[XML-DEV Mailing List Archive Home] [By Thread] [By Date] [Recent Entries] [Reply To This Message] Re: Reification, was Re: Ontologies
Bob Kline wrote: > On Wed, 20 Dec 2000, Jonathan Borden wrote: > > > In any case one of the activities of the ASTM XML Healthcare > > committee will be to issue an XML DTD for the codification of > > medical guidelines in which many of the raised issues are addressed > > (for example, the authority issuing the guideline, links to > > evidence/articles supporting the guideline, the time period in which > > the guideline applies, etc. etc.). > > What ironic timing for your example, coming as it does in the wake of > yesterday's article in the New England Journal of Medicine reporting > that doctors are consistently ignoring the warnings sent to them about > conditions under which a given medication should not be prescribed. :->} > Despite your surprise, the medical community is aware of errors and there are many people actively interested in ways to reduce errors. Yet the problems are not simple, but technology while greatly increasing the complexity of the system (and hence potential for errors), can also help to reduce errors. The 2001 edition of the Physician's Desk Reference (for medications) is 3506 pages of very fine print. It is updated yearly. Imagine if you were to need to look up each language token in a 3506 page specification before you typed it into a terminal. How much work would you get done? Now realize that many empoyers of physicians alot 15 minutes for a visit. So either the practice of medicine gets alot more efficient or more errors get made or the country decides to spend alot more money on healthcare. Something gives. Without some of the mechanisms we are discussing it is not possible to integrate various warnings and other guidelines issued by various organizations into accessable references AND provide for the absolute necessity of local variations in practice. In my own practice, particularly as we are involved in especially risky procedures, we have a rigorous quality assourance program staffed by a team of Ph.D. trained physicists. Using techniques similar to those associated with quality control on airplane control systems we are able to reduce our error rate to acceptable levels (i.e. we have had no uncorrected errors since this program started). But this is costly. Jonathan Borden (M.D.) The Open Healthcare Group http://www.openhealth.org
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