> >If there are enough people willing to build a free version, then things
> >will change.
>
> The question is why? We already have codes for billing and look-up. Why
> do we want more codes?
Current billing and look-up codes measure healthcare only after it has
happened, using an exit code. The desire for new 'coding systems' in my view
stems from a growing desire to document the process of healthcare as it
happens, rather than after it has happened.
Doctors want to do this because they're aware that idiosyncratic treatment
habits are becoming less and less defensible morally or legally with the
advent of EBM. Managers want to do this because whilst they may be able to
agree treatment protocols with clinicians in order to trade quality and
cost, they have no method at their disposal to actively enforce such
protocols or monitor the extent to which they are followed.
Having said that, it is true that commercial and end user interest in the US
remains more or less exclusively focussed on billing needs. But there are
signs that the natives are growing restless, and wanting to develop systems
that standardise - for example - prescribing habits. To do this they need
ways to document what is happening today, to document the facts that
influence a decision to treat rather than simply record the fact that a
treatment has occured, and therefore can be billed for.
So, people want to record stuff and have the computer analyse it. The
systems that have previously done this, but only for billing, have used
things called 'coding systems' but they're clearly not suited to the new
task. Therefore, people ask for new coding systems. Actually, in order to
support the new task, they need something that is only distantly related to
what they're used to.
That's my 2 cents on why we need something new, and why the new thing is
usually called a 'coding system' when in fact its something entirely
different and more complex.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Dr Jeremy Rogers MRCGP
Clinical Research Fellow
Department of Computer Science
Manchester University, Oxford Road
Manchester, United Kingdom, M13 9PL
Tel: (+44) 161 275 6239
Fax: (+44) 161 275 6204
[EMAIL PROTECTED]
http://www.cs.man.ac.uk/mig/people/jeremy/
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