Hi, Reply in text,
----- Original Message ----- From: "Christopher Feahr" <ch...@optiserv.com> To: "Karsten Hilbert" <Karsten.Hilbert at gmx.net>; <openehr-technical at openehr.org> Sent: Sunday, August 10, 2003 10:08 AM Subject: Re: HISTORY DATA SET IN EPR > Karsten, > I agree that the medical concepts shhould be carefully modeled first... > then extract the necessary terminologies... then build the necessary > code lists. I have not wanted to pay the $500 licence fee to look at > SNOMED CT, as it will be free for all in 3 months... so I apologize for > my ignorance there... but my understanding was the the SNOMED people had > already modeled complaints, signs/symproms, diagnosis, treatment plans, > prognosis, outcomes... the whole 9 yards. If that is true (seems too > good to be true!) then it may only require a (simple??) mapping of > SNOMED CT to a collection of EHR Archetypes. A symptom is not for example dyspnoea it has a number of clinical add on parameters that a clinician records beyond onset, duration course. This is not addressed ( my belief stand to be corrected ) in the snomed CT. > > My presumption, given the magnitude of the task of producing such a > granular model... not to mention, the massive physician input and > necessary vetting, for which there is no efficient mechanism...I am > assuming that the SNOMED modeling effort is still at a very high > level.of abstraction. Can anyone fill ne in on the present state of > this work? SNOMED CT claims to already have "350,000 coded medical > concepts", but since it was constructed by a group of pathologists, I am > assuming that other care domains are not represented in great detail. > You are right in your assumption it is mainly pathology focussed and not with a clinicans perspective. > Regards, > -Chris > > Christopher J. Feahr, O.D. > Optiserv Consulting (Vision Industry) > Office: (707) 579-4984 > Cell: (707) 529-2268 > http://Optiserv.com > http://VisionDataStandard.org > ----- Original Message ----- > From: "Karsten Hilbert" <Karsten.Hilbert at gmx.net> > To: <openehr-technical at openehr.org> > Sent: Sunday, August 10, 2003 4:55 AM > Subject: Re: HISTORY DATA SET IN EPR > > > > > The concept of modelling the symptoms in a genric manner manner and > have > > > these called up whenever there is a need to record the details. > > I am not sure I fully understand what you want to say. What do > > you mean by "modelling the symptoms" ? > > > > Symptoms could be recorded as free text. This approach you > > describe as inadequate. It *is* inadequate if the goal is to > > process the input computationally. The solution is not, > > however, to use (inadequate) coding systems as is discussed in > > Slee, Slee, Schmidt, "The Endangered Medical Record" (excerpt > > available from http://www.tringa.com ). > > > > Another approach would be to really *model* symptoms based on > > openEHR archetypes. This promises to offer some degree of > > computationality yet preserve the free text. Others in this > > list have more experience with that. > > > > Data-mining, however, shouldn't be the aim of an EMR. It > > should be focussed on patient care. Data-mining will occur > > with aggregates of extracts *from* EMRs. > > > > Karsten Hilbert, MD > > -- > > GPG key ID E4071346 @ wwwkeys.pgp.net > > E167 67FD A291 2BEA 73BD 4537 78B9 A9F9 E407 1346 > > - > > If you have any questions about using this list, > > please send a message to d.lloyd at openehr.org > > - > If you have any questions about using this list, > please send a message to d.lloyd at openehr.org > - If you have any questions about using this list, please send a message to d.lloyd at openehr.org
