Geoff Sayer wrote:
> Hi Jon
> 
> So what have you tried so far as a reason for SCT? 
> 
> What was the response?

It is a bootsrapping problem - it is hard for potential users to
perceive the benefits without some concrete examples of how SCT might be
deployed and used, and it is hard to create such examples without some
enthusiasm from potential users.

The solution is to start slowly, and the summer projects which a few of
Jon's honours students did on automatic identification and extraction of
SCT terms from free clinical narrative text was impressive for just a
few weeks effort. With a few person-years of R&D effort by a small team,
some very easy-to-use interfaces to SCT could be developed, I'm sure.
Uufortunately the restricted licensing terms for SCT six months agomeant
that Jon couldn't really show off the first-pass quick-and-dirty SCT
encoder properly to members of this list - but I think that the
licensing issues are solved now that we have a national license for SCT
(but the fine print of the NEHTA license for SCT takes some time to
fully assimilate).

> I am also struggling to see immediate benefits for SCT beyond the content
> will be free... but that the software houses will generate some cost in
> implementing the free content so from an economic perspective is not free
> and then there is the big national license fee that the govt has paid so is
> also not free...

On the cost issue, the cost of the national license is unknown but teh
US license was US$35m once off, so an Oz license should not have cost
more than few million as a once-off fee - so perhaps 20 or 30 cents per
Australian resident, or five or six cents per annum amortised over 5
years. I can think of worse uses of my taxes...

There will be some costs to software houses but again, such costs are
probably rather small when amortised over the patient user base, and the
benefits are rather likely to outstrip the costs.

The main potential cost driver for SCT use, which from your software
vendor's perspective I think you have overlooked in your rhetorical
questions to Jon, is the cost in clinician's time in encoding
information using SCT, using whatever interface is made available to
them. That's why serious R&D is needed into SCT interfaces which are as
efficient as possible and which minimise the intrusion of SCT encoding
into clinical practice, or at lest which strike the best cost-benefit
compromise. As Peter MacIsaacs said, the interfaces to SCT need to be
transparent, or at least highly translucent. Merely giving clinicians a
search box in which they enter keywords to look up SCT codes is not
going to cut the mustard, and if that is the only interface (or things
with a similar lack of sophistication), then SCT will end up being
vastly underutilised and probably a waste of time and money. We must do
better.

Tim C

> -----Original Message-----
> From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]
> On Behalf Of [EMAIL PROTECTED]
> Sent: Tuesday, 15 August 2006 7:46 a.m.
> To: General Practice Computing Group Talk
> Subject: RE: [GPCG_TALK] Arguments for the use of SNOMED CT (SCT)
> 
> Hi Geoff,
> I agree with your commentary about current perceptions of terminologies as
> lists and it is the problem we are having troubles in some quarters to
> persuade clincians to see value in SCT. Hence I asked my question to the
> people I though would have the best set of answers, the GPCG list. The
> result is your set of questions, which pinpoint the principal motivators.
> <big snip>
>> To get the debate going I have thrown out some questions to help Jon
>> along
>>
>> Will SCT result in better care? If so how?
>>
>> Will SCT make GPs more money? If so how?
>>
>> Will SCT mean that GPs are less likely to be sued? If so how?
>>
>> Will SCT make software development easier? If so how?
>>
>> Will SCT make software licensing cheaper? If so how?
>>
>> Unless you can mount these types of arguments I wouldn't worry about
>> interface design - these types of things need to be shown if it is going
>> to
>> be implemented and demonstrable differences are going to be obtained.
> 
> Now I need the GPCGs answers to those questions, my answers aren't good
> enough.
> thanks
> jon
> 
> 
> 
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