tag:blogger.com,1999:blog-23447705.post2365784878382041045..comments2024-03-29T09:18:22.495+11:00Comments on Australian Health Information Technology: What Is The Problem With E-Health - Could It Just Be Complexity or Is It Something Else?Dr David G More MB PhDhttp://www.blogger.com/profile/06902724829795199526noreply@blogger.comBlogger10125tag:blogger.com,1999:blog-23447705.post-34056227942235739672011-08-19T11:48:40.836+10:002011-08-19T11:48:40.836+10:00Andrew McIntyre said "I don't think the p...Andrew McIntyre said "I don't think the policy makers understand the space."<br /><br />The fact is the policy makers DO NOT UNDERSTAND the space. When MediConnect and HealthConnect were first conceived it was evident from the way they were approaching the problem(s) they did not understand the space. After a decade of floundering about there is no evidence that I can see to Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-23447705.post-17519769879825285182011-08-19T10:27:33.134+10:002011-08-19T10:27:33.134+10:00I would agree that the focus on inventing new stan...I would agree that the focus on inventing new standards to solve the problem is not required. What is required is some direction so that vendors can invest in the things you speak about. We have SNOMED-CT but almost nothing has been done to encourage its real use. I don't think the policy makers understand the space.Andrew McIntyrehttp://www.medical-objects.com.aunoreply@blogger.comtag:blogger.com,1999:blog-23447705.post-69752097512446545472011-08-18T11:17:23.191+10:002011-08-18T11:17:23.191+10:00There is nothing in HL7 V2, or any other interoper...There is nothing in HL7 V2, or any other interoperability standard, that is going to solve the issue of coding clinical notes using Primary Care Practice Management Software. <br /><br />To quote one of the more sagacious posts (from Lloyd McKenzie) on the HL7 Forums, relating to the 'Fresh Look' Taskforce': <br /><br />"Fully encoded SNOMED with detailed and nuanced data models Peter Jordannoreply@blogger.comtag:blogger.com,1999:blog-23447705.post-35374599063592726452011-08-17T22:35:48.176+10:002011-08-17T22:35:48.176+10:00I am sure that NLP could be used for population ba...I am sure that NLP could be used for population based decision support and is desirable to aid automatic coding of clinical notes, as long as a human gets to confirm that its correct. What google does is population based and that obviously works.<br /><br />While I am sure you could do some really useful Decision support with a single patient and NLP, I doubt it is safe enough to make strong Andrew McIntyrehttp://www.medical-objects.com.aunoreply@blogger.comtag:blogger.com,1999:blog-23447705.post-32985791710723836552011-08-17T22:09:22.440+10:002011-08-17T22:09:22.440+10:00Hi Enrico
It all sounds so good. But I've use...Hi Enrico<br /><br />It all sounds so good. But I've used speech recognition software...Grahame Grievehttps://www.blogger.com/profile/08635283945076545993noreply@blogger.comtag:blogger.com,1999:blog-23447705.post-29094859991298141312011-08-17T20:20:28.101+10:002011-08-17T20:20:28.101+10:00Hi Graham
Google is one example only - and I hea...Hi Graham<br /><br />Google is one example only - and I hear you about the requirement for large volumes of text to build up statistical profiles for the context in which terms occur. But we are exactly moving into that world right now as EHRs become ubiquitous. Look up i2b2 for the state of the art in text mining medical records - not yet 'perfect' but rapidly getting there.<br /><br /Enrico Coieranoreply@blogger.comtag:blogger.com,1999:blog-23447705.post-47291569196880685192011-08-17T19:16:30.053+10:002011-08-17T19:16:30.053+10:00hi Enrico
I missed hearing you at HIC, I'm af...hi Enrico<br /><br />I missed hearing you at HIC, I'm afraid. Google finds crude data is fine, because they pass the signal/noise ratio on to humans. And it works not so fine for me. Am I wrong to use the goodness of google search (or not) as a yardstick for the state of the art here?Grahame Grievehttps://www.blogger.com/profile/08635283945076545993noreply@blogger.comtag:blogger.com,1999:blog-23447705.post-474227543334512242011-08-17T18:04:16.977+10:002011-08-17T18:04:16.977+10:00This little discussion echoes a few things I said ...This little discussion echoes a few things I said at HIC recently, so let me reiterate a 'heretical' viewpoint.<br /><br />Google seems to find that 'crude data' is just fine for the many wonderful things it does in determining what are concepts or interest, what the terms for them are, and where they occur in a document set. Not a hint of SNOMED or UMLS to be seen - its all Enrico Coieranoreply@blogger.comtag:blogger.com,1999:blog-23447705.post-8270092568149725232011-08-17T15:57:31.781+10:002011-08-17T15:57:31.781+10:00Re Decision Support. I am a fan as there is eviden...Re Decision Support. I am a fan as there is evidence that well done it can improve safety and reduce errors. (the trick is to do it well) As the clinical information becomes more subtle it becomes harder and harder I suspect.<br /><br />An on this:<br /><br />"The real concern is the degree to which this crude data is suitable for decision support." <br /><br />Not quite - my concern isDr David G More MB PhDhttps://www.blogger.com/profile/06902724829795199526noreply@blogger.comtag:blogger.com,1999:blog-23447705.post-44425077444716341962011-08-17T15:50:34.315+10:002011-08-17T15:50:34.315+10:00hi David
> Tell me how we can handle a special...hi David<br /><br />> Tell me how we can handle a specialist letter <br /><br />The obvious answer is that the letter itself remains as narrative. It's accompanied by the relevant system details that can be and already are represented structurally - adverse reactions, medications, history (diagnoses and procedural detail), diagnostic reports.<br /><br />As you say, the structured data is Grahame Grievehttps://www.blogger.com/profile/08635283945076545993noreply@blogger.com