At 05:12 PM 11/30/00, you wrote:
> > I suggest that we focus on software that obtains,
> > categorizes, and makes available a patient's medication history
> > (including medication allergies).
>I agree.
Without dwelling on the excitement and feelings of tumescence I got when I
read those words, I think it is necessary to point out that the clinical
perspective, the *busy* clinical perspective, is very, very important for
these discussions. Because technology is driving us to measure things like
individual cell metabolism and the amount of trace elements in ear wax,
doesn't mean that that is what is needed either a) to care for a patient or
b) make a good medical record.
I am very interested in the relationship between Shakespere's sources and
his plays. In particular, I am interested in why he selected certain
pieces of text almost verbatim from his sources and completely neglected
other, frequently adjacent, pieces. I think we may assume that this
process was not entirely random, that Shakespere did not throw darts at his
sources and use whatever the dart hit in his plays. No, he obviously was
able to *hierarchize* the material in the sources, and his ability to do
this well was a major part of his genius. Medicine is nowhere near as
difficult as taking Holinshed and turning it into Henry IV, but the ability
to hierarchize information is key to both. We now have two busy clinicians
(from widely different specialities) who say that they assign the
medication history to the highest priority in their practice. It is
obviously a very useful focus.
>In lieu of an "application" I just keep two Applix (word processing)
>templates up, one for a med list and one for a prescription. I file
>them by the patient's chart number and date of visit, so they're a
>snap to pull up. I print out a copy for my patient, one for the
>paper chart, and if a prescription is necessary, I just paste the
>med list into my prescription template, print it, sign it, and hand
>it to the patient.
>
>I use the Medical Letter site for drug interactions; frankly, there's
>not often need to run this very often, as drug interactions tend to
>be constant, and the panel of medications in my practice is also
>stable, though large.
>
>It works, it's fast, the only improvement would be a link to the
>vaporware EMR that the mother house has been saying is just 3 years
>off for the last 5 years.
>
>It does require a little intranet: I have a 19-inch LCD screen, a
>LaserJet 6L, and a cheap linux box in every exam room. The LCD
>screens save precious real estate at premium of about a grand
>per room. I bought these out of my salary and it was worth every
>penny.
>
>The next logical step is to put the Rx app on a palm with an IR
>port, I guess, but I prefer not to write Rx's out of the formal
>setting of the exam room, and not having one is a good excuse
>when the occasional patient stops me in the mall and asks for
>a stat refill of that little blue pill he takes at bedtime --
>"You know, doc!"
>
>Dan Johnson
Words to live by. An extremely interesting system. Worth embodying in a
net application such as a subset of FreePM or freemed.
John Gage
