From: Andrew Ho <[EMAIL PROTECTED]>
>> They should make it _quicker_ to record a note than free text is.
>1. the computer interviews/examines the patient and writes the note
>2. mind-reading interface for note creation
>
>Help me out please - am I missing any possible approach?
Well, Microsoft Word and SUN StarWriter actually go some way toward it
with anticipation of what one is writing, many text-processors include
complex macros and glossaries, spreadsheets do more complex things for
function assembly and integrated programming environments get
downright complex. Medical records have many recurrent themes and
passages.
I wrote a tool some years ago for a particular purpose that offered
half a dozen phrases that separately or in combination served most of
its restricted set of purposes and were selected with a click on each
that applied. It was quicker and less boring than typing them.
The clinical terms thesaurus does allow 5 characters and 2 control
chords to make a 60 character note for people to read, associated with
a code that is a little quicker to handle programmatically, which if
one uses a decently fast system (say DRDOS on a 486 on a Novell 3
network for instance, or anything that can get near to that in modern
programming environments) is quicker than typing the whole phrase.
Imagine a daemon that watches what sort of things you type, and what
sort of events occur beore you type them, and stacks them up ready for
you. A hinting engine should be able to do that as well as be ready
to suggest what treatment or investigation is generally agreed to be
useful.
An unsophisticate might think it was telepathic.
As far as the computer doing the talking goes, I don't think Eliza and
her friends are up to taking over just yet, assuming all the Turing
+ves on here are carbon-based, and TV is probably better at presenting
narratives for people to try out as their lives for the moment.
The benefit of observing language and then presenting chunks of it for
re-use is that the computer then has a map for the ontology or other
representation of what is picked, whereas if one freetexts it from
scratch the degrees of freedom are inconveniently large for a
computational approach to determining meaning. I think this also
models some of the socialisation of students into the medical
profession, where one excuse for the professional vocabulary is that
it carries agreed meanings precisely between professionals where
ordinary language would not do so. I think it is only partly true in
that context, but if one is going to do it, lets get mechanical
assistance with precison and with the layered explanations of the
agreed meaning of phrases that are easier to add formally to an
electronic system.
To the extent that the medical record is a narrative, lets have some
narrative tools.
--
Midgley
