On Sat, 2003-01-11 at 13:18, Bruce Slater, MD wrote: > ---snip------ I like the concept > of palliative computing, in that, we are not trying to cure physicians of > computer illiteracy, rather deliver comfort care - or comfortable computing > tools. It is just that you will never help 2 finger typists with a GUI. > There is just too much that must be communicated in free text.
The other big advantage of a GUI, in both hospital medicine and primary care, is that it allows photographs to become an integral part of the medical record. Now that digital cameras (with quite good close-up "macro" facilities) are relatively affordable, and virtually foolproof, it makes enormous sense to start to use them to record all sorts of things. In geriatric medicine, serial photographs of decubitus and venous ulcers are fantastically useful for measuring progress, especially when more than one person is involved in the care. Photographs of recalcitrant rashes can also be helpful, especially in soliciting opinions from others in a form telemedicine. Here in Australia, melanoma is a big problem, and documenting doubtful looking naevi and other pigmented lesions for later comparison is very useful. Retinal photographs are now standard for monitoring diabetic and other retinopathies, but cheap digital otoscopes can't be far off, so instead of glimpsing the eardrum and noting down what you thought you saw, you can take a snapshot of it for the record. A pharyngeal camera with a tongue depressor attachment, perhaps? I suppose a digital colposcope might also be useful for specialist use. It is not unreasonable to assume that every clinician will routinely carry this type of technology in the not too distant future, and open source systems need to demonstrate they are ready to meet this challenge. Speaking of digital images and telemedicine, an admirable but not often discussed open source health care project is the iPath project lead by Kurt Brauchli in Basel - see http://ipath.sourceforge.net Tim C
