Hi Greig
The reason why I raise the issue of primary care meta data is that many drivers and automation is now available in PMS data, which is driven not by health concerns but by adherence to payment contracts. Other areas where patients are involved in ‘óut of scope/off label’ care, such as clinical trials of new medicines, acute infection management through non-guideline techniques, follow on investigations/titration of condition-specific patients, mean trending metadata like medicines prescribed over the last 5 years with adherence, or measuring lab results/investigations without knowing that the patient’s contextual journey and the provider’s clinical reasoning for ordering, is going to create a lot of biased reported outcomes when trying to generalise health journeys WITHOUT clinical notes.
Yes, agree clinical notes are often not usable either, but without trying, we are going to get incorrect insights.