[log in to unmask] writes
>looking in the doctor-patient relationship problems codes I was struck by
>the apparent absence of:-
>
>9NH2.    patient fancies doctor

In 15 years of General Practice, I've never needed to record that!  Is
it just me?
>
>in Read V3.1 (you remember Read version 3.1 - scheduled for release a
>little before Windows 95<GGG>)

It certainly has taken longer than expected, however, the terms are good
and plans for implementating Read 3 in General Practice are underway.

The recent publicity about the financial arrangements between the NHS
and James Read has been distracting from the really important issue of
"what terms do we need to run the NHS"?

It is my firm belief that we do need a common set of terms across the
NHS, particularly for communication between Clinicians, whether they be
GPs, Nurses, consultants, physios etc.

Those terms do need to be comprehensive and compatible.

They need to handle the huge quantity of historic patient data we have
in General practice, in older Read Code sets.

They need to map with ICD9 and ICD10 and OPCS and ICPC to allow
aggregation, comparison and analysis.

They need to handle decision support and reporting requirements for
modern general practice.

The Read Codes meet these sometimes conflicting requirements better than
any other system.  You really don't want to throw away your Read records
and start again.

>
>With University term just about to start I see that STUDENT is sitll not an
>occupation, and even for those graduating UNEMPLOYED remains a life event
>an not something to group and compare for morbidity with TOP administrators
>and civil servants, or MPs for instance.

I think that is your GP system implementation:

Student .133A.
Unemployed .13J7.

I agree they are not in the .0... OPCS employment category codes, but
firstly they are not OPCS Employment codes and again, in Version 3 the
link between the first character of the Read code and the chapter is
removed, with consequence that the terms can appear in two hierarchies.
0
>The NHSCCC/CAMS contention that Read is more comprehensive than any other
>code system and therefore is suitable to export to hospitals, and foreign
>countries unfortunately appears to be contradicted by postings from
>Australia, New Zealand, Portugal, Canada, Holland and our local hospitals.

I can see that Read Codes may not be the most suitable route outside of
the UK (I suspect it will be, but agree that is some way down the line),
however, in the UK NHS it has a vital part to play.

A lot of comments from hospitals is based on poorly viewed copies of old
Version 2 release sets... Only yesterday I had "but Metamyelocyte count
isn't present"... Oh yes it is.

We need to work with what we have got and work towards what we need.
All version 2 and 4 byte terms can be carried into Version 3 without
mapping, as they are all still present.

The GP SWG (of which I have the "honour" to be Chair!) is laying out
with the help of technical advisors from the GP System suppliers what is
needed to support GPs, and much effort is currently going into the
hospital sector as well.

>
>Can anyone nominate an area in which Read is actually worth the UKP 80 per
>year we are obliged to pay?  I can't.

We get monthly drug updates, which together with the Multilex data allow
us to precribe accurately, and report on that prescribing in a
consistent way.

--
Jon Rogers                                    Tel: 44 117 950 7100
Southmead Health Centre                       Fax: 44 117 944 5498
Bristol BS10 6DF   UK                      e-mail: [log in to unmask]


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