Hi Ed, One needs to distinguish between System Designers and Application Designers and both can be subdivided further, e.g., Fault-Tolerant. System Designers 'handle' the data and information; Application Designers 'handle' the content.
Understanding the difference between data and information is required for both and each has to be aware that some of the data and information may not be present for their consumption, perhaps a majority may be destined for others. A simple analogy is a communications technology, e.g., Fibre Channel networking, in which the data in packets are subject to further structuring beyond the current node. Some of the data can be 'local' and the remainder for remote users. The System/Application Designer retrieves the data, and information, required to perform their tasks and passes the remainder on. Good design includes data/information modification to indicate later that the access has been made. In some cases additional data, and information, is added to indicate that the data, and information, has reached the current node or another event has occurred, e.g., errors reported. The original data is left undisturbed. Such features are desirable, for example, in Fault-Tolerant Networking. An EHR-based system serves many users with different requirements and often little contact between groups of users, e.g., General Practice, Surgery, Mental Health, Public Health and Dental. For whatever reason a record is created, by whom and within an environment it is a container that users can add information but never delete information (persistent monotonically increasing). If at some point a user is moved to consider the content useless they should be able to create their own 'container' and link it to the original. 'Link' is very important since to do otherwise would produce chaos quickly. An EHR-based system compared with my paper-based Healthcare record (well over 100 pounds at present) shows the same separation of disciplines, e.g., GP enters their data, the Surgeon theirs, the Therapist theirs and the Emergency Room theirs, each reminding me it is my responsibility to inform the others of the results. All their 'data' end up in the same bin, i.e., my paper file. I often wondered why they would not or could not read each others reports until I tried to read them myself. I then realized why Attorneys have to summarize medical records and threaten to introduce the medical records into the court records. One could say that it is 'too much information' and one would expect to be prevented in Court from having a GP review and analyze the report from a Brain Surgeon, but in no way would one be allowed to 'edit' even their own historical record. My suggestion is to take what you need from the record, but be sure to take everything you need, and move on. Practitioners can't end up as Data/Information Editors. In creating records follow a set of rules that include 'error on the side of excessive reporting' and ignore potential future comments. Going back to 'fix' the record is really not a good idea. Recall one difference between paper-based records and Electronic Records: the time interval associated with data capture and recording is a lot shorter and hence reduces the amount of time available to reflect on what you are doing. Apart from the 'System/Application Designers' attempt to incorporate redundancy into a records system to enhance recoverability in the presence of hardware failures and software errors, extraneous record data in the opinion of a Practitioner rarely harms them. If it becomes an issue them a discussion with others associated with the record might relieve some tension. A better approach might be to focus on the accuracy and precision of the data, and information, that a Practitioner retrieves from the record. Regards! -Thomas Clark William E Hammond wrote: >However, in my opinion, one can have too much data. Information, by >definition, is more than data and conveys something understandable and >useful that was not known before. Information deals with raising entrophy. > >Long story short, designers of systems need to undersatnd the difference in >data and information - ands, ideally, provide just what is needed when it >is needed to address the circumstances of the situation. > >Ed Hammond > > > > > > "lakewood at copper.net" > > <lakewood To: > openehr-technical at openehr.org > > Sent by: cc: > > owner-openehr-technical@ Subject: Re: Issue 1 > > openehr.org > > > > > > 05/28/2005 10:47 PM > > Please respond to > > openehr-technical > > > > > > > > > >Hi Dr R LONJON, > >This response pertains to: >"... >In short according to Shannon (theory of information), too much >information, no precise, mask the good information to take a decision. > >..." >REFERENCE (Shannon Information): >http://www.iscid.org/encyclopedia/Shannon_Information > >"... >concerned with quantifying information (usually in terms of number of bits) >... >as they are communicated sequentially from a source to a receiver ... >The amount of ...information contained in a string of characters is >inversely related to the probability of the occurrence of the string >... >Shannon information is solely concerned with the improbability or >complexity of a string of characters rather than its patterning or >significance >..." > >REFERENCE (Complexity): http://www.iscid.org/encyclopedia/Complexity > >"... >often used to describe single systems made of multiple interacting parts. >However, >... can be used for a large variety of applications >...* *Computational ... Time ... Space ... Kolmogorov (algorithmic) ... >Connectivity ... >Descriptive/Interpretative ... Functional >..." > >Decision Theory (e.g., http://www.answers.com/topic/decision-theory) >would be more appropriate. > >Once Healthcare-related information is available to a Practitioner one >enters an environment in which >the types of decisions made and the content upon which they are based >are outside of >Communications Theory (see Decision Theory Reference). Rarely is there >'too much' information. >A more important issue is Upon which portion of the available >information, or all of it, should a >decision be based? > >Regards! > >-Thomas Clark > > > >Dr LONJON Roger wrote: > > > >>Hi all, >>the exercise of medicine is an art. >>This is not an exact science as the physics. >>With the biology, the anatomo-pathology, the x'ray explorations and >> >> >R.M.Imaging, > > >>the physician gets information that are validated. >>They are validated because there was physical signal registration that was >>digital, pictures in RMI. These pictures, as blades of microscope, can be >>reread, in the time by other physicians. >>They have a statute of data validated by the physician and therefore >> >> >publishable > > >>in the file of cares of the sick. >>The diagnosis makes by the physician is the result of a reasoning, from >> >> >one > > >>wholes of information that it to on his patient. One teaches it to >> >> >students > > >>future physicians. >>The diagnosis is sometimes fast, but often it asks for a delay of several >> >> >days > > >>weeks or years!! or never !! >>Hypoth?seses, elaborate by the physician, are only some likely, probable >>information. >>In France, there is an agreement to say that it is about " personal " >> >> >Notes > > >>that are not validated.and what are the property of the physician. >>They are not therefore publishable and especially no opposable in >> >> >judicial > > >>proc?s case. >>In short according to Shannon (theory of information), too much >> >> >information, no > > >>precise, mask the good information to take a decision. >> >> Distressed for my English!! >> >>Dr R LONJON >>France >> >>- >>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 > > > > - If you have any questions about using this list, please send a message to d.lloyd at openehr.org
