Archive for January, 2008

Smart Tags, ICD Coding – General Pondering

As usually happens when I am writing documents, my mind started wandering off on a tangent! One of the end points was the research pane in Office, which lead onto smart tags!

Ok, here’s the general ponderance; a large portion of my clients (by which I mean all) have at least Office 2000 installed, and the majority have Office 2003. I have noticed more and more just how much work is performed in the healthcare setting in Office, and how much more could be if IT or users were aware of the capabilities; case in point, there’s an Organisation Chart Wizard in Visio! Do people really need to dedicate a resource to actually creating Visio diagrams when they could easily create a Excel spreadsheet to hold the data and auto-generate the required diagrams?

That got me thinking about all the documents that are written in a healthcare setting using Word, and all the emails sent using Outlook. Medical coding is a pretty complex area where conditions are coded using a variety of systems (e.g. SNOMED and ICD-10). The systems are very verbose and detailed, and have a hierarchical nature; for example there is a relationship between heart failure and chest pains. So what if a smart tag system was developed to identify terminology in the documents as they are written, and insert the codes and formal names into the document? That could be pretty useful!

I figure the idea solution would separate out the coding vocabulary from the interpretation engine so multiple coding mechanisms could be selected by the end user. A well rounded engine would of course have use outside of coding, and could be used (I hope) outside of smart tags as well (e.g. the research pane)

A quick search of the web doesn’t show me anything particularly helpful, so I was wondering if anybody out there had experience in this area and/or a product or solution?



In the last few months I have been spending an increasing amount of time with clients talking about their needs on both specific projects and on general supporting requirements. This has crossed both Clinical requirements and supporting non-clinical requirements within Healthcare. One trend has emerged more obviously in that time; most of the functionality they are looking for already exists in one shape or form in their organisation already, yet they are generally unaware of it. In many cases the technology required to deliver the functionality they require is already on their desktops, or the organisation already holds licences for the software that would provide the functionality.

One of the great promises of SOA (as far as I am concerned anyway) is the ability to surface discreet units of functionality (or services) from existing Information systems, and to provide those units in an open way to allow compositional applications to be developed. In many ways this is one of the intents of service clouds and mash-ups. Yet mash-ups, particularly due to their name, do not appear to have the seriousness or business stability that would be required to deliver mission critical enterprise solutions to healthcare.

However I firmly believe that in order for the IT industry, and consultants in particular, to deliver the value our customers expect we need to do a better job of identifying existing capabilities within the client organisation and utilise those where-ever possible rather than developing and purchasing new systems.

So I have been playing around with a term for architecture that makes use of functionality and capabilities already existing in an organisation, yet with a view to a progressive overarching architecture. So far the term I have come up with is Cobble-tecture; the art of building what you need with what you have. Actually I don’t think it inspires anymore confidence that mash-ups now I write this, but I think the strategy is an important one, particularly in an industry where cost sensitivity is a huge issue. As I repeated put it to clients, ever dollar spent on an IT system is one less spent on providing healthcare, which is after all, the purpose of healthcare.

Oh and an addendum; One area I am increasingly interested in is the idea of a Search Driven Architecture. This would be where instead of collating all the data into a central structure, or building an index of data spread out over a large number of stores, a search engine is used to index and catalogue both structured and non-structured data over a wide range of systems and then provides the entry point for data search, aggregation and retrieval from the disparate data sources. More on that later…