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Proposal for a comprehensive multi-lingual patient information system

At present no comprehensive collection of patient information resources in different languages, capable of desktop access and printing by GPs exists in the UK. Although some material has been translated and adapted to meet local needs, some based on the PiLs system, and catalogues printed material to order are available on HealthPromise, we envisage a system which would allow GP's and other health professionals access to a comprehensive collection of material which could be printed off in the surgery.

Ideally, a skeleton programme could be set up, capable of being customised to the needs of the practitioners community. For example, a GP who finds he or she has a large community of Kosovan refugees should be able to download sets of  information sheet pertinent to that population, and plug them in to his/her skeleton system. The system could be modified to automatically search for new materials in a preferred set of languages or conditions.

An online dataset exists in Australia http://www.mhcs.health.nsw.gov.au/ and could act as a model for an online version. However, practitioners need to be able to easily assemble a collection for future use rather than go online each time a resource is needed.

There are three stages of development:

1. Core programme: capable of operating within major GP IT packages eg EMIS System 6000 etc. Practitioner to plug in, set preferences and allow the programme to connect to website and download according to preferences. (eg set language types: Hindi, Bengali, Urdu, Chinese, Turkish; set disease type: cardiovascular; set resource type printed; index by disease; include all results) so the engine would identify all printable resources on cardiovascular disease in those languages and arrange them to be indexed by disease. Potentially any number of relevant websites could be accessed.
2. Update programme: capable of updating collections on a regular basis, as directed by practitioner. Recent data compression techniques can allow this even to remote units. So on a monthly basis the programme could search all linked websites for material according to set preferences. Alerts could be sent by email eg "New Bengali childs asthma leaflet available!"
3. Websites: three options exist: firstly, a large single website updated by various sources, including printable and audio-visual resources. This ensures uniform quality and internal regulation, but may lead to an unwieldy site, and with diminished local ownership by contributors.

   Secondly several linked independent websites could agree to contribute. This could utilise existing resources, but might lead to variations in quality, style, duplication of material and longer searches.

   Thirdly, several semi-independent sites, maintained according to language groups, or by area could be accessed by users . This has the advantage of involving a local group more in terms of producing their own literature, and "owning" a site, but the disadvantage is longer searches and variations in quality of materials and enthusiasm of of participants.

We propose to design and pilot a prototype programme (CD-ROM based) and supporting website, potentially using existing printed material adapated for electronic storage and retrieval. This could be piloted by GPs in the West and East Midlands, and a full site and supporting programme could then be developed.

Contact:
Dr. Mike Griffiths
Department of Public Health
Dudley Health Authority
12 Bull Street
Dudley, UK