> [log in to unmask],Net writes:
> >accept that you have to search on all the terms that people may have
> >>used for
> >> depression instead of picking an approved one
>
> > that's fine if you want to use the system for care of individual
> >patients - and it might even be possible to use it like this for your
> >practice...
> >What about data for Health Needs Assessment? *Any* MIQUEST type query is
> >going to miss patients if GPs insist on doing their own thing !;->>
>
> No.
> If all the terms are included in the query then all the terms will be
> searched on.
> It substitutes an unfeasible regimentation - or an implausible degree
> of interest, skill, and agreement at the coalface by a rather loonger
> and more detailed thought and careful framing of question by the person
> who wants the answer.
>
> Radical idea for the NHS I know, but it does give the capacity to work
> around known weaknesses in our systems.
>
And believe it or not, this is the approach taken by that well-known
NHS-E pilot project - Collection of Health Data from General
Practice!
What seems to happen, however, is that with feedback of comparative
anonymised data, practices begin to consider the coding they use and
try to make it more consistent, firstly within the practice and then
across a group of practices. Believe it or not, there are many
practices that are only too happy to seek guidance and apply it as to
the appropriate use of coding, and these practices do not feel as
though they are being 'regimented'.
Going back to the original topic of discussion, depression, we are
carrying out some work on clinical coding for this 'problem' (I
hesitate to say diagnosis, condition, disease, or even syndrome -
depression is such a catch-all term covering a large number of
symptoms of varying degrees of severity with varying aetiology), so
the discussion on the topic has been very helpful for me. It is also
being worked on by the National Casemix Office as part of a project
they are doing to try to produce draft Health Benefit Groups and
Health Resource Groups for mental health and learning disability.
Anyone interested can talk to a chap called Richard Carthew, 01962
844588.
Sheila
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Sheila Teasdale, MMedSci Tel 0115-924 9924 ext 44258
Research Fellow Fax 0115-970 9389
Collection of Health Data from General Practice
Dept of General Practice
Queens Medical Centre
University of Nottingham
NOTTINGHAM NG7 2UH
email [log in to unmask]
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