Chris There are multiple dimensions to your question and your enquiry has not explained to what degree you or the division IT department you head have considered this or contributed to prompting discussion
1. What do doctors actually need (and actually utilise!) from past / transferred records. The answer will be clouded by "what ifs" and "threats of legal concerns" and philosophical view of the roles of medicine and the GP. For our surgery we obtain the paper printout or a electronic copy of whatever record is provided. The content, detail and quality vary enormously. Only salient details are kept eg problem lists where there is substantive evidence the list is accurate, a few key summary letters eg cardiologist report post cabg, ECG, We may seek path to resend the last few months of electronic path data (Hl-7 message is far more valuable than any paper or pit copy) Even at this very physical level most of the record is shredded / disgarded! Key problem lists, on confirmation with patient history are coded fresh entries into our problem list (many software players do NOT have hierarchical diagnosis codes and so interrelationships between software is very difficult to electronically "infer" and "code") Coded information is essential if you wish to look at practice wide disease management strategies. A blob file is of no use till someone reads it and interprets its significance. A Hl-7 would be nice but I am highly sceptical this could be delivered by anyone! "We" still struggle to get good reliable HL-7 for basic pathology. 2. The NSW electronic health record project (Health - e - link) has / had as a corner stone of its process the ability to suck in information from multiple GP systems to a central repository. This would have been an ideal way to get a handle on mapping basic core data items between software systems. The centralised summary is far more useful to the "patient" and possibly to the individual doctor seeing the "transferred" patient. It is web accessible anywhere in the world - no disc, no commercial transaction. It was to be a brief summary of key issues eg angina, hypertension, positive stress echo, HPV immunisation and would bypass the lengthy consultation notes .... Perhaps unfortunately the construction of the extraction interface was left to the software vendors - HCN etc. I am not sure this was wise and my opinion (retrospectively!!) is that govt should have engaged a separate entity with considerable experience in cross mapping validating and moving data to build these interfaces. Had this happened then the delivery would have paved a potential path for intersoftware movement of some core data - hopefully devoid commercial dominance. At the very least transfer from health -e link into my chosen software could be considered reasonable and plausible. Maybe even interface engines software to software. The direct commercial pathway with individual vendors allows (or allowed?) vendors a commercial luxury to keep the data extraction interface under wraps - good for share holders "less good" for open movement of patient records between systems. You will recall HUDGP chose to NOT support trials of the NSW electronic health record this despite it obvious importance to GP's and their patients and the beneficial implications to the exact topic you are now asking about. Craig _______________________________________________ Gpcg_talk mailing list [email protected] http://ozdocit.org/cgi-bin/mailman/listinfo/gpcg_talk
