Dear all, I have spent some time studying how doctors used an EPR using log data (Determinants of frequency and longevity of hospital encounters` data use<http://www.biomedcentral.com/1472-6947/10/15/abstract> ). I must say that some of our results were not so expected, namely the difference on the usage of past information according to patient age (reports of children and older are less used much faster).
I am currently leading a research team to repeat the same study on other logs and so I am very interested in collaborations. Regards Ricardo Correia On Sun, Oct 24, 2010 at 11:58 AM, Thomas Beale < thomas.beale at oceaninformatics.com> wrote: > > I think that the 'pebbles & nuggets' characterisation is probably right, > although I don't think anyone knows what the balance is, i.e. at what point > it ceases to be worthwhile to trawl back in time. The trouble is you get > patients like a 12 yo child with a history of chronic tonsilitis that is > only visible by looking at say 10 years of data. Or try the other end of > the spectrum - notes by GPs over some years may turn out to be indicative of > alzheimers, but only when a diagnostic guideline is applied to say 5 or even > 10 years of data. So how far is far enough? > > I think that what will be needed in the future is a way of filtering out > the useless pebbles on the way so to speak. Perhaps when data were archived > onto slower media. I wonder if anyone has seen research to indicate how far > back data might be useful based on specific morbidities? > > - thomas beale > > > On 23/10/2010 05:26, Derek Meyer wrote: > > Tim, > > I don't claim that all old information is useless. > > My hypothesis is that clinical care generates vast amounts of information, > and very little of this vast amount is useful. > > (This is an empirical hypothesis, and so could be measured, although I > don't know of a study that has. Perhaps a study that > > a) converts real patient records into facts, and the counts the number of > facts, > b) requires patients to be seen without a written health record and a > treatment plan formulated, > c) reviews the treatment plans in the light of the written record, and > d) counts facts which result in changes to the treatment plan, > e) calculates the ratio of facts that were useful in altering the treatment > plan compared with the total number of facts.) > > My hunch is that there are gold nuggets in historical records, but we have > to capture and store too many pebbles to get the nuggets we need. If there > was zero cost to capture and storage this wouldn't matter, but unfortunately > this is not the case with current technology. > > This is an economic problem, and the solution is to look for economic > benefits at the other side of the time spectrum. If information could be > sent to the person who needs it quickly, this time saving could justify the > cost of capturing and structuring the information. Once data are structured > and captured, it becomes cost effective to do a large number of other things > with these data. > > This is not an argument against openEHR - just another way of using > openEHR. > > Best, > > Derek. > > > > > On 22/10/10, *Tim Cook * <timothywayne.cook at gmail.com><timothywayne.cook > at gmail.com>wrote: > > On Fri, 2010-10-22 at 17:12 +0100, Derek Meyer wrote: > > Tony, > > > > This is very impressive piece of work. Every since I first came > > across openEHR I have intuitively felt that it is closer to the > > 'solution' than more static attempts at standardization. So why is > > progress so slow? I've appplied some lateral thinking to this, and > > come up with what many people on this list may (at best) think > > contrarian - but at the risk of being flamed.... > > > > The Case for NPfIT 2.0 www.nationalhealthexecutive.com page 52-53. > > > > (I'll go get my hard hat now...) > > All I can say Derek; is that if you think my past medical, mental and > social history older than six months is useless information. Much less > my familial history of a few generations. > > I am very happy that you are not my physician. > > Maybe if you had all of that information in a meaningful semantically > connected network. You could practice better preventive healthcare as > opposed to band-aid, reactive medicine??? :-) > > > > Cheers, > Tim > > > -- > *************************************************************** > Timothy Cook, MSc > Project Lead - Multi-Level Healthcare Information Modeling > http://www.mlhim.org > > LinkedIn Profile:http://www.linkedin.com/in/timothywaynecook > Skype ID == timothy.cook > Academic.Edu Profile: http://uff.academia.edu/TimothyCook > > You may get my Public GPG key from popular keyservers or > from this link http://timothywayne.cook.googlepages.com/home > > > _______________________________________________ > openEHR-technical mailing listopenEHR-technical at > openehr.orghttp://lists.chime.ucl.ac.uk/mailman/listinfo/openehr-technical > > > > -- > [image: Ocean Informatics] *Thomas Beale > Chief Technology Officer, Ocean Informatics<http://www.oceaninformatics.com/> > * > > Chair Architectural Review Board, *open*EHR > Foundation<http://www.openehr.org/> > Honorary Research Fellow, University College > London<http://www.chime.ucl.ac.uk/> > Chartered IT Professional Fellow, BCS, British Computer > Society<http://www.bcs.org.uk/> > Health IT blog <http://www.wolandscat.net/> > * > * > > _______________________________________________ > openEHR-technical mailing list > openEHR-technical at openehr.org > http://lists.chime.ucl.ac.uk/mailman/listinfo/openehr-technical > > -------------- next part -------------- An HTML attachment was scrubbed... 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