Recorded vignettes: a novel method for investigating documentation in the Electronic Healthcare Record (EHR)

Background: 360 million consultations documented annually in England1 Accurate descriptors required for secondary data functions: Computerised decision support; Financial reimbursement; Audit; Disease prevalence monitoring and research Coding is not explicitly taught within the GP curriculum How do you research how clinicians document? Previous studies: use real patients2/actors3 interacting with clinician studied; Lack standardisation; Expensive. Why Allergy? Growing clinical problem; 2014 NICE guidelines4: Poor clinical documentation is a major issue in allergy; EHR can’t distinguish between intolerance and allergy; Incorrect labelling of patients; Adverse impact on patient care? Little known about coding practices in non-incentivised condition such as allergy. Method: A novel method developed to standardize research of EHR use. Filmed 6 short vignettes (21-50 secs) Monologue of common allergic presentations as if in consultation with a doctor. Digital photographs were included to replicate rashes. Electronic distribution of study files Documented vignettes in their own EHR Returned screen-prints to the researcher for analysis - Codes, free text and EHR functions Questionnaire - Exploring decision-making and validation of method Initially piloted on 1 GP and 2 trainees leading to refinements. Results 7 GPs and 15 GP trainees were recruited All successfully completed Data was returned from 4 different EHRs SystmOne (6), EmisLV (2), EmisWeb (6) and Vision (8) Screen prints effectively captured data with minor technical difficulties reported by 2 participants The study took 1 - 2 hours to complete: longer than expected from the pilot study

Discovering Knitting at the Regent Street Polytechnic, 1898‐1948

The archive concerning the development and activities of the Regent Street Polytechnic held at the University of Westminster, London is an especially rich source of information concerning knitting, its changing status as craft, leisure activity, charitable work, and morale booster. Charting knitting's role in both world wars, the Boer War, and as a vital mainstay of the Royal National Mission to Deep Sea Fishermen, the text provides a unique insight into the spaces occupied by knitting within an educational institution and how it provided a voice and increased instrumentality for women within that establishment at the end of the nineteenth and beginning of the twentieth centuries

Exploring practical approaches to maximising data quality in electronic healthcare records in the primary care setting and associated benefits

Exploiting the information contained within electronic healthcare records (EHR) data will be key to addressing major challenges to public health both nationally and globally, ultimately offering a means of maximising efficiency and equality in care. There are, however, significant challenges in using EHRs effectively and particularly in ensuring the quality of data recorded. Incorrect or missing data could render records as useless or indeed misleading such that conclusions drawn from the data could have a negative impact. Amongst other difficulties, recording data can be time consuming to the extent of conflicting with the GP’s primary focus of patient consultation in an already time-constrained environment. Understanding the requirements of and the demands upon GPs must be central to addressing the issue of data quality (DQ) within EHRs. As part of on-going work into DQ at the Clinical Practice Research Datalink (CPRD) and in collaboration with the University of Sussex (UoS), a workshop session was held at the SAPC (Society for Academic Primary Care) conference in 2014 with the aim of exploring issues of DQ in primary care EHRs from the perspective of different users of GP data and with particular focus on how and why data is recorded in the first instance. The intended outcome was a furthered understanding of both the challenges and the direct benefits to GPs of ensuring high quality data with a view to establishing a workable approach to recording data and maximising benefits to all users of EHRs

Type-safe Linking and Modular Assembly Language

Linking is a low-level task that is usually vaguely specified, if at all, by language definitions. However, the security of web browsers and other extensible systems depends crucially upon a set of checks that must be performed at link time. Building upon the simple, but elegant ideas of Cardelli, and module constructs from high-level languages, we present a formal model of typed object files and a set of inference rules that are sufficient to guarantee that type safety is preserved by the linking process. Whereas Cardelli's link calculus is built on top of the simply-typed lambda calculus, our object files are based upon typed assembly language so that we may model important low-level implementation issues. Furthermore, unlike Cardelli, we provide support for abstract types and higher-order type constructors - features critical for building extensible systems or modern programming languages such as ML.Engineering and Applied Science