Wednesday, February 20, 2008

JCAHO policy on abbreviations

Effective January 1, 2004, hospitals accredited by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) were required to exclude certain types of abbreviations from hand-written medical records.

As yet (to the best of my knowledge), there is no equivalent ruling for the realm of electronic medical records. Electronic records provide enormous opportunity for the creation and propagation of miscommunications that can lead to medical errors.

Trailing and leading zeros, micrograms (mcg, not µg) and units (units, not U) are issues that can be easily solved in an electronic record. Abbreviations with alternate expansions (discussed in a prior blog , are due for a remedy.

Despite advances in text processing software, no computational algorithms now exist that can accurately expand polysemous abbreviations from their sentence context. Polysemous abbreviations (abbreviations with alternate expansions) must be accompanied by their correct expansions in order to be understood correctly. Text markup languages (HTML, XML RDF) all support this kind of annotation. In HTML, there is evan a designated tag just for abbreviations:

Reports can be viewed to "show tags" or "hide tags" for the convenience of readers.

These kinds of solutions should be easy to implement in EMRs (Electronic Medical Records).

-Jules Berman
Science is not a collection of facts. Science is what facts teach us; what we can learn about our universe, and ourselves, by deductive thinking. From observations of the night sky, made without the aid of telescopes, we can deduce that the universe is expanding, that the universe is not infinitely old, and why black holes exist. Without resorting to experimentation or mathematical analysis, we can deduce that gravity is a curvature in space-time, that the particles that compose light have no mass, that there is a theoretical limit to the number of different elements in the universe, and that the earth is billions of years old. Likewise, simple observations on animals tell us much about the migration of continents, the evolutionary relationships among classes of animals, why the nuclei of cells contain our genetic material, why certain animals are long-lived, why the gestation period of humans is 9 months, and why some diseases are rare and other diseases are common. In “Armchair Science”, the reader is confronted with 129 scientific mysteries, in cosmology, particle physics, chemistry, biology, and medicine. Beginning with simple observations, step-by-step analyses guide the reader toward solutions that are sometimes startling, and always entertaining. “Armchair Science” is written for general readers who are curious about science, and who want to sharpen their deductive skills.