Dr Jeremy Rogers <[log in to unmask]> writes

>Basically, we all have the impression that for all the data we are busily typing
>in -
>and the even greater volumes which it is suggested we SHOULD be typing in - we
>don't seem to get very much benefit.

Interestingly, in UK General Practice, we have had the first REDUCTION
in what we are asked to type in with the changes in the Health Promotion
rules.  These no longer require 80% of Family histories to be recorded,
but concentrate on locally agreed, evidence-based (groan!) health
promotion programmes, which only require data to be added to the
computer to evaluate effectiveness of the programme.  In some areas of
health promotion, this can conveniently be the same data as is needed to
record patient care, such as BP recording in hypertension.

>I would have thought that, after committing so much money to such a high
>profile,
>publically funded project as the READ codes, there would have been in existence
>from
>the start a more detailed and formal evaluation methodology.

True.  I missed the last NHSCCC Clinical Terms Review Panel meeting, but
know that the lack of decent evaluation did come up for discussion.
Evaluation is generally under-rated in so much of the NHS.

>How will we know if, in fact, READ can *never* fulfil
>the above
>requirements? Is anybody prepared to contenance this as a possibility?

I think that READ can already be shown to meet a number of the
requirements earlier stated.  In particular, there can be no doubt that
Hospital to GP communications of information is really only feasible
with a coding system, particularly for laboratory results, and the only
scheme that is in common use at the GP end is Read.

I am currently involved in helping to ensure that all laboratory result
terms can be recorded from a message into the GP system.  This has
involved looking at how hospitals record the data on their system, and
they are all different!  GPs however, with Read, are remarkably
consistent, and that consistency improves with use.

There are for example several ways of recording a normal smear in Read,
and in 1989 Meditel practices were using them in approximately the ratio
60%, 35% to 5% (show of hands at a conference!) - 5 years later and it
was 100%, 0%, 0% because all the applications and reports used the first
way of recording.

The same is not so yet with recording morbidity, as Ian Purves showed in
his paper to the PHCSG conference a couple of years ago, but even here
some diseases, such as diabetes and hypertension are being recorded very
consistently.

>> Jeremy, it is a continuing source of distress to me that NHSCCC and
>> Galen still do not seem to be using each others undoubted resource
>> fully.  We all want much the same thing, each of us has different
>> strengths to bring it about.  Any thoughts on how to do it?
>
>I can assure you that GALEN feels the same way. An offer to undertake some
>research
>collaboration was made last summer, but declined.

This is a pity.

--
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]


%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%