Doctor's shorthand?

terminology
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(Mangesh Kasbekar) #1

Hi all, I am interested in a topic related to UI/UX of Bahmni. There’s a well-known module for ophthalmology in OpenEMR, which supports doctors’ shorthand. I.e. If one enters the information in a recognized shorthand format, the module recognizes the shorthand and automatically makes appropriate EMR database entries. This can avoid the many clicks needed to fill forms. What do people think of such a feature? Could it really improve the UX? Has there been a discussion about such a feature in Bahmni in the past? if yes, I’d appreciate if someone could point me to it. thanks!

Mangesh


(Angshuman Sarkar) #2

We have a PAT call today. You might want to bring it up there.


(Andrew Kanter) #3

I would also add that any abbreviation or acronym is potentially ambiguous. The CIEL dictionary includes many of these with the full term disambiguated. You have to be careful that the UI understands the exact concept being used. For example “MI” even in cardiology can mean myocardial infarction or mitral insufficiency. CIEL does not use “naked” abbreviations unless there are other terms which disambiguate… such as “4 vessel CABG”


(Jonathan Teich) #4

Pretty clever work. https://www.open-emr.org/wiki/index.php/Eye_Exam

We did something similar with order entry at our hospital many years ago; you could type in medications like “ntg 1:400 1 tab bid x 3 prn chest pain” and it would create a complete order (ntg is a common abbreviation for nitroglycerin) – that was used for medications, labs, blood products, x-rays and a few other things. We referred to it as “Quick Mode” ordering and the information systems team liked to use it, but in fact the clinicians fairly quickly moved off it and went to the structured forms that were available to do the same thing.

It could be helpful in the case of very structured documentation – the eye exam is probably a good example. But you’d have to leave it and return to another mode for history, decision making, orders and any other parts of the exam (this system only does physical exam of the eye).

It takes effort to write the parser correctly and cover all the use cases safely. For example, there is a medication called “Tylenol #3” which includes codeine; does “Tylenol 3 bid x 7d” refer to 3 tablets of regular Tylenol (paracetamol) or one tablet of Tylenol #3?

My guess? Overall it may not be worth the trouble to create it. But it’s a fun exercise in lexical processing.


(Mangesh Kasbekar) #5

Thanks for the comments. Dealing with ambiguities would be a very hard problem. I liked the concept of shorthand, but given all the advances we see around us I wonder if it is ripe to be developed further. For instance:

When typing in google search box, a list of suggestions appears, and one can abandon typing and choose one of the terms. Could such a feature help in some cases of disambiguation? In the MI example above, if typing MI brought up both myocardial infarction and mitral insufficiency, perhaps the person typing could choose the right one. That way ambiguous information does not enter the freetext notes in the first place, for someone to later get confused by.

Second, I was doubtful if everyone in the world would be willing to learn the shorthand of the eye exam module. Would it make more sense to give an ability to every staff member to define their own shorthand?

For a little more context around me posting this question: I was chatting with a group of doctors who said that they get to spend less than 5 mins with each patient when they are in the OPD ward on a busy day. If they could have a way to spend less time on their computer that would be of help. “If I could type everything into Microsoft word, that would be ideal”, one of them joked. It made me think that even if shorthand and automatic form-filling isn’t a universally appreciated feature, perhaps some super-busy environments could use that feature.