In message <[log in to unmask]>, Jon Rogers
<[log in to unmask]> writes
>Donovan Ross <[log in to unmask]> writes
>>I would like to suggest that the demands for clinical information in
>>acute medicine do not distort the overall demands on primary care.
>
>There are demands for clinical information from clinicians working in
>both the acute sector and primary care.
>
>The work of providing good clinical information for others to use is one
>of the cornerstones of good clinical practice, and as you imply, such
>work does place demands on the clinicians.
>
>The challenge now is to provide good clinical information, in an
>electronic format, that is useful to the recipient. This may require
>common formats, codes and message handling mechanisms, but above all it
>requires the sender and recipient agreeing what is useful information to
>convey.
>
>This has to a great extent been the work of the Clinical Message
>development groups, initially in pathology, radiology and discharge/out-
>patient letters [they reported to the professions in December 1994], and
>more recently in Cytology, A&E and contracting [work on-going].
-I have no difficulty with the clinical argument. The problems increase with the
illusion of "Evidence Based Medicine".
In current medical news items, concerns are expressed over the use of analysed
medical data. I amplify those concerns, not only from the very negative
litiginous aspects but, also from the use of data in financial and political
areas.
I am a partner in a "Nationaly Funded Health Care Project".That is a non
fundholding general practice. When we introduced information processing to the
practice 7 years ago, one of the concerns was the abuse of collated information
by a third party. Financial and political changes since then have confirmed our
doubts.
The role of the doctor in primary care has become blurred. Are we community
physicians, advisors to the pharmaceutical and insurance industries or,
providers of care to the individual? Greek "tragedies" have grown from less.
Power divorced from responsibility is not autocratic, nor even fascist; it is
anarchistic: information providers should beware.
The practice of medicine has been considered evidence of culture - let's hope
it stays that way!
Don Ross
Half a <g>
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