David Guest <[EMAIL PROTECTED]> wrote: > > David More wrote: > > Hi David, > > > > I don't - but would want to want the decision support / knowledge > > management axis to the other capabilities. > DS is nice but nobody has shown you can do that yet. It might be > feasible with data codification but there are lots of implementation > issues before even that happens. I'd go for the low hanging fruit.
Agree. Decision support systems (DSS) should be the subject of much funded research and field trials, but it is not ready for prime-time because we don't have a good way of unambiguously representing medical information in a computable (coded) form, except in small niche sub-domains. Try building, say, a decision support system for antibiotic prescribing. The clinical problem/diagnosis/setting information is not encoded adequately in *any* existing clinical information system, and microbiology results are currently reported by labs as free text, expressed a zillion different ways. Sure you can build a system in the research lab which the clinician re-keys the relevant data into the DSS tool, but that will be used about once in practice before users become tired of re-typing data that is alreday in the system, but in the wrong form. But gee, wouldn't an open-source primary care reference IT platform would be a great way to turbocharge applied research and field trials into the use of SNOMED CT and classifications/codesets in real-life settings, and research and field trials of DSS built on top of that? As it stands at the moment, any academic group wishing to engage in such trials needs to negotiate on a commercial basis with the major closed-source provider(s) of GP clinical info systems, which is why we are seeing so little field work in this area. Australia can get a jump on the rest of the world here, if it moves swiftly. > > The worry, as always, is finding the sponsor / funder for such a > > project be it Government or a Commercial Provider prepared to use the > > Open Source Model. > There is market failure, the open source community failed and the Feds > find it politically unacceptable, which is why I suggest we all forget > about the EHR|F for the foreseeable future and let Greg get some sleep > at night. Forget Minister Abbott and colleagues. They are history (and so is Australia if they get back for yet another term). It is Minister-in-waiting Roxon and her colleagues Gillard and Rudd (and maybe even McCue...) who need to be convinced to fund such an initiative, perhaps in public-private partnership with, say, one or more private health insurance companies (providing, as I have mentioned before, said health insurer with an ongoing promotional opportunity via a poster/sign on the wall/reception desk of every general practice using the sponsored software). Tim C _______________________________________________ Gpcg_talk mailing list [email protected] http://ozdocit.org/cgi-bin/mailman/listinfo/gpcg_talk
