[EMAIL PROTECTED] wrote: > In response to Tony's pondering we are doing soemthing that is related. > Although let me say this is a research project where we are trying to push > the boundaries rather thatn satisfy a specification. It may not be > everyone's cup-of-tea. > We call the project Generative Hospital Information Systems and it has that > name because we consider it is system to generate special purpose > information systems. Some of its philosophical features are; > 1. The users define the the nature of the data they want to collect ( with > the help of a generic data dictionary) > 2. The users define the screen layouts and formats for collecting that > data. > 3. The patient's information is a story stored in a document repository > rather than a record repository, hence reteival is of a form previously > populated by someone else. > 4. The fundamental objective of the system is to support analytics, > everything else comes as an adjunct to that objective. This is justified > on the basis that clinicians purposive use of an IS is to get it to answer > questions as distinct from just retreiving patient hi-stories. > > Our first attempt will be to replicate the processes in the ED at a western > sydney hospital. We spent 3months there last summer doing a process > analysis which we now have on a piece of paper covering the better part of > a small wall. If we hit the spot we will have something that at least > performs up to the current EDIS but can do better with functionality for > clinicians, greater flexibilty to re-engineer and potentially much > superior analytics. We won't have analytics functioning for the first > release.
Mention of the ED focus might cause some subscribers to this list to lose interest, but it shouldn't. As I explained to Jon, it is not likely that such a system will see use in NSW or perhaps other Australian EDs - in most state hospitals, plans are already in place to upgrade to ED systems from one or other of the large hospital info system vendors, with the aim of very close integration with the rest of the hospital IT milieu from the same vendors. Besides, developing, proving, documenting and integrating any major, mission-critical hospital IT system requires millions of dollars of investment (much of that money needs to be spent on a lot of "process" which may not achieve a great deal, but nevertheless, the game has to be played according to its rules). However, such concerns are missing the point: the project which Jon describes is an R&D project to explore and develop new designs and methods for building complex health information systems, and as such it doesn't matter if the system is never deployed. And as a target in the hospital setting, the ED is a good choice, and is potentially more generalisable to other settings such as community health and primary care medical practice. I've also expressed the view to Jon that community health (incl. community nursing) and general practice are the areas that will really matter in the next 5-10 yrs with respect to health IT, as everyone (slowly) realises that the cost of using traditional acute care hospitals to deal with the full spectrum of health problems is just unsustainable. Thus I think it would be worth the while of subscribers to this list to take an active interest in this project, and, picking up on Tony's hypothetical, to seriously think about approaching Jon with regard to collaboration on the mooted open source GP system. Jon is still in the process of bootstrapping his health IT R&D facility, but it looks like it is going to fly. This nascent health IT facility, which will as I understand have a deliberate affirmative action policy with respect to open source, has a lot to recommend it as a potential home and vehicle for creating an open source GP system, based as it is in a university School of IT (with the access to staff expertise and to smart students looking for projects to work on, not to mention a shiny new glass-and-steel building to live in), and with joint governance arrangements with the Faculties of Medicine (including general practice) and Health Sciences (and teh National Centre for Classification in Health, whcih is also part of USyd). Jon also has a track record of taking academic research (in computational linguistics) and translating that into useful, large-scale production information systems - in particular, ScamSeek, which was commissioned by the Aust. Securities and Investments Commission to automatically seek out financial scams on the Internet, so that its officers could then investigate them and take appropriate action to protect vulnerable people from losing their life savings. Although the GP information marketplace is fairly tight, as many on this list have commented, there is still a lot of room for better, innovative systems, and the change-over costs for GP systems, while still significant, are not nearly so massive as the cost of changing information system horses in hospital settings. Also, a GP system, while still complex, is not so vastly complex that it boggles the mind ( thinking about the requirements for and complexities of modern health IT systems for, say, a teaching hospital, or for a network of teaching hospitals, causes liquefaction of my brain). As I have said before, my interest in all of this, as an ex-GP who is now a public health person, is in the huge role which primary care information systems, and yes, ones with much better analytics, should have in helping to improve population health. Tim C _______________________________________________ Gpcg_talk mailing list [email protected] http://ozdocit.org/cgi-bin/mailman/listinfo/gpcg_talk
