kuang oon wrote: > On 23/04/2007, at 12:30 PM, Tim Churches wrote: >> 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. > Hi TimC, > I agree with your diagnosis that unambiguous computer representation of > complex health data for decision support is a potential show stopper. > Am not so sure that piling higher and deeper into a numeric coding > model will be a sustainable solution in the long run.
Kuang, We've had this conversation (online) several times before. I continue to maintain that had you made the intellectual property behind your DOCLE and DOCLEscript coding system freely available, ten years ago, then there is some chance it would have caught on. But you didn't. Instead you sought and obtained patents on the ideas behind DOCLE and have refused requests for any form of royalty-free license to encourage others to experiment with it. As a result, it has well and truly missed he boat and is now just a curious footnote in the (so far) inglorious history of Australian medical informatics. > I digress here, > the following story may interest you. I was plowing through John Wood's > "Leaving Microsoft to change the world" and his adventures in founding > the Room To Read organization. On page 182 he talks of "But for the > Nepali women, the situation is even worse, with 75 percent of adult > women unable to read or write a simple sentence." Back to the main > thread. Could this quote hold the key to the sorry state of decision > support/e-health. The key is "A simple sentence" , or rather the > ability to string together a collection of simple sentences that makes > sense - is the hallmark of literacy. Using a model (fixated on > vocabulary) based on millions of concepts assigned a unique number SNOMED CT has about 350,000 concepts, not millions. > each, but without a syntax and grammar - the EHR systems we have been > building are functionally illiterate like the women described by John > Wood. Sure "sentences" are important, and if you read some of my posts over the last few years you'll see that I have opined that SNOMED CT by itself is not enough. But words are also importnat and your patented DOCLE system contains, as far as I know (since so little is published about it and it can be downloaded for free to examine), only about 3 or 4 thousand terms, all put together and selected by just you. Sorry, not enough, not even for the mundane aspects of general practice. And because of the way you have chosen to patent the system and not license it to anyone, you are going to have to work very hard in your garage to add enough terms to make it viable - probably another 40,000 are needed. > What are the examples of such simple sentences in healthcare that > we need to code ? > This guy/gal has a family history of diabetes mellitus - diabm:fh You mean diab:fm(Patented) > This guy/gal has diabetes mellitus as one of his list of problems - > diabm:eval diab:eval(Patented) > This guy/gal has chronic renal failure from diabetes mellitus - > crf:eval,from:diabm > This guy/gal has a right breast lump 2 cm on physical examination - > [EMAIL PROTECTED]:px,val:2cm,ctx;righ > This guy/gal has a cough for 2 weeks - coug:hx,for:2/52 > This guy/gal has been losing weight for 6 months - [EMAIL > PROTECTED]:hx,for:6/12 > This guy/gal is on gliclazide for diabetes mellitus - glic:rx,for:diabm > This guy/gal is on gliclazide 30mg once a day - > glic:rx,dose:30mg,qty:1,freq:1/7 > glic:rx,dose:30mg,qty:1,freq:1/7(Patented) I'm not joking. Under the terms of the Australian nd international patents you have on DOCLE, plus the copyright, I can't use any of the above codes to transmit information to a colleague without getting permission in writing from you first. Nor can I add new terms to your DOCLE system. Nor can I deploy it in a system without getting permission from you in writing (presumably with exchnage of money involved, else you would have given everyone a royalty-free license by now). Sorry Kuang, that's the reality. > Docle closures** which are "context complete clinical codes" , are the > "simple sentences" referred to by John Wood. > As to moving swiftly and getting a jump on the rest of the world....we > have already moved...to docle closures generated from natural text, > working with Ruby's string handling. OK, show us the goods, Kuang, by licensing DOCLE and your Ruby code in a manner that allows us to examine and use what you have done without having to ask your permission first, and without having to pay you anything. Tim C _______________________________________________ Gpcg_talk mailing list [email protected] http://ozdocit.org/cgi-bin/mailman/listinfo/gpcg_talk
