email: mailto:[EMAIL PROTECTED]
Tel: 0870 7701717 (John Bendall)
Web: http://www.crescendosystems.co.uk/
SPEECH RECOGNITION TURNS INDUSTRIAL GRADE
Philips provides
healthcare professionals world-wide with industrial grade
document creation
technology. The upcoming version of Philips SpeechMagic
optimizes the
accuracy, security and administration of medical document
creation. The
software architecture allows for fully centralised
administration and
management, facilitating integration with medical IT
systems such as
Electronic Patient Records (EPR) systems. The error rate has
been reduced
by 30% and scalability has been raised to up to 15,000 users
per
cluster.
Sophisticated learning algorithms ensure automated and
immediate adaptation
to the dictation style and pronunciation of each
author. SpeechMagic even
calculates the amount of correction a recognised
text will require and
intelligently routes the document to the most
suitable transcriptionist.
Crescendo, G2Speech, Hospital Engineering,
IMS Maxims, Soliton IT, and Voice
Technologies offer medical reporting
solutions "powered by SpeechMagic".
Major international firms also use the
technology to speech-enable their
products, among them AGFA Healthcare,
Kodak Health, GE Healthcare, iSOFT,
Siemens Medical Solutions and Philips
Medical Systems. </p>
Email: mailto:[EMAIL PROTECTED]
Tel: +44 (0)7789 650 190 (Gary R. Williams)
Web: http://www.philips.com/speechrecognition
DICTAPHONE HEALTHCARE SOLUTIONS FROM NUANCE
Nuance is the
world's leading provider of speech recognition, dictation,
and
transcription systems and services that simplify and enhance the
production
and management of electronic patient documentation. Today, more
than 4,000
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physicians, use
Dragon NaturallySpeaking powered speech recognition from
Dictaphone
Healthcare Solutions.
Medical professionals can also use
Nuance Dragon NaturallySpeaking version
9, a new release of the world's
best-selling speech recognition solution.
The new version promises to
transform the way medical professionals use
their PCs, moving accuracy
levels to near perfection.
Tel: 0870 760 5192 (Simon Howard)
Web: http://www.nuance.co.uk/naturallyspeaking/professional/
G2 SPEECH, EXPERT IN SPEECH TECHNOLOGY
G2 Speech delivers
productivity solutions for the medical market with a
high
return-on-investment: speech recognition integrated with an
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system. Besides radiology and pathology departments we supply
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wide solutions! G2 Speech has realised over 700 successful
projects. Over
10,000 different users work with one of our solutions every
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great deal of time on report creation. G2 Speech solutions
are powered by
SpeechMagic.
Email: mailto:[EMAIL PROTECTED]
Tel: +44 (0)20 8989 7330 (Henry Gallagher)
Web: http://www.g2speech.co.uk
DICTATING THE FUTURE WITH VOICE MESSENGER
Voice Messenger
powered by SpeechMagic from Voice Technologies is a highly
efficient
digital dictation and workflow management system with speech
recognition
built-in. Voice Messenger's medical application allows speech by
doctors to
be dictated directly into letters, forms or reports and converted
to text
in real time via the Web. As a result doctors can create reports,
which can
be checked and changed immediately or forwarded to medical
secretaries for
confirmation and checking.
Email: mailto:[EMAIL PROTECTED]
Tel: +44 (0)141 847 5610 (Heather Wylie - Managing Director)
Web: http://www.voicetechnologies.co.uk
TALKINGPOINT FOR HEALTHCARE
TalkingPoint for Healthcare is the
complete speech processing system for
medical professionals.
TalkingPoint is the leading speech recognition and digital
dictation
solution for both primary and secondary healthcare. It delivers
proven
savings and can be implemented trust-wide across a range of
clinical
specialities.
Whilst economic to purchase, TalkingPoint is
highly configurable and easy to
use. Its simple and practical methodology
delivers real cost savings from
day one, without breaking the capital
budget!
To find out how we can slash your typing bills and speed up
document
creation, contact us today.
Email: mailto:[EMAIL PROTECTED]
Tel: +44
(0)1908 847171 (Jim Robinson - Sales Consultant)
************************************************************
>
Quoting Geoff Sayer <[EMAIL PROTECTED]>:
>
> > Hi all
> >
> > This all assumes that "average"
GPs care about terming, coding and
> > classification... evidence
would suggest the contrary.
> >
> > Nearly all the GP
clinical apps have controlled medical vocabulary
> > already (and
some have classification capability to international
> >
standards
> > already)
> > yet I have never heard a GP say
(one that doesn't subscribe to
> GPCG)...
> >
> > "If
only I had SCT I would record reasons for prescribing and
> >
provide
> a
> > complete/current patient medical history... it
was the lack of a
> > suitable medical vocabulary that was holding
me back"
> >
> > I think a standard is important but the
fundamental lack of interest
> > amongst the masses remains the
same... I can hear a deafening
> > silence from the mainstream on
this development...
> >
> > We need to think about selling
what the benefits of SCT will be to
> > the end user from a day to
day practical perspective... and great
> > for research
won't
> > wash...
> >
> > What will it mean to
those GPs who have recorded data
> > inconsistently/consistently
over the past number of years... got
> > some migration tools ready
to bring into the new SCT era or do we
> > right of the
past...
> >
> > What will it allow GPs to do now that they
can't do now?
> >
> > This type of information on benefits
may inspire vendors as well I
> would
> > suggest.
>
>
> > Geoff
> >
> >
> > [EMAIL PROTECTED] wrote:
>
> > Quoting Tim Churches <[EMAIL PROTECTED]>:
>
> >> Just to clarify the architecture that I had in mind:
>
> >>
> > >> a) most of the look-up and other functions
exposed as Web
> > >> services
> > which
> >
>> can be called from any Web service-aware application, including
> > >> GUI desktop clinical applications
> >
>>
> > >> b) a separate Web browser front-end that uses
those Web services,
> to
> > >> allow browsing of SCT
from anywhere there is an Internet
> > >> connection
>
> > Tim, is it your intention that this evolve towards a "SNOMED
> > > module" which can be served up to vendors on a platter,
ready for
> integration
> > > into their own
products?
> >
> > Yes, exactly. By having the software
module as cross-platform open
> > source and the SNOMED-CT data
freely available to all under the
> > NEHTA sublicense, it would
exert competitive pressure on clinical
> information
> > system
vendors to either incorporate the module into their software
> > or
to provide something better.
> >
> > > Hopefully this
will partly answer the "it's too hard" excuse from
> >
vendors
> > which
> > > has stymied other attempts (as
Ken Harvey knows) to get
> > decision-support
> >
into
> > > the GP's desktop.
> >
> > Yup. One
less excuse.
> >
> > > For true integration you would
need a local server otherwise the
> > > EHR would experience a
performance hit (to which users in this
> domain
> > > are
exquisitely sensitive)
> >
> > Yup, that's what I
proposed.
> >
> > > Would you consider the LGPL licence,
as this allows integration
> > > but requires vendors to
contribute back changes (to the module). I
> > > agree BSD-type
licence is much simpler and would be more
> reassuring
> > >
to them legally (even Microsoft use BSD licensed code)
> >
>
> Either LGPL or Mozilla licenses would be fine - they are
> >
functionally equivalent in that they both require changes to the
> >
open sourced code
> to
> > be contributed back to the
community, but neither presents any
> > impediment to tight
integration of the open source code with closed
> > source code in a
vendor's product. BSD would also be OK but less
> > optimal,
although likely to be more favoured by closed-source
> > vendors
since it does not require them to make any enhancements they
> >
make tot
> he
> > code available to others. After seeing how
well the development of
> > the PostgreSQL open source database
proceeds using a BSD
> > (non-copyleft) license, I am a lot more
relaxed about the whole
> > copyleft thing than I used to be.
Ultimately it is up to Jon Patrick
> > and his team at USyd
>
how
> > they might license the proposed modules, but I would strong
> > recommend that they don't use the GPL, which would be sure to
> > discourage other software vendors from using the
modules.
> >
> > >> Automatic periodic refreshing
across the Internet of the Web
> service
> > >> software
code and the SCT data which it uses should be built-in.
> >
> ^^^^^^^^^^^^^
> > >
> > > I agree
with auto-updating the SCT codes, but the software itself?
> > >
The could get needlessly complicated if done in the first
> > >
iteration
> of
> > the
> >
> > > module.
IMHO users who want such a facility should select an OS
> > >
that
> > provides
> > > it ;-)
> >
> >
Yes, probably. I suppose I had in mind that the modules might use
>
> various soft-coded rules or other parameters which could be updated
> > dynamically from time to time, rather than the compiled
code.
> Whatever.
> >
> > > A client-side module
which regularly (say ~1/month) polls the
> central
> > > SCT
webservice for updates would be simpler to adminster, as well
> >
> as
> > faster, as
> > > it saves the GP the
adminstrative overhead of running a dedicated
> SCT
> >
server
> > > on their own network, at the cost of some bandwidth
(as each
> > > client
> is
> > > independently
updating) but this would not be significant given
> > >
the
> > size
> > > of the data.
> >
> >
Yup, that would work.
> >
> > > The question then is what
interface to provide to the EHR. A C
> > interface
> > >
(that is, "DLL" on Windows) is the most widely-acceptable
> > >
solution,
> > this
> > is how
> > > HeSA provide
their module for HIC Online. You could also use
> >
.NET/Mono,
> > but I'm
> > > not sure how many EHRs are
written in .NET at present.
> > > I have nothing against
webservices per se, but it's important not
> > > to
> >
let
> > > them be a solution in search of a problem, there may be
simpler
> > > and
> > more
> > > appropriate
options.
> >
> > I only suggested that Jon mention "Web
services" at every
> > opportunity
> to
> > keep
NEHTA happy... BTW, Argus Connect should re-write all their
> >
promotional material to say they their products uses Web services
>
> (and in very, very fine print mention that the Web service runs on
> > port 25
> as
> > a Simple Mail Transfer
Protocol service).
> >
> > Tim C
> >
> >
_______________________________________________
> > Gpcg_talk mailing
list
> > [email protected]
> > http://ozdocit.org/cgi-bin/mailman/listinfo/gpcg_talk
>
>
> > _______________________________________________
> >
Gpcg_talk mailing list
> > [email protected]
> > http://ozdocit.org/cgi-bin/mailman/listinfo/gpcg_talk
>
>
>
>
>
>
>
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