Hi Phillipe > Hi Chris, > > Maybe I missed some point, but I don't understand 2 things : > > 1) What do coloured sectors mean ?
The Grey sector means that those people have ben screened and diagnosed with an illness of some description eg malaria, scabies, pnuemonia, TB . The Pale yellow sector means that this part of the comunity population has NOT been screened however there is a potential for some of this population to have the illness(es) A single colour represents one type of illness Two colours means the patient has two illnesses eg TB & Scabies I think 4 colours is the maximum you would want to show before it became too difficult to display. > 2) Do you need "datawarehouse" or "epidemiology" >From my understanding of epidemiology it is not possible to represent a "true" epidemilogical picture on the small number of people in many rural communities. And given the poor literacy and numeracy among many of these groups I was trying to give the local community health information in a format that they could understand ie in symbols they could easily relate to. The idea being, the next month ,the Health worker could run the figures and show the health comiittee or community whether health in their community has improved , got worse or stayed the same. We would then represent any interventions medical , environmental etc to show that such and such action or behavior can bring about a change in community health status. I am approaching this from empowering the endusers ie the patient,family community to make decisions about what how when & why and even if they should take some action.. To take the use of symbols in health idea a little further: How can you explain to a young mother (whose language you do not speak) that not providing fluids to a child with diarrhoea may stop the diarrhoea but the child is likely to become very listless The Mother may well believe that the diarrhoea problem is solved and want a "tonic " to brighten the child up. How would many of us approach this situation? I think many of us would be reaching for our pencils and trying to think rapidly and draw the problem so she understands and can in future take more appropriate action - knowing that otherwise the scenaro is likely to be replayed. I think that in cross cultural exchanges there are certainly benefits to the use of symbols and diagrams to exchange information > If you work from descriptions, you need to use semantic in order to group > people with "same kind" of diseases. Not easy. > > If you can "classify" datas (with ICPC or ICD for example), it is easier > since the MD has done the job of "grouping" for you........ <snip> > ............Currently the only stat modules we developped are of the "top 25" > encountered pathologies - and currently only ICPC (CISP) is used - but > we/you can do what we/you want, since each module is autonomous. This is interesting in Central Australia we concentrated on collecting the top 20 illness groups (plus "Other" - which of course was huge:-(( ) I believe that epidemiologists would have problems with the data and say it was not was not concise enough to give a true statistical picture. ....but for our purposes we were able to demonstrate not only to the community but also to funding bodies that we were making signifcant inroads into many health problems. Would it be possible to have an ICD code for such an inconcise grouping of illnesses? To some extent a diagnosis in remote areas is of lesser importance to the patient than the cure. If the antibiotic cures the chest infection the patient is not likely to be concerned whether it is pnuemonia or bronchitis as long he feels better and can go back to work. Again this is another factor - the lack of diagnostic skills of the healthworker / RN .The doctor if there is one may well be hundreds of miles away telephone communications poor to non existant. How does an EHR cope with this (not unimportant) factor?? So while we seek useful tools for the clinicians perhaps we should also remember to include "symbolic " or educational tools for for the health worker further down the food chain:-)) Best wishes Chris
