@JFrederickR Wow, thanks for the reference! That was a fun paper and a fun thought arc. I agree with @jessiet1023 that sometimes it seems that NLP of narrative text will best out the benefits of structured documentation. And that seems to be the bulk of the research these days. /1 #AMIA2019
@JFrederickR @jessiet1023 We however lose a lot of the value of structured documentation when we emphasize only expressivity and NLP for data. Structured entry allows prompting and completeness. Maybe also accuracy and efficiency too. I think of this as DDS (documentation decision support). /2 #AMIA2019
@JFrederickR @jessiet1023 I remember Stephen Johnson’s thoughtful paper about “Structured Narrative” which found a way to combine the two. ncbi.nlm.nih.gov/pmc/articles/P… But like many such ideas, it is lost away in academia never to be implemented in the wider vendory world. /3 #AMIA2019
@JFrederickR @jessiet1023 And in the end, as I said the other day at the awesome @AMIAinformatics panel about turning documentation on it’s head, I worry that so much of what we do and how we do it is simply because of how tightly tied clinical documentation is with billing and legal issues. /4 #AMIA2019
@JFrederickR @jessiet1023 @AMIAinformatics Ultimately, we still need more research to understand this. Important questions: what really needs to be in notes? What gives notes utility, for what purposes? How to balance efficiency and quality? And yes, what is the right balance of structure and expressivity? 5/5 #AMIA2019
