Proceedings / AMIA ... Annual Symposium. AMIA Symposium
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Comparative Study
Does size matter?--Evaluation of value added content of two decades of successive coding schemes in secondary care.
Over the last two decades there has been a gradual evolution from the use of simple coding schemes to controlled clinical terminologies within clinical information systems in secondary care. This evolution has required significant resources in both the development of the different coding schemes and the cost of hardware, software and human effort in implementation. During this time there has been successively larger and more complex coding schemes available for use in the UK Health Service: Read Codes 4 byte set, Read Codes 5 byte set, ICD-10 and Clinical Terms Version 3. ⋯ The schemes are quantitatively evaluated by measuring their success in providing a concept match for every notion from the CIS and their relative merits are compared. Significant added value has accrued over the years in completeness of the schemes reflected in their increased size. There appears to be justification for the continued development of clinical terminologies to support secondary care.
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Patient safety has become a major public concern. Human factors research in other high-risk fields has demonstrated how rigorous study of factors that affect job performance can lead to improved outcome and reduced errors after evidence-based redesign of tasks or systems. These techniques have increasingly been applied to the anesthesia work environment. ⋯ A novel concept of "non-routine events" is introduced and pilot data are presented. The results support the assertion that human factors research can make important contributions to patient safety. Information technologies play a key role in these efforts.