Coding of procedures documented by general practitioners in Swedish primary care-an explorative study using two procedure coding systems

<p>Abstract</p> <p>Background</p> <p>Procedures documented by general practitioners in primary care have not been studied in relation to procedure coding systems. We aimed to describe procedures documented by Swedish general practitioners in electronic patient records and to compare them to the Swedish Classification of Health Interventions (KVÅ) and SNOMED CT.</p> <p>Methods</p> <p>Procedures in 200 record entries were identified, coded, assessed in relation to two procedure coding systems and analysed.</p> <p>Results</p> <p>417 procedures found in the 200 electronic patient record entries were coded with 36 different Classification of Health Interventions categories and 148 different SNOMED CT concepts. 22.8% of the procedures could not be coded with any Classification of Health Interventions category and 4.3% could not be coded with any SNOMED CT concept. 206 procedure-concept/category pairs were assessed as a complete match in SNOMED CT compared to 10 in the Classification of Health Interventions.</p> <p>Conclusions</p> <p>Procedures documented by general practitioners were present in nearly all electronic patient record entries. Almost all procedures could be coded using SNOMED CT.</p> <p>Classification of Health Interventions covered the procedures to a lesser extent and with a much lower degree of concordance. SNOMED CT is a more flexible terminology system that can be used for different purposes for procedure coding in primary care.</p

Negotiating agency: Amish and ultra-Orthodox women’s responses to the Internet

This study explores how women in two devout religious communities cope with the Internet and its apparent incompatibility with their communities’ values and practices. Questionnaires containing both closed and open-ended questions were completed by 82 participants, approximately half from each community. While their discourses included similar framings of danger and threat, the two groups manifested different patterns of Internet use (and nonuse). Rigorous adherence to religious dictates is greatly admired in these communities, and the women take pride in manipulating their status in them. Their agency is reflected in how they negotiate the tension inherent in their roles as both gatekeepers and agents-of-change, which are analyzed as valuable currencies in their cultural and religious markets

Model of patient related data and a structure of medical terms for knowledge-based systems in medicine.

Modelling medical knowledge is still a significant problem in Artificial Intelligence in Medicine. The topic of our project is to develop a general reference model for medical knowledge and decision making. This development requires a thorough analysis of the structure of patient related data. To support modelling patient related data, we also developed a repository for all relevant medical terms. For both we defined a model, derived a frame-like representation and coded a prototype implementation. In the repository, terms are described by specialisation, components, attributes, and possible values. The implementation of the repository, also consists of an acquisition tool and a definition browser. The model of patient related data is represented in a frame-like form, the Case-Data-Sheet. Case-based-data can be formalized in the Case-Data-Sheet by simple object-attribute-value-triples as well as by more complex structures with iterated attributes and multiple attributes. The above complex structures can be augmented by context-dependent information about patient-object and/or object-object relationships. We developed our prototype implementation to evaluate whether our model of patient related data is adequate and complete. This implementation consists of a comfortable user interface, that lets the user enter information about a patient with familiar terms and generally accepted descriptions. Our system then creates Case-Data-Sheets as necessary and automatically transforms the user&#39;s input into the corresponding data structures. The models for both, the patient-related data and the repository of terms, are implemented fairly straightforward in Smalltalk/V on PC. Future research should investigate, whether these models and the derived structures can be an adequate base for the formalization of patient related data in medical knowledge based systems