On Tuesday 24 December 2002 17:17, John Gage wrote:
> Now, to your practice example...
>
> >Give me all the patients who have a diagnosis of Ischemic Heart Disease
> >ranked by a score dependent upon
> >how high their BP is and how long ago taken
> >how high their cholesterol ditto
> >the inverse of how long since last seen
> >
> >separate them into patients who are already on this list of drugs
> >{aspirin, a beta blocker, a statin} and put first those who are not.
> >
> >That's the order I want to worry about them, and see them.
>
> Frankly speaking, I am unsure how many other practitioners there are
> out there who do it this way.
In the UK it seems likely (there is a singularity next summer but that may go
away) that GPs will be paid on the result of this...
Be more sure.
> In addition, there is a powerful odor
> of the straw man about this, because the process seems to assume both
> lack of knowledge and knowledge at the same time: "I know the
> patient's blood pressure is high and they are not taking a beta
> blocker, but I don't know their blood pressure is high and they're
> not taking a beta blocker." In other words, there is a kind of
> merging between the activities of a general practitioner and an
> epidemiologist that seems somewhat artificial.
You have described the newer part of the role thrust upon us, an element of
our discomfort, and the locus of our IT needs very succinctly.
If it smells agricultural, then it is possibly my bad explanation, but that
is the direction in which my efforts in the practice have been going for a
while.
I would hesitate to claim that it was working, becuase I have not got so far
as I listed yet, but in a not specially welcome CVS management audit my
practice came top of the PCT, which put some colleagues' noses out of joint.
We are not abd at Thyroid stuff either, despite having different views on how
to describe if from the clinical governance team.
(UK "not bad" = American "you will not find better". I have to watch this
language difference.)
> E-mail as medical record keeping system assumes several
> discrete and separate applications residing on the client. That is
> the way it should be no matter what software is used. The idea of a
> monolith consuming the entire client platform does not make sense
> IMHO.
I agree.
Happy hols everyone.
--
From one of the Linux desktops of Dr Adrian Midgley
http://www.defoam.net/
