|
Andrew
That
is what I thought. I'm not surprised, because it always
happens. And they then always point their finger at the Government
when they do it. As they say: People in glas houses, must not throw
stones.
Cedric
_______________________________________________________________________________________________________-
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
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The new version
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Tel: 0870 760 5192 (Simon
Howard)
Web: http://www.nuance.co.uk/naturallyspeaking/professional/
G2 SPEECH, EXPERT IN SPEECH TECHNOLOGY
G2 Speech delivers
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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
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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
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TalkingPoint is the leading speech recognition and digital
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Email: mailto:[EMAIL PROTECTED]
Tel: +44
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************************************************************
>
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]
> >
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>
>
>
>
>
>
>
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