>From: Mary Hawking <[log in to unmask]>
>Subject: Re: Data conversion/transfer: a proposal
>Date: Mon, 1 Jun 1998 07:19:59 +0100

>>It has been a requirement since RFA 1 for systems to be able to
output their 
>>data in to an ASCII file for which documentation must be available. 

>Is there a requirement to be able to import data from an ASCII file as
>well? and if so, is there any difference in the ASCII files generated
by
>different systems?

Alas, that one was never written in.  Bizarre IMHO.
However, work is going on in which at least one Meditellite is 
involved on sorting out a way of importing partial records from one 
system into another.

Given that the target is only to do better than retyping (or 
scanning and correcting the scannos) the printout from the last 
practice into an encounter entry it should be very easy to achieve 
something.

I think that the database approach to GP records ignores the 
unclassified morass of interesting material and marginal notes which 
makes up an important and very human-usable part of the record.
Each area of the EMR could do well to have a single memo field or 
plain format file associated with it, so that one would have a 
series of lines of summary info for instance, with a bucket at the 
bottom.  Yes, people would put things in the bucket that should be 
coded and classified, but 
 - getting them on the record means they can be processed 
  with electronic assistance
- code can be devised to inspect the bucket either periodically, in 
  the background, or on entry, to note such terms as asthma and MI 
  and for the bucket wizard to suggest an appropriate place to paste 
  these into the formatted EMR.
- an item in the bucket is clearly distinguished as being from 
  somewhere else or otherwise less true than the ones we enter in our 
  own coded areas.  About like hospital letters filed _with_ the 
  notes, rather than in them.

The treatment history bucket for instance might contain a list of 
OTC drugs and other preparations the patient has had.

Another approach to handling the data format incompatibility problem 
of course is to leave the data where it is in its original format, 
and publish it over the web in response to an interrogation which 
carries a code confirming the patient is registered to the inquiring 
practice.
The host practice system would then present the patient record in 
its normal format on a browser view, allowing each of us the 
occasional opportunity to view each other's systems form the comfort 
of our own desks.
Of course, it would be no time before peple startd writing screen 
scraping code, or Java/Script or whatever which presented the info 
in a common tagged format........... and then we can get on with a 
platform independent medical record displayed in a platform 
independent fashion using common standards which allow infinite 
variation by the individual programmers and users.

Bring on the bucket though, as the first step.


--- OffRoad 1.9r registered to Adrian Midgley


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