[log in to unmask],Net writes:
>We need IT guru's to adjust the systems - perhaps with
>laminated sheets next to the screens - so it is EASIER to use the agreed
>(note i dont use the word "proper") code .:^)
Aaaasaaaaararararararagh!
I hate laminated sheets.
In the last year at least five different specialty departments of the
hospital or HA have sent me laminated A3 - A4 sheets which they intend
I should keep on my desktop. It is a big desk, but there isn't space
for them.
Now, if you want to condition code entry then you must use a system
which works at the point of entry, perhaps popping up a reminder when a
code which is unusual and commonly mis-selected is chosen, and altering
the order in which they are presented.
This should be part of the coding system, not something blistered onto
medical practice for GPs to remember to do.
EMIS made a decision to prevent free text searching of their notes,
which may have been expedient at the time, but is now wrong. All the
srting and hinting being done by people going around to look at pateint
notes should be done in the program, in the sort of way that the
Regenstrief Institute did in the 70s off line, and in the sort of way
that WOrd 97 does in something approaching real time now.
2. Weird ideas again
"Surely it is of benefit for a PCG to know how many patients have
cataracts (early or otherwise) so we know how many to purchase for next
year. all it would take is for a practice to use one code rather than
the several available?"
OK, if there are several available search on them all.
It doesn't take noticeably longer, it is something you are normally
going to have to do anyway - search on code 9OX4 for people needing Flu
jabs, and on G3 and on H3 to pick out the ones who need it but havn't
expliitly been coded as needing it, and on Repeat prescriptions for
those being treated for H3 and G3 conditions that havn't been coded as
having them...
and these are jobs that the computer can do in its spare time, so they
should be running, and in the background, throwing up the occasional
improvement in data purity and the occasional opportunity to do some
good.
Don't accept systems of work which load those jobs onto people, even
people who are employed specially for that. There is always something
more useful that they will be better at, that involves doing the things
the automaton finds for us, talking to the patients about why we do it
and so on.
As for the cataracts - observe the historical trends, correct for
variations observed at the hospitals and sample GP data to improve
accuracy. Trying to track every individual is the sort of job that was
dumped by the patients not paper boys, and in the end of the Infernal
Bazaar. It is an accountant's approach to medicine, and not that of a
good accountant either.
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