I used to be part of a team with Randy Fernandez. I think he was the one given the MVP dictionary. I was not able to document the changes we put in it but from what I remember, these were highly internal concepts and I sincerely doubt that any other institution would use it. They did not use standards such as LOINC and ICD-10. We used the concept dictionary for the identifiers of their forms and specimens. We gave codes representing employees. The chief complaint was an open-ended textbox. They used a lot of remarks in their forms. Some of these remarks would even be pertaining to certain fields on probable inaccuracies. Some of these concepts are even used to create reports for internal audit.
These are not the best practices but it facilitates the implementation because these are what the employees know and are used to. One of our reasons for choosing OpenMRS was its ability to facilitate an evolutionary type of implementation wherein people don't need to assume at once the best practices and simply evolve to it via revision of the concept dictionary and its forms. By doing this, we allow people to immediately feel the benefits of computerization without having to make a lot of changes that could cause rejection. I think eventually, when these implementations mature and note inefficiencies with what they do, they will adhere to the best practices. On Tuesday, April 17, 2012, Andrew Kanter wrote: > Jonathan, > > I am surprised to hear that you tried the MVP dictionary and didn't speak > to us at all about it. The purpose of the shared dictionary is NOT to > create new concepts which are synonymous. We at CIEL have offered to help > sites map their content to existing concepts or if you can't find necessary > concepts to request them from us and we will add them (and then everyone > benefits). I would appreciate knowing what where the 200-300 concepts you > felt you needed to add. > > As for disease coverage, I think we cover the vast majority of diseases > and map these to ICD-10 and SNOMED CT. Again, if there is something > missing, or a map is incorrect, the community would benefit if you would > let us know. BTW, how did you get a copy of the MVP/CIEL dictionary? I > don't see you on our registration list. > > I could go a long way in explaining why it is best not to create concepts > on the fly. Maternalconceptlab.com is a great way to search the dictionary > and in many cases the concepts already exist. > > Thanks for letting us know of your difficulties, > Andy > > *-------------------- > Andrew S. Kanter, MD MPH > > - Director of Health Information Systems/Medical Informatics* > *Millennium Villages Project, Earth Institute, Columbia University* > *- Asst. Prof. of Clinical Biomedical Informatics and Clinical > Epidemiology* > *Columbia University* > > Email: [email protected] <javascript:_e({}, 'cvml', > '[email protected]');> > Mobile: +1 (646) 469-2421 > Office: +1 (212) 305-4842 > Skype: akanter-ippnw > Yahoo: andy_kanter > > ------------------------------ > *From:* Jonathan Galingan <[email protected] <javascript:_e({}, > 'cvml', '[email protected]');>> > *To:* [email protected] <javascript:_e({}, 'cvml', > '[email protected]');> > *Sent:* Monday, April 16, 2012 6:48 PM > *Subject:* Re: [OPENMRS-IMPLEMENTERS] Import Concept dictionary CSV > > Our government requires us to label our patients based on ICD-10 codes so > that they may be able to monitor the prevalence of certain diseases such as > cholera, dengue, measles, etc. Almost every doctor in our hospital agrees > that ICD-10 codes barely cover the diseases in their specialty but we know > that this helps our ministry of health allocate their resources to more > prevalent diseases. I heard that SNOMED covers more diseases but would > require some fee. Nevertheless, I think that the only way that these codes > could be tweaked to cover all diseases for better research is if clinicians > themselves use it and note the bugs. > > In terms of using the MVP dictionary. I implemented it in one clinic and > could only use 10-20 concepts then I had to create around 200 to 300 more > which were highly synonymous to existing ones. This prompted to forego the > MVP dictionary in this present implementation as it would create a lot of > confusion with the employees and developers here. > > If integration between OpenMRS implementations would occur, I think it is > easier to simply map concepts after than to restrict the creation while the > implementation is ongoing. > > On Tue, Apr 17, 2012 at 5:22 AM, Hannan, Terry J < > [email protected]> wrote: > > ** ** ** ** ** ** > Andy, this is a wonderful clarification of this issue. I would like to > send this to members of our College (ACHI). May I have your permission? > Terry**** > ** ** > Dr Terry J. Hannan MBBS;FRACP;FACHI;FACMI > Consultant Physician > Clinical Associate Professor School of Human Health Sciences, ******** > University****** of ******Tasmania**** ****Department of Medicine, ******* > *Launceston**** ****General**** ****Hospital******** > ********Charles Street******** Launceston 7250**** > Past President **Australasian** **College** of Health Informatics(2007-9) > **** > Visiting Professor, Universita di Modena, e reggio emelia, ****Italy > (Sept-Nov 2010)******** > ** ** > ****Moderator: ****http://www.ghdonline.org/**** > ** ** > Ph. 61 3 6348 7578 > Mob. 0417 144 881 > Fax 61 3 6348 7577 > Email > > ------------------------------ > Click here to unsubscribe <javascript:_e({}, 'cvml', > '[email protected]?body\x3dSIGNOFF%20openmrs-implement-l');>from > OpenMRS Implementers' mailing list -- Jonathan D. Galingan, MD Project Manager for Computerization Philippine General Hospital _________________________________________ To unsubscribe from OpenMRS Implementers' mailing list, send an e-mail to [email protected] with "SIGNOFF openmrs-implement-l" in the body (not the subject) of your e-mail. [mailto:[email protected]?body=SIGNOFF%20openmrs-implement-l]
