Hello Siri, How Are You?

I know I'm late, but with the impending announcement of the next insanely great thing, I thought I'd go through my old Siri conversations to share. This was my first, when I got the phone and introduced myself to Siri.

Before I go further, let's get the silly stuff out of the way...

Yes, yes. It's only the most obvious Monty Python and Douglas Adams references in the Universe.

What happens if I simply say, "The Beatles?"

Cool.

Now let's settle into the groove of everyday life. Good morning, Siri.

Okay, so you can't read me the weather. So much for leaving you in my pocket as I walk out the door.

At least you understand me, even when I, uh... don't quite enunciate clearly.

...most of the time, anyway.

Okay, sometimes.

Er, I may need to work on my pronunciation.

Sometimes, I press the Siri button by accident, or forget what I wanted.

Back to everyday life, I'm hoping Siri can guide me to my meeting... 

...or not. I thought Siri stored a conversational context to help answer questions. Does Siri not remember my most recent questions? How do you get from this meeting to my own address? Or does she think I should skip out on my meeting and just go home?

Now where's that to-do list? 

ARGLE BARGLE!!!

I can already tell, this is going to be way more fun than autocorrect.

EMRs, iPods, and Saddlebags

I've heard that the size and shape of the modern hard-cover book was determined by the carrying capacity of 15th century saddle bags because after the invention of the printing press people had to carry those books far and wide on horseback, and the size and shape of the iPod was determined by the size and shape of your average front shirt pocket. This makes me wonder: what is the size and shape of the ideal electronic medical record?

What is a C32/CCD?

HealthUnity has a pretty good explanation of HIE technology including their HIE Use Cases. Documents on transmitted through HIE systems today typically conform to the HL7v3 Clinical Document Architecture (CDA). The Continuity of Care Document (CCD) is the most common of these, meant to be what your doctor needs to know at a glance. It looks something like this:

It's a clinical document with basic information about you and your doctors (any health care providers, really), information about the document itself (author, time of creation, purpose, etc), and a structured body which contains some number of sections - one for each category of health information being shown. For example, allergies, vaccinations, and current medications may be of immediate use, with the latest results, vital signs, and diagnoses. Much more can be documented depending on the purpose of the document.

To summarize: You (the patient) are the record "target." Every provider involved in the events documented is conveniently listed up front with contact information, followed by one or more sections. A section has a human-readable title and text followed by any number of coded entries. Each section is identified by its templateId (and so is the document itself, with its own templateId on the ClinicalDocument level).

Which sections are included depends on the document's purpose. A summary document has a bit of everything, while a lab or radiology report may have only the results section. There are many of these specified by HITSP (composite documents start with a "C" for example C32 is CCD and C84 is History & Physical).