On Tue, 2004-10-05 at 20:11, Calle Hedberg wrote:

> Finally, just to put the focus back where it started: One key difference 
> between countries with far too few doctors - but often easier access to e.g. 
> admin staff (South Africa has 40% unemployment rate, many of them 
> matriculants that could fill admin positions) - is that it makes little 
> sense to increase doctor workload but decrease admin workload. It makes more 
> sense to do the opposite, and I think that's one reason why most EHR systems 
> don't work well here - they are tailored for health systems with a much 
> higher density of doctors.
> 
> So while we might regret excessive brain-drain, it is not likely to change 
> much in the short term. What needs to change is the design and focus of EHR 
> systems in societies with already over-loaded health personnel.

These are excellent points, and in such contexts handwriting recognition
software is not the issue - rather it is designing paper forms in a way
which maximise the ease of use by health care professionals, and 
minimise transcription errors when admin staff keypunch the information
captured on them. There may be lessons to be learnt from other
industries which also still thrive on paper forms filled out by clients
and sales agents - such as the insurance industry.

Has anyone done any R&D into voice recording for health information
systems, I wonder? Certainly there are highly developed dictation
systems for radiologists and procedural specialists (such as
endoscopists) who need a hands-free recording capability. Some of these
systems even use voice recognition as opposed to a human typist.

I recently borrowed a solid state MP3 player with 256MB of flash memory
to record a seminar session with its in-built microphone. I was
impressed by the quality of the recording, and many hours could be
squeezed on to the device (even more if voice-specific compression
algorithms like Speex were used). Might a cheap, ruggedised version of
these  devices designed specifically for voice recording might find
application in healthcare settings in the two-thirds world?
-- 

Tim C

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