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.
Tim et al,
GPs are already coding data in programs like MD. It's diagnosis/past
history dialogues have forced them to consciously avoid using the
available coded entries if they don't want to use them, and enter
uncoded stuff instead. It just happens to be another coding system
DOCLE, not SNOMED.
GPs will NEVER manually code data. Most hospitals pay data entry staff
in their IM Departments to do that. Software will automatically code
data by offering pre-coded data options to GPs, as MD and other programs
do now.
Similarly, some GPs are receiving diabetes-related HL7-format
investigation results coded using the Australian pathology results
standards based on SNOMED, I believe, developed by Prof. Michael Legg,
and his Standards Australia HL7 committee.
These coded results can be interpreted by MD and thus facilitate
diabetes assessments and cycles of care, which is undeniably important.
I see getting more GPs using these HL7, coded results as a lever to
increase their awareness of coding issues, as they perceive the benefits.
Getting the vendors, particularly HCN to move uniformly to SNOMED may be
a big issue though, as doing so will cost them money.
Greg
--
Greg Twyford
Information Management & Technology Program Officer
Canterbury Division of General Practice
E-mail: [EMAIL PROTECTED]
Ph.: 02 9787 9033
Fax: 02 9787 9200
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