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Rapid Responses: Rapid Responses published:
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![[Read Rapid Response]](/icons/misc/sectionDOWN.gif)
Great text, bad picture
- Adrian K Midgley (14 May 2004)
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In reply
- Jonathan Monks (18 May 2004)
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An excellent paper
- Steven Ford (23 May 2004)
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Facilitating Data Entry
- Dinal Vekaria (31 January 2007)
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Adrian K Midgley, GP Exeter EX1 2QS
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The author sums up many of the misgivings that those of us who are used to using electronic records in medicine have about the current wave of enthusiasm for a big bucks big bang computerisation of the NHS. But the picture of a computer being used is very different from the curent consultation in general practice.
Presumably it was a stock photo. Put the patient and the clinician - or even the clerk - at the apices of a triangle, such that each can see the screen. Competing interests: Sometimes people pay me for advice on this sort of thing |
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Jonathan Monks, Programme Manager (Single Assessment Process) Worcestershire Health and Social Care Services WR 5 2XE
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Very interesting article and outlines the difficulties for all assessors and clinicians face when creating an electronic patient/client record. I would point out this is not just an issue for health staff but also social, voluntary and independent sector providers of health and social care services. We are all used to talking to our patients and clients but do not necessarily record these conversations and observations well in any format. We are certainly not good at sharing information across services, agencies and organisations and all to often information that is shared is of a poor quality, written in jargon or abbreviated so much as to have no meaning to anybody but the author. The use of electronic records with a mixture of free text and coding appears to work best providing the operational and clinical processes have been understood in the production of the system. We are regulated and we need to ensure we make the best use of public monies. We also need to research where the gaps in our services are. We need to know if we are improving the delivery of services whether that’s assessments and diagnosis or treatment and care plan. Management information produced electronically can help organisations carry out this important task. However it is then incumbent on the person inputting information to do this as accurately as they can. We often forget that it not just the patient/client that information is important for. The saying rubbish in rubbish out comes to mind. I would agree that any system used should be kept as simple as possible as most of us aren’t computer geniuses and for many it a skill we are reluctantly learning on the job. I guess what we have to ensure is that whatever systems are developed over the coming decade are developed with the patient/client and clinician/assessor in mind. Not just a system that looks good, delivered on time at great cost and are so technically advanced it is impossible for anybody who is not an IT wizard use. It will be interesting to see what transpires Competing interests: None declared |
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Steven Ford, GP Haydon & Allen Valleys Medical Practice
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Editor This is, by a substantial margin, the most pleasing paper that I can recall reading on the subject of IT implementation in health care. At last, a recognition that the whole of a patient cannot be coded. Hard- and software have a great distance to travel before they can effectively emulate the best features of a consultation and make available to the clinician the narrative, subtexts and soft data that are so crucial in evaluating a patient. Steven Ford Competing interests: None declared |
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Dinal Vekaria, SHO Oxleas NHS TRust, Greenwich, LONDON, SE18
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I am writing in response specifically to a section of your article regarding the various intricacies and complexities involved in the data entry procedure. As you are no doubt aware, we are entering into the Rio system with varying amounts of apprehension, one of which raised by many of my junior doctor colleagues is the effect it would have upon their time-managment, with special focus on the sometimes large amounts of text which will need to be entered on the Rio system. I have been working on a Voice Recognition Software package championed by my Consultant, which has drastically reduced my time spent typing long entries. I am also conducting a survey to see how the Voice Recognition Software responds to a variety of different accents and backgrounds, which we obviously have within our multinational NHS! The results have been very positive on all counts, and the ease and speed of data entry has improved by a subjective estimate of 300%, and also allowed us to use the software in a variety of situations including emergency assesments and Outpatients Clinics. I have no declaration of interest and I have intentionally omitted the trade name of the Software we used, but as the software is constantly improving, I am sure that such software will greatly facilitate the huge amounts of electronic data entry we now face with the impending change. Also, I know that this will contribute greatly to the viewing of the patient as a whole entity with more data being able to be entered with less effort. Competing interests: None declared |
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