My interpretation of your concerns is that the world has multiple groups of Clinicians
distributed throughout with differing Healthcare, culture and Patient communities, plus
they may not all speak English or have a 'good' command of the language.
Language specialist have considered at length modifications to the English language
throughout the world and subsequent impacts. I am reminded of my re-learning of
English after marriage (my Wife is a UK citizen). I remember her telling a female
friend that she would 'knock her up later' and having to expand on that one.
My speculation on the English language is that chaos would ensue if American
Practitioners were immediately swapped with UK Practitioners. The NHS and
insurance aside, I am convinced that communication would be severely affected.
The development of archetypes is important. Global deployment is a separate
issue and re-designs may be necessary. In fact, they may be necessary. The UN and
EU employ large numbers of translators but both have one thing that allows them to
muddle through, i.e., the subject matter stretches from BS to the certain and definite,
e.g., some topics one doesn't worry about.
Healthcare must deal with the certain and definite. Charles Simony i has a point about the
'problem domain'. Personally I prefer 'Information domains' and 'Practice domains' both
dealing directly with Healthcare.
'Information domains' are what outsiders tap into, e.g., when exchanging information with a
Healthcare Provider in India we would both have information requirements, transfer, a
protocol and common language.
'Practice domains', e.g., in India, would likely be comprised of a large number of
sub-domains encompassing both the native and international practice of Healthcare,
e.g., what is acceptable from others and native. An external observer may conclude that
there is sufficient commonality in specific areas to develop a means of describing what is
going on but the benefit of such an effort may be only for the external observer.
External observers have been wrong frequently in the past. For example, concluding that
native peoples around the world have similar rites of worship because they dance around
a fire or built pyramids should be subject to review.
Engaging a second Provider to render a second opinion does not necessarily mean that the
second Provider even read the records. Exchanging a medical record between India
(created) and the UK (reviewed) should not establish the authenticity of the record nor
guarantee that it is accurate and precise. Self-authentication, self-verification and
self-tracking are not yet key elements of EHRs.
But something has to be done for the Practitioners to improve current practices. Then the
new practices can be reviewed for deployment.
The Patient and Patient records interest me. At some point the Patient has to be integrate to
such an extent that Patient-oriented records can be used to connect to Practitioner records
in a meaningful, substantive way. Rationale: Not everyone has an NHS that does most things
for the Patient. In many areas Patients may have to create and maintain their own records
especially if they require privacy. They may also have a legal right to access the records.
Building bridges between languages has been marginally successful in the past. The need for translators remains strong. The accuracy and precision of translations remains questionable.
Employing robots as translators may not improve anything simply because they require
accuracy and precision to begin with.
The number of global spoken and programming languages is large as is the number of dialects.
Developing a 'problem domain' language is probably going to add considerable complexity to
an already complex situation. English barely makes it today but is unlikely to disappear. A new
language would have to be assimilated by many Practitioners.
Test: (1)Create a lengthy English-language message describing a medical diagnosis and a
procedure (2)Translate into a foreign language and ship (3)receive a copy and translate it
back into English (4)Evaluate it.
This does not produce acceptable results in many cases.
The industry might be stuck with fractured English for the time being. Suggestion: Improve upon
existing communications techniques, e.g., go graphical.
Regards!
-Thomas Clark
Wayne Wilson wrote:
Smith, Todd wrote:
This was a fairly interesting interview in that it seems to be expressing inMaybe. It resonated more fully with me from my days in the OMG when a group of us was getting our minds around the RM-ODP concepts. RM-ODP included a multi-dimensional view of all software tasks and one of those dimensions was the business domain. I once asked a famous author of a modeling book, in an OMG session, just what language we could use for modeling the business domain, and he answered, 'English seems to work well'.
a commercial sense what GEHR has been trying to do from an open-source sense
for a while now.
It sounds sort of flippant, but it contained the seeds of deeper meaning. What Simonyi is trying to do is very similar, he talks about the problem domain and how their language is not that of the programmers. He thinks there is some automated bridge between the two, and that's what this article is about.
I am not sure that the current concept of archetypes is in the conceptual space of most clinicians. This is not a criticism or archetypes by the way.
Where I think Simonyi is going to run up against it, is in the rather easy simplication he makes of the english language (or german, or indian, or whatever). Folks have been working on extracting meaning from free text for a quite a while, and still other folks have emphasised the non-textual contexts (strange concept that) embedded in anyone's understanding of how and what they do. I don't really think it's all that simple.
But if it is, then I suspect we can all be replaced by robots. Then we can start having the discussion about who owns the robots, so that the owners of the capital (i.e. the robots) can sit on the beach in a sunny climate, sipping our favorite beverage, reading books, discussing metaphysics with the lady in the next lounge chair and every once in while checking up on the financial status of our robots.
This too might sound flippant, I don't intend it that way.
