Clinical information systems should support patient care.

We generate our clinical correspondence from data. This is, unusually, the opposite of what almost everyone else does when they get data from correspondence.

I need to prepare a full video as a demonstration, but for now I will link to a series of tweets that demonstrate this functionality in the clinic.

First, we give the patient an iPad in clinic. The same infrastructure and platform will be used for patient-held devices, but for now, we use clinic-based applications. This uses Apple’s ResearchKit software. However, the clever thing here is the use of SNOMED CT. The application derives semantic understanding of the patient’s problems from the electronic health record and queues the correct questionnaires for that patient.

Additionally, if that patient has already indicated that they don’t wish to be involved in research, it won’t ask them again, but if not, they will be asked to consent for appropriate research projects.

We used to use paper questionnaires. These were duly completed and then filed, not to be used. In addition, paper questionnaires can’t adapt to what has been entered. Here, the iPad applicaton queues a different set of questions based on the responses so far.

Finally, while there is excitement about the use of patient’s own devices and patient reported outcomes, what is the point of those data if they cannot be used for clinical care? Here, the data entered by the patient is immediately presented to the clinician and is automatically incorporated into the clinic letter.

You’ll notice in the last video, I also tweak the current medication list (mapped to the NHS dictionary of medicines and devices) and those changes appear in our correspondence automatically.