OMR - transportable medical record

THE OON MEDICAL RECORD (OMR) - THE IDEAL TRANSPORTABLE
MEDICAL RECORD IS ITSELF A SMALLTALK PROGRAM

Y. K. OON

Docle Systems 29 Darryl St. Scoresby 3179 Australia

Computerised patient information flow is slowed or blocked when transcribing from one
system to another. Information can be transcribed from free flow text by scanning or manual
rekeying. An ideal portable record system will obviate the above tasks. It will allow the
computer system to directly process and integrate the data into the host database. Assuming
the existence of heterogeneous software and hardware, a transportable medical record will
solve at least the following problems: 1) When a patient computer record is moved to another
practice. 2) Integrating pathology, radiology and hospital reports electronically. 3) The
updating of clinical host system via e-mail/intelligent cards. 4) Inter-hospital record transfers.
5) When migrating to a new clinical software/hardware environment.
A high level language to represent a medical record was proposed by the author in 1985 to
solve the above problems. The Porta language main features are: 1) A patient record is an
ASCII file. 2) The paradigm is that of a patient medical history expressed in a high level
computer language called Porta. 3) It relies heavily on keywords and had a facility for
handling groups of data. While a Porta type standard is still viable, a more sensible option
now exists. 
The search for a high level language to represent medical data has resulted in the
development of a more elegant transportable medical record based on the Smalltalk
language. A patient clinical data is encoded as a Smalltalk program. It is called OMR (Oon
Medical Record) for easy reference. The OMR is a standard feature of the clinical software
developed by Docle Systems P/L and is detailed in a book recently published by Docle
Systems. The OMR method is designed as a framework  for data interchange among health
professionals. The OMR is based on an ASCII representation of a logical Smalltalk
Dictionary object. The host system reinstantiates the patient Dictionary object by the
evaluation of the OMR which is a valid Smalltalk expression. The advantages of the OMR
method are: 1) The parser for the OMR is the Smalltalk parser itself. This solves the syntax
conundrum. It allows the user to formulate the data structure to be at any level of complexity
of for example, dictionary of dictionaries. 2) OMR makes no assumptions on how the user
views the data structure. Hospitals and ancillary services will each have their own protocols
within the OMR framework. 3) OMR has solved the vexing issue of standardising keywords
by pushing this problem up one level. Keywords are tied up with protocol that is organisation
dependent. 4) As keywords are lumped with protocols, it makes OMR useful for pathology,
radiology and e-mail. 5) OMR design has a strategy for break-in processing. The initialize
component of OMR is a Trojan horse program that is automatically invoked to automatically
configure the system. It also sets up 'hot links' with other modules to accept the current
protocol. 6) The OMR ASCII representation is human readable as a safety back up. 7) In non
Smalltalk host systems, a parser for the Smalltalk Collection class is easy to implement.

In summary, the OMR has many features that makes it an ideal electronic medical record.

[1] Y. K. OON - THE OON MEDICAL RECORD Docle Systems July 1994 
The above book is available  at US$25 plus $5 handling from Docle Systems
 fax 03 97649788